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Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. Lancet Psychiatry 2021; 8:320-328. [PMID: 33675688 PMCID: PMC7973414 DOI: 10.1016/s2215-0366(21)00040-7] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anorexia nervosa and bulimia nervosa are the only eating disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, yet binge-eating disorder and other specified feeding or eating disorder (OSFED) are more prevalent. This study sought to estimate the prevalence and burden of binge-eating disorder and OSFED globally and present a case for their inclusion in GBD. METHODS We sourced studies from the GBD 2019 anorexia nervosa and bulimia nervosa epidemiological databases, two systematic reviews that included studies with epidemiological estimates of binge-eating disorder and OSFED, and experts in the field. Studies, published between Jan 1, 1998, and March 1, 2019, were included if they reported non-zero prevalence of two or more eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder, or OSFED) and diagnosed cases according to DSM-IV or DSM-5. The proportions of total eating disorder cases that met diagnostic criteria for each individual eating disorder were estimated via network meta-regression and simulation using studies reporting eating disorder prevalence. The global cases unrepresented in GBD 2019 were estimated using the proportions from the simulation and the GBD 2019 eating disorder prevalence. Disability weights for binge-eating disorder and OSFED were then estimated along with disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs). FINDINGS 54 studies, of which 36 were from high-income countries, were included in the analysis. The number of global eating disorder cases in 2019 that were unrepresented in GBD 2019 was 41·9 million (95% UI 27·9-59·0), and consisted of 17·3 million (11·3-24·9) people with binge-eating disorder and 24·6 million (14·7-39·7) people with OSFED (vs 13·6 million [10·2-17·5] people with eating disorders in GBD 2019). Together, binge-eating disorder and OSFED caused 3·7 million (95% UI 2·0-6·5) DALYs globally, bringing the total eating disorder DALYs to 6·6 million (3·8-10·6) in 2019. INTERPRETATION Binge-eating disorder and OSFED accounted for the majority of eating disorder cases and DALYs globally. These findings warrant the inclusion of binge-eating disorder and OSFED in future iterations of GBD, which will bring the burden experienced by people living with these disorders to the attention of policy makers with the means to target this burden. FUNDING Queensland Health, Australian National Health and Medical Research Council, and Bill & Melinda Gates Foundation.
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Affiliation(s)
- Damian F Santomauro
- School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
| | - Sarah Melen
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW, Australia; Department of Psychology, Macquarie University, North Ryde, NSW, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Harvey Whiteford
- School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Alize J Ferrari
- School of Public Health, The University of Queensland, Herston, QLD, Australia; Queensland Centre for Mental Health Research, Wacol, QLD, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Eating Disorders in Top Elite Beach Handball Players: Cross Sectional Study. CHILDREN-BASEL 2021; 8:children8030245. [PMID: 33810150 PMCID: PMC8004950 DOI: 10.3390/children8030245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 01/12/2023]
Abstract
(1) Background: The preoccupation with the increasing appearance of eating disorders (ED) in athletes continues to grow, especially in athletes who practice team sports. ED severely affects the eating habits of the athletes, who tend to use unhealthy approaches to control their body weight. The development of nutritional education and early interventions by training staff is essential, and these factors are widely perceived as beneficial in sports medicine. This study evaluates the frequency at which beach handball (BH) players develop ED, also comparing the differences by sex and age (junior: adolescents vs. senior: young adults). In addition, the relation between body composition variables and ED was studied. (2) Methods: A descriptive and cross-sectional study was carried out in 69 top elite handball players (36 males and 33 females) from the Spanish National BH Team; who were separated by age (junior: adolescents and senior: young adults). The athletes completed the Eating Attitudes Test in its 26 item version (EAT-26). (3) Results: The prevalence of ED indicated that 11% of females had a high possibility of developing an ED, and 3% of males. Regarding the EAT-26 total score and subscales, no significant differences were found between female and male participants, or between the junior and senior categories. The correlations showed an association between body composition, in terms of body mass index, and the EAT-26 total score in both males and females. In the case of males, the correlation was negative. (4) Conclusions: Although there are no significant differences between sex or categories, it has been found that elite athletes are a population that is at high risk of developing ED.
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Prochnow T, Patterson MS, Umstattd Meyer MR. A social network approach to analyzing body dissatisfaction among sorority members using two network generators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:159-167. [PMID: 31498736 DOI: 10.1080/07448481.2019.1657121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/24/2019] [Accepted: 08/13/2019] [Indexed: 06/10/2023]
Abstract
Objective: This article uses social network analysis (SNA) to analyze how various measures of social connectedness relate to body dissatisfaction (BD) in sorority members.Participants: 208 sorority members participated in the study.Methods: Measures of social connectedness (network variables) were created based on two relational networks: persons members felt closest to and persons they spent the most time with. SNA tested whether demographic variables, body mass index (BMI), compulsive exercise, and network variables were related to BD in both networks.Results: Members reported BD was related to less social connectedness in the "close-to" and the "time-spent" networks, although specific network variables varied between the two. Compulsive exercise, BMI, and grade classification were related to BD in both networks.Conclusions: How a sorority member connects to others in her network could impact BD in this population. This study supports efforts facilitating increased social connection within a sorority as a means to decrease BD.
