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Pharmacopsychiatry 2023; 56(03): 118-125
DOI: 10.1055/a-2018-4946
Original Paper

The Role of Mood Stabilizers in Children and Adolescents with Anorexia Nervosa: A 1-year Follow-Up, Propensity Score-Matched Study

Jacopo Pruccoli
1   IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell’Alimentazione in età evolutiva, Child Neurology and Psychiatry unit, Bologna, Italy
2   Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
,
Antonia Parmeggiani
1   IRCCS Istituto delle Scienze Neurologiche di Bologna, Centro Regionale per i Disturbi della Nutrizione e dell’Alimentazione in età evolutiva, Child Neurology and Psychiatry unit, Bologna, Italy
2   Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Università di Bologna, Bologna, Italy
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Funding The research received no grant from any funding agency.
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Abstract

Background The existing literature on the use of mood stabilizers (MS) in children and adolescents with anorexia nervosa (AN) is limited, for the most part, to small case studies.

Methods This was an observational, naturalistic, propensity score-matched study. Subjects treated and not-treated with MS were compared by being matched via propensity score on age, sex, concurrent atypical antipsychotics, and concurrent antidepressants. General and AN-specific psychopathology was assessed with Symptom Check List-90-R, Beck Depression Inventory-II, Eating Disorders Inventory-3, and Body Uneasiness Test-A. Potential differences in admission-discharge modifications (body mass index (BMI), psychopathology) among the two groups were assessed. Finally, re-hospitalizations after 1-year follow-up were assessed with Kaplan-Meier analyses.

ResultsThe study enrolled 234 hospitalized patients (15.9+/−3.3 years; 26, 11.1% receiving MS). After propensity-score matching, 26 MS patients matched with 26 MS-not-treated subjects were included. MS were used for a mean of 126.1 (+/−87.3) days, and two cases of side effects were documented (alopecia and somnolence with valproate). No significant difference between MS-treated and not-treated patients emerged concerning admission-discharge improvements in BMI and AN-specific or general psychopathology. The cumulative survival from re-hospitalization at 12 months was 64,4% (95%-CI, 31.3–97.5) for MS and 58.7% (95%-CI, 22.2–95.2) for MS-not-treated subjects. No significant difference in survival rate emerged (hazard ratio, 0.04; Log-rank test: p=0.846).

Conclusions This propensity score-matched study expands on the scant existing evidence of the use and side effects of MS in children and adolescents with AN. These results should be assessed in wider longitudinal samples.

Key words

Mood stabilizers - lithium - valproate - anorexia nervosa - eating disorders - children - adolescents

Supplementary Material



Publication History

Received: 08 January 2023
Received: 08 January 2023

Accepted: 17 January 2023

Article published online:
15 May 2023

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