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Huryk KM, Drury CR, Loeb KL. Diseases of affluence? A systematic review of the literature on socioeconomic diversity in eating disorders. Eat Behav 2021; 43:101548. [PMID: 34425457 DOI: 10.1016/j.eatbeh.2021.101548] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 06/01/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
The stereotype that eating disorders (ED) primarily present among individuals of higher socioeconomic status (SES) has long persisted in popular and professional perception. This belief has likely contributed to disparities in ED identification and treatment, particularly among those of lower SES backgrounds. The objective of this article was to systematically review the literature investigating socioeconomic diversity in distinct ED diagnoses. A PRISMA search was conducted to identify studies that empirically assessed the association between ED pathology and indicators of SES via PubMed and PsycINFO. This search generated 13,538 articles, of which 62 articles published between 1973 and August 2020 met criteria for inclusion in the review. Included studies were primarily cross-sectional and covered diagnoses of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with quality ratings of poor, fair, and good. Results are examined in the context of studies' sampling methods, operationalization of SES, and statistical analyses. There is no consistent pattern of evidence to suggest a relationship between high SES and ED. Instead, all ED present across a wide range of socioeconomic backgrounds. Limitations included the predominance of cross-sectional study designs and poor to fair quality ratings. Future research should include adequately powered, community-based longitudinal studies that examine how sociocultural factors, including SES, intersect to influence ED risk and treatment outcome. The existing data suggest an urgent need to prioritize affordable and accessible ED treatment.
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Affiliation(s)
- Kathryn M Huryk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Catherine R Drury
- School of Psychology, Fairleigh Dickinson University, 1000 River Road, T-WH1-01, Teaneck, NJ 07666, USA.
| | - Katharine L Loeb
- Chicago Center for Evidence-Based Treatment, 25 E Washington St, Suite 1015, Chicago, IL 60602, USA.
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Using shape and weight overvaluation to empirically differentiate severity of other specified feeding or eating disorder. J Affect Disord 2021; 295:446-452. [PMID: 34507225 DOI: 10.1016/j.jad.2021.08.049] [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] [Received: 03/08/2021] [Revised: 07/18/2021] [Accepted: 08/21/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Although no severity specifiers are noted in the Diagnostic and Statistical Manual of Mental Disorders - 5 for other specified feeding or eating disorder (OSFED), shape/weight overvaluation is a proposed eating disorder (ED) severity specifier. We used structural equation modeling (SEM) Trees to empirically determine values of shape/weight overvaluation that differentiate OSFED severity. We additionally tested whether the SEM Tree-defined thresholds or a clinical cutoff for shape/weight overvaluation differentiated severity more meaningfully. METHODS Participants were 690 females with OSFED presenting to residential ED treatment. SEM Tree analyses specified an outcome model of OSFED severity and then recursively partitioning the outcome model into severity groups. The SEM Tree-defined and clinical cutoff severity groups were compared on clinical characteristics. RESULTS SEM Trees identified one split that occurred at value 5.12 on our shape/weight overvaluation items from the Eating Disorder Examination Questionnaire. The subgroup with higher overvaluation had significantly greater intensity of ED and depressive symptoms and longer lengths of stay. The subgroups created from the shape/weight overvaluation clinical-cut off value of 4 differed on the same clinical characteristics as the SEM Tree-derived groups, with the exception of laxative use frequency. Effect sizes were larger for the clinical cutoff as compared to the SEM Tree severity specification scheme. LIMITATIONS These cross-sectional data were used from a predominately white and female residential treatment sample; this likely skewed the subgroups and may limit generalizability. CONCLUSIONS Shape/weight overvaluation can meaningfully differentiate OSFED severity. The clinical cutoff slightly outperformed the empirically determined thresholds for shape/weight overvaluation.
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Mikhail ME, Carroll SL, Clark DA, O'Connor S, Burt SA, Klump KL. Context matters: Neighborhood disadvantage is associated with increased disordered eating and earlier activation of genetic influences in girls. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:875-885. [PMID: 34843291 DOI: 10.1037/abn0000719] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Emerging evidence suggests socioeconomic disadvantage may increase risk for eating disorders (EDs). However, there are very few studies on the association between disadvantage and EDs, and all have focused on individual-level risk factors (e.g., family income). Neighborhood disadvantage (i.e., elevated poverty and reduced resources in one's neighborhood) is associated with increased risk for anxiety/depression and poor physical health. To date, no studies have examined phenotypic associations between neighborhood disadvantage and disordered eating, or how any form of disadvantage may interact with genetic individual differences in risk for EDs. We examined phenotypic and etiologic associations between neighborhood disadvantage and disordered eating in 2,922 girls ages 8-17 from same-sex twin pairs recruited through the Michigan State University Twin Registry. Parents rated the twins on nine items assessing core disordered eating symptoms (e.g., weight preoccupation, binge eating), and neighborhood disadvantage was calculated from 17 indicators of contextual disadvantage (e.g., median home value, neighborhood unemployment). Puberty was measured using the Pubertal Development Scale to examine whether associations were consistent across development. At a phenotypic level, greater neighborhood disadvantage was associated with significantly greater disordered eating symptoms in girls at all stages of puberty (β = .07). Moreover, Genotype × Environment models showed that girls living in more disadvantaged neighborhoods exhibited stronger and earlier (i.e., during pre/early puberty) activation of genetic influences on disordered eating. Results highlight the critical importance of considering contextual disadvantage in research on etiology and risk for disordered eating, and the need for increased screening and treatment for EDs in disadvantaged youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - D Angus Clark
- Department of Psychiatry and Addiction Center, University of Michigan, Ann Arbor
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Warne N, Heron J, Mars B, Kwong ASF, Solmi F, Pearson R, Moran P, Bould H. Disordered eating and self-harm as risk factors for poorer mental health during the COVID-19 pandemic: A UK-based birth cohort study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.04.30.21256377. [PMID: 33972955 PMCID: PMC8109211 DOI: 10.1101/2021.04.30.21256377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Young adults and especially those with pre-existing mental health conditions, such as disordered eating and self-harm, appear to be at greater risk of developing metal health problems during the COVID-19 pandemic. However, it is unclear whether this increased risk is affected by any changes in lockdown restrictions, and whether any lifestyle changes could moderate this increased risk. METHODS In a longitudinal UK-based birth cohort (The Avon Longitudinal Study of Parents and Children, ALSPAC) we assessed the relationship between pre-pandemic measures of disordered eating and self-harm and mental health during the COVID-19 pandemic in 2,657 young adults. Regression models examined the relationship between self-reported disordered eating, self-harm, and both disordered eating and self-harm at age 25 years and depressive symptoms, anxiety symptoms and mental wellbeing during a period of eased restrictions in the COVID-19 pandemic (May-July 2020) when participants were aged 27-29 years. Analyses were adjusted for sex, questionnaire completion date, pre-pandemic socioeconomic disadvantage and pre-pandemic mental health and wellbeing. We also examined whether lifestyle changes (sleep, exercise, alcohol, visiting green space, eating, talking with family/friends, hobbies, relaxation) in the initial UK lockdown (April-May 2020) moderated these associations. RESULTS Pre-existing disordered eating, self-harm and comorbid disordered eating and self-harm were all associated with the reporting of a higher frequency of depressive symptoms and anxiety symptoms, and poorer mental wellbeing during the pandemic compared to individuals without disordered eating and self-harm. Associations remained when adjusting for pre-pandemic mental health measures. There was little evidence that interactions between disordered eating and self-harm exposures and lifestyle change moderators affected pandemic mental health and wellbeing. CONCLUSIONS Young adults with pre-pandemic disordered eating, self-harm and comorbid disordered eating and self-harm were at increased risk for developing symptoms of depression, anxiety and poor mental wellbeing during the COVID-19 pandemic, even when accounting for pre-pandemic mental health. Lifestyle changes during the pandemic do not appear to alter this risk. A greater focus on rapid and responsive service provision is essential to reduce the impact of the pandemic on the mental health of these already vulnerable individuals.
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Affiliation(s)
- Naomi Warne
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Becky Mars
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Alex S. F. Kwong
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | | | - Rebecca Pearson
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Helen Bould
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, UK
- Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK
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Abstract
PURPOSE OF REVIEW To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality. RECENT FINDINGS Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk. SUMMARY Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.
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Affiliation(s)
- Annelies E. van Eeden
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | | | - Hans W. Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
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56
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Marek RJ, Anderson JL. Measurement of Eating Pathology Using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). J Pers Assess 2021; 104:674-679. [PMID: 34678090 DOI: 10.1080/00223891.2021.1991361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Eating disorders are prevalent among college student populations. Although previous iterations of the instrument did not include specific measurement of eating pathology, the Minnesota multiphasic personality inventory-3 (MMPI-3) now includes a specific scale (i.e., Eating Concerns [EAT]) to assess problematic eating behaviors. The current study examined the MMPI-3 assessment of eating pathology among 249 undergraduate women. A pattern emerged where symptoms of internalizing psychopathology on the MMPI-3 were generally associated with symptoms of eating disorder. However, the newly included EAT scale demonstrated the strongest associations with most areas of eating dysfunction. Further, hierarchical regression analyses suggested that the EAT scale added substantial incremental predictive utility (up to 23%) over other MMPI-3 scales combined in assessing eating pathology. Classification accuracy statistics yielded high sensitivity and specificity coefficients when predicting eating disorder risk at an EAT scale score cutoff of 75 T or higher. These findings support the use of the MMPI-3 in assessing eating pathology in college women, although its performance with men and with women not of college age remains to be studied.
