551
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Schnepper R, Georgii C, Eichin K, Arend AK, Wilhelm FH, Vögele C, Lutz APC, van Dyck Z, Blechert J. Fight, Flight, - Or Grab a Bite! Trait Emotional and Restrained Eating Style Predicts Food Cue Responding Under Negative Emotions. Front Behav Neurosci 2020; 14:91. [PMID: 32581738 PMCID: PMC7283754 DOI: 10.3389/fnbeh.2020.00091] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
In today's society, obesity rates are rising as food intake is no longer only a response to physiological hunger signals that ensure survival. Eating can represent a reward, a response to boredom, or stress reduction and emotion regulation. While most people decrease food intake in response to stress or negative emotions, some do the opposite. Yet, it is unclear who shows emotional overeating under which circumstances. Emotion regulation theories describe emotional overeating as a learned strategy to down-regulate negative emotions. Cognitive theories, by contrast, attribute emotional overeating to perceived diet breaches in individuals who chronically attempt to diet. After consuming "forbidden foods", they eat more than individuals who do not restrict their food intake. This laboratory study investigated emotional overeating by exposing individuals to a personalized emotion induction while showing images of palatable foods. Outcome variables indexed cue reactivity to food images through picture ratings (valence, desire to eat), facial expressions (electromyography of the corrugator supercilii muscle), and brain reactivity by detecting event-related potentials (ERPs) by means of electroencephalography (EEG). The influence of emotion condition (negative, neutral) and individual differences (self-reported trait emotional and restrained eating) on outcome variables was assessed. Valence ratings and appetitive reactions of the corrugator muscle to food pictures showed a relative increase in the negative condition for individuals with higher emotional eating scores, with the opposite pattern in lower scores. Desire to eat ratings showed a similar pattern in individuals who showed a strong response to the emotion induction manipulation, indicative of a dose-response relationship. Although no differences between conditions were found for ratings or corrugator activity with restrained eating as a predictor, an ERP at P300 showed increased activation when viewing food compared to objects in the negative condition. Findings support emotion regulation theories: Emotional eaters showed an appetitive reaction in rating patterns and corrugator activity. EEG findings (increased P300) suggest a motivated attention toward food in restrained eaters, which supports cognitive theories. However, this did not translate to other variables, which might demonstrate successful restraint. Future studies may follow up on these findings by investigating eating disorders with emotion regulation difficulties.
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Affiliation(s)
- Rebekka Schnepper
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Claudio Georgii
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Katharina Eichin
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Ann-Kathrin Arend
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Frank H. Wilhelm
- Department of Psychology, Division of Clinical Psychology and Psychopathology, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Annika P. C. Lutz
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Zoé van Dyck
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Jens Blechert
- Department of Psychology, Division of Health Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria
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552
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Mensi MM, Balottin L, Rogantini C, Orlandi M, Galvani M, Figini S, Chiappedi M, Balottin U. Focus on family functioning in anorexia nervosa: new perspectives using the Lausanne Trilogue Play. Psychiatry Res 2020; 288:112968. [PMID: 32320861 DOI: 10.1016/j.psychres.2020.112968] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 12/14/2022]
Abstract
31 families of female adolescents affected by anorexia nervosa (AN) and 20 of girls with emotional and behavioral disorders participated in a semi-standardized videotaped game: the Lausanne Trilogue Play (LTPc). We aimed to clarify if there is a typical AN family profile and if the LTPc procedure could predict the risk of developing AN. We confirmed that AN families exhibit dysfunctional alliances. Particularly because of the difficulty of the three members to be available to the interaction at least with their body (participation) and to comply with the role expected at each stage of the game (organization). Moreover, these families show a significant worse functioning, especially regards to the mother-daughter phase of the game, in focal attention and affective contact functional levels, while in triadic and couple phases they present lower scores than comparison group in all functional levels. Furthermore, we found that LTPc may predict the possibility of belonging to a family with a daughter with AN rather than one whose daughter has a different disorder. Therefore, LTPc would allow clinicians foresee the risk of developing AN and tailoring the most suitable therapeutic intervention and finally see its effectiveness using LTPc for later follow-up video feedback sessions.
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Affiliation(s)
- Martina Maria Mensi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; Child Neuropsychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Laura Balottin
- Childhood, Adolescence and Family Unit, ULSS 16, University of Padua, Italy
| | - Chiara Rogantini
- Child Neuropsychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Marika Orlandi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Marta Galvani
- Department of Mathematics, University of Pavia, Pavia, Italy; BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Silvia Figini
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy; BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Matteo Chiappedi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
| | - Umberto Balottin
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy; Child Neuropsychiatry Unit, Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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553
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McClelland J, Robinson L, Potterton R, Mountford V, Schmidt U. Symptom trajectories into eating disorders: A systematic review of longitudinal, nonclinical studies in children/adolescents. Eur Psychiatry 2020; 63:e60. [PMID: 32450945 PMCID: PMC7355161 DOI: 10.1192/j.eurpsy.2020.55] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background. Eating disorders (EDs) are serious mental illnesses that can be life-threatening. Stage of illness models and early intervention strategies could be informed by a better understanding of symptomatology that precedes the onset of an ED. This review aims to explore which symptoms (both ED and other psychiatric disorder-related) exist prior to the onset of an ED and whether there any prospective associations between these symptomatologies. Methods. A systematic literature review was conducted in MEDLINE, Embase, and PsycINFO for large, longitudinal, prospective studies in nonclinical cohorts of children/adolescents that report symptoms prior to the onset of an ED. A quality assessment of included studies was conducted using the Newcastle-Ottawa Quality Assessment Scale. Results. A total of 22 studies were included, and over half were assessed to be of good quality. Studies identified the presence of a broad range of ED and other psychiatric disorder-related symptoms prior to ED onset. Possible prospective associations were identified, including early eating and feeding difficulties in childhood, to ED-related symptoms (e.g., dieting and body dissatisfaction) and other psychiatric disorder-related symptoms (e.g., anxiety and depression) in childhood/early adolescence, progressing to severe symptomatology (e.g., extreme weight control behaviors and self-harm) in mid-adolescence/emerging adulthood. Conclusion. The trajectory of symptoms identified to precede and possibly predict onset of an ED may inform early intervention strategies within the community. Suggestions for further research are provided to establish these findings and the clinical implications of these discussed, in order to inform how best to target prodromal stages of EDs.
