Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of General Psychiatry
Published in: Annals of General Psychiatry 1/2010

Open Access 01-12-2010 | Review

Estimated intelligence quotient in anorexia nervosa: a systematic review and meta-analysis of the literature

Authors: Carolina Lopez, Daniel Stahl, Kate Tchanturia

Published in: Annals of General Psychiatry | Issue 1/2010

Login to get access

Abstract

Background

It has been hypothesised that people with anorexia nervosa have a higher intelligence quotient (IQ) level than the general population. The purpose of this review was to systematically appraise the research into reported IQ levels in people with anorexia nervosa.

Methods

A search using the terms intelligence quotient, IQ, intelligence, cognition, eating disorders and anorexia was conducted in electronic databases only.

Results

In all, 30 peer-reviewed studies written in English that used well established measures of intelligence quotient (the National Adult Reading Test and Wechsler Intelligence Scales) were identified. This review established that people with anorexia nervosa score 10.8 units and 5.9 units above the average intelligence quotient of the normative population on the National Adult Reading Test and Wechsler Intelligence Scales, respectively. An association was found between Body Mass Index and intelligence quotient, as measured by the National Adult Reading Test.

Conclusions

More studies including other eating disorder categories and recovered people are needed to explore important questions regarding the role of the intelligence quotient in treatment response.
Appendix
Available only for authorised users
Literature
1.
Tchanturia K, Campbell I, Morris R, Treasure J: Neuropsychological studies in anorexia nervosa. Int J Eat Disord. 2005, 35: 1-15.
2.
Roberts ME, Tchanturia K, Stahl D, Southgate L, Treasure J: A systematic review and meta-analysis of set shifting ability in eating disorders. Psychol Med. 2007, 37: 1075-1084. 10.1017/S0033291707009877.CrossRefPubMed
3.
Lopez C, Tchanturia K, Stahl D, Treasure J: Central coherence in eating disorders: a systematic review. Psychol Med. 2008, 38: 1393-1404. 10.1017/S0033291708003486.CrossRefPubMed
4.
Lock JD, Fitzpatrick KK: Anorexia nervosa. Clin Evid. 2009, 1: 1-19.
5.
National Institute for Clinical Excellence: National Clinical Practice Guideline: Eating Disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa, and related eating disorders. 2004, London, UK: National Institute for Clinical Excellence
6.
Bulik CM, Berkman ND, Brownley KA, Sedway JA, Lohr KN: Anorexia nervosa treatment: a systematic review of randomized controlled trials. Int J Eat Disord. 2007, 40: 310-320. 10.1002/eat.20367.CrossRefPubMed
7.
Southgate L, Tchanturia K, Treasure J: Neuropsychological studies in eating disorders: a review. Eating Disorders: New Research. 2006, Hauppauge, NY, USA: Nova Science Publishers, 1-69.
8.
Tchanturia K, Hambrook D: Cognitive remediation therapy for anorexia nervosa. Treatment of Eating Disorders. 2009, New York, USA: Guilford Press, 130-150.
9.
Lezak M: Neuropsychological Assessment. 2007, Oxford, UK: Oxford University Press
10.
Dura JR, Bornstein RA: Differences between IQ and school achievement in anorexia nervosa. J Clin Psychol. 1989, 45: 433-435. 10.1002/1097-4679(198905)45:3<433::AID-JCLP2270450313>3.0.CO;2-X.CrossRefPubMed
11.
Blanz BJ, Detzner U, Lay B, Rose F, Schmidt MH: The intellectual functioning of adolescents with anorexia nervosa and bulimia nervosa. Eur Child Adolesc Psychiatry. 1997, 6: 129-135.CrossRefPubMed
12.