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57
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López-Ojeda W, Hurley RA. Sexual Dimorphism in Brain Development: Influence on Affective Disorders. J Neuropsychiatry Clin Neurosci 2021; 33:A485-89. [PMID: 34018811 DOI: 10.1176/appi.neuropsych.20100269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Wilfredo López-Ojeda
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (López-Ojeda, Hurley). The Departments of Psychiatry and Behavioral Medicine (López-Ojeda) and Psychiatry and Radiology (Hurley), Wake Forest School of Medicine, Winston-Salem, N.C.; and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley)
| | - Robin A Hurley
- The Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center, and the Research and Academic Affairs Service Line, W.G. Hefner Veterans Affairs Medical Center, Salisbury, N.C. (López-Ojeda, Hurley). The Departments of Psychiatry and Behavioral Medicine (López-Ojeda) and Psychiatry and Radiology (Hurley), Wake Forest School of Medicine, Winston-Salem, N.C.; and the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Hurley)
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58
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Spadini S, Ferro M, Lamanna J, Malgaroli A. Activity-based anorexia animal model: a review of the main neurobiological findings. J Eat Disord 2021; 9:123. [PMID: 34600568 PMCID: PMC8487535 DOI: 10.1186/s40337-021-00481-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The genesis of anorexia nervosa (AN), a severe eating disorder with a pervasive effect on many brain functions such as attention, emotions, reward processing, cognition and motor control, has not yet been understood. Since our current knowledge of the genetic aspects of AN is limited, we are left with a large and diversified number of biological, psychological and environmental risk factors, called into question as potential triggers of this chronic condition with a high relapse rate. One of the most valid and used animal models for AN is the activity-based anorexia (ABA), which recapitulates important features of the human condition. This model is generated from naïve rodents by a self-motivated caloric restriction, where a fixed schedule food delivery induces spontaneous increased physical activity. AIM In this review, we sought to provide a summary of the experimental research conducted using the ABA model in the pursuit of potential neurobiological mechanism(s) underlying AN. METHOD The experimental work presented here includes evidence for neuroanatomical and neurophysiological changes in several brain regions as well as for the dysregulation of specific neurochemical synaptic and neurohormonal pathways. RESULTS The most likely hypothesis for the mechanism behind the development of the ABA phenotype relates to an imbalance of the neural circuitry that mediates reward processing. Evidence collected here suggests that ABA animals show a large set of alterations, involving regions whose functions extend way beyond the control of reward mechanisms and eating habits. Hence, we cannot exclude a primary role of these alterations from a mechanistic theory of ABA induction. CONCLUSIONS These findings are not sufficient to solve such a major enigma in neuroscience, still they could be used to design ad hoc further experimental investigation. The prospect is that, since treatment of AN is still challenging, the ABA model could be more effectively used to shed light on the complex AN neurobiological framework, thus supporting the future development of therapeutic strategies but also the identification of biomarkers and diagnostic tools. Anorexia Nervosa (AN) is a severe eating disorder with a dramatic effect on many functions of our brain, such as attention, emotions, cognition and motion control. Since our current knowledge of the genetic aspects behind the development of AN is still limited, many biological, psychological and environmental factors must be taken into account as potential triggers of this condition. One of the most valid animal models for studying AN is the activity-based anorexia (ABA). In this model, rodents spontaneously limit food intake and start performing increased physical activity on a running wheel, a result of the imposition of a fixed time schedule for food delivery. In this review, we provide a detailed summary of the experimental research conducted using the ABA model, which includes extended evidence for changes in the anatomy and function of the brain of ABA rodents. The hope is that such integrated view will support the design of future experiments that will shed light on the complex brain mechanisms behind AN. Such advanced knowledge is crucial to find new, effective strategies for both the early diagnosis of AN and for its treatment.
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Affiliation(s)
- Sara Spadini
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy
| | - Mattia Ferro
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Jacopo Lamanna
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonio Malgaroli
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy.
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy.
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59
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Meneguzzo P, Todisco P, Calonaci S, Mancini C, Dal Brun D, Collantoni E, Donini LM, Tenconi E, Favaro A. Health-related quality of life assessment in eating disorders: adjustment and validation of a specific scale with the inclusion of an interpersonal domain. Eat Weight Disord 2021; 26:2251-2262. [PMID: 33315213 PMCID: PMC8437832 DOI: 10.1007/s40519-020-01081-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/18/2020] [Accepted: 11/22/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Quality of life is a fundamental aspect of both clinical practice and research on eating disorders (ED) due to the significant impacts these disorders have on everyday life. Disorder-specific scales can improve the quality of research and findings and offer greater sensitivity and responsiveness. However, no specific instrument is available in Italian for ED. The aim of this paper is to adjust and to validate a reliable scale with specific items regarding physical and interpersonal well-being. METHODS The Italian version of the Eating Disorder Quality of Life (IEDQOL) scale was developed, on the basis of the original English scale, with the addition of items pertaining to physical well-being and interpersonal interactions. In this study, 180 ED patients and 190 healthy controls from the community were enrolled both from inpatient units and outpatient services. A statistical analysis with an exploratory factorial approach was performed in order to validate the tool. RESULTS The results showed that the IEDQOL has very good psychometric properties with test-retest validity and sensitivity between patients and controls (d = 2.17 for total score). Moreover, the interpersonal domain showed excellent psychometric values (Cronbach's α > 0.70 in all the subgroups) and a robust correlation with other quality of life constructs. CONCLUSION Future studies on the Italian population should use IEDQOL as outcome element that can be useful also with other disorder-specific psychopathological constructs and corroborate the reliability of the data. Future research in the ED field should only use this specific tool. LEVEL OF EVIDENCE Case-control analytic study, Level III.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy. .,Eating Disorders Unit, Casa Di Cura "Villa Margherita", Arcugnano, VI, Italy.
| | - Patrizia Todisco
- Eating Disorders Unit, Casa Di Cura "Villa Margherita", Arcugnano, VI, Italy
| | - Sofia Calonaci
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy
| | - Cecilia Mancini
- Experimental Medicine Department, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Rome, Italy
| | - David Dal Brun
- Department of Linguistic and Literary Studies, University of Padova, Padua, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy
| | - Lorenzo Maria Donini
- Experimental Medicine Department, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, Rome, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy.,Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, via Giustiniani 2, 35128, Padua, Italy.,Padova Neuroscience Center, University of Padova, Padua, Italy
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Dunne JP, Shindul-Rothschild J, White L, Lee CS, Wolfe BE. Mindfulness in persons with anorexia nervosa and the relationships between eating disorder symptomology, anxiety and pain. Eat Disord 2021; 29:497-508. [PMID: 31791198 DOI: 10.1080/10640266.2019.1688009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Mindfulness is useful for some psychiatric illnesses, but limited research exists among persons with anorexia nervosa (AN). This study aimed to determine the relationship between mindfulness, eating disorder symptomology and indicators of health in women with AN (n = 59) entering residential treatment. Participants completed a self-administered survey, including the Cognitive Affective Mindfulness Scale and other measures. Additional data from medical records were collected. Greater mindfulness was associated with less eating disorder symptoms (p = .049). This relationship was most profound in individuals with AN, including restrictive and binge-purge subtypes compared to individuals with atypical AN (interaction p-value = 0.044). Greater mindfulness was significantly associated with less shape (p = .023) and weight concern (p = .047). Expectedly, anxiety was inversely associated with eating disorder symptoms (p = .001). Greater pain was associated with less eating disorder symptoms (p = .024). Overall, mindfulness may be a protective factor against some eating disorder symptomology.
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Affiliation(s)
- Julie P Dunne
- W. F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA.,Cambridge Eating Disorder Center, Cambridge, Massachusetts, USA
| | | | - Laura White
- W. F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Christopher S Lee
- W. F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Barbara E Wolfe
- College of Nursing, University of Rhode Island, Kingston, Rhode Island, USA
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61
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Parmar DD, Alabaster A, Vance S, Ritterman Weintraub ML, Lau JS. Disordered Eating, Body Image Dissatisfaction, and Associated Healthcare Utilization Patterns for Sexual Minority Youth. J Adolesc Health 2021; 69:470-476. [PMID: 34053814 DOI: 10.1016/j.jadohealth.2021.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE To determine the prevalence of disordered eating behaviors (DEBs) and body image dissatisfaction (BID) according to sexual minority youth (SMY) status and describe healthcare utilization patterns by SMY status. METHODS Retrospective data from 107,528 adolescents, who had a Well Check in Kaiser Permanente Northern California in 2016, were used to compare DEB and BID by SMY status. Multivariate logistic models were used to examine the associations of SMY, birth-assigned sex, age, race/ethnicity, and body mass index on DEB and BID. The utilization of specialized eating disorder (ED) medical and mental health services and general mental health services was described at one Kaiser Permanente Northern California facility. RESULTS BID was reported in 20,763 (19.3%) adolescents, DEB in 1,458 (1.7%) adolescents, and 5,363 (5%) adolescents identified as SMY. SMY had higher odds of having DEB and BID than non-SMY, respectively (adjusted odds ratio 2.0 95% confidence interval [1.9-2.2] and adjusted odds ratio 3.8 [3.4-4.2]). Regardless of SMY status, adolescents with older age, female sex, nonwhite race, and elevated body mass index had higher odds of ED risk factors. SMY with ED risk factors had higher ED medical utilization than non-SMY with ED risk factors (4.6% vs. 1.6%). However, SMY status was not associated with utilization of specialized ED mental health services. CONCLUSIONS SMY had increased rates of DEB and BID but had underutilization of specialized ED mental health services. Future targeted efforts to prevent eating disorder-related mortality and morbidity for SMY should include targeted eating disorder screening and referral to specialized ED medical and mental health services.
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Affiliation(s)
- Deepika D Parmar
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California; Pediatrics Residency Program, Kaiser Permanente Northern California, Oakland, California.
| | - Amy Alabaster
- Division of Research, Kaiser Permanente, Oakland, California
| | - Stanley Vance
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | | | - Josephine S Lau
- Division of Adolescent Medicine, The Permanente Medical Group, Kaiser Permanente Northern California, San Leandro, California
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62
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Lister NB, Baur LA, Paxton SJ, Jebeile H. Contextualising Eating Disorder Concerns for Paediatric Obesity Treatment. Curr Obes Rep 2021; 10:322-331. [PMID: 33970441 DOI: 10.1007/s13679-021-00440-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE OF REVIEW Eating disorders are complex mental health conditions that share risk factors with obesity. This review outlines the context for concerns that paediatric obesity treatment presents a risk for eating disorder development. RECENT FINDINGS Most children and adolescents undergoing professionally supervised obesity treatment will have improvements or no change to eating disorder risk profiles. However, some may subsequently develop a clinical eating disorder, and this is proposed to relate to weight-focussed dietary interventions that are standard in paediatric obesity treatment. Nevertheless, dietary restraint may not be a strong predictor of eating disorder risk in the context of paediatric obesity treatment. Most international guidelines recommend weight maintenance or weight loss as a treatment goal, and weight loss is related to improvements in cardiometabolic health but not eating disorder risk in the short term. The risk of inducing or exacerbating an eating disorder during paediatric weight management is likely to be low; however, the serious consequences combined with increasing scale of obesity treatment, and lack of empirical evidence, are of concern. There is a need for further research to identify long-term predictors of eating disorder development for children and adolescents who seek treatment for their obesity.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia.