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Affiliation(s)
- Jessica McClelland
- South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lauren Robinson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rachel Potterton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Victoria Mountford
- South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Maudsley Health, Abu Dhabi, United Arab Emirates
| | - Ulrike Schmidt
- South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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554
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Gut microbiota alteration in a mouse model of Anorexia Nervosa. Clin Nutr 2020; 40:181-189. [PMID: 32460959 DOI: 10.1016/j.clnu.2020.05.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/20/2020] [Accepted: 05/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Anorexia Nervosa is a severe disease depending on both biological, psychological and environmental factors. The gut microbiota has recently been proposed as one of the biological factors potentially involved in the onset or maintenance of Anorexia Nervosa. To unravel the potential role of the gut microbiota in this disease, we characterized the dysbiosis occurring in a mouse model of Anorexia and correlated bacteria level changes with different physiological parameters such as body weight, food intake or levels of hypothalamic neuropeptides. METHODS We used the Activity-Based Anorexia (ABA) mouse model, which combines food restriction and physical activity, and which mimics core features of Anorexia Nervosa. We characterized the gut microbiota alteration in ABA mice by combining 16S rRNA gene sequencing and quantitative PCR analyses of targeted genera or species. RESULTS We identified 68 amplicon sequence variants (ASVs) with decreased levels and 8 ASVs with increased levels in the cecal content of ABA mice compared to control mice. We observed in particular in ABA mice increases in the abundance of Clostridium cocleatum and several Lactobacillus species and a decrease in the abundance of Burkholderiales compared to control mice. Interestingly, we show that most of the observed gut microbiota alterations are due to food restriction and are not affected by physical activity. In addition, we identified several bacterial groups that correlate with mice body weight, food intake, lean and fat masses as well as with hypothalamic mRNA levels of NPY (Neuropeptide Y) and POMC (Pro-opiomelanocortin). CONCLUSIONS Our study provides a comprehensive characterization of the gut microbiota dysbiosis occurring in the Activity-Based Anorexia mouse model. These data constitute a valuable resource to further decipher the role of the gut microbiota in the different facets of anorexia pathophysiology, such as functional gastrointestinal disorders, appetite regulation and mood disorders.
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555
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Savidaki M, Demirtoka S, Rodríguez-Jiménez RM. Re-inhabiting one's body: A pilot study on the effects of dance movement therapy on body image and alexithymia in eating disorders. J Eat Disord 2020; 8:22. [PMID: 32426135 PMCID: PMC7212562 DOI: 10.1186/s40337-020-00296-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/17/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Body image disturbance and alexithymia are two core aspects of Eating Disorders (EDs). However, standard treatments for EDs do not include specific techniques to approach these issues on a bodily level. This pilot study evaluated the effects of a Dance Movement Therapy (DMT) intervention on body image and alexithymia in patients with EDs, and also explored their experience of the therapeutic process. METHOD 14 patients with EDs were recruited from a private clinic. Seven were assigned via quasi-randomization to the DMT group and the others (n = 5) continued their treatment as usual. The length of the intervention was 14 weeks. All participants completed the Multidimensional Body Self Relations Questionnaire (MBSRQ) and the Toronto Alexithymia Scale (TAS-20) at the beginning and at the end of the intervention. Additionally, the DMT group wrote reflective diaries about their experience at the end of each session, which were analyzed using qualitative methods. RESULTS Between the pre- and post-intervention, the participants of the DMT group significantly improved in Body Areas Satisfaction (effect size: 0.95) and Appearance Evaluation (effect size: 1.10), and they decreased significantly in Appearance Orientation (effect size: 1.30). A decrease in Overweight Preoccupation was observed (effect size: 0.75), however this was not statistically significant. The control group did not show significant changes in any of the MBSRQ subscales. Neither the DMT group nor the control group improved significantly in the alexithymia scores. The qualitative analysis revealed valuable insights into the participants' processes throughout the sessions. In general, participants received the DMT intervention positively. They reported improvements in their mood states and an increase in their self-awareness. They also appreciated the relationship with the group and the therapist. CONCLUSION These results indicate that DMT might be a complementary treatment option for EDs, as it may be able to address body image issues more effectively than verbal therapies. More studies with larger samples are needed to confirm these promising preliminary results.
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Affiliation(s)
- Maria Savidaki
- Psychology Department, Autonomus University of Barcelona, Plaça Cívica, Barcelona, 08193 Spain
| | - Sezin Demirtoka
- Psychology Department, Autonomus University of Barcelona, Plaça Cívica, Barcelona, 08193 Spain
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556
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Silén Y, Sipilä PN, Raevuori A, Mustelin L, Marttunen M, Kaprio J, Keski-Rahkonen A. DSM-5 eating disorders among adolescents and young adults in Finland: A public health concern. Int J Eat Disord 2020; 53:520-531. [PMID: 31999001 DOI: 10.1002/eat.23236] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to assess the lifetime prevalence, 10-year incidence, and peak periods of onset for eating disorders as defined by the Fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) among adolescents and young adults born in the 1980s in Finland. METHOD Virtually all Finnish twins born in 1983-1987 (n = 5,600) were followed prospectively from the age of 12 years. A subsample of participants (n = 1,347) was interviewed using a semi-structured diagnostic interview in their early twenties. RESULTS The prevalence of lifetime DSM-5 eating disorders was 17.9% for females and 2.4% for males (pooled across genders, 10.5%). The estimated lifetime prevalences for females and males, respectively, were 6.2 and 0.3% for anorexia nervosa (AN), 2.4 and 0.16% for bulimia nervosa (BN), 0.6 and 0.3% for binge-eating disorder (BED), 4.5 and 0.16% for other specified feeding or eating disorder (OSFED), and 4.5 and 1.6% for unspecified feeding or eating disorder (UFED). Among females, the prevalence of OSFED subcategories was as follows: atypical AN 2.1%, purging disorder 1.3%, BED of low frequency/limited duration 0.7%, and BN of low frequency/limited duration 0.4%. The 10-year incidence rate of eating disorders was 1,700 per 100,000 person-years among females (peak age of onset 16-19 years) and 220 per 100,000 person-years among males. DISCUSSION Eating disorders are a common public health concern among youth and young adults, affecting one in six females and one in 40 males. Adequate screening efforts, prevention, and interventions are urgently needed.
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Affiliation(s)
- Yasmina Silén
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pyry N Sipilä
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anu Raevuori
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Linda Mustelin
- Department of Public Health & Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Mauri Marttunen
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health & Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Anna Keski-Rahkonen
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
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557
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Fürtjes S, King JA, Goeke C, Seidel M, Goschke T, Horstmann A, Ehrlich S. Automatic and Controlled Processing: Implications for Eating Behavior. Nutrients 2020; 12:nu12041097. [PMID: 32326623 PMCID: PMC7230536 DOI: 10.3390/nu12041097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/05/2020] [Accepted: 04/12/2020] [Indexed: 12/14/2022] Open
Abstract
It is a widely held view that humans have control over their food choices and consumption. However, research also suggests that eating behavior is often triggered by contextual cues and guided by automaticities and habits. Interestingly, the dichotomy between automatic and controlled processing has recently been challenged, suggesting that they may be intertwined. In a large female sample (n = 567), we investigated the hypothesis that task-based and self-reported measures of automatic and controlled processing would interact and impact self-reported eating behavior. Results analyzed via structural equation modeling suggest that automatic, but not controlled processing, during a modified flanker task, including a context-specific proportion congruent (CSPC) manipulation, was inversely associated with self-reported self-control. The influence of self-control on unhealthy eating behavior (i.e., uncontrolled and emotional eating, heightened consumption of fat and sugar) was only indirect via habitual behavior, which itself had a strong direct impact. Unhealthy eating was further associated with real-life outcomes (e.g., body mass index (BMI)). Our findings suggest that eating behavior may indeed be guided primarily by automaticities and habits, whereas self-control might facilitate this association. Having self-control over eating might therefore be most effective by avoiding contextual cues eliciting undesired automatic behavior and establishing habits that serve long-term goals.
