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Gailledrat L, Rousselet M, Venisse JL, Lambert S, Rocher B, Remaud M, Guilleux A, Sauvaget A, Eyzop E, Grall-Bronnec M. Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group. PLoS One 2016; 11:e0165232. [PMID: 27776159 PMCID: PMC5077091 DOI: 10.1371/journal.pone.0165232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 10/07/2016] [Indexed: 12/30/2022] Open
Abstract
Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with "no / mild" or "marked" body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to "marked" body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16-61]), 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3), the use of laxatives (OR = 49.8), a high score on the item "body dissatisfaction" of the Eating Disorders Inventory scale (OR = 1.7), a higher minimum body mass index (OR = 1.73), and a high score on the item "loss of control over behavior, thoughts and emotions" from the dissociation questionnaire (OR = 10.74). These results are consistent with previous studies, and highlight the importance of denial.
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Affiliation(s)
- Lucie Gailledrat
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Morgane Rousselet
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
- EA 4275 "Biostatistics, Pharmacoepidemiology and Subjective Measures in Health Sciences", Nantes University, Institute of Health Research IRS, 22 boulevard Bénoni Goullin, 44 200 Nantes, France
| | - Jean-Luc Venisse
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Sylvain Lambert
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Bruno Rocher
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Manon Remaud
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Alice Guilleux
- EA 4275 "Biostatistics, Pharmacoepidemiology and Subjective Measures in Health Sciences", Nantes University, Institute of Health Research IRS, 22 boulevard Bénoni Goullin, 44 200 Nantes, France
| | - Anne Sauvaget
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Emeline Eyzop
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
| | - Marie Grall-Bronnec
- Clinical Investigation Unit “Behavior Addictions / Complex Affective Disorders”, Addictology and Psychiatry Department, Nantes University Hospital, Hôpital Saint Jacques, 85 rue Saint Jacques, 44 093 Nantes cedex 1, France
- EA 4275 "Biostatistics, Pharmacoepidemiology and Subjective Measures in Health Sciences", Nantes University, Institute of Health Research IRS, 22 boulevard Bénoni Goullin, 44 200 Nantes, France
- * E-mail:
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202
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Gaetani S, Romano A, Provensi G, Ricca V, Lutz T, Passani MB. Eating disorders: from bench to bedside and back. J Neurochem 2016; 139:691-699. [DOI: 10.1111/jnc.13848] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/12/2016] [Accepted: 09/12/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Silvana Gaetani
- Department of Physiology and Pharmacology “V. Erspamer”; Sapienza University of Rome; Rome Italy
| | - Adele Romano
- Department of Physiology and Pharmacology “V. Erspamer”; Sapienza University of Rome; Rome Italy
| | - Gustavo Provensi
- Department of Neuroscience, Psychology, Drug Discovery and Child Health (NEUROFARBA); University of Florence; Florence Italy
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Discovery and Child Health (NEUROFARBA); University of Florence; Florence Italy
| | - Thomas Lutz
- Institute of Veterinary Physiology; Vetsuisse Faculty University of Zurich; Zurich Switzerland
- Center of Integrative Human Physiology; University of Zurich; Zurich Switzerland
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203
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Mohler-Kuo M, Schnyder U, Dermota P, Wei W, Milos G. The prevalence, correlates, and help-seeking of eating disorders in Switzerland. Psychol Med 2016; 46:2749-2758. [PMID: 27444809 DOI: 10.1017/s0033291716001136] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Eating disorders (EDs) have long-term physical and mental impacts on those affected. However, few population-based studies have estimated the prevalence of EDs. We aimed to estimate the lifetime and 12-month prevalence rates of EDs using DSM-IV criteria, and to examine differences against the DSM-5 criteria for anorexia. METHOD A nationally representative sample of 10 038 residents in Switzerland was interviewed, and prevalence rates for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) were assessed using WHO Composite International Diagnostic Interviews (WHO-CIDI). RESULTS The lifetime prevalence rate for any ED was found to be 3.5%. Lifetime prevalence estimates for AN, BN, and/or BED were 1.2%, 2.4%, and 2.4%, respectively, among women and 0.2%, 0.9%, and 0.7%, respectively, among men. Utilizing the DSM-5 criteria, the prevalence of AN in women increased by more than 50%, from 1.2% to 1.9%. Among those meeting the criteria for any ED, only 49.4% of men and 67.9% of women had ever sought professional help about their problems with eating or weight. CONCLUSIONS The higher prevalence of BN we detected relative to other studies should prompt further monitoring for a possible increasing trend. The female v. male ratios, especially for bulimia and BED, are decreasing. Given that more than half of those affected have never consulted any professional about their problems with eating or weight, routine inquiries about eating and weight by clinicians, school teachers/psychologists, and family members may help those who are at risk, especially among men.