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
- Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Hiba Jebeile
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
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63
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Masheb RM, Ramsey CM, Marsh AG, Decker SE, Maguen S, Brandt CA, Haskell SG. DSM-5 eating disorder prevalence, gender differences, and mental health associations in United States military veterans. Int J Eat Disord 2021; 54:1171-1180. [PMID: 33665848 DOI: 10.1002/eat.23501] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Little is known about prevalence estimates of new and revised DSM-5 eating disorders diagnoses in general, and especially among high-risk, underserved and diverse eating disorder populations. The aim of the current study was to determine prevalence, gender differences and correlates of DSM-5 eating disorders in veterans. METHOD Iraq and Afghanistan war era veterans (N = 1,121, 51.2% women) completed the Eating Disorder Diagnostic Scale-5 and validated measures of eating pathology and mental health between July 2014 and September 2019. RESULTS Overall more women than men (32.8% vs. 18.8%, p < .001) reported symptoms consistent with a DSM-5 eating disorder. Prevalence estimates (women vs. men) for the specific diagnoses were: Anorexia Nervosa (AN; 0.0% vs. 0.0%), Bulimia Nervosa (BN; 6.1% vs. 3.5%), Binge-Eating Disorder (BED; 4.4% vs. 2.9%), Atypical AN (AAN; 13.6% vs. 4.9%), Subclinical BN (0.0% vs. 0.2%), Subclinical BED (1.4% vs. 0.6%), Purging Disorder (2.1% vs. 0.7%), and Night Eating Syndrome (NES; 5.2% vs. 6.0%). Women were more likely to have BN or AAN, and there was no difference for BED or NES among genders. The eating disorder group had a higher mean BMI, and significantly greater eating pathology and mental health symptoms than the non-eating disorder group. DISCUSSION Approximately one-third of women, and one-fifth of men, reported symptoms consistent with a DSM-5 eating disorder diagnosis. These high prevalence estimates across genders, and associated mental health concerns, suggest an urgent need to better understand and address eating disorders in military and veteran populations.
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Affiliation(s)
- Robin M Masheb
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, New Haven, Connecticut, USA
| | - Christine M Ramsey
- Yale School of Medicine, New Haven, Connecticut, USA.,Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Alison G Marsh
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Suzanne E Decker
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, New Haven, Connecticut, USA
| | - Shira Maguen
- University of California San Francisco Medical School, San Francisco, CA, USA.,San Francisco VA Health Care System, San Francisco, CA, USA
| | - Cynthia A Brandt
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, New Haven, Connecticut, USA
| | - Sally G Haskell
- VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Yale School of Medicine, New Haven, Connecticut, USA
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64
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van Eeden AE, Oldehinkel AJ, van Hoeken D, Hoek HW. Risk factors in preadolescent boys and girls for the development of eating pathology in young adulthood. Int J Eat Disord 2021; 54:1147-1159. [PMID: 33682181 PMCID: PMC8359416 DOI: 10.1002/eat.23496] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Despite a growing literature on potential risk factors for eating disorders, longitudinal research starting before adolescence is scarce, and little is known about risk factors in males. We investigated risk factors in preadolescent boys and girls for the development of eating pathology in adolescence and young adulthood. METHOD This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch population-based cohort study (N = 2,229) from preadolescence into adulthood. Potential risk factors were measured at age 11, based on self-report, reports of one of the parents, and records of the Preventive Child Healthcare. Variables included sociodemographic variables, pregnancy and perinatal factors, eating- and weight-related factors, psychological functioning, stressful experiences and family factors. At age 19, two-stage screening including interviews by eating disorder experts was used to examine the prevalence of eating disorders. At age 22 and 26, eating pathology was assessed by the Eating Disorder Diagnostic Scale. RESULTS Preadolescent anxious distress and high weight were associated with eating pathology in adolescence and young adulthood in both boys and girls. Overeating in preadolescence was found to be a prodromal symptom of eating disorders during late adolescence. No evidence was found for sex-specific risk factors. DISCUSSION Anxious preadolescents with high weight are at increased risk for the development of eating pathology later on. Clinicians should be aware of eating disorder symptoms - like overeating - in this high-risk group of children, and could consider an early intervention to prevent the development of full-blown eating disorders.
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Affiliation(s)
- Annelies E. van Eeden
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Department of PsychiatryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | - Albertine J. Oldehinkel
- Department of PsychiatryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
| | | | - Hans W. Hoek
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Department of PsychiatryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of EpidemiologyColumbia University, Mailman School of Public HealthNew YorkNew YorkUSA
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65
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Jenkins ZM, Eikelis N, Phillipou A, Castle DJ, Wilding HE, Lambert EA. Autonomic Nervous System Function in Anorexia Nervosa: A Systematic Review. Front Neurosci 2021; 15:682208. [PMID: 34262430 PMCID: PMC8273292 DOI: 10.3389/fnins.2021.682208] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/18/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Autonomic nervous system (ANS) dysfunction has been suggested to contribute to the high prevalence of cardiovascular complications in individuals with anorexia nervosa (AN), yet has not been thoroughly investigated. The current review aimed to synthesize the evidence of basal ANS function in individuals with a current diagnosis of AN and those with a previous diagnosis who had achieved weight restoration, as compared to controls. Methods: A systematic review of nine databases was conducted and studies that were published in a peer-review journal, in English, that included at least one assessment of ANS function in individuals with a current or previous diagnosis of AN were selected. Forty-six studies were included with a total of 811 participants with a current diagnosis of AN and 123 participants with a previous diagnosis of AN. Results: ANS function was assessed through heart rate variability (n = 27), orthostatic challenge, blood pressure variability or baroreflex sensitivity (n = 11), adrenergic activity (n = 14), skin conductance level (n = 4), and pupillometry (n = 1). Individuals with AN demonstrated increased parasympathetic activity and decreased sympathetic activity, suggestive of autonomic dysregulation. Following weight restoration, autonomic function trended toward, or was equivalent to, control levels. Discussion: Autonomic dysregulation is indicated through a range of assessments in individuals with AN. Future investigations should utilize a variety of assessments together in order to conclusively establish the nature of autonomic dysfunction in AN, and following extended weight restoration. Moreover, investigation into the co-occurrence of ANS function and cardiovascular risk is required.
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Affiliation(s)
- Zoe M. Jenkins
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrea Phillipou
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Mental Health, Austin Health, Melbourne, VIC, Australia
| | - David J. Castle
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Helen E. Wilding
- Library Service, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Elisabeth A. Lambert
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
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66
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Fox CK, Northrop EF, Rudser KD, Ryder JR, Kelly AS, Bensignor MO, Bomberg EM, Bramante CT, Gross AC. Contribution of Hedonic Hunger and Binge Eating to Childhood Obesity. Child Obes 2021; 17:257-262. [PMID: 34061621 PMCID: PMC8147497 DOI: 10.1089/chi.2020.0177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Studies examining the association between hedonic hunger, that is, having frequent thoughts about food in the absence of an energy deficit, and obesity in youth show mixed results. This may be due to the confounding effect of binge eating, which has been associated with both hedonic hunger and obesity. The purpose of this study was to determine the extent to which hedonic hunger is associated with obesity independent of binge eating in youth. Methods: Data for this cross-sectional study were collected from youth enrolled in a larger study of cardiovascular disease and obesity. Linear regression models were used to assess the association between hedonic hunger measured by Power of Food Scale (PFS) and binge eating measured by Eating Disorder Examination-Questionnaire, on percent of the 95th BMI percentile (BMIp95). Results: Among 269 participants (mean age 12.8 years), 16.4% endorsed binge eating. PFS was positively associated with BMIp95 with a difference in percent of BMIp95 of 5.9% [95% confidence interval (1.5-10.3), p = 0.009]. However, when binge eating was added to the model, the relationship between PFS and BMIp95 was no longer significant. Conclusion: Hedonic hunger, above and beyond binge eating, may not be associated with BMI. Future research should examine whether screening for and targeting binge eating rather than hedonic hunger in weight management care may have more impact on obesity outcomes. Clinical Trial Registration number: NCT01508598.
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Affiliation(s)
- Claudia K. Fox
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA.,Address correspondence to: Claudia K. Fox, MD, MPH, Center for Pediatric Obesity Medicine, Department of Pediatrics Medical School, University of Minnesota, 717 Delaware Street SE, Room 370G, Minneapolis, MN 55454, USA
| | - Elise F. Northrop
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Kyle D. Rudser
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Justin R. Ryder
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Aaron S. Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Megan O. Bensignor
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Eric M. Bomberg
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Carolyn T. Bramante
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Amy C. Gross
- Center for Pediatric Obesity Medicine, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN, USA
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67
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The Synergistic Effects of a Complementary Physiotherapeutic Scheme in the Psychological and Nutritional Treatment in a Teenage Girl with Type 1 Diabetes Mellitus, Anxiety Disorder and Anorexia Nervosa. CHILDREN-BASEL 2021; 8:children8060443. [PMID: 34070247 PMCID: PMC8225211 DOI: 10.3390/children8060443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 01/09/2023]
Abstract
Type 1 diabetes mellitus (T1DM) is a chronic disease that can affect the physical and mental health of children and adolescents, often leading to anxiety disorders with chronic activation of the hypothalamic axis (HPA). Moreover, a great proportion of adolescents with T1DM also demonstrate anorexia nervosa (AN), due to the increased preoccupation with food and the need to have an acceptable body image. Herein is described the first case study of an adolescent patient diagnosed with T1DM, anxiety disorder (AD), and AN. A 14-year-old girl with T1DM since the age of 12 years presented weight loss at age 13 years and 3 months and low body mass index (BMI), which did not improve despite dietary recommendations and adequate disease control. Additionally, she presented menstrual disorders at the age of 12 years and 11 months (menstrual age 12 years and 1 month). A psychological evaluation of the teenager was conducted using a semi-structured interview that assessed perceived stress, health status, quality of life, and depression. AD and AN were diagnosed and the patient initiated an intervention focusing on psychological health and nutrition and which incorporated physiotherapeutic relaxation sessions and breathing exercises. After 3 months of treatment, the patient’s BMI was increased, and a normal menstrual cycle was apparent. These results have since remained consistent. Stress leads to the appearance of AN and menstrual disorders. Therefore, physiotherapeutic programs could reduce stress and effectively ameliorate AN and AD.
