Anorexia nervosa in childhood and adolescence. Course and significance for adulthood

The estimated prevalence of anorexia nervosa is highest in teenagers and probably increasing in prepubertal girls, while morbidity rates in female adults remain constant. Childhood and adolescent AN often take a chronic and disabling course with severe consequences for somatic and mental health in adulthood and an eventually high mortality. Besides a reduced growth, diminished reproduction rate and an increased risk of osteoporosis a prolonged course of the disorder may impact on the development of the adolescent brain, probably by hormonal dysfunctions such as those of the corticoid and gonadal system and by severe changes in neuropeptides such as leptin. Thus, besides a genetic disposition, longer lasting effects of starvation on brain development might explain the high prevalence of mental disorders in adulthood of former AN patients. Neuropsychological findings resembling those in obsessive-compulsive disorder and autism spectrum disorders are of growing importance because they might contribute to more effective and specific interventions in both adolescent and adult eating disorders.