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Affiliation(s)
- Sophia Fürtjes
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, 01069 Dresden, Germany; (S.F.); (J.A.K.); (M.S.)
| | - Joseph A. King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, 01069 Dresden, Germany; (S.F.); (J.A.K.); (M.S.)
| | - Caspar Goeke
- Institute of Cognitive Science, University of Osnabrück, 49074 Osnabrück, Germany;
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, 01069 Dresden, Germany; (S.F.); (J.A.K.); (M.S.)
| | - Thomas Goschke
- Department of Psychology, Technische Universität Dresden, 01069 Dresden, Germany;
| | - Annette Horstmann
- Department of Psychology, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland;
- Leipzig University Medical Center, Universität Leipzig, 04109 Leipzig, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, 01069 Dresden, Germany; (S.F.); (J.A.K.); (M.S.)
- Correspondence:
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558
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Kvardova N, Machackova H, Smahel D. The Direct and Indirect Effects of Online Social Support, Neuroticism, and Web Content Internalization on the Drive for Thinness among Women Visiting Health-Oriented Websites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072416. [PMID: 32252325 PMCID: PMC7177790 DOI: 10.3390/ijerph17072416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022]
Abstract
One of the debates about media usage is the potential harmful effect that it has on body image and related eating disturbances because of its representations of the “ideal body”. This study focuses on the drive for thinness among the visitors of various health-oriented websites and online platforms because neither has yet been sufficiently studied in this context. Specifically, this study aims to bring more insight to the risk factors which can increase the drive for thinness in the users of these websites. We tested the presumption that web content internalization is a key factor in this process, and we considered the effects of selected individual factors, specifically the perceived online social support and neuroticism. We utilized survey data from 445 Czech women (aged 18–29, M = 23.5, SD = 3.1) who visited nutrition, weight loss, and exercise websites. The results showed a positive indirect link between both perceived online social support and neuroticism to the drive for thinness via web content internalization. The results are discussed with regard to the dual role of online support as both risk and protective factor. Moreover, we consider the practical implications for eating behavior and weight-related problems with regard to prevention and intervention.
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559
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Yaseen F, Bertram M, Vickery M, Murphy M. A change in practice after the introduction of a state-wide service plan: standardisation of the provision of care to patients with an eating disorder in a regional hospital including support from a new Eating Disorders Outreach Service. Australas Psychiatry 2020; 28:213-219. [PMID: 32336136 DOI: 10.1177/1039856220908177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A state-wide service plan was introduced to guide local practice of the inpatient management of patients with an eating disorder. There was significant change in our management of such patients in our regional hospital. Our aim is to describe the changes and characterise our current practice. METHOD We undertook a retrospective review of the characteristics of nine consecutive inpatients and a descriptive qualitative study to examine the care provided to the patients and to identify the resultant care provisions a year after the introduction of the service plan. RESULTS Patient demographics and clinical characteristics were within the expected range. By the end of the year, the following changes were identified: (i) a team of local champions emerged; (ii) a case conference and template became routine; (iii) high utilisation of the new Eating Disorder Outreach Service (EDOS); (iv) common treatment challenges and methods to address them. CONCLUSIONS Standardisation of care and a systematic team approach are helpful in allowing small regional non-specialist centres to successfully manage complex patients. Funding of a local coordinator and assistance from EDOS was paramount to facilitate change. Other regional services may wish to adopt some of the practices described.
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560
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Foran AM, O'Donnell AT, Muldoon OT. Stigma of eating disorders and recovery-related outcomes: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2020; 28:385-397. [PMID: 32219911 DOI: 10.1002/erv.2735] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/16/2020] [Accepted: 03/12/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE People with eating disorders (EDs) tend to engage in behaviours that are ordinarily perceived as normal in society, such as restrictive dieting. However, when people are diagnosed with an ED, they may often feel stigmatized, which is likely to act as a barrier to recovery. To date, there is a limited understanding of how stigma of EDs impacts recovery-related outcomes. METHOD A systematic search was performed using PsychINFO and PubMed. Multiple combined searches of terms relating to stigma, EDs, and recovery-related outcomes were conducted. PRISMA guidelines were followed throughout the selection process and resulted in nine studies meeting specific inclusion criteria. The extracted data are examined in a critical narrative synthesis. RESULTS Our review suggested that across different samples and measures, stigmatization of EDs is negatively related to a range of factors important for recovery. These include psychological, social and physical health outcomes, ED psychopathology and treatment-seeking behaviours. CONCLUSIONS Based on the quality assessment, it was concluded that future research would benefit from the use of research designs that can demonstrate causality and generalize findings across community samples. Therefore, in order to improve recovery-related outcomes, treatment plans must consider the type of ED stigma experienced and its relation with specific recovery-related outcomes.
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Affiliation(s)
- Aoife-Marie Foran
- Centre for Social Issues Research, Department of Psychology, University of Limerick, Limerick, Republic of Ireland
| | - Aisling T O'Donnell
- Centre for Social Issues Research, Department of Psychology, University of Limerick, Limerick, Republic of Ireland
| | - Orla T Muldoon
- Centre for Social Issues Research, Department of Psychology, University of Limerick, Limerick, Republic of Ireland
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561
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Zhu J, Yang Y, Touyz S, Park R, Hay P. Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review. Front Psychiatry 2020; 11:206. [PMID: 32265758 PMCID: PMC7106475 DOI: 10.3389/fpsyt.2020.00206] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/03/2020] [Indexed: 12/26/2022] Open
Abstract
This Mini-Review presents recent research into evidence for psychological treatments for people with severe and enduring anorexia nervosa (SEAN). Two psychological therapies, specialist supportive clinical management (SSCM), and cognitive behavior therapy for anorexia nervosa (CBT-AN) have limited (one randomized controlled study) evidence of efficacy. Both have had adaptations for SEAN, notably with revision of the primary treatment goal of improved quality of life and full weight recovery a secondary goal. A major issue with existing studies is poor definition of SEAN, and the large deficit in research that has used an agreed definition of SEAN. In particular, it may be problematic to extrapolate from studies of people with either severe and/or enduring but not intractable or "resistant" illness. People with longstanding AN who have not received evidence based care should be offered this with an expectation of recovery. Similarly, people with SEAN may be offered care with judicious mitigation of expectations. In the future, trials should include people with SEAN clearly defined. Trials with a subsample of participants likely to have SEAN, if identified at randomisation, are an opportunity for secondary analyses of such participants. This would widen the evidence base for psychological treatments providing hope for people with this devastating illness. Finally, there is an urgent need not only to strengthen our existing knowledge with studies of sufficient power, but also, fundamentally, to derive novel conceptualizations of what "treatment" involves.