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68
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Silén Y, Sipilä PN, Raevuori A, Mustelin L, Marttunen M, Kaprio J, Keski-Rahkonen A. Detection, treatment, and course of eating disorders in Finland: A population-based study of adolescent and young adult females and males. EUROPEAN EATING DISORDERS REVIEW 2021; 29:720-732. [PMID: 34008267 PMCID: PMC8349843 DOI: 10.1002/erv.2838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/22/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022]
Abstract
Objective: We assessed the detection, treatment and outcomes of DSM-5 eating disorders in a nationwide community setting. Method: The FinnTwin12 cohort comprises twins born in 1983–1987 in Finland (n = 5,600), with follow-up starting at age 12. We outline treatment and outcomes of the 127 females and 15 males diagnosed with a lifetime DSM-5 eating disorder in interviews conducted for a subsample (n = 1,347) in their early 20s. Results: Only 45 (32%) of those diagnosed with eating disorder in the interviews had their condition detected in healthcare, and even fewer received treatment (30% of females, 13% of males). Anorexia nervosa (AN), bulimia nervosa, and atypical AN were detected and treated more often than other eating disorders. Five years after disease onset, 41% of those diagnosed had recovered. There were no statistically significant differences in the course of different eating disorders (log-rank p = 0.66) but the outcome was more favourable among males (log-rank p = 0.008). The likelihood of 5-year recovery did not differ between those who had and who had not received treatment (41.1% vs. 40.5%, log-rank p = 0.66). Conclusion: Although eating disorders are common and symptoms are persistent for many, they remain under-diagnosed and under-treated. In real-world settings, effectiveness of provided treatments may be limited.
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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
- 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
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland.,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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69
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Jebeile H, Lister NB, Baur LA, Garnett SP, Paxton SJ. Eating disorder risk in adolescents with obesity. Obes Rev 2021; 22:e13173. [PMID: 33410207 DOI: 10.1111/obr.13173] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 10/27/2020] [Indexed: 01/13/2023]
Abstract
The intersection between adolescent obesity and eating disorder risk is one that requires urgent attention. This review aimed to synthesize the literature on the risk of clinical eating disorders in adolescents with obesity, discuss challenges with assessing risk, and examine implications for clinical practice and future research. Obesity and eating disorders can coexist resulting in exacerbated physical and psychological health issues. Recognized eating disorder risk factors, including body dissatisfaction, poor self-esteem, depression, and engaging in dieting behaviors, are elevated and frequently reported in adolescents with obesity, highlighting a vulnerability to the development of eating disorders. Unsupervised dieting to manage weight may exacerbate eating disorder risk, while structured and supervised weight management is likely to reduce eating disorder risk for most adolescents. However, some adolescents may present to an obesity service with an undiagnosed eating disorder or may develop an eating disorder during or following treatment. We conclude that a risk management approach, with screening or monitoring for eating disorder-related risk factors and behaviors, should be utilized to identify those at risk. Future research to identify eating disorder risk factors specific to adolescents with obesity is required to inform screening and monitoring protocols, patient care, and address current knowledge gaps.
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Affiliation(s)
- Hiba Jebeile
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Natalie B Lister
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
| | - Louise A Baur
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Sarah P Garnett
- The University of Sydney, Children's Hospital Westmead Clinical School, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia.,Kids Research, The Children's Hospital at Westmead, Westmead, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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70
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Hübel C, Abdulkadir M, Herle M, Loos RJF, Breen G, Bulik CM, Micali N. One size does not fit all. Genomics differentiates among anorexia nervosa, bulimia nervosa, and binge-eating disorder. Int J Eat Disord 2021; 54:785-793. [PMID: 33644868 PMCID: PMC8436760 DOI: 10.1002/eat.23481] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Genome-wide association studies have identified multiple genomic regions associated with anorexia nervosa. No genome-wide studies of other eating disorders, such as bulimia nervosa and binge-eating disorder, have been performed, despite their substantial heritability. Exploratively, we aimed to identify traits that are genetically associated with binge-type eating disorders. METHOD We calculated genome-wide polygenic scores for 269 trait and disease outcomes using PRSice v2.2 and their association with anorexia nervosa, bulimia nervosa, and binge-eating disorder in up to 640 cases and 17,050 controls from the UK Biobank. Significant associations were tested for replication in the Avon Longitudinal Study of Parents and Children (up to 217 cases and 3,018 controls). RESULTS Individuals with binge-type eating disorders had higher polygenic scores than controls for other psychiatric disorders, including depression, schizophrenia, and attention deficit hyperactivity disorder, and higher polygenic scores for body mass index. DISCUSSION Our findings replicate some of the known comorbidities of eating disorders on a genomic level and motivate a deeper investigation of shared and unique genomic factors across the three primary eating disorders.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK
- National Centre for Register‐based Research, Aarhus Business and Social SciencesAarhus UniversityAarhusDenmark
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Mohamed Abdulkadir
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
- Department of Psychiatry, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Moritz Herle
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Ruth J. F. Loos
- Charles Bronfman Institute for Personalized MedicineIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Nadia Micali
- Department of Pediatrics Gynaecology and Obstetrics, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
- Department of Psychiatry, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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71
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Olsen EM, Koch SV, Skovgaard AM, Strandberg-Larsen K. Self-reported symptoms of binge-eating disorder among adolescents in a community-based Danish cohort-A study of prevalence, correlates, and impact. Int J Eat Disord 2021; 54:492-505. [PMID: 33382143 DOI: 10.1002/eat.23458] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 12/13/2020] [Accepted: 12/13/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Binge-eating disorder (BED) was established as a diagnosis in 2013 with the DSM-5 and has been included in the ICD-11 in 2018. In adulthood, BED is prevalent and correlated with somatic and mental health problems. Less is known about BED in adolescence, although this age period could represent a window of opportunity for early intervention. This study aimed to investigate the 1-year prevalence, correlates, and impact of BED symptoms in a community sample of adolescents. METHOD We included 1,404 girls and 1,105 boys from the 16-years-follow-up of the Copenhagen Child Cohort study, CCC2000. The adolescents self-reported on BED symptoms, weight-status, body perception, mental health problems, and self-rated impact of food and weight-related thoughts and behaviors. Information about socio-economic factors and hospital diagnosed psychiatric disorders were obtained from national registries. RESULTS A total of 8.5% reported weekly overeating with loss of control (10.9% of girls, 4.8% of boys), and 2.6% (3.6% of girls, 1.2% of boys) reported symptoms consistent with BED according to the DSM-5. Regardless of sex, BED was correlated with concurrent overweight, body-dissatisfaction, low self-esteem, and mental health problems, especially emotional, but also with problems of behavior, inattention, and peer-relations, and with high self-rated impact on everyday life. Immigrant background and lower socio-economy were potential risk factors for BED in boys in this sample. DISCUSSION BED was prevalent and correlated with mental health problems and overall impact among adolescents in this community sample, indicating the need for clinical attention and intervention towards binge-eating disorder in the adolescent period.
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Affiliation(s)
- Else M Olsen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, The Capital Region, Copenhagen, Denmark.,Outpatient Clinic for Eating disorders, Psychiatric Centre Ballerup, The Capital Region, Copenhagen, Denmark
| | - Susanne V Koch
- Clinic for Eating disorders, Centre of Child- & Adolescent Psychiatry, Roskilde, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne M Skovgaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Katrine Strandberg-Larsen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Thompson-Brenner H, Singh S, Gardner T, Brooks GE, Smith MT, Lowe MR, Boswell JF. The Renfrew Unified Treatment for Eating Disorders and Comorbidity: Long-Term Effects of an Evidence-Based Practice Implementation in Residential Treatment. Front Psychiatry 2021; 12:641601. [PMID: 33746797 PMCID: PMC7973044 DOI: 10.3389/fpsyt.2021.641601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The Renfrew Unified Treatment for Eating Disorders and Comorbidity (UT) is a transdiagnostic, emotion-focused treatment adapted for use in residential group treatment. This study examined the effect of UT implementation across five years of treatment delivery. Methods: Data were collected by questionnaire at admission, discharge (DC), and 6-month follow-up (6MFU). Patient outcomes were measured by the Eating Disorder Examination-Questionnaire, Center for Epidemiologic Studies-Depression Scale, Brief Experiential Avoidance Questionnaire (BEAQ), Anxiety Sensitivity Index, and Southampton Mindfulness Scale. Data were analyzed for N = 345 patients treated with treatment-as-usual (TAU), and N = 2,763 treated with the UT in subsequent years. Results: Results from multilevel models demonstrated a significant interaction between implementation status (TAU vs. UT) and time, both linear and quadratic, for the depression, experiential avoidance, anxiety sensitivity, and mindfulness variables. Patients treated with the UT showed more improvement in these variables on average, as well as more rebound between DC and 6MFU. Results from multilevel models examining eating disorder outcome showed no significant difference between the TAU and UT for the full sample, but a significant three-way interaction indicated that the UT produced more improvement in the EDE-Q relative to the TAU particularly for patients who entered treatment with high levels of experiential avoidance (BEAQ score). Conclusion: This long-term study of a transdiagnostic, evidence-based treatment in residential care for eating disorders and comorbidity suggests implementation was associated with beneficial effects on depression and emotion function outcomes, as well as eating disorder severity for patients with high levels of baseline emotion regulation problems. These effects did not appear to diminish in the 5 years following initial implementation.
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Affiliation(s)
| | - Simar Singh
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | | | | | | | - Michael R. Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, United States
| | - James F. Boswell
- Department of Psychology, University at Albany, Albany, NY, United States
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73
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Gonzales M, Blashill AJ. Ethnic/racial and gender differences in body image disorders among a diverse sample of sexual minority U.S. adults. Body Image 2021; 36:64-73. [PMID: 33171428 PMCID: PMC7987714 DOI: 10.1016/j.bodyim.2020.10.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 12/16/2022]
Abstract
This study assessed the occurrence of probable eating disorders (EDs), ED symptoms, probable body dysmorphic disorder (BDD), BDD symptoms, drive for muscularity, and appearance and performance enhancement drug (APED) misuse, in an ethnically/racially diverse sample of 962 cisgender sexual minority (SM) individuals in the United States, aged 18-30 years old. The overall occurrence of probable ED, probable BDD, and APED misuse in the current sample was 32.7 %, 50.9 %, and 30.6 %, respectively. With respect to ethnicity/race, Hispanic SMs reported the highest rates of EDs, BDD, APED misuse, and drive for muscularity, and may therefore be particularly at risk for developing body image disorders (BIDs). With respect to gender, SM men reported significantly greater drive for muscularity and APED misuse compared to SM women, while SM women reported significantly higher occurrence of probable ED and ED symptoms. The occurrence of EDs, BDD, and APED misuse were higher among SMs in this sample compared to previous rates found among heterosexual samples, suggesting that SMs, regardless of gender and ethnicity/race, are vulnerable to experiencing BIDs and APED misuse. Future research is needed to identify the mechanisms that place SMs at (increased) risk for BIDs, which will aid prevention/intervention development.
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Affiliation(s)
- Manuel Gonzales
- Department of Psychology, College of Sciences, San Diego State University, 5500 Campanile Drive, San Diego CA 92182-4611, United States.
| | - Aaron J Blashill
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, College of Sciences, San Diego State University, 5500 Campanile Drive, San Diego CA 92182-4611, United States.