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Affiliation(s)
- Tyler Prochnow
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, USA
| | - Megan S Patterson
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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Ridout SJ, Ridout KK, Kole J, Fitzgerald KL, Donaldson AA, Alverson B. Comparison of eating disorder characteristics and depression comorbidity in adolescent males and females: An observational study. Psychiatry Res 2021; 296:113650. [PMID: 33352418 DOI: 10.1016/j.psychres.2020.113650] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
Depression comorbid with eating disorders is common and can worsen the severity of both disorders. Little is published regarding depression and eating disorders in male adolescents. This retrospective observational study compared eating disorder presentation and depression comorbidity between medically-hospitalized male and female adolescents. Standardized chart abstraction was performed for 148 subjects (n=127 females, =21 males). Male adolescents had significantly greater pre-hospitalization weight loss and longer eating disorder duration, and were 1.6 times more likely to have comorbid depression compared to female patients. These findings suggest increased detection and treatment of both disorders in adolescent males is warranted.
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Affiliation(s)
- Samuel J Ridout
- Department of Psychiatry, The Pemanente Medical Group, Santa Rosa, CA, USA
| | - Kathryn K Ridout
- Department of Psychiatry, The Pemanente Medical Group, Santa Rosa, CA, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Adjunct Investigator, Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
| | - Jonathan Kole
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Abigail A Donaldson
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA; Division of Adolescent Medicine, Hasbro Children's Hospital, Providence, RI, USA
| | - Brian Alverson
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA; Division of Hospitalist Medicine, Hasbro Children's Hospital, Providence, RI, USA
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Modan-Moses D, Yaroslavsky A, Pinhas-Hamiel O, Levy-Shraga Y, Kochavi B, Iron-Segev S, Enoch-Levy A, Toledano A, Stein D. Prospective Longitudinal Assessment of Linear Growth and Adult Height in Female Adolescents With Anorexia Nervosa. J Clin Endocrinol Metab 2021; 106:e1-e10. [PMID: 32816013 DOI: 10.1210/clinem/dgaa510] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 08/03/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Growth retardation is an established complication of anorexia nervosa (AN); however, findings concerning the adult height of AN patients are inconsistent. OBJECTIVE The objective of this work was to assess linear growth and adult height in female adolescents with AN. DESIGN AND SETTING A prospective observational study was conducted in a tertiary university hospital. PARTICIPANTS Participants included all 255 female adolescent AN patients hospitalized in the pediatric psychosomatic department between January 1, 2000 and May 31, 2015. INTERVENTIONS Height and weight were assessed at admission and during hospitalization. Patients were subsequently invited for measurement of adult height. Additional data collected included premorbid height data, menstrual history, skeletal age, pertinent laboratory studies, and parental heights. MAIN OUTCOME MEASURE The main outcome measure of this study was adult height. RESULTS Mean age at admission was 15.4 ± 1.75 years, mean body mass index (BMI) was 15.7 ± 1.8 kg/m2 (BMI SDS = -2.3 ± 1.45 kg/m2). Premorbid height SD scores (SDS) were not significantly different from those expected in normal adolescents (0.005 ± 0.96). However, height SDS at admission (-0.36 ± 0.99), discharge (-0.34 ± 0.96), and at adult height (-0.29 ± 0.95), were significantly (P < .001) lower than expected. Furthermore, adult height was significantly (P = .006) shorter compared to the midparental target height. Stepwise forward linear regression analysis identified age (r = 0.32, P = .002) and bone age (r = -0.29, P = .006) on admission, linear growth during hospitalization (r = 0.47, P < .001), and change in luteinizing hormone during hospitalization (r = -0.265, P = .021) as independent predictors of improvement in height SDS from the time of admission to adult height. CONCLUSIONS Whereas the premorbid height of female adolescent AN patients is normal, linear growth retardation is a prominent feature of their illness. Weight restoration is associated with catch-up growth, but complete catch-up is often not achieved.