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Affiliation(s)
- James Zhu
- South West and North Coast Psychiatry Training Network, Sydney Local Health District, Sydney, NSW, Australia
| | - Yive Yang
- School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Stephen Touyz
- InsideOut Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - Rebecca Park
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Phillipa Hay
- Western Sydney University, Translational Health Research Institute, Sydney, NSW, Australia
- South Western Sydney Local Health District, Camden and Campbelltown Hospitals, Sydney, NSW, Australia
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562
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Goutaudier N, Ayache R, Aubé H, Chabrol H. Traumatic anticipation of childbirth and disordered eating during pregnancy. J Reprod Infant Psychol 2020; 38:243-258. [PMID: 32189512 DOI: 10.1080/02646838.2020.1741525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND While research on Fear Of Childbirth (FOC) during pregnancy is on the rise, research regarding pretraumatic stress reactions is lacking. Moreover, less is known regarding negative anticipation of childbirth and Eating Disorders (ED). This study aims at identifying typologies of women in the prepartum period based on FOC and pretraumatic stress symptoms and investigating whether or not the identified profiles differ on levels of bulimic symptoms and Drive for Thinness (DT). PARTICIPANTS AND METHODS a sample of 213 pregnant women completed questionnaires assessing FOC, pretraumatic stress, DT and bulimic symptoms. RESULTS four clusters based on pretraumatic stress and FOC symptoms were identified: one characterised by traumatic symptoms, one showing moderated FOC symptoms, one with high symptomatology and one with low symptoms. Higher ED symptoms were found in women with both FOC and pretraumatic stress symptoms, and in the cluster showing elevated pretraumatic stress symptomatology. CONCLUSIONS To our knowledge, this is the first study focusing on anticipated traumatic reactions and ED in pregnant women. While some women evidenced FOC and pretraumatic stress symptoms, two different clusters, one with FOC and one with pretraumatic stress, were found. These findings suggest that, while sharing similarities, these constructs are different.
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Affiliation(s)
- Nelly Goutaudier
- Centre de Recherches sur la Cognition et l'Apprentissage -UMR CNRS 7295, Université de Poitiers , Poitiers, France
| | - Raphael Ayache
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse Jean-Jaurès , Toulouse, France
| | - Hélène Aubé
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse Jean-Jaurès , Toulouse, France
| | - Henri Chabrol
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse Jean-Jaurès , Toulouse, France
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563
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Mathis KJ, Costa CB, Xandre PE. Treating Individuals With Eating Disorders: Part 1. J Psychosoc Nurs Ment Health Serv 2020; 58:7-13. [PMID: 32129875 DOI: 10.3928/02793695-20200217-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
According to the American Psychiatric Association, eating disorders (EDs) are characterized by a persistent disturbance of eating or eating-related behaviors that result in altered consumption or absorption of food and that significantly impair physical health and/or psychosocial functioning. EDs are chronic psychiatric illnesses and are notoriously difficult to treat. The etiology of eating disorders is unknown and thought to be a complex interplay among biological predisposition, environmental and sociocultural factors, neurobiological influences, and psychological factors. Moreover, prevalence of eating disorders is increasing despite variation in prevalence estimates across studies. Nurses are well-positioned to implement appropriate screening for and comprehensive assessment of EDs as well as offer patient-centered treatment options including referrals when indicated. As the first in a two-part series, this article provides an overview of the clinical characteristics of EDs and key areas for assessment and diagnostic considerations. The follow-up article in this series will focus on pharmacological treatment strategies. [Journal of Psychosocial Nursing and Mental Health Services, 58(3), 7-13.].
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564
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Galmiche M, Lucas N, Déchelotte P, Deroissart C, Le Solliec MA, Rondeaux J, Azhar S, Grigioni S, Colange G, Delay J, Achamrah N, Folope V, Belmonte L, Lamarre A, Rimbert A, Saillard T, Petit A, Quillard M, Coeffier M, Gillibert A, Lambert G, Legrand R, Tavolacci MP. Plasma Peptide Concentrations and Peptide-Reactive Immunoglobulins in Patients with Eating Disorders at Inclusion in the French EDILS Cohort (Eating Disorders Inventory and Longitudinal Survey). Nutrients 2020; 12:nu12020522. [PMID: 32085628 PMCID: PMC7071399 DOI: 10.3390/nu12020522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 12/12/2022] Open
Abstract
Eating disorders (EDs) are increasingly frequent. Their pathophysiology involves disturbance of peptide signaling and the microbiota–gut–brain axis. This study analyzed peptides and corresponding immunoglobulin (Ig) concentrations in groups of ED. In 120 patients with restrictive (R), bulimic (B), and compulsive (C) ED, the plasma concentrations of leptin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and insulin were analyzed by Milliplex and those of acyl ghrelin (AG), des-acyl ghrelin (DAG), and α-melanocyte-stimulating hormone (α-MSH) by ELISA kits. Immunoglobulin G (in response to an antigen) concentrations were analyzed by ELISA, and their affinity for the respective peptide was measured by surface plasmon resonance. The concentrations of leptin, insulin, GLP-1, and PYY were higher in C patients than in R patients. On the contrary, α-MSH, DAG, and AG concentrations were higher in R than in C patients. After adjustment for body mass index (BMI), differences among peptide concentrations were no longer different. No difference in the concentrations of the IgG was found, but the IgG concentrations were correlated with each other. Although differences of peptide concentrations exist among ED subtypes, they may be due to differences in BMI. Changes in the concentration and/or affinity of several anti-peptide IgG may contribute to the physiopathology of ED or may be related to fat mass.
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Affiliation(s)
- Marie Galmiche
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
| | - Nicolas Lucas
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Pierre Déchelotte
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
- Correspondence: ; Tel.: +06-08-49-66-26
| | - Camille Deroissart
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Marie-Anne Le Solliec
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Julie Rondeaux
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Saida Azhar
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Sébastien Grigioni
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Guillaume Colange
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Julie Delay
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Najate Achamrah
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Vanessa Folope
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Liliana Belmonte
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Adèle Lamarre
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Agnès Rimbert
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Tiphaine Saillard
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - André Petit
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - Muriel Quillard
- CIC-CRB 1404 INSERM, University Hospital of Rouen, 76000 Rouen, France;
| | - Moise Coeffier
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- Nutrition unit, University Hospital of Rouen, 76000 Rouen, France; (G.C.); (J.D.); (A.L.); (T.S.)
| | - André Gillibert
- Department of Biostatistics, Rouen University Hospital, F 76000 Rouen, France;
| | - Grégory Lambert
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Romain Legrand
- TargEDys SA, 91160 Longjumeau, France; (N.L.); (C.D.); (M.-A.L.S.); (J.R.); (S.A.); (G.L.); (R.L.)
| | - Marie-Pierre Tavolacci
- Inserm UMR1073, 76000 Rouen, France; (M.G.); (S.G.); (N.A.); (V.F.); (L.B.); (A.R.); (A.P.); (M.C.); (M.-P.T.)