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74
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Age dependency of body mass index distribution in childhood and adolescent inpatients with anorexia nervosa with a focus on DSM-5 and ICD-11 weight criteria and severity specifiers. Eur Child Adolesc Psychiatry 2021; 30:1081-1094. [PMID: 32666204 PMCID: PMC8295075 DOI: 10.1007/s00787-020-01595-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 07/01/2020] [Indexed: 11/28/2022]
Abstract
Both DSM-5 and ICD-11 have provided weight cut-offs and severity specifiers for the diagnosis of anorexia nervosa (AN) in childhood, adolescence and adulthood. The aims of the current study focusing on inpatients aged < 19 years were to assess (1) the relationship between age and body mass index (BMI; kg/m2), BMI-centiles, BMI-standard deviation scores (BMI-SDS) and body height-SDS at referral, (2) the percentages of patients fulfilling the DSM-5 and ICD-11 weight criteria and severity categories for AN, and (3) the validity of the AN severity specifiers via analysis of both weight related data at discharge and inpatient treatment duration. The German Registry for Anorexia Nervosa encompassed complete data sets for 469 female patients (mean age = 15.2 years; range 8.9-18.9 years) with a diagnosis of AN (n = 404) or atypical AN (n = 65), who were ascertained at 16 German child and adolescent psychiatric hospitals. BMI at referral increased up to age 15 to subsequently plateau. Approximately one tenth of all patients with AN had a BMI above the fifth centile. The ICD-11 specifier based on a BMI-centile of 0.3 for childhood and adolescent AN entailed two equally sized groups of patients. Discharge data revealed limited validity of the specifiers. Height-SDS was not correlated with age thus stunting had no impact on our data. We corroborate the evidence to use the tenth instead of the fifth BMI-centile as the weight criterion in children and adolescents. Weight criteria should not entail major diagnostic shifts during the transition from adolescence to adulthood. The severity specifiers based on BMI or BMI-centiles do not seem to have substantial clinical validity.
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75
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Trends in the prevalence and disability-adjusted life years of eating disorders from 1990 to 2017: results from the Global Burden of Disease Study 2017. Epidemiol Psychiatr Sci 2020; 29:e191. [PMID: 33283690 PMCID: PMC7737181 DOI: 10.1017/s2045796020001055] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIM Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. METHODS We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. RESULTS The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59-0.71) and 0.66 (95% UI: 0.60-0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20-982.30; ASR of DALYs = 170.74, 95% UI: 113.43-244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14-2.32; EAPC for DALYs = 2.22, 95% UI: 2.13-2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). CONCLUSION The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.
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76
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Sabry W, ElMahlawy N, Essawy H, Al-Saleet G, Saad M, Morsy M. Occurrence, sociodemographic, and clinical correlates of eating disorders among a sample of secondary school students in Egypt. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00073-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Abstract
Background
Eating disorders are common in adolescents. Data on occurrence rates, sociodemographic correlates, and risk factors in Egyptian population are needed along with better screening tools to inform future research and service development. We aimed to estimate the occurrence of eating disorders in a representative sample of Egyptian adolescent students and to examine the sociodemographic and clinical risk factors associated with eating disorders. So, a multistage random selection of 407 adolescent students from public and private secondary schools in Eastern Tanta, Egypt, was carried out. All participants were subjected to screening using the Eating Attitude Test (EAT) and the eating disorders section of the clinician version of the Structured Clinical Interview for DSM-IV axis-I disorders
Results
Occurrence estimates of anorexia nervosa and bulimia nervosa were 6.1% and 3.2%, respectively. Being female, overweight (BMI = 25–29.9 kg/m2), low self-esteem, and high body shape preoccupation were significantly associated with eating disorders risk among adolescents.
Conclusions
Eating disorders are prevalent in the general adolescent population. The unmet treatment needs in the adolescent population place these disorders as important public health concerns.
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77
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Jenkins ZM, Chait LM, Cistullo L, Castle DJ. A comparison of eating disorder symptomatology, psychological distress and psychosocial function between early, typical and later onset anorexia nervosa. J Eat Disord 2020; 8:56. [PMID: 33292580 PMCID: PMC7640671 DOI: 10.1186/s40337-020-00337-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Epidemiological studies suggest that the incidence of anorexia nervosa (AN) is increasing in younger populations, with some evidence that clinical differences occur according to age of onset (AOO), which may impact prognostic outcomes. The current study sought to compare eating disorder (ED) symptomatology, psychological distress and psychosocial function between early onset (EO), typical onset (TO) and later onset (LO) AN in a large sample of treatment-seeking patients with a diagnosis of AN. METHODS Participants included 249 individuals with a diagnosis of AN who were assessed at an outpatient ED service. The sample was divided into three groups based on AOO; those with an AOO ≤14 years (N = 58) were termed 'EO-AN', those with an AOO between 15 and 18 years (N = 113) were termed 'TO-AN' and those with an AOO of > 18 years (N = 78) were termed 'LO-AN'. Comparisons were made between AOO groups on assessments of ED symptomatology, psychological distress and psychosocial function. RESULTS EO-AN patients reported a significantly longer illness duration than both TO-AN and LO-AN groups. After controlling for effect of illness duration, the EO-AN group demonstrated significantly higher ED symptomatology and dysmorphic concern compared to the LO-AN group. The EO-AN group demonstrated significantly decreased cognitive flexibility compared to both the TO-AN and LO-AN groups. DISCUSSION These findings suggest that clinical differences do occur according to AOO in AN whereby EO-AN may represent a more severe form of illness that is not attributable to increased illness duration. Treatment strategies which specifically address patients with EO-AN may improve long term health outcomes and recovery.
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Affiliation(s)
- Zoe M Jenkins
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia. .,Department of Psychiatry, University of Melbourne, Melbourne, Australia.
| | - Lior M Chait
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia
| | | | - David J Castle
- Mental Health Service, St. Vincent's Hospital, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia
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78
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Lamontagne SJ, Wilkin MM, Menard JL, Olmstead MC. Mid-adolescent stress differentially affects binge-like intake of sucrose across estrous cycles in female rats ✰. Physiol Behav 2020; 228:113194. [PMID: 33011230 DOI: 10.1016/j.physbeh.2020.113194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 02/07/2023]
Abstract
Binge eating disorder (BED), characterized by excessive food consumption within a discrete period of time, is the most prevalent of all eating disorders, with higher rates in women than men. Chronic stress, particularly during adolescence, is a significant risk factor for BED in women, but the mechanism underlying this relationship remains elusive. We investigated the phenomenon by testing the impact of mid-adolescent intermittent physical stress (IPS) on binge-like intake of sucrose in adult female rats, assessing how the behavior changed across reproductive cycles. One hundred and nineteen Long-Evans rats were exposed to IPS (n = 59) or no stress (NS; n = 60) for 12 days during mid-adolescence (PD35-46). Binge-like eating was induced in adult animals using an intermittent access protocol: animals were provided with 12 h or 24 h access to sucrose, 12 h access to saccharin, or 12 h access to food over 28 days. After 1- or 28-day abstinence, compulsive responding for sucrose was measured using a conditioned suppression paradigm. Rats given 12 h access to sucrose developed binge-like intake, measured as increased consumption during the first hour; the effect was magnified in IPS animals and most pronounced during proestrous. Solution intake in IPS rats was predicted by open arm entries in the elevated plus maze, suggesting that increased risk-taking behavior is associated with greater binge-like eating. IPS blocked conditioned suppression after 28 days of abstinence, pointing to a role of mid-adolescent stress in compulsivity. Collectively, these findings emphasize the impact of stress on the emergence of binge eating in females and suggest that intervention programs for women with a history of adolescent adversity should be investigated as a means to reduce risk for BED.
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Affiliation(s)
- Steven J Lamontagne
- Department of Psychology, Queen's University, Kingston, Ontario, Canada, K7L 3N6
| | - Meaghan M Wilkin
- Department of Psychology, Queen's University, Kingston, Ontario, Canada, K7L 3N6
| | - Janet L Menard
- Department of Psychology, Queen's University, Kingston, Ontario, Canada, K7L 3N6; Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada, K7L 3N6
| | - Mary C Olmstead
- Department of Psychology, Queen's University, Kingston, Ontario, Canada, K7L 3N6; Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada, K7L 3N6.
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79
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Krug I, Binh Dang A, Granero R, Agüera Z, Sánchez I, Riesco N, Jimenez-Murcia S, Menchón JM, Fernandez-Aranda F. Drive for thinness provides an alternative, more meaningful, severity indicator than the DSM-5 severity indices for eating disorders. EUROPEAN EATING DISORDERS REVIEW 2020; 29:482-498. [PMID: 32964518 DOI: 10.1002/erv.2776] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess an alternative trans-diagnostic indicator for severity based on drive for thinness (DT) for anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and other specified feeding or eating disorder (OSFED), and to compare this new approach to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) severity categories for EDs. METHOD A total of 2,811 ED [428 AN-restrictive (AN-R), 313 AN-binge purging (AN-BP), 1,340 BN, 329 BED, 154 OSFED/atypical AN (AT), and 223 OSFED/purging disorder (PD)] patients were classified using: (a) The DSM-5 severity categories and (b) a DT categorisation. These severity classifications were then compared based on ED symptoms, general psychopathology, personality, and impulsive behaviours. RESULTS For the DSM-5 categories, most ED patients fell into the 'mild' to 'moderate' categories. Using the DT categories, AN patients were mainly represented in the 'low' DT category, and BN, OSFED/AT, and PD in the 'high' DT category. The clinically significant findings were stronger for the DT than the DSM-5 severity approach (medium-to-large effect sizes). AN-BP and AN-R provided the most pronounced effects. CONCLUSION Our findings question the clinical value of the DSM-5 severity categorisation, and provide initial support for an alternative DT severity approach for AN. HIGHLIGHTS : This study assessed an alternative trans-diagnostic drive for thinness (DT) severity. Category for all eating disorder (ED) sub-types, and then compared this to the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) severity indices for EDs. ED symptoms, general psychopathology, personality, and impulsive behaviours were assessed using both classifications in a total of 2,811 female patients diagnosed with EDs. Clinically significant findings were stronger for the DT than the DSM-5 severity category (medium-to-large effect sizes); there was differentiation of the anorexia nervosa (AN) patients into mainly 'low' DT, and bulimia nervosa (BN) spectrum patients into mainly 'high' DT, vs. most patients were clustered in the 'mild-to-moderate' DSM-5 categories. Our findings provide initial support for an alternative trans-diagnostic DT severity category that may be more clinically meaningful than the DSM-5 severity indices for EDs.