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Affiliation(s)
- Dalit Modan-Moses
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Amit Yaroslavsky
- Pediatric Psychosomatic Department, Division of Child and Adolescent Psychiatry, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Orit Pinhas-Hamiel
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Yael Levy-Shraga
- Pediatric Endocrinology and Diabetes Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Brigitte Kochavi
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Sharon Iron-Segev
- Institute of Biochemistry, Food Science and Nutrition, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
- School of Nutrition, Peres Academic Center, Rehovot, Israel
| | - Adi Enoch-Levy
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Anat Toledano
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Daniel Stein
- Pediatric Psychosomatic Department, Division of Child and Adolescent Psychiatry, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
- The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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Iron-Segev S, Best D, Arad-Rubinstein S, Efron M, Serur Y, Dickstein H, Stein D. Feeding, Eating, and Emotional Disturbances in Children with Avoidant/Restrictive Food Intake Disorder (ARFID). Nutrients 2020; 12:nu12113385. [PMID: 33158087 PMCID: PMC7694203 DOI: 10.3390/nu12113385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 02/03/2023] Open
Abstract
Avoidant/restrictive food intake disorder (ARFID) is a relatively new diagnostic category. We sought to determine whether the Stanford Feeding Questionnaire (SFQ), an instrument for assessing picky eating, can differentiate children with ARFID from control children, and whether children with ARFID would show more nonfeeding/eating emotional problems than controls. Fifty children with ARFID were compared to 98 controls. Parents completed the SFQ, Screen for Child Anxiety Related Emotional Disorders (SCARED), Strength and Difficulties Questionnaire (SDQ), and Sensory Responsiveness Questionnaire (SRQ). On the SFQ, 12 items represented child ARFID behaviors (SFQ-ARFID Scale), and another 15 items represented parental feeding problems (SFQ-PFP Scale). We found that the SFQ-ARFID and SFQ-PFP Scale scores were significantly higher in children with ARFID vs. controls. Children with ARFID demonstrated higher SDQ-Total-Difficulties, higher SDQ-Internalizing-Difficulties and lower SRQ-Hedonic scores compared with controls. Of all parameters, the SFQ-ARFID Scale best differentiated children with ARFID from control children (area under receiver operating characteristics curve = 0.939, 95% CI, 0.895–0.983, p < 0.001). These findings suggest that parental reports show more eating problems and emotional disturbances in children with ARFID vs. controls, and more parental feeding problems. Further research is required to determine whether the SFQ-ARFID Scale may serve as an effective screening tool for the identification of ARFID.
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Affiliation(s)
- Sharon Iron-Segev
- Faculty of Agriculture, Food and Environment, Institute of Biochemistry, Food Science and Nutrition, School of Nutritional Sciences, Hebrew University of Jerusalem, Rehovot 7600001, Israel;
- Peres Academic Center, School of Nutritional Sciences, Rehovot 7610202, Israel
- Correspondence: ; Tel.: +972-526-402-535
| | - Danielle Best
- Faculty of Agriculture, Food and Environment, Institute of Biochemistry, Food Science and Nutrition, School of Nutritional Sciences, Hebrew University of Jerusalem, Rehovot 7600001, Israel;
| | - Shani Arad-Rubinstein
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel; (S.A.-R.); (M.E.); (Y.S.); (H.D.); (D.S.)
| | - Martin Efron
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel; (S.A.-R.); (M.E.); (Y.S.); (H.D.); (D.S.)
| | - Yaffa Serur
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel; (S.A.-R.); (M.E.); (Y.S.); (H.D.); (D.S.)
| | - Hadar Dickstein
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel; (S.A.-R.); (M.E.); (Y.S.); (H.D.); (D.S.)
| | - Daniel Stein
- Pediatric Psychosomatic Department, Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Tel Hashomer 5262000, Israel; (S.A.-R.); (M.E.); (Y.S.); (H.D.); (D.S.)
- Sackler Faculty of Medicine Tel Aviv University, Tel Aviv 6997801, Israel
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Vuillier L, Carter Z, Teixeira AR, Moseley RL. Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology. Mol Autism 2020; 11:63. [PMID: 32758290 PMCID: PMC7406391 DOI: 10.1186/s13229-020-00364-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 07/15/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Autistic people are disproportionately vulnerable to anorexia nervosa and other eating disorders (ED), and within the general population, autistic traits correlate with ED psychopathology. A putative mechanism which may underpin this heightened risk is alexithymia, a difficulty identifying and describing emotional states which is observed in both autism and ED. In two experiments with independent non-clinical samples, we explored whether alexithymia might mediate the heightened risk of eating psychopathology in individuals high in autistic traits. METHODS Our first experiment used the PROCESS macro for SPSS to examine relationships between alexithymia (measured by the Toronto Alexithymia Scale (TAS-20)), autistic traits (autism quotient (AQ)), and eating psychopathology (Eating Attitudes Test (EAT-26)) in 121 participants. Our second experiment (n = 300) replicated and furthered this analysis by examining moderating effects of sex and controlling for anxiety and depression as covariates. We also included an additional performance-based measure of alexithymia, the Levels of Emotional Awareness Scale (LEAS). RESULTS Study 1 suggested that TAS-20 scores mediated the relationship between heightened autistic traits and eating psychopathology. Replication and further scrutiny of this finding, in study 2, revealed that this mediation effect was partial and specific to the female participants in this sample. The mediation effect appeared to be carried by the difficulty identifying feelings subscale of the TAS-20, even when depression and anxiety were controlled for. LEAS scores, however, were not significantly related to autistic traits or eating psychopathology. LIMITATIONS Cross-sectional data prevents any conclusions around the direction and causality of relationships between alexithymia, autistic traits, and eating psychopathology (alongside depression and anxiety), necessitating longitudinal research. Our non-clinical sample was predominantly Caucasian undergraduate students, so it remains to be seen if these results would extrapolate to clinical and/or autistic samples. Divergence between the TAS-20 and LEAS raises crucial questions regarding the construct validity of these measures. CONCLUSIONS Our findings with respect to autistic traits suggest that alexithymia could partially explain the prevalence of ED in autistic people and may as such be an important consideration in the pathogenesis and treatment of ED in autistic and non-autistic people alike. Further research with clinical samples is critical to explore these ideas. Differences between men and women, furthermore, emphasize the importance of looking for sex-specific as well as generic risk factors in autistic and non-autistic men and women.
