Are Prognostic Nutrition Index Levels Associated with Prognosis in Adolescents with Anorexia Nervosa?

Abstract

The aim of this study was to investigate the relationship between prognostic nutritional index (PNI) levels and sociodemographic data, disease characteristics, comorbidity, and prognosis in children and adolescents diagnosed with anorexia nervosa (AN). The study included 45 patients diagnosed with AN and 42 healthy controls. The researcher administered the Sociodemographic Data Form, the Affective Disorders and Schizophrenia Interview Schedule for School-Age Children-Present and Lifetime Version (K-SADS), the General Assessment Scale for Children (CGAS) to both groups, and the Clinical Global Impression-Severity Scale (CGI-SS) to the patient group. Eating Attitude Test (EAT), Eating Disorder Examination Questionnaire (EDE-Q), Self-Reflection and Insight Scale, The Revised Child Anxiety Depression Scale–Child Version (RCADS-CV), Leyton Obsession Inventory-Child Version (LOE-CV), Parental Autonomy Support Scale (PASS), and Shortened Level of Expressed Emotion Scale (SLEES) were completed by participants. In the patient group, PNI levels were significantly lower than in the control group (p<0.05). A negative correlation was found between symptom severity scores and PNI levels (p < 0.05). A positive correlation was found between body mass index (BMI) and PNI levels (p=0.05). PNI levels were significantly lower in those with Major Depressive Disorder (MDD), non-suicidal self-injury (NSSI), and suicide attempts compared to those without (p< 0.05). In children and adolescents diagnosed with AN, PNI levels were not associated with exiting the diagnostic criteria but may be associated with disease severity, BMI, comorbid MDD, NSSI, and suicide attempt. Therefore, it was thought that PNI levels may be an indirect prognostic factor for AN in children and adolescents.

Keywords

• Prognostic nutritional index
• anorexia nervosa
• non-suicidal self-injury
• suicide attempt

Anoreksiya Nervosa Hastalığı Olan Ergenlerde Prognostik Nutrisyonel Endeks Düzeyleri Prognoz ile İlişkili midir?

Abstract

Bu çalışmada, anoreksiya nervoza (AN) tanısı alan çocuk ve ergenlerde prognostik nutrisyonel endeks (PNI) düzeyleri ile sosyodemografik veriler, hastalık özellikleri, komorbidite ve prognoz arasındaki ilişkinin incelenmesi amaçlanmıştır. Çalışmada AN tanısı alan 45 hasta ve 42 sağlıklı kontrol denek dahil edilmiştir. Araştırmacı, her iki gruba Sosyodemografik Veri Formu, Okul Çağı Çocukları için Duygusal Bozukluklar ve Şizofreni Görüşme Programı - Mevcut ve Yaşam Boyu Versiyonu (K-SADS), Çocuklar için Genel Değerlendirme Ölçeği (CGAS) ve hasta grubuna Klinik Global İzlenim-Şiddet Ölçeği (CGI-SS) uygulamıştır. Yeme Tutumu Testi (EAT), Yeme Bozukluğu Muayene Anketi (EDE-Q), Öz Yansıtma ve İçgörü Ölçeği, Revize Edilmiş Çocuk Anksiyete Depresyon Ölçeği-Çocuk Versiyonu (RCADS-CV), Leyton Obsesyon Envanteri-Çocuk Versiyonu (LOE-CV), Ebeveyn Özerklik Desteği Ölçeği (PASS) ve Kısaltılmış Duygu İfade Düzeyi Ölçeği (SLEES) katılımcılar tarafından doldurulmuştur. Hasta grubunda PNI düzeylerinin kontrol grubuna göre anlamlı olarak daha düşük olduğu saptanmıştır (p<0,05). Semptom şiddeti puanı ile PNI düzeyleri arasında negatif korelasyon saptanmıştır (p < 0,05). Vücut kitle indeksi (BMI) ile PNI düzeyleri arasında pozitif korelasyon bulundu (p=0,05). Majör Depresif Bozukluk (MDB), intihar girişimi olmayan ve intihar girişimi olanlarda PNI düzeyleri, MDB, intihar girişimi olmayanlara göre anlamlı olarak daha düşüktü (p < 0,05). AN tanısı alan çocuk ve ergenlerde PNI düzeyleri tanı kriterlerinden çıkma ile ilişkili bulunmamakla birlikte, hastalık şiddeti, BMI, komorbid MDD, NSSI ve intihar girişimi ile ilişkili olabilir. Bu nedenle, PNI düzeylerinin çocuk ve ergenlerde AN için dolaylı bir prognostik faktör olabileceği düşünülmüştür.

Keywords

• prognostik nütrisyonel endeks
• anoreksiya nervoza
• intihar amaçlı olmayan kendine zarar verme
• intihar girişimi

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