Anorexia nervosa among first- and second-generation immigrant children and adolescents in Italy: treatment and clinical outcomes.

Abstract

PURPOSE Cultural and environmental factors have frequently been implicated in the pathogenesis of Eating Disorders (ED). Although ED have been considered as "Western culture-bound syndromes", increasing rates of ED among non-Western groups are being documented. The present study aims to investigate treatment and clinical outcomes among first-generation immigrant children and adolescents (FGI) (patients born abroad) and second-generation immigrant youth (SGI, patients born in Italy) with Anorexia Nervosa (AN). METHODS The study retrospectively compares treatment, hospitalizations, traumatic past events, clinical features, and treatment outcome (improvement in percentual body-mass index - %BMI) between FGI and SGI young patients with AN (10-18 years). Correlations were adjusted for age and severity (%BMI) at presentation. Treatments and outcomes were investigated at the baseline (T0), 2 weeks (T1), one month (T2), 3 months (T3), 6 months (T4), and 12 months (T5). RESULTS Thirty-six patients (50% FGI) were enrolled. At T1 (F(1.26)=6.335, p=0.018), and at T2 (F(1.30)=18.752, p<0.001) FGI presented a significantly higher %BMI improvement than SGI. FGI required significantly less (OR=0.379, p=0.017), and shorter (F(1.32)=5.827, p=0.022) hospitalizations, when compared with SGI. CONCLUSIONS When compared to SGI, FGI with AN required fewer and shorter hospitalizations and had a better early-treatment weight outcome. Larger nationwide studies should investigate the need for and access to treatment of immigrant populations with AN.