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Affiliation(s)
- L. Vuillier
- Department of Psychology, Bournemouth University, Poole, UK
| | - Z. Carter
- Department of Psychology, Bournemouth University, Poole, UK
| | - A. R. Teixeira
- Department of Psychology, Bournemouth University, Poole, UK
| | - R. L. Moseley
- Department of Psychology, Bournemouth University, Poole, UK
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Chua JYX, Tam W, Shorey S. Research Review: Effectiveness of universal eating disorder prevention interventions in improving body image among children: a systematic review and meta-analysis. J Child Psychol Psychiatry 2020; 61:522-535. [PMID: 31746023 DOI: 10.1111/jcpp.13164] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Increasingly, children are at risk of developing eating disorders. A systematic review and a meta-analysis were conducted to examine the effectiveness of universal eating disorder prevention interventions in improving body image, internalization of appearance ideals, and self-esteem among children aged 5-17 years old. METHODS Nine electronic databases were systematically searched from each database's point of inception to March 2019. The Cochrane Risk of Bias tool assessed each study's risk of bias, while the GRADE approach judged the overall evidence for each review outcome. A meta-analysis was conducted using the random-effect model to obtain standardized mean differences with 95% confidence intervals under the inverse variance method. Heterogeneity was assessed using I2 statistic and Cochran's Q chi-squared test. Publication bias was assessed using funnel plots. RESULTS A total of 24 studies (22 trials) were included in this review. Universal interventions were found to be effective in improving children's body esteem, self-esteem, and internalization of appearance ideals at postintervention and at follow-up timepoints. Subgroup analyses found that girls benefited more from these interventions than boys. Multisessional interventions with an optimal duration of approximately one month were found to be more effective. CONCLUSIONS The findings encourage the incorporation of universal preventive interventions into school curricula to benefit most children. Laypeople such as teachers can deliver these interventions, but content experts should address topics on body dissatisfaction. Due to the low quality of evidence, as accorded by the GRADE approach, current findings should be validated by future research.
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Affiliation(s)
| | - Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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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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Karageorgiou V, Furukawa TA, Tsigkaropoulou E, Karavia A, Gournellis R, Soureti A, Bellos I, Douzenis A, Michopoulos I. Adipokines in anorexia nervosa: A systematic review and meta-analysis. Psychoneuroendocrinology 2020; 112:104485. [PMID: 31805456 DOI: 10.1016/j.psyneuen.2019.104485] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The association between adipokine dysregulation and weight loss of patients with anorexia nervosa (AN) has been long investigated, in search of a causal relationship. We sought to: a) synthesize the available evidence on potential differences between AN patients and controls with regards to adipokine measurements (namely, leptin, adiponectin, resistin, soluble leptin receptor, visfatin, vaspin and omentin), b) estimate the potential differences between constitutionally thin (CT) subjects and AN patients, and c) present the available evidence with regards to biomarker efficacy of adipokines in AN. METHODS A structured literature search, last updated in 2/2019, was conducted in the following databases: MEDLINE, clinicaltrials.gov, PsycINFO, PSYNDEX and WHO Registry Network. The primary outcome was the standardized mean difference of each adipokine between AN patients and controls of normal BMI. Secondary outcomes included the correlation of leptin with BMI and bone mineral density among AN patients. The study protocol is published in PROSPERO (CRD42018116767). RESULTS In a total of 622 screened studies, after exclusion of non-relevant articles and duplicates, 84 reports on leptin, 31 reports on adiponectin, 12 on resistin, 10 on soluble leptin receptor, 5 on visfatin, 3 on vaspin and omentin were finally included in the meta-analysis. Publication bias assessment underlined the possibility of non-significant studies being underrepresented; still, significant heterogeneity renders this statement inconclusive. Leptin [ELISA: SMD (95% CI): -3.03 (-4, -2.06)], radioimmunoassay [RIA: -3.84 (-4.71, -2.98)] and resistin [-1.67 (-2.85, -0.48)] were significantly lower in patients with AN compared with controls, whereas visfatin decrease did not reach significance (-2.03 (-4.38, 0.3). Mean adiponectin, vaspin and soluble leptin receptor levels were significantly higher. In subgroup analysis, a significantly attenuated SMD was reported in ELISA studies compared with RIA studies. Leptin was significantly lower in AN patients compared to CT subjects and BMI marginally did not appear to confound the result. In all analyses, except for the correlation of leptin with BMI in AN patients, high heterogeneity was present. Meta-regression analysis indicated a potential confounding action of controls' BMI and age on leptin SMD and between-assay differences. Publication bias assessment underlined the possibility of nonsignificant studies being underrepresented; still, further investigation did not corroborate this and significant heterogeneity renders this statement inconclusive. CONCLUSION A distinct profile of adipokine dysregulation is apparent in AN patients, following the anticipated pattern of low BMI. A precise estimation of the magnitude is hindered by heterogeneity, partly caused by varying assays and methodologies. Interestingly, while mean leptin levels are lower in AN subjects compared with constitutionally thin women, there is an overlap in individual levels between the two groups and therefore, they cannot be used to differentiate between these states.
