A complete case analysis: a comparison of younger and older women with anorexia nervosa
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Abstract
Anorexia nervosa (AN) is often perceived as a psychiatric disorder that occurs during adolescence and young adulthood. However, AN does afflict older women and is steadily increasing in this population. Few studies have investigated AN in older women and even fewer studies have compared older and younger women with AN. The aim of this thesis is to explore the similarities and differences between younger women and older women with AN and identify unique features that set apart older women with AN from their younger counterparts. The study population includes 45 women aged 35 and older and 132 women between the ages of 18 and 25 with AN. The results demonstrate several features that distinguish older women with AN from younger women with AN. Older women had lower bone density at the hip (0.77 ± 0.12 vs. 0.82 ± 0.12, p less than 0.02) and femoral neck (0.68 ± 0.10 vs. 0.75 ± 0.12, p less than 0.0001) sites, a higher rate of post-traumatic stress disorder (6.67% vs. 0.00%, p less than 0.02) and a trend toward a higher rate of depression (74.36% vs. 57.58%, p = 0.06). The older women also reported a higher rate of psychiatric drug use (p less than .0.01), including a higher rate of antidepressant (p less than 0.01), selective serotonin reuptake inhibitor (p less than 0.01), tricyclic antidepressant (p less than 0.04), anticonvulsant (p less than 0.03), mood stabilizer (p less than 0.03), and stimulant (p less than 0.03) use as well as a trend toward a higher rate of monoamine oxide inhibitor (p = 0.06) and anti-psychotic use (p = 0.07). Identifying features that are unique to older women with AN will make it possible for health professionals to tailor programs and interventions that specifically address the needs of these women.
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Thesis (M.A.)--Boston University
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