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      Clinical and Cognitive Functioning Changes After Partial Hospitalization in Patients With Anorexia Nervosa

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          Abstract

          Introduction: Anorexia nervosa is usually associated with emotional and cognitive difficulties. Little knowledge is available about the changes in cognitive functioning in patients undergoing treatments. The aim of the present study was to longitudinally assess the impact of partial hospitalization on clinical and cognitive functioning in anorexia nervosa.

          Materials and Methods: 56 women with anorexia nervosa according to DSM-5 criteria and 58 healthy women were enrolled in the study. At baseline, all participants underwent clinical, diagnostic and neuropsychological assessment (T0). Patients were also assessed at the end of the treatment program (T1; n = 56).

          Results: BMI improved significantly throughout treatment. At baseline, patients showed significantly poorer executive abilities and less specific autobiographical memory. After the day-hospital program, decision-making abilities improved significantly. Response to treatment was predicted by BMI at admission and duration of illness, but neuropsychological performance did not contribute to the prediction model.

          Discussion: Cognitive difficulties, mostly regarding executive functions, resulted differently affected by clinical improvement. In particular, while cognitive monitoring and cognitive inhibition appear to be mostly stable trait-like characteristics, decision-making is both more state-dependent and sensitive to clinical status. None of the cognitive variables added information about the response to day hospital treatment; patients with short duration of illness and a rapidly decreasing BMI would benefit more from intensive interventions than less “acute” patients. These observations, if confirmed by future studies, have important clinical implications in order to understand the impact of malnutrition on cognitive functioning and to provide individualized effective treatment for patients with anorexia nervosa.

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          Most cited references57

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          Diagnostic and Statistical Manual of Mental Disorders

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            The assessment and analysis of handedness: The Edinburgh inventory

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              The unity and diversity of executive functions and their contributions to complex "Frontal Lobe" tasks: a latent variable analysis.

              This individual differences study examined the separability of three often postulated executive functions-mental set shifting ("Shifting"), information updating and monitoring ("Updating"), and inhibition of prepotent responses ("Inhibition")-and their roles in complex "frontal lobe" or "executive" tasks. One hundred thirty-seven college students performed a set of relatively simple experimental tasks that are considered to predominantly tap each target executive function as well as a set of frequently used executive tasks: the Wisconsin Card Sorting Test (WCST), Tower of Hanoi (TOH), random number generation (RNG), operation span, and dual tasking. Confirmatory factor analysis indicated that the three target executive functions are moderately correlated with one another, but are clearly separable. Moreover, structural equation modeling suggested that the three functions contribute differentially to performance on complex executive tasks. Specifically, WCST performance was related most strongly to Shifting, TOH to Inhibition, RNG to Inhibition and Updating, and operation span to Updating. Dual task performance was not related to any of the three target functions. These results suggest that it is important to recognize both the unity and diversity of executive functions and that latent variable analysis is a useful approach to studying the organization and roles of executive functions. Copyright 2000 Academic Press.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                20 April 2021
                2021
                : 12
                : 653506
                Affiliations
                [1] 1Department of Neuroscience, University of Padova , Padua, Italy
                [2] 2Padova Neuroscience Center, University of Padova , Padua, Italy
                Author notes

                Edited by: Cheri Alicia Levinson, University of Louisville, United States

                Reviewed by: Sara Buzzichelli, University of Turin, Italy; Susana Jiménez-Murcia, Bellvitge University Hospital, Spain

                *Correspondence: Elena Tenconi elena.tenconi@ 123456unipd.it

                This article was submitted to Psychosomatic Medicine, a section of the journal Frontiers in Psychiatry

                †These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fpsyt.2021.653506
                8093567
                33959056
                b2d47ef2-0c33-447c-9a3c-c9a5a5536785
                Copyright © 2021 Tenconi, Collantoni, Meregalli, Bonello, Zanetti, Veronese, Meneguzzo and Favaro.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 14 January 2021
                : 19 March 2021
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 58, Pages: 10, Words: 7650
                Categories
                Psychiatry
                Brief Research Report

                Clinical Psychology & Psychiatry
                anorexia nervosa,cognitive functioning,executive functions,partial hospitalization,dh treatment,longitudinal assessment,follow-up

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