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Affiliation(s)
- Vasilios Karageorgiou
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine, School of Public Health, Kyoto, Japan
| | - Evdoxia Tsigkaropoulou
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Anna Karavia
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Rossetos Gournellis
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Anastasia Soureti
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Ioannis Bellos
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Athanasios Douzenis
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece
| | - Ioannis Michopoulos
- Eating Disorders Unit, 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 'Attikon' University Hospital, Athens, Greece.
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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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Crawford-Faucher A, Deaton D. Selected Behavioral and Psychiatric Problems. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_36-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aulinas A, Plessow F, Pulumo RL, Asanza E, Mancuso CJ, Slattery M, Tolley C, Thomas JJ, Eddy KT, Miller KK, Klibanski A, Misra M, Lawson EA. Disrupted Oxytocin-Appetite Signaling in Females With Anorexia Nervosa. J Clin Endocrinol Metab 2019; 104:4931-4940. [PMID: 31251345 PMCID: PMC6734487 DOI: 10.1210/jc.2019-00926] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT In healthy females, oxytocin levels decrease postmeal, corresponding to increased satiety. The postprandial response of oxytocin in females with anorexia nervosa (AN)/atypical AN is unknown. OBJECTIVES To determine the pattern of postprandial serum oxytocin levels in females with AN/atypical AN, relationship with appetite, and effect of weight, eating behavior, and endogenous estrogen status. DESIGN Cross-sectional. SETTING Clinical research center. PARTICIPANTS 67 women (36 with AN [<85% expected body weight (EBW)]; 31 with atypical AN [≥ 85% EBW)]), age 22.4 ± 0.9 (mean ± SEM) years, categorized by weight, restricting vs binge/purge behavior, and estrogen status. INTERVENTIONS Standardized mixed meal. MAIN OUTCOME MEASUREMENTS Blood sampling for oxytocin occurred fasting and 30, 60, and 120 minutes postmeal. Subjective appetite was assessed using visual analog scales. RESULTS In females with AN/atypical AN, oxytocin levels decreased from fasting to 60 (P = 0.002) and 120 (P = 0.005) minutes postmeal. The decrease in oxytocin from fasting to 120 minutes was greater in females with atypical AN than AN (P = 0.027) and did not differ by restricting vs binge/purge behavior or estrogen status. Controlling for caloric intake, the decrease in oxytocin was inversely related to the decrease in hunger postmeal in females with atypical AN (P = 0.04). CONCLUSIONS In females with AN/atypical AN, oxytocin levels decrease postmeal, as established in healthy females. Weight, but not restricting vs binge/purging nor endogenous estrogen status, affects postprandial oxytocin levels. The postprandial change in serum oxytocin levels is related to appetite in females with atypical AN only, suggesting a disconnect between oxytocin secretion and appetite in the undernourished state.
