Psychosocial functioning needs attention in adolescent eating disorders

We studied the differences in psychosocial functioning in the early stages of adolescent anorexia nervosa (AN) and bulimia nervosa (BN). The study group comprised 57 adolescent eating disorder (ED) outpatients (girls). Psychosocial functioning was evaluated by GAF (Global Assessment of Functioning), and by Morgan-Russell psychosocial subscales. GAF scores were very low in both AN and BN. On the Morgan-Russell subscales, bulimics reported more unsatisfactory relationships with family and impairment in work/school. Anorectics tended to have more difficulties in emancipation from family and in social contacts. Multivariate analysis showed associations of BN and high GSI with difficulties in relationships with family and of AN with difficulties in emancipation from family and with fewer social activities. Longer duration of illness predicted best impaired working ability. In adolescent EDs, psychosocial functioning is markedly impaired. We emphasize the importance of evaluating psychosocial functioning at the very onset of ED.