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Affiliation(s)
- M Mohler-Kuo
- Epidemiology, Biostatistics, and Prevention Institute,University of Zurich,Zurich,Switzerland
| | - U Schnyder
- Department of Psychiatry and Psychotherapy,University Hospital Zurich,Zurich,Switzerland
| | - P Dermota
- Epidemiology, Biostatistics, and Prevention Institute,University of Zurich,Zurich,Switzerland
| | - W Wei
- Epidemiology, Biostatistics, and Prevention Institute,University of Zurich,Zurich,Switzerland
| | - G Milos
- Department of Psychiatry and Psychotherapy,University Hospital Zurich,Zurich,Switzerland
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204
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Castellini G, Lelli L, Tedde A, Piaceri I, Bagnoli S, Lucenteforte E, Sorbi S, Monteleone AM, Hudziak JJ, Nacmias B, Ricca V. Analyses of the role of the glucocorticoid receptor gene polymorphism (rs41423247) as a potential moderator in the association between childhood overweight, psychopathology, and clinical outcomes in Eating Disorders patients: A 6 years follow up study. Psychiatry Res 2016; 243:156-60. [PMID: 27400218 DOI: 10.1016/j.psychres.2016.06.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 06/13/2016] [Accepted: 06/19/2016] [Indexed: 10/21/2022]
Abstract
Childhood overweight and the SNP rs41423247 of the glucocorticoid receptor gene (GR) were reported to represent predisposing factors for Eating Disorders (EDs). The distribution of the polymorphism was evaluated in 202 EDs patients, and in 116 healthy subjects. The Structured Clinical Interview for the DSM-IV and self-reported questionnaires were administered at the admission to the clinic and at 3 time points (end of a cognitive behavioral therapy, 3 and 6 years follow up). G-allele was associated with childhood overweight, depressive disorder comorbidity, and diagnostic instability. G-allele carriers reporting childhood overweight showed greater frequency of subjective binge eating and emotional eating.
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Affiliation(s)
- Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy; Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Italy
| | - Lorenzo Lelli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Andrea Tedde
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Irene Piaceri
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Ersilia Lucenteforte
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | | | - James J Hudziak
- Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT, United States; Erasmus University, Sophia Children's Hospital, Rotterdam, The Netherlands; Department of Child Psychiatry, Washington University, St. Louis, MO, United States
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy.
