Clinical phenotypes of anorexia nervosa: mathematical models based on latent class analysis of psychopathological symptoms

Olga A. Karpenko; Карпенко Ольга Анатольевна; Timur S. Syunyakov; Сюняков Тимур Сергеевич; Alexander B. Berdalin; Бердалин Александр Берикович; Anastasia V. Evlampieva; Евлампиева Анастасия Валериановна; Olga V. Andrianova; Андрианова Ольга Владиславовна; Laura E. Gilmutdinova; Гильмутдинова Лаура Эдуардовна; Alla V. Novichkova; Новичкова Алла Владимировна; Andrey K. Aleksanian; Алексанян Андрей Корюнович; Julia A. Nikolkina; Николкина Юлия Аркадьевна; Evgeniya V. Mazurova; Мазурова Евгения Владимировна; Aleksey A. Shafarenko; Шафаренко Алексей Александрович; Lyudmila S. Satyanova; Сатьянова Людмила Степановна

doi:10.17816/CP15730

Clinical phenotypes of anorexia nervosa: mathematical models based on latent class analysis of psychopathological symptoms

Authors: Karpenko O.A.¹, Syunyakov T.S.¹, Berdalin A.B.¹, Evlampieva A.V.¹, Andrianova O.V.¹, Gilmutdinova L.E.¹, Novichkova A.V.¹, Aleksanian A.K.¹, Nikolkina J.A.¹, Mazurova E.V.¹, Shafarenko A.A.¹, Satyanova L.S.¹
Affiliations:
1. Mental-health clinic No. 1 named after N.A. Alexeev
Issue: Vol 6, No 4 (2025)
Pages: 5-22
Section: RESEARCH
URL: https://journals.rcsi.science/2712-7672/article/view/368179
DOI: https://doi.org/10.17816/CP15730
ID: 368179

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Abstract

BACKGROUND: Anorexia nervosa (AN) is characterized by heterogeneous clinical manifestations, which complicates diagnosis and treatment. It is important to define the clinical variants and therapeutic targets for AN.

AIM: To identify empirical patient phenotypes within the AN diagnostic category using Latent Class Analysis (LCA) of clinically assessed psychopathological symptoms.

METHODS: Psychiatrists clinically assessed psychopathological symptoms of AN using an original checklist (57 symptoms in total) and the Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to identify mental disorders. Patients completed the Symptom Check List-90-Revised questionnaire (SCL-90-R) to self-assess psychopathological symptoms and distress. Clinically homogeneous patient subgroups were identified using LCA.

RESULTS: A total of 115 patients with AN were examined. Based on the LCA, four patient groups (C1–C4) were identified, with high classification certainty (R²=0.908), model significance (p<0.001), and clear separation of the latent groups (class separation index = 0.957). ED-related symptoms were key determinants of class formation only in 68 patients (59%) — those in C1 and C3. No statistically significant differences were found between classes on any SCL-90-R subscales or most M.I.N.I. diagnoses. In C1 (n=41), core ED symptoms dominated: dysmorphophobia, fears related to eating, weight gain, loss of control. In C2, low frequencies are observed for core ED symptoms; this group was characterized by a high incidence of sleep disturbances, anxiety, apathy, melancholy, and anhedonia. C3 represents a polymorphic clinical profile with a combination of core ED symptoms, affective symptoms, thought disorders, cognitive impairments, and sleep disturbances. C4 was defined by the presence of hypochondriacal concerns, somatoform autonomic symptoms, and apathy; none of the core ED symptoms were typical for C4.

CONCLUSION: Four empirically derived clinical phenotypes of AN were identified, each characterized by a distinct symptomatic profile. Each phenotype was defined by specific combinations of core ED symptoms and general psychopathological manifestations.