Objective Epidemiological studies suggest that the incidence of anorexia nervosa (AN) is increasing in younger populations, with some evidence that clinical differences occur according to age of onset (AOO), which may impact prognostic outcomes. The current study sought to compare eating disorder (ED) symptomatology, psychological distress and psychosocial function between early onset (EO), typical onset (TO) and later onset (LO) AN in a large sample of treatment-seeking patients with a diagnosis of AN. Methods Participants included 249 individuals with a diagnosis of AN who were assessed at an outpatient ED service. The sample was divided into three groups based on AOO; those with an AOO ≤14 years (N = 58) were termed ‘EO-AN’, those with an AOO between 15 and 18 years (N = 113) were termed ‘TO-AN’ and those with an AOO of > 18 years (N = 78) were termed ‘LO-AN’. Comparisons were made between AOO groups on assessments of ED symptomatology, psychological distress and psychosocial function. Results EO-AN patients reported a significantly longer illness duration than both TO-AN and LO-AN groups. After controlling for effect of illness duration, the EO-AN group demonstrated significantly higher ED symptomatology and dysmorphic concern compared to the LO-AN group. The EO-AN group demonstrated significantly decreased cognitive flexibility compared to both the TO-AN and LO-AN groups. Discussion These findings suggest that clinical differences do occur according to AOO in AN whereby EO-AN may represent a more severe form of illness that is not attributable to increased illness duration. Treatment strategies which specifically address patients with EO-AN may improve long term health outcomes and recovery.

中文翻译：

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早发性、典型性和晚发性神经性厌食症的进食障碍症状、心理困扰和社会心理功能的比较

目的 流行病学研究表明，神经性厌食症 (AN) 在年轻人群中的发病率正在增加，一些证据表明，根据发病年龄 (AOO) 会出现临床差异，这可能会影响预后结果。目前的研究试图比较早发型 (EO)、典型发作 (TO) 和晚发型 (LO) AN 之间的饮食失调 (ED) 症状、心理困扰和心理社会功能，这些 AN 在大量寻求治疗的诊断为一个。方法 参与者包括在门诊 ED 服务中接受评估的 249 名诊断为 AN 的个体。样本根据AOO分为三组；AOO ≤ 14 岁（N = 58）的被称为“EO-AN”，AOO 介于 15 至 18 岁（N = 113）的被称为“TO-AN”，AOO 大于 18 年 (N = 78) 被称为“LO-AN”。在 AOO 组之间对 ED 症状、心理困扰和社会心理功能的评估进行了比较。结果 EO-AN 患者报告的病程明显长于 TO-AN 和 LO-AN 组。在控制了病程的影响后，与 LO-AN 组相比，EO-AN 组表现出显着更高的 ED 症状和变形问题。与 TO-AN 和 LO-AN 组相比，EO-AN 组的认知灵活性显着降低。讨论 这些发现表明，根据 AN 中的 AOO 确实存在临床差异，其中 EO-AN 可能代表一种更严重的疾病形式，不能归因于疾病持续时间的增加。