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen, 76000 Rouen, France
- CIC-CRB 1404 INSERM, University Hospital of Rouen, 76000 Rouen, France;
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565
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Bagaric M, Touyz S, Heriseanu A, Conti J, Hay P. Are bulimia nervosa and binge eating disorder increasing? Results of a population-based study of lifetime prevalence and lifetime prevalence by age in South Australia. EUROPEAN EATING DISORDERS REVIEW 2020; 28:260-268. [PMID: 32061193 DOI: 10.1002/erv.2726] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/04/2019] [Accepted: 01/17/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to provide updated lifetime prevalence estimates of eating disorders, specifically bulimia nervosa (BN) and binge eating disorder (BED) and investigate changes over time in lifetime prevalence by age. METHOD Two thousand nine hundred seventy-seven participants from South Australia were interviewed in the Health Omnibus Survey. DSM-5 criteria were used for current and broad (in accord with the International Statistical Classification of Diseases and Related Health Problems-11 [ICD-11]) criteria for lifetime prevalence of BED. RESULTS This study found that the lifetime prevalence of BN was 1.21% (95% CI [0.87, 1.67]) and 2.59% (95% CI [2.07, 3.22]) for males and females, respectively, and that lifetime prevalence for BED-broad was 0.74% (95% CI [0.49, 1.11]) and 1.85% (95% CI [1.42, 2.40]) for males and females, respectively, which is higher than reported in previous research. Current prevalence (past 3 months) of BN was 0.40% (95% CI [0.23, 0.70]) and 0.81% (95% CI [0.54, 1.20]) for males and females, respectively, and current prevalence for BED was found to be 0.03 (95% CI [0.01, 0.04]) and 0.20% (95% CI [0.09, 0.44]) for males and females, respectively. CONCLUSIONS The current study confirmed the moderate community prevalence of BN and BED. BED was found to be less prevalent than BN in the present study, and a significant lifetime prevalence by age effect was found for both. Lifetime prevalence by age indicated that past increases in prevalence may be waning in this century and that overall BN and BED are not increasing in Australia.
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Affiliation(s)
- Marija Bagaric
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Stephen Touyz
- School of Psychology, Inside Out Institute, University of Sydney, Camperdown, NSW, Australia
| | - Andreea Heriseanu
- School of Psychology, University of Sydney, Camperdown, NSW, Australia.,School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Janet Conti
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
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566
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Chevinsky JD, Wadden TA, Chao AM. Binge Eating Disorder in Patients with Type 2 Diabetes: Diagnostic and Management Challenges. Diabetes Metab Syndr Obes 2020; 13:1117-1131. [PMID: 32341661 PMCID: PMC7166070 DOI: 10.2147/dmso.s213379] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/26/2020] [Indexed: 12/21/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with an increased risk of disordered eating behaviors including binge eating disorder (BED). Comorbid BED in patients with T2DM has been associated with adverse clinical outcomes such as higher body mass index (BMI) and depressive symptoms. Identifying and addressing this disorder in patients with T2DM is a significant challenge for health-care providers. The purpose of this narrative review is to discuss current perspectives on BED in the context of T2DM with implications for screening and management of these highly comorbid conditions. BED continues to be underrecognized and underdiagnosed. However, there are established tools that providers can use to screen for BED such as the SCOFF Questionnaire and Questionnaire on Eating and Weight Patterns-5. There are several effective treatments for BED including cognitive behavioral therapy, interpersonal therapy, and lisdexamfetamine dimesylate. However, few studies have examined the effects of these treatments in patients with co-morbid T2DM and BED.
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Affiliation(s)
| | - Thomas A Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
| | - Ariana M Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
- Correspondence: Ariana M Chao University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA19104, USATel +1215-746-7183Fax +1215-898-2878 Email
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567
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Kiekens G, Claes L. Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know. Curr Psychiatry Rep 2020; 22:68. [PMID: 33037934 PMCID: PMC7547297 DOI: 10.1007/s11920-020-01191-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. RECENT FINDINGS While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000, Leuven, Belgium. .,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
| | - Laurence Claes
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000 Leuven, Belgium ,grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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568
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Cury MEG, Berberian A, Scarpato BS, Kerr-Gaffney J, Santos FH, Claudino AM. Scrutinizing Domains of Executive Function in Binge Eating Disorder: A Systematic Review and Meta-Analysis. Front Psychiatry 2020; 11:288. [PMID: 32362845 PMCID: PMC7181673 DOI: 10.3389/fpsyt.2020.00288] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/24/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cognitive deficits are implicated in theoretical explanatory models for binge eating disorder (BED). Furthermore, evidence suggest that alterations in executive function may underlie symptoms in BED. The current systematic review and meta-analysis provides an update on executive functioning in individuals with BED. METHODS Literature searches (up to November 2019) were conducted in electronic databases combining binge eating or BED with executive functions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was used. Studies of any design comparing adults with BED with those without BED in executive function domains were selected. Methodological quality of studies was based on the Newcastle-Ottawa scale. RESULTS Of 1,983 citations identified, 28 case-control studies met inclusion criteria for this review. Six meta-analyses that examined four domains (decision-making, cognitive flexibility, inhibitory control, and working memory) were conducted. The only meta-analysis to show a significant difference in executive functioning between BED and obese controls was working memory (SMD = 0.32, 95% IC: -0.60, -0.03; p = 0.028), with an effect size of small magnitude. Qualitative inspection of the literature indicated mixed findings for control inhibition, decision making and cognitive flexibility in individuals with BED compared to controls (obese or normal weight). In addition, people with BED showed poorer problem solving performance, but similar planning abilities to obese controls. CONCLUSIONS Individuals with BED were found to show worse performance on working memory tasks compared to obese individuals without the disorder. The findings did not provide definitive evidence of alterations in other aspects of executive functioning. Interest in executive functioning in people with BED is increasing but is limited by insufficient data from small studies with varied methodology. Future studies should focus on using similar tests and outcome measures, in order to enable more pertinent comparisons across studies.
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Affiliation(s)
- Maria Elisa Gisbert Cury
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Arthur Berberian
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Bruno Sini Scarpato
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Jess Kerr-Gaffney
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Flavia H Santos
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Angélica Medeiros Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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569
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Bizri M, Geagea L, Kobeissy F, Talih F. Prevalence of Eating Disorders Among Medical Students in a Lebanese Medical School: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2020; 16:1879-1887. [PMID: 32801721 PMCID: PMC7414930 DOI: 10.2147/ndt.s266241] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Eating disorders are among the most severe psychiatric disorders. Medical students are subjected to high levels of stress and have a high risk of developing burnout and mental health problems, including eating disorders. Due to societal stigma and lack of awareness, it is plausible that disordered eating behaviors among students may go unrecognized and under-reported. The current study aimed to evaluate the prevalence and possible factors associated with eating disorders among medical students at the American University of Beirut in Lebanon (AUB). METHODS This cross-sectional descriptive study was conducted in 2017 at AUB. Electronic anonymous surveys were sent to all 412 medical students, with a mean age of 23, enrolled in our four-year medical school. In addition to demographic data, students were asked to complete two validated questionnaires, the SCOFF and EAT-26, to assess eating disorders risk. RESULTS Total responses were 156, out of which 124 completed the whole survey. A total of 131 participants completed the Eat-26 questionnaire and 124 participants completed the SCOFF questionnaire. Out of those, 17% on EAT-26 and 19% on SCOFF were found to be at high risk of developing eating disorders. CONCLUSION There seems to be a high level of underrecognized and under-treated disordered eating behaviors among female medical students at AUB. Raising awareness among medical students is important, as well as developing better prevention and treatment strategies.
