Physical and Psychological Effects of Nasogastric Tube (NGT) Use in Adolescents with Anorexia Nervosa: An Exploratory Study.

Background

Anorexia nervosa (AN) may require nasogastric tube (NGT) feeding when oral intake is insufficient. Evidence on the psychological impact and prognostic correlates of NGT use in adolescents affected with AN is limited.

Methods

Fifty-seven adolescent inpatients (96.5% female; age range 12-18 years; and mean age 15.0 ± 1.51 years) affected with AN admitted in a child psychiatry ward and treated with NGT re-feeding in addition to oral nutrition were included in the study. A 21-item VAS questionnaire was administered at intake (T0), after NGT introduction (T1), after one week of NGT use (T2), and after NGT dismissal (T3) to assess the physical and psychological effects. Participants were also assessed with psychometric measures including personality (TCI), eating psychopathology (EDI-2), general psychopathology (BDI-II, SCL-90-R, and TAS), and family functioning (FAD). The measures were compared between each timepoint with paired t-tests and ANOVA for repeated measures. Pearson correlations were performed between the VAS scores and psychometric measures.

Results

From admission to discharge, weight increased by +3.2 kg and BMI by +1.2 kg/m2. Items 1, 3, 4, 6, 15, 18, and 20 of the VAS questionnaire items showed significant improvement over time. TCI personality traits, EDI-2 eating and BDI, SCL-90 and TAS general psychopathology, and FAD family functioning were related to NGT perception by the AN adolescents.

Conclusions

NGT was helpful in weight progression during inpatient treatment. It was generally well tolerated, with progressive improvement in psychological and physical discomfort during treatment. The meaningful associations with specific psychometric features suggest the possibility to tailor the NGT use based on adolescent characteristics. Multidisciplinary care and tailored psychoeducation may enhance NGT acceptance.