Muñoz R, Amado H: Anorexia nervosa: an affective disorder. New Dir Ment Health Serv. 1986, 31: 13-19.CrossRefPubMed
13.
Rajewska A, Talarczyk M: The estimation of the level of intelligence quotient and aspirations in patients with anorexia nervosa. Eur Psychiatry. 1996, 11: 374s-10.1016/0924-9338(96)89205-4.CrossRef
14.
Hiler EW: Wechsler-Bellevue Intelligence: a predictor of continuation in psychotherapy. J Clin Psychol. 1958, 14: 192-194. 10.1002/1097-4679(195804)14:2<192::AID-JCLP2270140226>3.0.CO;2-L.CrossRefPubMed
15.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009, 6: e1000100-10.1371/journal.pmed.1000100.PubMedCentralCrossRefPubMed
16.
Nelson HE: National Adult Reading Test (NART): Test Manual. 1982, Windsor: UK: NFER-NELSON Publishing Co
17.
Crawford JR, Deary IJ, Starr J, Whalley LJ: The NART as an index of prior intellectual functioning: retrospective validity study covering 66-year interval. Psychol Med. 2001, 31: 451-458. 10.1017/S0033291701003634.CrossRefPubMed
18.
Schretlen DJ, Buffington AL, Meyer SM, Pearlson GD: The use of word-reading to estimate "premorbid" ability in cognitive domains other than intelligence. J Int Neuropsych Soc. 2005, 11: 784-787.CrossRef
19.
Bradburn MJ, Deeks JJ, Altman DG: sbe24: metan - an alternative meta-analysis command. Stata Tech Bull. 1998, 44: 1-15.
20.
Tobias A: Assessing the influence of a single study in the meta-analysis estimate. Stata Tech Bull. 1999, 47: 15-17.
21.
Steichen T: sbe19: tests for publication bias in meta-analysis. Stata Tech Bull. 1998, 41: 9-15.
22.
Steichen T: METATRIM: Stata module to perform nonparametric analysis of publication bias, S410501 SSC. 2000, Boston, MA, USA: Boston College Department of Economics
23.
Thomas JD, Hersen M: Understanding research in Clinical and Counseling Psychology. 2003, Hillsdale, NJ: Lawrence Erlbaum Associates
24.
Everitt BS: Modern Medical Statistics. 2003, London, UK: Arnold Publishers
25.
26.
27.
Begg CB, Mazumdar M: Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994, 50: 1088-1101. 10.2307/2533446.CrossRefPubMed
28.
29.
Duval S, Tweedie R: Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000, 56: 455-463. 10.1111/j.0006-341X.2000.00455.x.CrossRefPubMed
30.
Steichen T: Nonparametric trim and fill analysis of publication bias in meta-analysis. Stata Tech Bull. 2001, 10: 57-
31.
Dickson H, Brooks S, Uher R, Tchanturia K, Treasure K, Campbell I: The inability to ignore: distractibility in women with restricting anorexia nervosa. Psychol Med. 2008, 38: 1741-1748. 10.1017/S0033291708002961.CrossRefPubMed
32.
Mathias J, Kent P: Neuropsychological consequences of extreme weight loss and dietary restriction in patients with anorexia nervosa. J Clin Exp Neuropsychol. 1998, 20: 548-564. 10.1076/jcen.20.4.548.1476.CrossRefPubMed
33.
Woodberry K, Giuliano A, Seidman L: Premorbid IQ in schizophrenia: a meta-analytic review. Am J Psychiatry. 2008, 165: 579-587. 10.1176/appi.ajp.2008.07081242.CrossRefPubMed
34.
Reichenberg A, Weiser M, Rapp MA, Rabinowitz J, Caspi A, Schmeidler J, Knobler HY, Lubin G, Nahon D, Harvey PD, Davidson M: Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia. Arch Gen Psychiatry. 2005, 62: 1297-1304. 10.1001/archpsyc.62.12.1297.CrossRefPubMed
35.
Bosanac P, Kurlender S, Stojanovska L, Hallam K, Norman T, McGrath C, Burrows G, Wesnes K, Manktelow T, Olver J: Neuropsychological study of underweight and "weight-recovered" anorexia nervosa compared with bulimia nervosa and normal controls. Int J Eat Disord. 2007, 40: 613-621. 10.1002/eat.20412.CrossRefPubMed
36.
