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Examining the significance of age of onset in persons with lifetime anorexia nervosa: Comparing child, adolescent, and emerging adult onsets in nationally representative U.S. study
Author(s) -
Grilo Carlos M.,
Udo Tomoko
Publication year - 2021
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.23580
Subject(s) - comorbidity , anorexia nervosa , age of onset , young adult , epidemiology , psychology , psychiatry , psychiatric comorbidity , alcohol dependence , pediatrics , eating disorders , medicine , demography , gerontology , alcohol , disease , sociology , biochemistry , chemistry
Abstract Objective This study compared sociodemographic and clinical profiles of adult patients with lifetime DSM‐5 ‐defined anorexia nervosa (AN) categorized by age‐of‐onset using data from U.S. national sample of adults. Method Study included 216 participants from Third National Epidemiological Survey Alcohol and Related Conditions (NESARC‐III) who met criteria for lifetime AN based on structured diagnostic interviews (AUDADIS‐5) with age‐of‐onset prior to age 25. Of the 216 participants, 30 were categorized as child‐onset (<15 years old), 104 adolescent‐onset (15–18 years of age), and 82 “emerging‐adult” (19–24 years of age); the three groups were compared on their clinical characteristics. Results Among participants with lifetime diagnoses of AN with onsets earlier than 25 years, adjusted prevalence rates for the three groups were: 11.8% ( SE = 2.04; child‐onset), 39.6% ( SE = 2.69; adolescent‐onset), and 48.6% ( SE = 2.67; emerging‐adult). Child‐onset group reported more frequent adverse childhood experiences (ACEs), lowest BMI, longest episode‐duration, was least likely to attend college, and had highest rate of lifetime psychiatric comorbidity. Child‐onset group had earliest age of help‐seeking and were most likely to have been hospitalized. Group differences persisted in analyses adjusting for sociodemographic characteristics and duration of AN episode. Discussion Our findings, based on a nationally representative sample of U.S. adults with lifetime diagnoses of AN, suggest that those with child‐onset had more severe AN, greater life difficulties, and greater lifetime psychiatric comorbidity. Findings emphasize the importance of earlier recognition and rapid referral to effective treatments.