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Affiliation(s)
- Anna Aulinas
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Franziska Plessow
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | - Elisa Asanza
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Christiane Tolley
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Jennifer J Thomas
- Harvard Medical School, Boston, Massachusetts
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Kamryn T Eddy
- Harvard Medical School, Boston, Massachusetts
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Anne Klibanski
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Division of Pediatric Endocrinology, Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Correspondence and Reprint Requests: Elizabeth A. Lawson, Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachussetts 02114. E-mail:
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Hernandez D, Mehta N, Geliebter A. Meal-Related Acyl and Des-Acyl Ghrelin and Other Appetite-Related Hormones in People with Obesity and Binge Eating. Obesity (Silver Spring) 2019; 27:629-635. [PMID: 30900406 DOI: 10.1002/oby.22431] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 12/21/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Potential mechanisms of abnormal food intake, such as dysregulation of meal-related appetite hormones, including acyl ghrelin (AG) and des-acyl ghrelin (DAG), were investigated among men and women with obesity, with and without binge eating (BE). METHODS Participants (n = 42: 19 female, 23 male) were assigned to a liquid meal and water condition in counterbalanced order, and blood samples for measuring hormones were obtained before and after these conditions. RESULTS Participants with BE had significantly lower fasting and postingestive AG concentrations than participants without BE in both conditions. During the meal condition, postprandial decreases in AG concentrations were significantly smaller for the BE group than for the non-BE group. There were no significant differences in DAG by BE group. Leptin increased significantly less after meals for those with BE compared with those without BE. There were no differences in other hormones by BE group. Fasting and postmeal hunger ratings were significantly higher for those with BE than for those without BE. CONCLUSIONS In individuals with BE, lower fasting AG may be due to downregulation by habitual overeating, and a smaller postmeal decline in AG may contribute to overeating. Lower postmeal leptin concentrations may also contribute to overeating.
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Affiliation(s)
- Dominica Hernandez
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Nandini Mehta
- Department of Medicine, Lenox Hill, Northwell Health, New York, New York, USA
| | - Allan Geliebter
- Department of Psychiatry, Mount Sinai St. Luke's, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychology, Touro College and University System, New York, New York, USA
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Whitaker C, Gough B, Fawkner H, Deighton-Smith N. Young men's body dissatisfaction: A qualitative analysis of anonymous online accounts. J Health Psychol 2019; 26:636-649. [PMID: 30819027 DOI: 10.1177/1359105319832352] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Associated with numerous adverse health outcomes, body dissatisfaction in young men requires close examination. This study explores online accounts relating to male body image, including young men's personal disclosures within one online newspaper article, and posts responding to this topic. Discursively informed thematic analysis indicated that non-disclosure was considered a problematic social expectation by the young men featured in the article. Also, reader posts variously constructed body dissatisfaction as a symptom of adolescence, a lack of self-care and an incapacity to capitalise on compensatory qualities. Our analysis suggests young men may welcome safe opportunities to critically discuss prevailing body image ideals.
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Wu KL, Lorenz AK, Christensen KJ, Feely MA, Carey EC, Strand JJ. Resurgence of Eating Disorders with Olanzapine. J Palliat Med 2019; 22:231-233. [DOI: 10.1089/jpm.2018.0364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kelly L. Wu
- Center for Palliative Medicine, Division of General Internal Medicine, Mayo Clinic, Phoenix, Arizona
| | - Amanda K. Lorenz
- Center for Palliative Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Kelly J. Christensen
- Center for Palliative Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Molly A. Feely
- Center for Palliative Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Elise C. Carey
- Center for Palliative Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jacob J. Strand
- Center for Palliative Medicine, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Wisting L, Wonderlich J, Skrivarhaug T, Dahl-Jørgensen K, Rø Ø. Psychometric properties and factor structure of the diabetes eating problem survey - revised (DEPS-R) among adult males and females with type 1 diabetes. J Eat Disord 2019; 7:2. [PMID: 30675355 PMCID: PMC6337821 DOI: 10.1186/s40337-018-0232-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although an increasing amount of research has now established good psychometric properties and a three-component factor structure of the Diabetes Eating Problem Survey - Revised (DEPS-R) in pediatric samples with type 1 diabetes (T1D), research using adult samples has been limited and divergent. This study therefore aimed to investigate psychometric properties and test a three-factor model of the DEPS-R among adults with T1D. METHODS A total of 282 adults with T1D aged 18-79 years participated in the study. Measures included the DEPS-R, the Eating Disorder Examination Questionnaire (EDE-Q), and clinical data from the Norwegian Quality Improvement of Laboratory Examinations (NOKLUS) system. RESULTS The DEPS-R total mean score (SD) for the total sample, males, and females were 13.8 (9.2), 11.2 (7.8), and 15.6 (9.6) respectively. Good fit indices for the confirmatory factor analysis were found. The Cronbach's alpha of the DEPS-R was .84, suggesting good internal consistency. The DEPS-R correlated significantly with the EDE-Q among both males (.52, p < .01) and females (.68, p < .001). Also, the DEPS-R correlated significantly with BMI in both genders (.33, p < .001 in females and .35, p < .001 in males). HbA1c correlated significantly with the DEPS-R in females (.27, p < .01), but not in males. CONCLUSIONS Good fit for a three-factor structure of the DEPS-R was confirmed. Further, the DEPS-R demonstrated good psychometric properties among adults with T1D, and can be recommended for clinical use for this patient group.