Tchanturia K, Pei-Chi L, Uher R, Lawrence N, Treasure J, Campbell IC: An investigation of decision making in anorexia nervosa using the Iowa Gambling Task and skin conductance measurements. J Int Neuropsychol Soc. 2007, 13: 635-641. 10.1017/S1355617707070798.CrossRefPubMed
37.
Tchanturia K, Morris R, Anderluh M, Collier D, Nikolaou V, Treasure J: Set shifting in anorexia nervosa: an examination before and after weight gain, in full recovery and relationship to childhood and adult OCPD traits. J Psychiatr Res. 2004, 38: 545-552. 10.1016/j.jpsychires.2004.03.001.CrossRefPubMed
38.
Pendleton Jones B, Duncan C, Brouwers P, Mirsky A: Cognition in eating disorders. J Clin Exp Neuropsychol. 1991, 13: 711-728. 10.1080/01688639108401085.CrossRef
39.
Howlin P, Magiati I, Charman T: Systematic review of early intensive behavioral interventions for children with autism. Am J Intellect Dev Disabil. 2009, 114: 23-41.CrossRefPubMed
40.
Halmi KA, Agras WS, Crow S, Mitchell J, Wilson GT, Bryson SW, Kraemer HC: Predictors of treatment acceptance and completion in anorexia nervosa: implications for future study designs. Arch Gen Psychiatry. 2005, 62: 776-781. 10.1001/archpsyc.62.7.776.CrossRefPubMed
41.
Kingston K, Szmukler G, Andrewes D, Tress B, Desmond P: Neuropsychological and structural brain changes in anorexia nervosa before and after refeeding. Psychol Med. 1996, 26: 15-28. 10.1017/S0033291700033687.CrossRefPubMed
42.
Seed J, Dixon R, McCluskey S, Young A: Basal activity of the hypothalamic-pituitary-adrenal axis and cognitive function in anorexia nervosa. Eur Arch Psychiatry Clin Neurosci. 2000, 250: 11-15. 10.1007/PL00007533.CrossRefPubMed
43.
Tchanturia K, Anderluh MB, Morris RG, Rabe-Hesketh S, Collier DA, Sanchez P, Treasure JL: Cognitive flexibility in anorexia nervosa and bulimia nervosa. J Int Neuropsychol Soc. 2004, 10: 513-520. 10.1017/S1355617704104086.CrossRefPubMed
44.
Fowler L, Blackwell A, Jaffa A, Palmer R, Robbins TW, Sahakian BJ, Dowson JH: Profile of neurocognitive impairments associated with female in-patients with anorexia nervosa. Psychol Med. 2005, 36: 517-527. 10.1017/S0033291705006379.CrossRefPubMed
45.
Lopez C, Tchanturia K, Stahl D, Booth R, Holliday J, Treasure J: An examination of the concept of central coherence in women with anorexia nervosa. Int J Eat Disord. 2008, 41: 143-152. 10.1002/eat.20478.CrossRefPubMed
46.
Southgate L, Tchanturia K, Treasure J: Information processing bias in anorexia nervosa. Psychiatry Res. 2008, 160: 221-227. 10.1016/j.psychres.2007.07.017.CrossRefPubMed
47.
Tchanturia K, Davies H, Lopez C, Schmidt U, Treasure J, Wykes T: Neuropsychological task performance before and after cognitive remediation in anorexia nervosa: a pilot case series. Psychol Med. 2008, 38: 1371-1373. 10.1017/S0033291708003796.CrossRefPubMed
48.
Key A, O'Brien A, Gordon I, Christie D, Lask B: Assessment of neurobiology in adults with anorexia nervosa. Eur Eat Disord Rev. 2006, 14: 308-314. 10.1002/erv.696.CrossRef
49.
Thompson S: Implications of neuropsychological test results of women in a new phase of anorexia nervosa. Eur Eat Disord Rev. 1993, 1: 152-165. 10.1002/erv.2400010304.CrossRef
50.
Galderisi S, Mucci A, Monteleone P, Sorrentino D, Piegari G, Maj M: Neurocognitive functioning in subjects with eating disorders: the influence of neuroactive steroids. Biol Psychiatry. 2003, 53: 921-927. 10.1016/S0006-3223(02)01668-2.CrossRefPubMed
51.
Holliday J, Tchanturia K, Landau S, Collier DA, Treasure J: Is impaired set-shifting an endophenotype of anorexia nervosa?. Am J Psychiatry. 2005, 162: 2269-2275. 10.1176/appi.ajp.162.12.2269.CrossRefPubMed
52.