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205
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Brockmeyer T, Schmidt U, Friederich HC. The ABBA study - approach bias modification in bulimia nervosa and binge eating disorder: study protocol for a randomised controlled trial. Trials 2016; 17:466. [PMID: 27670138 PMCID: PMC5037622 DOI: 10.1186/s13063-016-1596-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 08/30/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The core symptoms of bulimia nervosa (BN) and binge eating disorder (BED) are recurrent episodes of binge eating. Despite negative psychological and physical consequences, BN/BED patients show uncontrollable approach tendencies towards food. This cognitive bias occurs at an early stage of information processing. Cognitive bias modification (CBM) directly targets such biases and has been shown to be effective in treating several mental disorders. In alcohol addiction, automatic action tendencies towards alcohol cues and relapse rates were successfully reduced by a specific form of CBM, termed approach bias modification. Based on these findings and data from a proof-of-concept study in people with high levels of food craving, CBM is considered a promising new treatment approach for BN/BED. Given the similarities between BN/BED and addictive disorders, the rationale for using approach bias modification appears to be particularly strong. The aim of the present study is to examine whether, compared to a sham training, computerised approach bias modification (10 sessions) can reduce binge-eating episodes in BN/BED patients from pre-treatment to follow-up. Additionally, we will investigate whether this CBM programme also reduces global eating disorder psychopathology, trait and cue-elicited food craving, food intake as well as approach and attentional bias towards visual food cues. Treatment acceptance will be determined by attrition rates and responses on a feedback form. METHODS This is a double-blind, randomised, placebo-controlled, parallel-group superiority trial with two parallel arms. A total of 54 BN/BED patients will be recruited. Approach bias towards food will be retrained by a computer task adopting an implicit learning paradigm. Patients in the control condition (sham) will conduct a similar task but will not be trained to avoid food cues. Methods against bias include public registration, randomisation by a central study office, standardisation of the treatments and blinding of assessors. Furthermore, the session number and duration will be equivalent in the two conditions. DISCUSSION This is the first registered randomised controlled trial of approach bias modification in a clinical BN/BED sample. Results from this study will provide an indication of the efficacy of approach bias modification training for BN/BED and the potential mechanisms of action underlying this treatment. TRIAL REGISTRATION DRKS00010231 (retrospectively registered on 24 March 2016; first version).
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Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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206
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Gay A, Jaussent I, Sigaud T, Billard S, Attal J, Seneque M, Galusca B, Van Den Eynde F, Massoubre C, Courtet P, Guillaume S. A Lack of Clinical Effect of High-frequency rTMS to Dorsolateral Prefrontal Cortex on Bulimic Symptoms: A Randomised, Double-blind Trial. EUROPEAN EATING DISORDERS REVIEW 2016; 24:474-481. [DOI: 10.1002/erv.2475] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/12/2016] [Accepted: 08/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Aurelia Gay
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | | | - Torrance Sigaud
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Stephane Billard
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
| | - Jerome Attal
- Inserm U1061; University of Montpellier; Montpellier France
- University Department of Adult Psychiatry; CHRU Montpellier; Montpellier France
| | - Maude Seneque
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
| | - Bogdan Galusca
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Frederique Van Den Eynde
- Eating Disorders Program, Department of Psychiatry, Douglas Hospital; McGill University; Montreal Canada
| | - Catherine Massoubre
- University Department of Psychiatry and Addictology, North Hospital; CHU St-Etienne; St Etienne France
- TAPE Laboratory, EA7423; Jean Monnet University; Saint Etienne France
| | - Philippe Courtet
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
| | - Sebastien Guillaume
- Inserm U1061; University of Montpellier; Montpellier France
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital; CHRU Montpellier; Montpellier France
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207
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Añez E, Fornieles-Deu A, Fauquet-Ars J, López-Guimerà G, Puntí-Vidal J, Sánchez-Carracedo D. Body image dissatisfaction, physical activity and screen-time in Spanish adolescents. J Health Psychol 2016; 23:36-47. [DOI: 10.1177/1359105316664134] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional study contributes to the literature on whether body dissatisfaction is a barrier/facilitator to engaging in physical activity and to investigate the impact of mass-media messages via computer-time on body dissatisfaction. High-school students ( N = 1501) reported their physical activity, computer-time (homework/leisure) and body dissatisfaction. Researchers measured students’ weight and height. Analyses revealed that body dissatisfaction was negatively associated with physical activity on both genders, whereas computer-time was associated only with girls’ body dissatisfaction. Specifically, as computer-homework increased, body dissatisfaction decreased; as computer-leisure increased, body dissatisfaction increased. Weight-related interventions should improve body image and physical activity simultaneously, while critical consumption of mass-media interventions should include a computer component.