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Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - An Binh Dang
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Psychobiology and Methodology, Universitat Autònoma de Barcelona-UAB, Barcelona, Spain
| | - Zaida Agüera
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn, Barcelona, Spain.,Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn, Barcelona, Spain
| | - Nadine Riesco
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn, Barcelona, Spain
| | - Susana Jimenez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jose M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,Ciber Salud Mental (CIBERSAM), Instituto Salud Carlos III, Madrid, Spain
| | - Fernando Fernandez-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBERobn, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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80
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Hazzard VM, Schaefer LM, Mankowski A, Carson TL, Lipson SM, Fendrick C, Crosby RD, Sonneville KR. Development and Validation of the Eating Disorders Screen for Athletes (EDSA): A Brief Screening Tool for Male and Female Athletes. PSYCHOLOGY OF SPORT AND EXERCISE 2020; 50:101745. [PMID: 32733166 PMCID: PMC7392177 DOI: 10.1016/j.psychsport.2020.101745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To develop and validate the Eating Disorders Screen for Athletes (EDSA), a brief eating disorders screening tool for use in both male and female athletes. METHODS Data from Division I athletes at a Midwestern university (N=434) were used to conduct exploratory factor analysis (EFA) by gender. Data from athletes competing at various levels at universities across the United States (N=862) were then used to conduct confirmatory factor analysis (CFA) and receiver operator characteristic (ROC) curve analysis by gender. Athletes from a range of lean and non-lean sports were included. Gender-specific empirically derived cut-offs on the Eating Disorder Examination-Questionnaire were used to classify high eating disorder risk for ROC curve analysis. Measurement invariance by gender, level of competition, and sport type was also examined. RESULTS A six-item, one-factor structure for the EDSA was supported by EFA and CFA in both genders, and internal consistency was good for both male (α=. 80) and female athletes (α=.86). ROC curve analyses indicated that the EDSA was highly accurate in predicting eating disorder risk status and identified a score of 3.33 as the optimal cut-off for both male (sensitivity=.96, specificity=.80) and female athletes (sensitivity=.96, specificity=.64). Results also supported strong measurement invariance for the EDSA by gender, level of competition (Division I versus club), and sport type (lean versus non-lean). CONCLUSIONS The EDSA shows promise as a brief screening tool to identify male and female athletes at risk for eating disorders.
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Affiliation(s)
- Vivienne M. Hazzard
- University of Michigan School of Public Health, Ann Arbor, MI
- Sanford Center for Biobehavioral Research, Fargo, ND
| | | | | | - Traci L. Carson
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Sarah M. Lipson
- Department of Psychology, Harvard University, Cambridge, MA
- Department of Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA
| | - Claire Fendrick
- University of Michigan School of Public Health, Ann Arbor, MI
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81
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Hazzard VM, Simone M, Borg SL, Borton KA, Sonneville KR, Calzo JP, Lipson SK. Disparities in eating disorder risk and diagnosis among sexual minority college students: Findings from the national Healthy Minds Study. Int J Eat Disord 2020; 53:1563-1568. [PMID: 32449541 PMCID: PMC7487157 DOI: 10.1002/eat.23304] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine differences in eating disorder (ED) risk and diagnosis by sexual orientation in a national sample of college students. METHOD Data from 178 U.S. colleges and universities participating in the Healthy Minds Study between 2016 and 2019 were analyzed (36,691 cisgender men, 81,730 cisgender women; 15.7% self-identifying as sexual minorities). Outcomes were ED risk (≥2 on the SCOFF) and self-reported lifetime ED diagnosis. Prevalence estimates adjusted for demographics and weight status were computed via logistic regression. RESULTS Higher proportions of questioning (29.1%), bisexual (26.3%), and gay men (30.9%) exhibited elevated risk than heterosexual men (14.3%), and a higher proportion of gay men exhibited elevated risk than bisexual men. Higher proportions of questioning (34.5%) and bisexual women (34.6%) exhibited elevated risk than heterosexual women (27.6%); proportions of lesbian (28.1%) and heterosexual women were similar. Among those with elevated risk, higher proportions of bisexual (5.0%) and gay men (7.1%) and of questioning (14.7%), bisexual (18.1%), and lesbian women (19.6%) had been diagnosed relative to heterosexual men (2.0%) and heterosexual women (10.3%), respectively. DISCUSSION Questioning and bisexual individuals appear to be particularly vulnerable; they may experience elevated ED risk relative to their heterosexual peers yet underdiagnosis relative to their gay or lesbian peers.
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Affiliation(s)
- Vivienne M Hazzard
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Melissa Simone
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Skylar L Borg
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Kelley A Borton
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Jerel P Calzo
- Division of Health Promotion and Behavioral Science, San Diego State University School of Public Health, San Diego, California, USA
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
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82
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Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, Brinton RD, Carrero JJ, DeMeo DL, De Vries GJ, Epperson CN, Govindan R, Klein SL, Lonardo A, Maki PM, McCullough LD, Regitz-Zagrosek V, Regensteiner JG, Rubin JB, Sandberg K, Suzuki A. Sex and gender: modifiers of health, disease, and medicine. Lancet 2020; 396:565-582. [PMID: 32828189 PMCID: PMC7440877 DOI: 10.1016/s0140-6736(20)31561-0] [Citation(s) in RCA: 974] [Impact Index Per Article: 243.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 02/09/2023]
Abstract
Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men's and women's health.
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Affiliation(s)
- Franck Mauvais-Jarvis
- Diabetes Discovery & Sex-Based Medicine Laboratory, Section of Endocrinology, John W Deming Department of Medicine, Tulane University School of Medicine and Southeast Louisiana Veterans Health Care System Medical Center, New Orleans, LA, USA.
| | - Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Peter J Barnes
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Roberta D Brinton
- Department of Pharmacology and Department of Neurology, College of Medicine, Center for Innovation in Brain Science, University of Arizona, Tucson, AZ, USA
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics and Center for Gender Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Dawn L DeMeo
- Channing Division of Network Medicine and the Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Geert J De Vries
- Neuroscience Institute and Department of Biology, Georgia State University, Atlanta, GA, USA
| | - C Neill Epperson
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Ramaswamy Govindan
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Sabra L Klein
- W Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Amedeo Lonardo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Modena, Italy
| | - Pauline M Maki
- Department of Psychiatry, Department of Psychology, and Department of Obstetrics & Gynecology, University of Illinois at Chicago, Chicago, IL, USA
| | - Louise D McCullough
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Vera Regitz-Zagrosek
- Berlin Institute of Gender Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Cardiology, University Hospital Zürich, University of Zürich, Switzerland
| | - Judith G Regensteiner
- Center for Women's Health Research, Divisions of General Internal Medicine and Cardiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Joshua B Rubin
- Department of Medicine, Department of Paediatrics, and Department of Neuroscience, Washington University School of Medicine St Louis, MO, USA
| | - Kathryn Sandberg
- Center for the Study of Sex Differences in Health, Aging and Disease, Georgetown University, Washington, DC, USA
| | - Ayako Suzuki
- Division of Gastroenterology, Duke University Medical Center Durham, NC, USA; Durham VA Medical Center, Durham, NC, USA
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83
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Children's Eating Attitudes Test (ChEAT): a validation study in Finnish children. Eat Weight Disord 2020; 25:961-971. [PMID: 31119587 PMCID: PMC7399682 DOI: 10.1007/s40519-019-00712-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/09/2019] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To validate the Children's Eating Attitudes Test (ChEAT) in the Finnish population. MATERIALS AND METHODS In total 339 children (age 10-15 years) from primary schools in Southern Finland were evaluated at two time points. They answered the ChEAT and SCOFF test questions, and had their weight, height and waist circumference measured. Retesting was performed 4-6 weeks later. Test-retest reliability was evaluated using intra-class correlation (ICC), and internal consistency was examined using Cronbach's alpha coefficient (C-alpha). ChEAT was cross-calibrated against SCOFF and background variables. Factor analysis was performed to examine the factor structure of ChEAT. RESULTS The 26-item ChEAT showed high internal consistency (C-alpha 0.79), however, a 24-item ChEAT showed even better internal consistency (C-alpha 0.84) and test-retest reliability (ICC 0.794). ChEAT scores demonstrated agreement with SCOFF scores (p < 0.01). The mean ChEAT score was higher in overweight children than normal weight (p < 0.001). Exploratory factor analysis yielded four factors (concerns about weight, limiting food intake, pressure to eat, and concerns about food), explaining 57.8% of the variance. CONCLUSIONS ChEAT is a valid and reliable tool for measuring eating attitudes in Finnish children. The 24-item ChEAT showed higher reliability than the 26-item ChEAT. LEVEL OF EVIDENCE Level 5, cross-sectional, descriptive study.
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Knoll-Pientka N, Bühlmeier J, Peters T, Albrecht M, Adams F, Wustrau K, Teufel M, Hebebrand J, Föcker M, Libuda L. Risk factors for a low weight gain in the early stage of adolescent anorexia nervosa inpatient treatment: findings from a pilot study. Eat Weight Disord 2020; 25:911-919. [PMID: 31168729 DOI: 10.1007/s40519-019-00705-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 04/27/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Body weight restoration is a major treatment aim in juvenile inpatients with anorexia nervosa (AN) (i.e., 500-1000 g/week according to the German guidelines). Several studies suggest the early weight gain to be crucial for remission. The identification of patients at risk of a low early weight gain could enable an adequate adaptation of treatment. Thus, we aimed at detecting risk factors of a low weight gain during inpatient treatment. METHODS The presented work analyzes data from a pilot study in 30 female adolescent inpatients with AN (restricting subtype; age range at admission: 12.6-17.6 years). Premorbid characteristics, history of symptomatology, anthropometric data, and eating-disorder psychopathology were compared between those who gained at least an average of 500 g/week during the first 7 weeks of treatment (high weight gainers, HWG) and those who did not (low weight gainers, LWG). RESULTS At admission, LWG (n = 15) had a significantly higher BMI(-SDS) and scored significantly higher in the eating-disorder examination questionnaire (EDE-Q) than HWG (n = 15). A logistic regression analysis indicated both parameters to be independently associated with a low weight gain. CONCLUSION Higher EDE-Q scores seem to be a major risk factor for a low weight gain at the beginning of treatment. Moreover, a higher BMI(-SDS) at admission does not necessarily indicate a less severe AN symptomatic, as it was associated with a lower weight gain in our sample during the first 7 weeks of treatment. Reassessment of our results in larger studies is required to draw firm conclusions for clinical practice. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Nadja Knoll-Pientka
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany. .,Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Judith Bühlmeier
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Muriel Albrecht
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Frederike Adams
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Katharina Wustrau
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Martin Teufel
- LVR-Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Lars Libuda
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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85
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Jaworski M, Panczyk M, Śliwczyński A, Brzozowska M, Janaszek K, Małkowski P, Gotlib J. Eating Disorders in Males: An 8-Year Population-Based Observational Study. Am J Mens Health 2020; 13:1557988319860970. [PMID: 31268395 PMCID: PMC6610443 DOI: 10.1177/1557988319860970] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of the study was the realistic evaluation of the prevalence of
eating disorders (ED) among Polish men who sought treatment through the National
Health Fund (NFZ) in the years 2010–2017. According to ICD-10, four types of ED
were analyzed: anorexia nervosa—AN (F50.0), atypical anorexia nervosa (F50.1),
bulimia nervosa—BN (F50.2), and atypical bulimia nervosa (F50.3). The NFZ database was used. The ED groups were defined according to ICD-10 codes.