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Affiliation(s)
- Line Wisting
- 1Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.,Oslo Diabetes Research Centre, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway
| | - Joseph Wonderlich
- 3Department of Psychology, George Mason University, Fairfax, VA 22030 USA
| | - Torild Skrivarhaug
- Oslo Diabetes Research Centre, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.,4Department of Paediatric and Adolescent Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.,5Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, N-0315 Oslo, Norway.,The Norwegian Diabetic Centre, Sponhoggveien 19, N-0284 Oslo, Norway
| | - Knut Dahl-Jørgensen
- Oslo Diabetes Research Centre, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.,4Department of Paediatric and Adolescent Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.,5Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Problemveien 7, N-0315 Oslo, Norway.,The Norwegian Diabetic Centre, Sponhoggveien 19, N-0284 Oslo, Norway
| | - Øyvind Rø
- 1Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.,7Institute of Clinical Medicine, Mental Health and Addiction, University of Oslo, Problemveien 7, N-0315 Oslo, Norway
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Nedic Erjavec G, Svob Strac D, Tudor L, Konjevod M, Sagud M, Pivac N. Genetic Markers in Psychiatry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:53-93. [PMID: 31705490 DOI: 10.1007/978-981-32-9721-0_4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Psychiatric disorders such as addiction (substance use and addictive disorders), depression, eating disorders, schizophrenia, and post-traumatic stress disorder (PTSD) are severe, complex, multifactorial mental disorders that carry a high social impact, enormous public health costs, and various comorbidities as well as premature morbidity. Their neurobiological foundation is still not clear. Therefore, it is difficult to uncover new set of genes and possible genetic markers of these disorders since the understanding of the molecular imbalance leading to these disorders is not complete. The integrative approach is needed which will combine genomics and epigenomics; evaluate epigenetic influence on genes and their influence on neuropeptides, neurotransmitters, and hormones; examine gene × gene and gene × environment interplay; and identify abnormalities contributing to development of these disorders. Therefore, novel genetic approaches based on systems biology focused on improvement of the identification of the biological underpinnings might offer genetic markers of addiction, depression, eating disorders, schizophrenia, and PTSD. These markers might be used for early prediction, detection of the risk to develop these disorders, novel subtypes of the diseases and tailored, personalized approach to therapy.
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Affiliation(s)
- Gordana Nedic Erjavec
- Division of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka 54, HR-10000, Zagreb, Croatia
| | - Dubravka Svob Strac
- Division of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka 54, HR-10000, Zagreb, Croatia
| | - Lucija Tudor
- Division of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka 54, HR-10000, Zagreb, Croatia
| | - Marcela Konjevod
- Division of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka 54, HR-10000, Zagreb, Croatia
| | - Marina Sagud
- School of Medicine, University of Zagreb, Salata 2, HR-10000, Zagreb, Croatia
- Department of Psychiatry, University Hospital Centre Zagreb, Kispaticeva 12, HR-10000, Zagreb, Croatia
| | - Nela Pivac
- Division of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka 54, HR-10000, Zagreb, Croatia.
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Fiechtner L, Fonte ML, Castro I, Gerber M, Horan C, Sharifi M, Cena H, Taveras EM. Determinants of Binge Eating Symptoms in Children with Overweight/Obesity. Child Obes 2018; 14:510-517. [PMID: 30153037 PMCID: PMC6249668 DOI: 10.1089/chi.2017.0311] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Examining binge eating symptoms before the diagnosis of binge eating disorder in children with obesity could provide important information on prevention of future eating disorders. METHODS We examined the prevalence and multilevel determinants of three binge eating symptoms: (1) sneaking, hiding, or hoarding food; (2) eating in the absence of hunger, and (3) inhibition or embarrassment when eating in front of others among 817 children aged 5-12 years old with overweight/obesity receiving primary care in eastern Massachusetts. We examined the associations of child and parent/household characteristics with the prevalence ratios (PRs) of these three binge eating symptoms. RESULTS Approximately one-third of parents reported that their children would sneak, hide, or hoard food; 40% ate large amounts in the absence of hunger; and 8% were inhibited/embarrassed when eating in front of others. In multivariate analyses, greater screen time was associated with a higher prevalence of sneaking, hiding, or hoarding (PR 1.06, 95% CI: 1.01-1.11). We found that children with severe obesity (PR 1.50, 95% CI: 1.24-1.81 vs. nonsevere obesity) had higher prevalence of eating in the absence of hunger. Increased hours of screen time were associated with higher prevalence of eating in the absence of hunger, (PR: 1.07, 95% CI: 1.03-1.11), whereas longer sleep duration (PR: 0.90, 95% CI: 0.82-0.99) was associated with lower prevalence of eating in the absence of hunger. CONCLUSIONS Eating in the absence of hunger was the most common symptom in our sample and was associated with screen time and sleep. ClinicalTrials.gov NCT01537510.