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Affiliation(s)
- Maya Bizri
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Luna Geagea
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Firas Kobeissy
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Farid Talih
- American University of Beirut Medical Center, Beirut, Lebanon
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570
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Pursey KM, Hay P, Bussey K, Trompeter N, Lonergan A, Pike KM, Mond J, Mitchison D. Diabetes and disordered eating behaviours in a community-based sample of Australian adolescents. J Eat Disord 2020; 8:5. [PMID: 32128205 PMCID: PMC7047351 DOI: 10.1186/s40337-020-0282-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 01/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND People with diabetes have been shown to be at risk for disordered eating compared to their non-diabetic peers. However, the majority of studies have been conducted in relatively small samples drawn from clinical diabetes settings or registries. Community-based samples are required to better understand disordered eating behaviours in this population. In a large community-based population sample of Australian adolescents, this study aimed to (1) investigate disordered eating behaviours in adolescents reporting a diagnosis of diabetes compared to their non-diabetic peers and (2) test associations between disordered eating behaviours and insulin restriction. METHODS Secondary school students (n = 4854; mean (SD) age 14.4 (1.6) years; 47% boys) completed an online survey, including self-reported presence of diabetes, demographics, weight status, substance use, insulin restriction and disordered eating behaviours. Clinically meaningful cut-offs for disordered eating behaviours were generated for analysis. RESULTS Disordered eating behaviours, specifically self-induced vomiting (diabetes 19.2%, no diabetes 3.3%; p < 0.001), laxative use (diabetes 15.4%, no diabetes 2.1%; p < 0.001), use of cigarettes (diabetes 26.9%, no diabetes 4.3%; p < 0.001) and other drugs (diabetes 28.9%, no diabetes 4.0%; p < 0.001), cleanse/detox (diabetes 30.8%, no diabetes 10.5%; p < 0.001) and extreme weight loss diets (diabetes 13.5%, no diabetes 4.7%; p < 0.003) were higher in those reporting a diagnosis of diabetes. In addition, 17% of those with diabetes reported frequent insulin restriction (≥ once per week), and insulin restriction was associated with more frequent disordered eating behaviours. CONCLUSION There was a high rate of disordered eating behaviours in adolescents with diabetes compared to their peers without diabetes. The findings of this study may have the potential to inform future health promotion, prevention, and early intervention approaches for those with comorbid diabetes and disordered eating behaviours. Future longitudinal studies are required to evaluate disordered eating behaviours in those with diabetes over time in community-based samples.
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Affiliation(s)
- Kirrilly M Pursey
- 1Faculty of Health and Medicine, University of Newcastle, Callaghan, 2308 NSW Australia
| | - Phillipa Hay
- 2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia.,Campbelltown and Camden Hospitals, Campbelltown, NSW Australia
| | - Kay Bussey
- 4Department of Psychology and Centre for Emotional Health, Macquarie University, Sydney, NSW Australia
| | - Nora Trompeter
- 4Department of Psychology and Centre for Emotional Health, Macquarie University, Sydney, NSW Australia
| | - Alexandra Lonergan
- 4Department of Psychology and Centre for Emotional Health, Macquarie University, Sydney, NSW Australia
| | - Kathleen M Pike
- 5Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York, NY USA
| | - Jonathon Mond
- 6Centre for Rural Health, University of Tasmania, Launceston, Australia.,7School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Deborah Mitchison
- 2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW Australia.,8Department of Psychology, Macquarie University, Sydney, NSW Australia
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571
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Breton J, Déchelotte P, Ribet D. Intestinal microbiota and Anorexia Nervosa. CLINICAL NUTRITION EXPERIMENTAL 2019. [DOI: 10.1016/j.yclnex.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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572
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Hay P. Hidden eating disorders and the treatment gap. JORNAL BRASILEIRO DE PSIQUIATRIA 2019. [DOI: 10.1590/0047-2085000000244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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573
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Tavolacci MP, Gillibert A, Zhu Soubise A, Grigioni S, Déchelotte P. Screening four broad categories of eating disorders: suitability of a clinical algorithm adapted from the SCOFF questionnaire. BMC Psychiatry 2019; 19:366. [PMID: 31752796 PMCID: PMC6868823 DOI: 10.1186/s12888-019-2338-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/23/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We evaluated the performance of a clinical algorithm (Expali™), combining two or more positive answers to SCOFF questionnaire with Body Mass Index (BMI), to identify four Broad Categories of eating disorders (ED) derived from DSM-5. METHODS The clinical algorithm (Expali™) was developed from 104 combinations of BMI levels and answers to five SCOFF questions with at least two positive answers. Two senior ED physicians allocated each combination to one of the four Broad Categories of ED derived from DSM-5: restrictive disorder, bulimic disorder, hyperphagic disorder and other unspecified ED diagnosed by ED clinicians. The performance of Expali™ was evaluated on data from 206 patients with ED. Sensitivity, specificity values and Youden index were calculated for each category. RESULTS The 206 patients were diagnosed as follows: 31.5% restrictive disorder, 18.9% bulimic disorder, 40.8% hyperphagic disorder and 8.8% other ED. The sensitivity of Expali™ for restrictive, bulimic, hyperphagic and other unspecified ED were respectively: 76.9, 69.2, 79.7 and 16.7%. The Youden index was respectively 0.73, 0.57, 0.67 and 0.07. CONCLUSIONS In a SCOFF-positive ED population (at least two positive answers), the clinical algorithm Expali™ demonstrated good suitability by correctly classifying three of the four Broad Categories of eating disorders (restrictive, bulimic and hyperphagic disorder). It could be useful both to healthcare professionals and the general population to enable earlier detection and treatment of ED and to improve patient outcomes.
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Affiliation(s)
- Marie-Pierre Tavolacci
- Normandie Univ, UNIROUEN, U1073, Rouen University Hospital, Clinical Investigation Center 1404, F-76000, Rouen, France.