Connan F, Murphy F, Connor SE, Rich P, Murphy T, Bara-Carill N, Landau S, Krljes S, Ng V, Williams S, Morris RG, Campbell IC, Treasure J: Hippocampal volume and cognitive function in anorexia nervosa. Psychiatry Res. 2006, 146: 117-125. 10.1016/j.pscychresns.2005.10.006.CrossRefPubMed
53.
Steinglass JE, Walsh T, Stern Y: Set shifting deficit in anorexia nervosa. J Int Neuropsychol Soc. 2006, 12: 431-435. 10.1017/S1355617706060528.CrossRefPubMed
54.
McCormick LM, Keel PK, Brumm MC, Bowers W, Swayze V, Andersen A, Andreasen N: Implications of starvation-induced change in right dorsal anterior cingulate volume in anorexia nervosa. Int J Eat Disord. 2008, 41: 602-610. 10.1002/eat.20549.PubMedCentralCrossRefPubMed
55.
McDowell , Moser , Ferneyhough K, Bowers W, Andersen A, Paulsen J: Cognitive impairment in anorexia is not due to depressed mood. Int J Eat Disord. 2003, 33: 351-355. 10.1002/eat.10149.CrossRefPubMed
56.
Grunwald M, Ettrich C, Assmann B, Dähne A, Krause W, Busse F, Gertz HJ: Deficits in haptic perception and right parietal theta power changes in patients with anorexia nervosa before and after weight gain. Int J Eat Disord. 2001, 29: 417-428. 10.1002/eat.1038.CrossRefPubMed
57.
Grunwald M, Ettrich C, Krause W, Assmann B, Dähne A, Weiss T, Gertz HJ: Haptic perception in anorexia nervosa before and after weight gain. J Clin Exp Neuropsychol. 2001, 23: 520-529. 10.1076/jcen.23.4.520.1229.CrossRefPubMed
58.
Gordon DP, Halmi KA, Ippolito PM: A comparison of the neuropsychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders. J Adolesc. 1984, 7: 245-266. 10.1016/0140-1971(84)90032-0.CrossRefPubMed
59.
Grunwald M, Ettrich C, Busse F, Assmann B, Dähne A, Gertz H: Angle paradigm: a new method to measure right parietal dysfunctions in anorexia nervosa. Arch Clin Neuropsychol. 2002, 17: 485-496.CrossRefPubMed
60.
Bayless JD, Kanz JE, Moser DJ, McDowell BD, Bowers WA, Andersen AE, Paulsen JS: Neuropsychological characteristics of patients in a hospital-based eating disorder program. Ann Clin Psychiatry. 2002, 14: 203-207.CrossRefPubMed
61.
Wilbur C, Colligan R: Psychologic and behavioral correlates of anorexia nervosa. J Dev Behav Pediatr. 1981, 2: 89-92. 10.1097/00004703-198109000-00005.CrossRefPubMed
62.
Ranseen JD, Humphries LL: The intellectual functioning of eating disorders patients. J Am Acad Child Adolesc Psychiatry. 1992, 31: 844-846. 10.1097/00004583-199209000-00010.CrossRefPubMed
63.
Small A, Teagno L, Madero J, Gross H, Ebert M: A comparison of anorexics and schizophrenics on psychodiagnostic measures. Int J Eat Disord. 1982, 1: 49-56. 10.1002/1098-108X(198221)1:3<49::AID-EAT2260010306>3.0.CO;2-O.CrossRef
Metadata
Title
Estimated intelligence quotient in anorexia nervosa: a systematic review and meta-analysis of the literature
Authors
Carolina Lopez
Daniel Stahl
Kate Tchanturia
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2010
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/1744-859X-9-40

Other articles of this Issue 1/2010

Annals of General Psychiatry 1/2010 Go to the issue

Primary research

Serum glutamine, set-shifting ability and anorexia nervosa

Review

Human depression: a new approach in quantitative psychiatry

Case report

Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports

Primary research

The Factors Influencing Depression Endpoints Research (FINDER) study: final results of Italian patients with depression

Case report

Fluvoxamine for blonanserin-associated akathisia in patients with schizophrenia: report of five cases

Review

Global Assessment of Functioning (GAF): properties and frontier of current knowledge