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Affiliation(s)
- Lauren Fiechtner
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA.,Department of Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA.,Address correspondence to: Lauren Fiechtner, MD, MPH, Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, 175 Cambridge Street, 5th Floor, Boston, MA 02114
| | - Maria Luisa Fonte
- Unit of Human Nutrition and Dietetics, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Ines Castro
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Monica Gerber
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Chrissy Horan
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Mona Sharifi
- Section of General Pediatrics, Department of Pediatrics, Yale University School of Medicine, New Haven, CT
| | - Hellas Cena
- Unit of Human Nutrition and Dietetics, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
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Imperatori C, Mancini M, Della Marca G, Valenti EM, Farina B. Feedback-Based Treatments for Eating Disorders and Related Symptoms: A Systematic Review of the Literature. Nutrients 2018; 10:E1806. [PMID: 30463330 PMCID: PMC6265864 DOI: 10.3390/nu10111806] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 01/27/2023] Open
Abstract
The effectiveness of biofeedback and neurofeedback has been investigated in a range of psychiatric disorders. However, to date, there are few studies on the clinical usefulness of feedback-based techniques for eating disorders (EDs) and EDs-related symptoms (e.g., food craving). A systematic search of PubMed, Scopus and PsychINFO identified 162 articles. Among these, thirteen studies exploring the therapeutic use of biofeedback and neurofeedback in EDs or EDs-related symptoms were included. Biofeedback and neurofeedback were implemented respectively in five and eight of all reviewed articles. No studies incorporated different feedback modalities or both biofeedback and neurofeedback. The considered studies provide preliminary data of the usefulness of feedback-based techniques in the treatment of several dysfunctional eating behaviors (e.g., food craving, rumination). Although no significant effect has been reported for other important EDs-related symptoms (i.e., body image disturbance), feedback-based techniques are also associated with significant modifications of both sympathetic reaction to food-related stimuli and brain activity in several regions of the reward system (e.g., insula). Taken together the results of the present review suggest that feedback-based treatments may be useful in the treatment of several dysfunctional eating behaviors operating both on top-down and bottom-up individual coping strategies. Methodological and clinical issues are also discussed.
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Affiliation(s)
- Claudio Imperatori
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy.
| | - Miranda Mancini
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy.
| | - Giacomo Della Marca
- Sleep Disorders Unit, Institute of Neurology, Catholic University, 00153 Rome, Italy.
| | - Enrico Maria Valenti
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy.
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy.
| | - Benedetto Farina
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy.
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The Role of Ghrelin in Anorexia Nervosa. Int J Mol Sci 2018; 19:ijms19072117. [PMID: 30037011 PMCID: PMC6073411 DOI: 10.3390/ijms19072117] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/11/2018] [Accepted: 07/17/2018] [Indexed: 12/26/2022] Open
Abstract
Ghrelin, a 28-amino acid peptide hormone expressed in X/A-like endocrine cells of the stomach, is the only known peripherally produced and centrally acting peptide that stimulates food intake and therefore attracted a lot of attention with one major focus on the treatment of conditions where an increased energy intake or body weight gain is desired. Anorexia nervosa is an eating disorder characterized by a pronounced reduction of body weight, a disturbed body image and hormonal alterations. Ghrelin signaling has been thoroughly investigated under conditions of anorexia nervosa. The present review will highlight these alterations of ghrelin in anorexia and discuss possible treatment strategies targeting ghrelin signaling. Lastly, gaps in knowledge will be mentioned to foster future research.
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Limburg K, Shu CY, Watson HJ, Hoiles KJ, Egan SJ. Implications of DSM-5 for the diagnosis of pediatric eating disorders. Int J Eat Disord 2018. [PMID: 29517799 DOI: 10.1002/eat.22856] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The aim of the study was to compare the DSM-IV, DSM-5, and ICD-10 eating disorders (ED) nomenclatures to assess their value in the classification of pediatric eating disorders. We investigated the prevalence of the disorders in accordance with each system's diagnostic criteria, diagnostic concordance between the systems, and interrater reliability. METHOD Participants were 1062 children and adolescents assessed at intake to a specialist Eating Disorders Program (91.6% female, mean age 14.5 years, SD = 1.75). Measures were collected from routine intake assessments. RESULTS DSM-5 categorization led to a lower prevalence of unspecified EDs when compared with DSM-IV. There was almost complete overlap for specified EDs. Kappa values indicated almost excellent agreement between the two coders on all three diagnostic systems, although there was higher interrater reliability for DSM-5 and ICD-10 when compared with DSM-IV. DISCUSSION DSM-5 nomenclature is useful in classifying eating disorders in pediatric clinical samples.
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Affiliation(s)
- Karina Limburg
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technichal University of Munich, Munich, Germany.,Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Chloe Y Shu
- Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Hunna J Watson
- School of Psychology, Curtin University, Perth, Australia.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA.,School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
| | - Kimberley J Hoiles
- Eating Disorders Program, Child and Adolescent Mental Health Service, Perth, Australia
| | - Sarah J Egan
- School of Psychology, Curtin University, Perth, Australia
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