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Affiliation(s)
| | | | - Jordi Fauquet-Ars
- Universitat Autonòma de Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Spain
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208
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Eating disorders need more experimental psychopathology. Behav Res Ther 2016; 86:2-10. [PMID: 27600853 DOI: 10.1016/j.brat.2016.08.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 07/30/2016] [Accepted: 08/08/2016] [Indexed: 12/12/2022]
Abstract
Eating disorders are severe and disabling mental disorders. The scientific study of eating disorders has expanded dramatically over the past few decades, and provided significant understanding of eating disorders and their treatments. Those significant advances notwithstanding, there is scant knowledge about key processes that are crucial to clinical improvement. The lack of understanding mechanisms that cause, maintain and change eating disorders, currently is the biggest problem facing the science of eating disorders. It hampers the development of really effective interventions that could be fine-tuned to target the mechanisms of change and, therefore, the development of more effective treatments. It is argued here that the science of eating disorders and eating disorder treatment could benefit tremendously from pure experimental studies into its mechanisms of change, that is, experimental psychopathology (EPP). To illustrate why eating disorders need more EPP research, some key symptoms - restriction of intake, binge eating and body overvaluation - will be discussed. EPP studies challenge some generally accepted views and offer a fresh new look at key symptoms. This will, consequently, better inform eating disorder treatments.
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209
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Pazzaglia M, Zantedeschi M. Plasticity and Awareness of Bodily Distortion. Neural Plast 2016; 2016:9834340. [PMID: 27630779 PMCID: PMC5007354 DOI: 10.1155/2016/9834340] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/20/2016] [Accepted: 08/01/2016] [Indexed: 12/26/2022] Open
Abstract
Knowledge of the body is filtered by perceptual information, recalibrated through predominantly innate stored information, and neurally mediated by direct sensory motor information. Despite multiple sources, the immediate prediction, construction, and evaluation of one's body are distorted. The origins of such distortions are unclear. In this review, we consider three possible sources of awareness that inform body distortion. First, the precision in the body metric may be based on the sight and positioning sense of a particular body segment. This view provides information on the dual nature of body representation, the reliability of a conscious body image, and implicit alterations in the metrics and positional correspondence of body parts. Second, body awareness may reflect an innate organizational experience of unity and continuity in the brain, with no strong isomorphism to body morphology. Third, body awareness may be based on efferent/afferent neural signals, suggesting that major body distortions may result from changes in neural sensorimotor experiences. All these views can be supported empirically, suggesting that body awareness is synthesized from multimodal integration and the temporal constancy of multiple body representations. For each of these views, we briefly discuss abnormalities and therapeutic strategies for correcting the bodily distortions in various clinical disorders.
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Affiliation(s)
- Mariella Pazzaglia
- Department of Psychology, University of Rome “La Sapienza,” Via dei Marsi 78, 00185 Rome, Italy
- IRCCS Santa Lucia Foundation, Via Ardeatina 306, 00179 Rome, Italy
| | - Marta Zantedeschi
- Department of Psychology, University of Rome “La Sapienza,” Via dei Marsi 78, 00185 Rome, Italy
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210
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Pisetsky EM, Utzinger LM, Peterson CB. Incorporating Social Support in the Treatment of Anorexia Nervosa: Special Considerations for Older Adolescents and Young Adults. COGNITIVE AND BEHAVIORAL PRACTICE 2016; 23:316-328. [PMID: 27429544 DOI: 10.1016/j.cbpra.2015.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Currently, research support is strongest for family-based treatment (FBT) for the treatment of anorexia nervosa (AN) in adolescents. However, a strong evidence base for treatments for older adolescents and young adults with AN is lacking. Emphasizing social support in the treatment of AN may be beneficial for older adolescents and young adults with AN. This paper provides a brief review of the literature on FBT for adolescent AN and provides a case example of adolescent AN treated with FBT. We then discuss novel treatments that have incorporated social support for older adolescents and young adults with AN, such as modified FBT and couples-based interventions. We provide case studies of each of these novel treatment approaches as well. Additionally, this paper highlights and discusses developmental considerations and challenges in working with older adolescents and young adults with AN.
