Are there gender differences in core symptoms, temperament, and short-term prospective outcome in anorexia nervosa?

OBJECTIVE The objective of this study was to compare symptoms, premorbid personality phenotypes, and short-term outcome between males and females with anorexia nervosa. METHOD Symptom and personality ratings were obtained at the time of hospital admission, and outcome was assessed at discharge and again 1 year later. RESULTS Gender effects were negligible at admission, with the exception of greater weight concern among females. Lifetime anxiety disorders and personality traits implicated in liability for anorexia nervosa were common among patients of both genders. Females had greater persistence of symptom morbidity over the 1-year follow-up. CONCLUSION Although gender has little effect on the clinical features of anorexia nervosa, the illness runs a more protracted early course in females. Possible mechanisms underlying greater persistence of morbidity in females include sexual dimorphisms in brain neurotransmission, gender differences in attitudes regarding ideal body weight, and anxiety-related personality phenotypes associated with anorexia nervosa.