| | - André Gillibert
- grid.41724.34Rouen University Hospital, Clinical Investigation Center 1404, F-76000 Rouen, France
| | - Aurélien Zhu Soubise
- grid.41724.34Rouen University Hospital, Clinical Investigation Center 1404, F-76000 Rouen, France
| | - Sébastien Grigioni
- grid.41724.34Department of Nutrition, Normandie Univ, UNIROUEN, U1073, Rouen University Hospital, F-76000 Rouen, France
| | - Pierre Déchelotte
- grid.41724.34Department of Nutrition, Normandie Univ, UNIROUEN, U1073, Rouen University Hospital, F-76000 Rouen, France
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574
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Adult attachment in eating disorders mediates the association between perceived invalidating childhood environments and eating psychopathology. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00524-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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575
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Breithaupt L, Köhler-Forsberg O, Petersen L. Reconsidering the Association Between Infection-Related Health Care Use and Occurrence of Eating Disorders: Chicken or Egg?-Reply. JAMA Psychiatry 2019; 76:1212-1213. [PMID: 31411651 DOI: 10.1001/jamapsychiatry.2019.2189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lauren Breithaupt
- Department of Psychology, George Mason University, Fairfax, Virginia.,Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Risskov, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Liselotte Petersen
- National Centre for Register-Based Research, School of Business and Social Services, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark
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576
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Dominique M, Legrand R, Galmiche M, Azhar S, Deroissart C, Guérin C, do Rego JL, Leon F, Nobis S, Lambert G, Lucas N, Déchelotte P. Changes in Microbiota and Bacterial Protein Caseinolytic Peptidase B During Food Restriction in Mice: Relevance for the Onset and Perpetuation of Anorexia Nervosa. Nutrients 2019; 11:E2514. [PMID: 31635300 PMCID: PMC6835841 DOI: 10.3390/nu11102514] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 02/06/2023] Open
Abstract
Microbiota contributes to the regulation of eating behavior and might be implicated in the pathophysiology of anorexia nervosa. ClpB (Caseinolytic peptidase B) protein produced mainly by the Enterobacteriaceae family has been identified as a conformational mimetic of α-MSH, which could result in similar anorexigenic effects. The aim of this study was to highlight the role of the microbiome and the ClpB protein in deregulation and self-maintenance of anorexia pathology. Male C57Bl/6 mice were undergone to the ABA (Activity-Based Anorexia) protocol: after 5 days of acclimatization, both ABA and LFA (Limited Food Access) mice had progressively limited access to food until D17. At the end of protocol, the plasma ClpB concentration and Enterobacteriaceae DNA in colonic content were measured. As expected, dietary restriction induced lost weight in LFA and ABA mice. At D10, colonic permeability and plasma concentration of the ClpB protein were significantly increased in LFA and ABA mice vs. controls. At D17, plasma concentration of ClpB was increased in LFA and ABA mice and, it was correlated with proportion of Enterobacteriaceae in the faeces. These abnormally high ClpB concentrations and all associated factors, and therefore might contribute to the initiation and/or perpetuation of anorexia nervosa by interfering with satiety signaling.
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Affiliation(s)
- Manon Dominique
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
- Inserm UMR1073, Nutrition, Gut and Brain Laboratory, University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
| | - Romain Legrand
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
| | - Marie Galmiche
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
- Inserm UMR1073, Nutrition, Gut and Brain Laboratory, University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
| | - Saïda Azhar
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
| | | | - Charlène Guérin
- Inserm UMR1073, Nutrition, Gut and Brain Laboratory, University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
| | - Jean-Luc do Rego
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Animal Behavior Platform, Service Commun d'Analyse Comportementale (SCAC), University of Rouen Normandy, 76183 Rouen, France.
| | - Fatima Leon
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Animal Behavior Platform, Service Commun d'Analyse Comportementale (SCAC), University of Rouen Normandy, 76183 Rouen, France.
| | - Séverine Nobis
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Animal Behavior Platform, Service Commun d'Analyse Comportementale (SCAC), University of Rouen Normandy, 76183 Rouen, France.
| | - Grégory Lambert
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
| | - Nicolas Lucas
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
| | - Pierre Déchelotte
- TargEDys SA, University of Rouen Normandy, 76183 Rouen, France.
- Inserm UMR1073, Nutrition, Gut and Brain Laboratory, University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Institute for Research and Innovation in Biomedicine (IRIB), University of Rouen Normandy, Unirouen, 76183 Rouen, France.
- Rouen University Hospital, CHU Charles Nicolle, 76183 Rouen, France.
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577
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Ward ZJ, Rodriguez P, Wright DR, Austin SB, Long MW. Estimation of Eating Disorders Prevalence by Age and Associations With Mortality in a Simulated Nationally Representative US Cohort. JAMA Netw Open 2019; 2:e1912925. [PMID: 31596495 PMCID: PMC6802241 DOI: 10.1001/jamanetworkopen.2019.12925] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Eating disorders (EDs) are common psychiatric disorders associated with high mortality. However, data on ED disease dynamics and treatment coverage are sparse. OBJECTIVES To model the individual-level disease dynamics of ED from birth to age 40 years and to estimate the association of increased treatment coverage with ED-related mortality. DESIGN, SETTING, AND PARTICIPANTS In this decision analytical model study, an individual-level Markov state transition model was empirically calibrated in April 2019 using a Bayesian approach to synthesize available clinical and epidemiologic ED data. The simulation model was calibrated to nationally representative US survey data from 2007 and 2011. A virtual cohort of 100 000 individuals (50 000 [50%] male) was modeled from birth to age 40 years for 4 ED diagnoses: anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders. EXPOSURES Age-specific ED incidence and mortality rates and background (all-cause) mortality. MAIN OUTCOMES AND MEASURES The main outcomes were age-specific 12-month and lifetime ED prevalence and number of deaths per 100 000 general population individuals by age 40 years. The mean and 95% uncertainty intervals (UIs) of 1000 simulations, accounting for stochastic and parameter uncertainty, are reported. RESULTS The highest estimated mean annual prevalence of ED occurred at approximately age 21 years for both male individuals (7.4%; 95% UI, 3.5%-11.5%) and female individuals (10.3%; 95% UI, 7.0%-14.2%), with lifetime mean prevalence estimates increasing to 14.3% (95% UI, 9.7%-19.0%) for male individuals and 19.7% (95% UI, 15.8%-23.9%) for female individuals by age 40 years. Ninety-five percent of first-time cases occurred by age 25 years. Current treatment coverage averts an estimated mean of 41.7 deaths per 100 000 people (95% UI, 13.0-82.0 deaths per 100 000 people) by age 40 years, whereas increasing treatment coverage for all patients with ED could avert an estimated mean of 70.5 deaths per 100 000 people by age 40 years (95% UI, 26.0-143.0 deaths per 100 000 people). CONCLUSIONS AND RELEVANCE In this simulation modeling study, the estimated lifetime prevalence of ED was high, with approximately 1 in 7 male and 1 in 5 female individuals having an ED by age 40 years. The initial onset of EDs was highly concentrated during adolescence and young adulthood, suggesting that this is a critical period for prevention efforts. However, the high estimated prevalence of recurring ED later in life highlights the importance of identification and treatment of ED at older ages as well. These findings suggest that increasing treatment coverage could substantially reduce ED-related mortality.
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Affiliation(s)
- Zachary J. Ward
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Patricia Rodriguez
- Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle
| | - Davene R. Wright
- Comparative Health Outcomes, Policy, and Economics Institute, University of Washington, Seattle
- Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Michael W. Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC
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578
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Patmore J, Meddaoui B, Feldman H. Cultural considerations for treating Hispanic patients with eating disorders: A case study illustrating the effectiveness of CBT in reducing bulimia nervosa symptoms in a Latina patient. J Clin Psychol 2019; 75:2006-2021. [PMID: 31509250 DOI: 10.1002/jclp.22860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Eating disorders (ED's) are the deadliest of all mental disorders, yet there is a paucity of research examining the clinical presentation of eating disorders in Hispanic populations and limited guidelines for culturally sensitive treatment. Given the rapid growth of Hispanic communities in the U.S., it is important to acknowledge the unique clinical profile of patients within this demographic and examine eating pathology within this socio-cultural context. This case study aims to illustrate the utility, relevance, and effectiveness of cognitive behavioral therapy (CBT) on alleviating eating disorder symptoms in an adult Latina patient with bulimia nervosa to understand the broader implications of applying manualized treatments to diverse populations. We outline the strengths of CBT in quickly modifying problematic thought patterns and decreasing pathological behaviors while raising questions about cultural generalizability. In addition, we explore CBT's limitations in addressing certain underlying ED pathology-driving and maintaining factors for minority individuals.