Demographic data were collected from the web page of Statistics Poland (GUS).
The annual prevalence of EDs was estimated, and the age groups were categorized
into nine groups. For the incidence of EDs in male patients in the years
2010–2017, relative risk (RR) with 95% confidence interval (95% CI) was
calculated. The frequency trend of AN in males remains relatively stable. AN occurred mainly
in young men (between 11 and 30 years). It was noted that AN affected
approximately 100 men in each year of observation, while atypical anorexia
nervosa affected about 40 men. In 2017, the RR for EDs in young males was 0.041
(95% CI [0.033, 0.051]). Bulimia was relatively rare (about 35 males each
year). The incidence of EDs in males is a relatively constant phenomenon. The real
number of male patients with EDs may be higher. The current conceptualizations
of ED pathology should be modified and better adapted to men. Clinical
guidelines for specialists working with males with EDs should be developed.
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Affiliation(s)
- Mariusz Jaworski
- 1 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland
| | - Mariusz Panczyk
- 1 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland
| | - Andrzej Śliwczyński
- 2 Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Melania Brzozowska
- 2 Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Katarzyna Janaszek
- 2 Department of Analysis and Strategy, The National Health Fund, Warsaw, Poland
| | - Piotr Małkowski
- 3 Department of Surgical and Transplant Nursing and Extracorporeal Treatment, Medical University of Warsaw, Poland
| | - Joanna Gotlib
- 1 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland
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86
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Pluhar EI, Abdullah S, Burton ET. Endorsement of Binge Eating Symptoms in a Sample of Predominantly Non-Hispanic Black Adolescents. Clin Pediatr (Phila) 2020; 59:766-772. [PMID: 32274933 DOI: 10.1177/0009922820915897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Binge eating disorder (BED) as well as individual subthreshold binge eating symptoms are related to deleterious physical and socioemotional outcomes among adolescents. The present study examined the prevalence of specific binge eating behaviors among a sample of primarily non-Hispanic Black outpatients presenting to weight management and endocrinology clinics. Analyses are based on 103 adolescents (69.9% female, 66.9% non-Hispanic Black) who endorsed one or more binge eating symptoms on a nonstandardized clinical assessment patterned after Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The most commonly endorsed symptom was eating in excess of what is considered normal (71.8%), while least commonly endorsed symptoms included guilt, distress, and embarrassment due to overeating (17.5% to 26.2%). More than half of the participants endorsed multiple specific binge eating symptoms. The level of subthreshold symptomatology reported underscores the importance of developmental and cultural tailoring of prevention and intervention efforts to address these behaviors as a means of curbing clinical-level onset of BED.
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Affiliation(s)
- Emily I Pluhar
- Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA USA
| | - Syidah Abdullah
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - E Thomaseo Burton
- University of Tennessee Health Science Center, Memphis, TN, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
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87
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Exposure therapy for eating disorders: A systematic review. Clin Psychol Rev 2020; 78:101851. [DOI: 10.1016/j.cpr.2020.101851] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/07/2020] [Accepted: 03/10/2020] [Indexed: 12/25/2022]
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Incidence of Anorexia Nervosa in Women: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113824. [PMID: 32481615 PMCID: PMC7312606 DOI: 10.3390/ijerph17113824] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 11/25/2022]
Abstract
Background: Anorexia nervosa (AN) among the general population is a rare but often fatal illness. Objective: To summarize the incidence of AN using a systematic review and meta-analysis. Methods: Four online databases (PubMed, Scopus, WoS and Embase) were consulted. The review was conducted according to with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was limited to women. The methodological quality of the studies was assessed by the Newcastle–Ottawa Scale (NOS). Results: A total of 31 articles were included in the study. The incidence rate of AN ranged from 0.5 to 318.0 cases per 100,000 women–years. The incidence in studies based on outpatient healthcare services (OHS) was higher than those based on hospital admissions (HA) (8.8 95% CI: 7.83–9.80 vs. 5.0 95% CI: 4.87–5.05). In young women, the incidence in OHS was higher than HA (63.7, 95% CI 61.21–66.12 vs. 8.1 95% CI 7.60–8.53). The linear trend in the incidence of AN was increasing in all ages of women and young women, both in studies with hospital admission records, and in those based on outpatient healthcare services. Conclusion: The incidence of AN depends on the methodology, the type of population and the diagnostic criteria used.
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89
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van Eeden AE, Hoek HW, van Hoeken D, Deen M, Oldehinkel AJ. Temperament in preadolescence is associated with weight and eating pathology in young adulthood. Int J Eat Disord 2020; 53:466-475. [PMID: 32073176 PMCID: PMC7318707 DOI: 10.1002/eat.23241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/14/2020] [Accepted: 01/26/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Few longitudinal studies have investigated the role of temperament traits on weight and eating problems thus far. We investigated whether temperament in preadolescence influences body weight and the development of eating pathology in adolescence and young adulthood. METHOD This study used data from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2,230) from preadolescence into adulthood. At age 11, the temperament dimensions negative affectivity and effortful control were measured with the Early Adolescent Temperament Questionnaire-Revised. Body mass index (BMI) was measured at all assessment waves. At age 19, the prevalence of eating disorders was investigated by two-stage screening including interviews by eating disorder experts. At age 22 and 26, the Eating Disorder Diagnostic Scale was used to assess the level of eating pathology. RESULTS Higher negative affectivity in preadolescence was associated with higher BMI and eating pathology in young adulthood. Lower effortful control in preadolescence was found to be a risk factor for the development of obesity in young adulthood. No association was found between effortful control in preadolescence and eating pathology in later life. DISCUSSION Both negative affectivity and effortful control play a role in the development of weight or eating problems during adolescence.
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Affiliation(s)
- Annelies E. van Eeden
- Parnassia Psychiatric InstituteThe HagueThe Netherlands,University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands
| | - Hans W. Hoek
- Parnassia Psychiatric InstituteThe HagueThe Netherlands,University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands,Columbia UniversityMailman School of Public Health, Department of Epidemiology, New YorkNew York
| | | | - Mathijs Deen
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | - Albertine J. Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands
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90
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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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91
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de Jong M, Spinhoven P, Korrelboom K, Deen M, van der Meer I, Danner UN, van der Schuur S, Schoorl M, Hoek HW. Effectiveness of enhanced cognitive behavior therapy for eating disorders: A randomized controlled trial. Int J Eat Disord 2020; 53:447-457. [PMID: 32040244 PMCID: PMC7317943 DOI: 10.1002/eat.23239] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Enhanced cognitive behavior therapy (CBT-E) is a transdiagnostic treatment suitable for the full range of eating disorders (EDs). Although the effectiveness of CBT(-E) is clear, it is not being used as widely in clinical practice as guidelines recommend. The aim of the present study was to compare the effectiveness of CBT-E with treatment as usual (TAU), which was largely based on CBT principles. METHOD We conducted a randomized controlled trial on a total of 143 adult patients with an ED who received either CBT-E or TAU. The primary outcome was recovery from the ED. Secondary outcome measures were levels of ED psychopathology, anxiety, and depressive symptoms. Self-esteem, perfectionism, and interpersonal problems were repeatedly measured to examine possible moderating effects. We explored differences in duration and intensity between conditions. RESULTS After 80 weeks, there were no differences between conditions in decrease in ED psychopathology, or symptoms of anxiety and depression. However, in the first six weeks of treatment there was a larger decrease in ED psychopathology in the CBT-E condition. Moreover, when the internationally most widely used definition of recovery was applied, the recovery rate at 20 weeks of CBT-E was significantly higher (57.7%) than of TAU (36.0%). At 80 weeks, this difference was no longer significant (CBT-E 60.9%; TAU 43.6%). Furthermore, CBT-E was more effective in improving self-esteem and was also the less intensive and shorter treatment. DISCUSSION With broader use of CBT-E, the efficiency, accessibility and effectivity (on self-esteem) of treatment for EDs could be improved.
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Affiliation(s)
- Martie de Jong
- Center for Eating DisordersPsyQ, Part of Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden UniversityLeidenThe Netherlands
- Department of PsychiatryLeiden University Medical CenterLeidenThe Netherlands
| | - Kees Korrelboom
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Methodology and Statistics Unit, Institute of PsychologyLeiden UniversityLeidenThe Netherlands
| | - Iris van der Meer
- Center for Eating DisordersPsyQ, Part of Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | | | - Selma van der Schuur
- Center for Eating Disorders—PsyQPart of Lentis Psychiatric InstituteGroningenThe Netherlands
| | - Maartje Schoorl
- Institute of Psychology, Leiden UniversityLeidenThe Netherlands
| | - Hans W. Hoek
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
- Department of PsychiatryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
- Department of EpidemiologyColumbia University, Mailman School of Public HealthNew YorkNew York
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92
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Erriu M, Cimino S, Cerniglia L. The Role of Family Relationships in Eating Disorders in Adolescents: A Narrative Review. Behav Sci (Basel) 2020; 10:E71. [PMID: 32252365 PMCID: PMC7226005 DOI: 10.3390/bs10040071] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Adolescents' eating disorders have been explored through various conceptual and empirical models. Only recently, scientific literature in this area has more specifically investigated the role of relationships, with particular attention to family functioning. Objective: This paper reviews family relationships aspects of eating disorders in adolescence. Methods: A narrative literature review of relational issues in adolescents' eating disorders was performed. Results: Empirical evidence of family relationships in adolescents' eating disorders confirms the relevance of relational aspects in the development and maintenance of the pathology. In particular, the contribution of the relational-systemic approach is wide, suggesting the need to refer to the family context for a better understanding of adolescents' sufferance. Additionally, the empirical contributions from the conceptual model of Developmental Psychopathology, highlighting the importance of risk and protection factors in family relationships, provides knowledge about the phenomenon of adolescents' eating disorders in terms of complexity. Conclusions: An integrated relational model aimed to explore adolescents' eating disorders is worthy of investigation to accomplish specific program of intervention.
