Electrocardiographic findings in adolescents with eating disorders.

OBJECTIVES: We sought to determine the prevalence and clinical correlates of electrocardiographic findings in adolescents with eating disorders. STUDY DESIGN: We undertook matched case-control study of electrocardiographic findings at initial assessment in 62 adolescents with anorexia nervosa, 9 with bulimia nervosa, and 26 with eating disorder not otherwise specified presenting from March 1995 to September 1996. RESULTS: Mean (+/- 1 standard deviation) age was 15.0 +/- 1.4 years (95% were female). Patients with anorexia nervosa had significantly lower heart rates (mean case-control difference: -20 +/- 17 beats per minute), lower R in V(6) (-2.6 +/- 5.5 mm), longer QRS interval (+.004 +/-.010 seconds), shorter mean QTc (-.0136 +/-.033 seconds) and lesser QTc dispersion (-.010 +/-. 031 seconds). The bulimia nervosa group had slightly longer mean QTc (.019 +/-.020 seconds), with no significant case-control differences in the eating disorder not otherwise specified group. CONCLUSION: Electrocardiographic findings are abnormal in adolescents with anorexia nervosa but not in adolescents with bulimia nervosa or eating disorder not otherwise specified.

Self-assessment of sexual maturation in adolescent females with anorexia nervosa.

PURPOSE: To evaluate the accuracy of self-assessment of pubertal maturation and to determine the desired stage of pubertal maturity in adolescent females with anorexia nervosa. METHODS: Standardized figure drawings depicting Tanner's sexual maturation stages were given to a consecutive sample of 40 adolescent females with anorexia nervosa who were instructed to assess current and desired pubertal development. Pubertal development was assessed independently by two investigators. The percent agreement between physician and subject ratings was determined. RESULTS: Percent agreement between physician and subject ratings was 30% for developmental stage for breasts and 50% for pubic hair. Subjects underestimated breast development 3.4 times as often as they overestimated it and overestimated pubic hair development 1.5 times as often as they underestimated it. Multivariate probit analysis showed that inaccuracy in breast self-assessment was inversely related to a desire for sexual maturity (p < 0.05). Ninety percent of subjects stated that their desired stage of breast development was equal to or more mature than their present stage. Eighty percent stated that their desired stage of pubic hair development was equal to or more mature than their present stage. CONCLUSIONS: Self-assessment of sexual maturity by adolescents with anorexia nervosa using standardized figure drawings depicting Tanner's stages is not accurate. Patients desiring a sexually immature body were most likely to be inaccurate in their self-assessment of their pubertal stage.