Adolescents and young adults (AYA) with anorexia nervosa (AN) frequently have co-occurring anxiety and depression, which can negatively impact prognosis. To inform treatment of co-occurring anxiety and depression, we assessed the association of nutritional intake and hunger/stress hormones on anxiety and depression using a six-month longitudinal study of 50 AYA females receiving care for AN. At baseline and six months, we measured anxiety (Spielberger State/Trait Anxiety Inventory [STAI]), depression (Beck Depression Inventory [BDI]), body mass index (BMI), 3-day dietary intake (total calories and proportion of fat, carbohydrate, protein), and serum cortisol, leptin, and adiponectin. We performed mixed effects linear regression analyses, adjusting for age, duration of AN, and percentage of median BMI (%mBMI). At baseline, median age was 16.3 (interquartile range [IQR] = 2.5) years, duration of AN was 6 (IQR = 8.8) months and %mBMI was 87.2 (IQR = 10.5)%. Fifty-six percent had clinically significant anxiety; 30 % had depression. Over 6 months, participants had significant improvements in %mBMI (+2.2[IQR = 9.2]%, p < .01), STAI (−9.0[IQR = 25.0], p < .01), and BDI (−5.0[IQR = 13.8], p < .01) scores. Participants with larger improvements in caloric intake had greater improvements in STAI (p = .03) and BDI scores (p = .04). Larger improvement in BDI was significantly associated with increased fat intake (p < .01), but not carbohydrate or protein intake. Change in STAI was not associated with changes in fat, carbohydrate, or protein intake. Changes in STAI or BDI scores were not associated with changes in cortisol, leptin, or adiponectin. Increased caloric intake may augment treatment of co-occurring anxiety and depression, and increased fat intake may improve depression for AYA with AN.

患有神经性厌食症 (AN) 的青少年和年轻人 (AYA) 经常同时出现焦虑和抑郁，这会对预后产生负面影响。为了为同时发生的焦虑和抑郁的治疗提供信息，我们对 50 名接受 AN 护理的 AYA 女性进行了为期 6 个月的纵向研究，评估了营养摄入和饥饿/应激激素与焦虑和抑郁之间的关系。在基线和六个月时，我们测量了焦虑（斯皮尔伯格状态/特质焦虑量表 [STAI]）、抑郁（贝克抑郁量表 [BDI]）、体重指数 (BMI)、3 天饮食摄入量（总热量和脂肪比例） 、碳水化合物、蛋白质）和血清皮质醇、瘦素和脂联素。我们进行了混合效应线性回归分析，调整了年龄、AN 持续时间和中位 BMI 百分比 (%mBMI)。基线时，中位年龄为 16.3（四分位距 [IQR] = 2.5）岁，AN 持续时间为 6（IQR = 8.8）个月，%mBMI 为 87.2（IQR = 10.5）%。百分之五十六有临床上显着的焦虑；30%患有抑郁症。6 个月内，参与者的 %mBMI (+2.2[IQR = 9.2]%， p  < .01)、STAI (−9.0[IQR = 25.0]，p < .01) 和 BDI (−5.0[IQR])显着改善= 13.8]，p < .01) 分数。热量摄入改善较大的参与者 STAI ( p  = .03) 和 BDI 评分 ( p  = .04)改善较大。BDI 的较大改善与脂肪摄入量增加显着相关 ( p  < .01)，但与碳水化合物或蛋白质摄入量无关。STAI 的变化与脂肪、碳水化合物或蛋白质摄入量的变化无关。STAI 或 BDI 评分的变化与皮质醇、瘦素或脂联素的变化无关。增加热量摄入可能会增强对同时发生的焦虑和抑郁的治疗，而增加脂肪摄入可能会改善患有 AN 的 AYA 的抑郁症状。