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Affiliation(s)
- Michela Erriu
- Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.E.); (S.C.)
| | - Silvia Cimino
- Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.E.); (S.C.)
| | - Luca Cerniglia
- Psychology Faculty, Department of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy
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93
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A study on binge eating behavior in urban adolescents. Asian J Psychiatr 2020; 50:101998. [PMID: 32229430 DOI: 10.1016/j.ajp.2020.101998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 11/22/2022]
Abstract
AIM The study was aimed at studying binge eating behavior in urban adolescents. This was in keeping with the increasing prevalence of obesity and lifestyle disorders amongst Indian population especially in adolescent groups. METHODS 2000 adolescents English speaking schools in Mumbai were administered the Binge Eating Scale and the Eating Behaviors and Pattern Questionnaire after assent and parental consent. The prevalence of Binge eating behavior was estimated along with the socio-demographic data and other data from scale which was analyzed using the Chi square test and ANOVA where appropriate. RESULTS The mean age of the total sample was 15.05 ± 1.65 years. Females reported higher Binge eating behavior than males and majority of the sample belonging to upper and lower middle- class families reported high binge eating behavior. The prevalence of Binge eating behavior was high with 1002 (50.1 %) adolescents reporting moderate binge eating while 736 (36.8 %) reporting severe binge eating. Significantly greater adolescents in the binge eating group reported irregular menses and being overweight and obese. There was a significantly greater proportion of adolescents in the binge eating group that ate out weekly and ate more fried food. CONCLUSION There is an increasing trend of obesity and lifestyle disorders in adolescent population that can be linked to Binge eating behavior however, the role of binge eating in context of one of the potential cause of lifestyle disorders and obesity has not been studied in Indian adolescents despite the prevalence of Binge eating and overweight being high in this population, we need further larger studies to corroborate the findings of this study.
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94
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Martínez-Sánchez SM, Martínez-García TE, Munguía-Izquierdo D. Clinical, Psychopathological, Physical, and Sleep Evolution in Adolescents with Restrictive Anorexia Nervosa Participating in a Day Hospital Program. Psychiatry Investig 2020; 17:366-373. [PMID: 32252510 PMCID: PMC7176561 DOI: 10.30773/pi.2020.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/15/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To analyze the clinical, psychopathological, physical, and sleep-related evolution of adolescents with restricting-type of anorexia nervosa (AN-R) after 10 weeks of a daytime hospital program. METHODS Body composition, physical activity and sleep were measured objectively before and after 10 weeks of treatment. In addition, psychopathology and body image disturbances were measured with a self-report questionnaire. RESULTS Fourteen female adolescents with AN-R (14.3±1.6 years old) participated in the study. A significant increase was found in eight of the ten variables for body composition (p<0.05). There were no significant changes in psychopathology, body image disturbances or physical activity. Concerning sleep, a significant, moderately standardized and substantial increase in night latency was found (p=0.002), and there was a significant, small standardized and substantial decrease in night efficiency (p=0.035). CONCLUSION After 10 weeks of follow-up with adolescent patients with AN-R who attended a day hospital program, there was a positive evolution of body composition. However, with regard to sleep patterns, there was a worsening of latency and night efficiency. Therefore, sleep care should be addressed in acute treatment programs for adolescents with AN-R.
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Affiliation(s)
- Sofía M Martínez-Sánchez
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | | | - Diego Munguía-Izquierdo
- Physical Performance Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.,Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
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95
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Body Image Victimization Experiences and Disordered Eating Behaviors among Chinese Female Adolescents: The Role of Body Dissatisfaction and Depression. SEX ROLES 2020. [DOI: 10.1007/s11199-020-01122-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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96
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Sugimoto N, Nishida A, Ando S, Usami S, Toriyama R, Morimoto Y, Koike S, Yamasaki S, Kanata S, Fujikawa S, Furukawa TA, Sasaki T, Hiraiwa-Hasegawa M, Kasai K. Use of social networking sites and desire for slimness among 10-year-old girls and boys: A population-based birth cohort study. Int J Eat Disord 2020; 53:288-295. [PMID: 31743492 DOI: 10.1002/eat.23202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Desire for slimness (DS) is a well-established risk factor for eating disorders among adolescents, particularly girls. It is known that exposure to traditional media such as television can increase DS. However, the association between DS and the use of new media, such as social networking sites (SNS), adjusting for relevant potential confounders, has not been examined to-date. In this study, we assessed the relationship between DS and SNS use among early adolescent girls and boys, adjusting for body mass index (BMI), time spent watching television, and Internet use. METHOD DS, SNS use, and confounding variables were assessed using self-report questionnaires and face-to-face interviews from a cross-sectional population-based survey of 4,478 10-year-old Japanese adolescents (2,100 girls and 2,378 boys). RESULTS After adjusting for confounding variables, SNS use was associated with increased risk of DS among girls (odds ratio [OR] = 1.93; 95% confidence interval [CI], 1.17-3.18, p = .010), but not among boys (OR = 1.07; 95% CI, 0.64-1.80, p = .786). DISCUSSION Exposure to SNS was associated with an increased risk of DS among early adolescents, especially girls. Targeting SNS use in early adolescence seems a promising approach to prevention of DS and subsequent eating problems, particularly among girls.
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Affiliation(s)
- Noriko Sugimoto
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Department of Psychiatry & Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
- Department of Psychiatry & Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Usami
- Center for Research and Development on Transition from Secondary to Higher Education, The University of Tokyo, Tokyo, Japan
| | - Rie Toriyama
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Yuko Morimoto
- Department of Psychiatry & Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shinsuke Koike
- Institute for Diversity & Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
| | - Syudo Yamasaki
- Department of Psychiatry & Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Toshiaki A Furukawa
- Health Promotion & Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
| | - Tsukasa Sasaki
- Department of Physical and Health Education, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- Department of Evolutionary Studies of Biosystems, The Graduate University for the Advanced Studies, SOKENDAI, Hayama, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
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97
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Numata N, Hirano Y, Sutoh C, Matsuzawa D, Takeda K, Setsu R, Shimizu E, Nakazato M. Hemodynamic responses in prefrontal cortex and personality characteristics in patients with bulimic disorders: a near-infrared spectroscopy study. Eat Weight Disord 2020; 25:59-67. [PMID: 29557056 DOI: 10.1007/s40519-018-0500-7] [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] [Received: 09/19/2017] [Accepted: 03/10/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study sought to identify the prefrontal cortex hemodynamic response that is dependent on cognitive performance in patients with bulimic disorders (BD), and investigate its association with personality characteristics. METHODS Nineteen female patients with BD and 23 healthy women were recruited. Their personality characteristics related to eating disorders were examined using a self-reporting questionnaire, namely the eating disorder inventory-2 (EDI-2). Cerebral blood flow response in the prefrontal cortex during the digit span backward task (DSBT) was measured using near-infrared spectroscopy (NIRS). Change in oxygenated hemoglobin concentration (ΔoxyHb), obtained using NIRS, were used as an index of brain activity. Further, the relationship between prefrontal cortical activity and personality characteristics was investigated in patients with BD. RESULTS The cognitive performance of patients with BD was significantly lower in the DSBT compared with healthy subjects. There was no difference between the groups in ΔoxyHb during the task. Task scores of patients with BD correlated with asceticism and perfectionism. Moreover, the asceticism score was negatively correlated with ΔoxyHb of the bilateral prefrontal cortex in patients with BD. CONCLUSION The results suggest that cognitive performance and brain activity induced during DSBT might be affected by asceticism in BD patients. LEVEL OF EVIDENCE III, case-control study.
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Affiliation(s)
- Noriko Numata
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Daisuke Matsuzawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kotaro Takeda
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Rikukage Setsu
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
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98
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Tanofsky-Kraff M, Schvey NA, Grilo CM. A developmental framework of binge-eating disorder based on pediatric loss of control eating. AMERICAN PSYCHOLOGIST 2020; 75:189-203. [PMID: 32052994 PMCID: PMC7027731 DOI: 10.1037/amp0000592] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marian Tanofsky-Kraff
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine
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99
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Bye A, Nath S, Ryan EG, Bick D, Easter A, Howard LM, Micali N. Prevalence and clinical characterisation of pregnant women with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2020; 28:141-155. [DOI: 10.1002/erv.2719] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/30/2019] [Accepted: 12/23/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Amanda Bye
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child HealthUniversity College London London UK
| | - Selina Nath
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
| | - Elizabeth G. Ryan
- Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
| | - Debra Bick
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College London London UK
| | - Abigail Easter
- Centre for Implementation Science, Health Service and Population Research, Institute of Psychiatry, Psychology & NeuroscienceKing's College London London UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and MedicineKing's College London London UK
- South London and Maudsley NHS Foundation Trust London UK
| | - Nadia Micali
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child HealthUniversity College London London UK
- Department of PsychiatryUniversity of Geneva Geneva Switzerland
- Department of Pediatrics, Gynaecology and ObstetricsUniversity of Geneva Geneva Switzerland
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100
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Allen MS, Robson DA, Laborde S. Normal variations in personality predict eating behavior, oral health, and partial syndrome bulimia nervosa in adolescent girls. Food Sci Nutr 2020; 8:1423-1432. [PMID: 32180952 PMCID: PMC7063343 DOI: 10.1002/fsn3.1425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/21/2019] [Accepted: 12/31/2019] [Indexed: 01/22/2023] Open
Abstract
Eating disorders are among the most prevalent disorders in adolescence and can have negative consequences including poor quality of life, medical complications, and even death. This study addresses whether normal variations in personality relate to eating behavior and eating disorder symptomatology in adolescent girls. Participants were a near-representative sample of Australian adolescent girls (n = 1,676). Three personality traits (neuroticism, extraversion, and conscientiousness) were assessed at age 12 and again at age 14, and self-reported eating and weight management behaviors were assessed at age 14. After controlling for sociodemographic factors, higher levels of conscientiousness at age 12, and increases in conscientiousness between ages 12 and 14, were associated with greater fruit and vegetable consumption, a lower intake of high fat foods and high sugar drinks, less frequent meal skipping, better oral health, and decreased risk of partial syndrome bulimia nervosa at age 14. Higher neuroticism at age 12 was associated with more frequent meal skipping, and increases in neuroticism between ages 12 and 14 were associated with more frequent meal skipping and increased risk of partial syndrome bulimia nervosa at age 14. Extraversion was generally unrelated to eating and weight management behaviors. These findings provide evidence that normal variations in personality are related to eating behavior, oral health, and eating disorder symptoms during midadolescence.
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Affiliation(s)
- Mark S Allen
- School of Psychology University of Wollongong Wollongong NSW Australia
| | - Davina A Robson
- School of Psychology University of Wollongong Wollongong NSW Australia
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