De Young K, Bottera A, Kambanis E, et al. - Among individuals with anorexia nervosa (AN), eating disorder-related beliefs often approach delusional intensity. Researchers herein investigated the changes in the intensity of delusional beliefs over time and determined the prognostic value of such change.

• A total of 50 individuals with severe to extreme AN (≥ 18 years old; M [SD] body mass index = 12.7 [1.3] kg/m²) were assessed within 96 hr of admission; 35 (70%) completed the assessment at discharge (M[SD] = 25.53[13.21] days).

• There appeared no significant decrease in the admission-to-discharge delusional intensity.

• As per outcomes of tests of predictive effects, higher delusional intensity at intake appeared to be predictive of higher fear of fatness and restrictive eating, two hallmark features of AN, but not BMI, body checking, feared food avoidance, eating disorder-related impairment, depression, binge eating, or purging behavior at discharge.

• Findings suggest a possible correlation of delusional intensity with the severity of central eating disorder attitudes and behaviors.

• Hence, delusional intensity is possibly a negative prognostic indicator, possibly warranting further treatment.