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Affiliation(s)
| | | | - Helen Feldman
- Teachers College, Columbia University, New York City, New York
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579
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Igudesman D, Sweeney M, Carroll IM, Mayer-Davis EJ, Bulik CM. Gut-Brain Interactions: Implications for a Role of the Gut Microbiota in the Treatment and Prognosis of Anorexia Nervosa and Comparison to Type I Diabetes. Gastroenterol Clin North Am 2019; 48:343-356. [PMID: 31383275 PMCID: PMC6686879 DOI: 10.1016/j.gtc.2019.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Anorexia nervosa has poor prognosis and treatment outcomes and is influenced by genetic, metabolic, and psychological factors. Gut microbes interact with gut physiology to influence metabolism and neurobiology, although potential therapeutic benefits remain unknown. Type 1 diabetes is linked to anorexia nervosa through energy dysregulation, which in both disease states is related to the gut microbiota, disordered eating, and genetics.
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Affiliation(s)
- Daria Igudesman
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Megan Sweeney
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Ian M Carroll
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Elizabeth J Mayer-Davis
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Cynthia M Bulik
- Department of Nutrition, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27599, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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580
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Breton J, Legrand R, Achamrah N, Chan P, do Rego JL, do Rego JC, Coëffier M, Déchelotte P, Fetissov SO. Proteome modifications of gut microbiota in mice with activity-based anorexia and starvation: Role in ATP production. Nutrition 2019; 67-68:110557. [PMID: 31563744 DOI: 10.1016/j.nut.2019.110557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/04/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Activity-based anorexia (ABA) in rodents is a behavioral model of anorexia nervosa, characterized by negative energy balance, hyperactivity, and dysbiosis of gut microbiota. Gut bacteria are known to produce energy substrates including adenosine triphosphate (ATP) and acetate. The aim of this study was to determine whether ABA alters the proteome of gut microbiota relevant to ATP and acetate production. METHODS The ABA was developed in male mice and compared with food-restricted and ad libitum-fed conditions. Proteomic analysis of feces was performed using the two-dimentional gel electrophoresis and mass spectrometry. The in vitro ATP-producing capacity of proteins extracted from feces was assayed. RESULTS Increased levels of the phosphoglycerate kinase, an ATP-producing glycolytic enzyme, was detected in feces of food-restricted mice and this enzyme was further increased in the ABA group. Starvation also upregulated several other proteins synthetized by order Clostridiales including Clostridiaceae and Lachnospiraceae families. No significant differences in the in vitro ATP-producing capacity by bacterial proteins from ABA, food-restricted, and ad libitum-fed control mice were found. However, plasma levels of acetate strongly tended to be increased in the activity groups including ABA mice. CONCLUSION The data revealed that starvation in food-restricted and ABA mice induced proteome modification in gut bacteria favoring ATP production mainly by the order Clostridiales. However, this did not result in increased total ATP-production capacity by gut microbiota. These changes can be interpreted as an adaptation of specific gut bacteria to the host malnutrition beneficial for host survival.
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Affiliation(s)
- Jonathan Breton
- Normandie University, UNIROUEN, Nutrition, Gut and Brain Laboratory Rouen, France; Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Nutrition Department, Rouen University Hospital, Rouen, France.
| | - Romain Legrand
- Normandie University, UNIROUEN, Nutrition, Gut and Brain Laboratory Rouen, France; Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France
| | - Najate Achamrah
- Normandie University, UNIROUEN, Nutrition, Gut and Brain Laboratory Rouen, France; Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Nutrition Department, Rouen University Hospital, Rouen, France
| | - Philippe Chan
- Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Normandie University, UNIROUEN, PISSARO Proteomic Platform, Mont-Saint-Aignan, France
| | - Jean Luc do Rego
- Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Normandie University, UNIROUEN, Animal Behavior Platform SCAC, Rouen, France
| | - Jean Claude do Rego
- Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Normandie University, UNIROUEN, Animal Behavior Platform SCAC, Rouen, France
| | - Moïse Coëffier
- Normandie University, UNIROUEN, Nutrition, Gut and Brain Laboratory Rouen, France; Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Nutrition Department, Rouen University Hospital, Rouen, France
| | - Pierre Déchelotte
- Normandie University, UNIROUEN, Nutrition, Gut and Brain Laboratory Rouen, France; Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France; Nutrition Department, Rouen University Hospital, Rouen, France
| | - Sergueï O Fetissov
- Normandie University, UNIROUEN, Nutrition, Gut and Brain Laboratory Rouen, France; Normandie University, UNIROUEN, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France.
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581
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Sex differences in orthorexic eating behaviors: A systematic review and meta-analytical integration. Nutrition 2019; 67-68:110534. [PMID: 31525607 DOI: 10.1016/j.nut.2019.06.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Other than the ongoing debate about the epidemiologic and clinical relevance of pathologically healthful eating, a phenomenon called orthorexia nervosa, there is not much consensus about sex differences in prevalence rates. The aim of this study was to provide a systematic review and meta-analytical combination of derived data to better conceptualize the presence and size of sex differences in the prevalence and levels of orthorexic eating behaviors and orthorexia nervosa. METHODS Sixty-seven publications were included in the synthesis providing data from k = 89 subsamples (39 255 participants, 67.7% women) for meta-analytical procedures. Separate analyses were conducted for each measurement tool. The impact of four moderators proposed to explain sex differences was examined: sample composition (general population versus special interest in health population; subgroup analysis), and in a meta-regression sample's mean age, year of publication, and sex distribution. RESULTS The results showed significant sex differences in only one of four instruments in use. Studies measuring orthorexic behaviors showed that women were significantly more likely to report pathologically healthful eating than men (small effect size). Studies employing tools to assess tendencies toward healthy eating indicated similar levels in women and men. Subgroup and moderator analyses showed comparable effects sizes in general population and high-risk samples, and that the sex difference was inconsistently and minimally related to the sample's mean age, year of publication, or sex distribution. CONCLUSIONS The findings indicate that, depending on the instrument in use, tendencies toward healthy eating are comparable between the genders, although pathologically healthful eating is slightly more pronounced in women. Future studies will have to adopt valid criteria for diagnosing Orthorexia nervosa and investigate additional factors contributing to pathologic healthful eating and orthorexia nervosa.
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582
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Brodrick BB, Jacobs MA, McAdams CJ. Psychosis in Anorexia Nervosa: A Case Report and Review of the Literature. PSYCHOSOMATICS 2019; 61:181-187. [PMID: 31371095 DOI: 10.1016/j.psym.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 06/15/2019] [Accepted: 06/17/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Brooks B Brodrick
- Department of Internal Medicine, University of Texas Southwestern, Dallas, TX; Department of Psychiatry, University of Texas Southwestern, Dallas, TX; Department of Internal Medicine at Parkland Health and Hospital System, Dallas, TX.
| | - Mallory A Jacobs
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX
| | - Carrie J McAdams
- Department of Psychiatry, University of Texas Southwestern, Dallas, TX; Department of Psychiatry, Children's Medical Center, Dallas, TX
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