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Affiliation(s)
- Emily M Pisetsky
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
| | | | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN
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211
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van Furth EF, van der Meer A, Cowan K. Top 10 research priorities for eating disorders. Lancet Psychiatry 2016; 3:706-707. [PMID: 27475763 DOI: 10.1016/s2215-0366(16)30147-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Eric F van Furth
- Rivierduinen Eating Disorders Ursula, POB 405, 2300 AK Leiden, the Netherlands; Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands.
| | - Angela van der Meer
- Rivierduinen Eating Disorders Ursula, POB 405, 2300 AK Leiden, the Netherlands
| | - Katherine Cowan
- James Lind Alliance, National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, Southampton, UK
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212
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Koyanagi A, Stickley A, Haro JM. Psychotic-like experiences and disordered eating in the English general population. Psychiatry Res 2016; 241:26-34. [PMID: 27152907 DOI: 10.1016/j.psychres.2016.04.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 03/10/2016] [Accepted: 04/15/2016] [Indexed: 12/25/2022]
Abstract
There are no studies on psychotic-like experiences (PLEs) and disordered eating in the general population. We aimed to assess this association in the English adult population. Data from the 2007 Adult Psychiatric Morbidity Survey (APMS) were analyzed. This was a nationally representative survey comprising 7403 English adults aged ≥16 years. The Psychosis Screening Questionnaire was used to identify the past 12-month occurrence of five forms of psychotic symptoms. Questions from the five-item SCOFF screening instrument were used to identify those with eating disorder (ED) symptoms and possible ED in the past year. The prevalence of any PLE was 5.1% (female) and 5.4% (male), while that of possible ED was 9.0% (female) and 3.5% (male). After adjustment for potential confounders, possible ED was associated with hypomania/mania in females (OR=3.23 95%CI=1.002-10.39), strange experiences [females (OR=1.85 95%CI=1.07-3.20) and males (OR=3.54 95%CI=1.65-7.57)], and any PLE in males (OR=3.44 95%CI=1.85-6.39). An interaction analysis revealed that the association was stronger among males for: auditory hallucinations and uncontrolled eating; and any PLE with uncontrolled eating, food dominance, and possible ED. Clinical practitioners should be aware that PLEs and disordered eating behavior often coexist. When one condition is detected, screening for the other may be advisable, especially among males.
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Affiliation(s)
- Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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213
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Parling T, Cernvall M, Ramklint M, Holmgren S, Ghaderi A. A randomised trial of Acceptance and Commitment Therapy for Anorexia Nervosa after daycare treatment, including five-year follow-up. BMC Psychiatry 2016; 16:272. [PMID: 27473046 PMCID: PMC4966749 DOI: 10.1186/s12888-016-0975-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 06/14/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND No specific psychotherapy for adult anorexia nervosa (AN) has shown superior effect. Maintenance factors in AN (over-evaluation of control over eating, weight and shape) were addressed via Acceptance and Commitment Therapy (ACT). The study aimed to compare 19 sessions of ACT with treatment as usual (TAU), after 9 to 12 weeks of daycare, regarding recovery and risk of relapse up to five years. METHODS Patients with a full, sub-threshold or partial AN diagnosis from an adult eating disorder unit at a hospital were randomized to ACT (n = 24) and TAU (n = 19). The staff at the hospital, as well as the participants, were unaware of the allocation until the last week of daycare. Primary outcome measures were body mass index (BMI) and specific eating psychopathology. Analyses included mixed model repeated measures and odds ratios. RESULTS Groups did not differ regarding recovery and relapse using a metric of BMI and the Eating Disorder Examination Questionnaire (EDE-Q). There were only significant time effects. However, odds ratio indicated that ACT participants were more likely to reach good outcome. The study was underpowered due to unexpected low inflow of patients and high attrition. CONCLUSION Longer treatment, more focus on established perpetuating factors and weight restoration integrated with ACT might improve outcome. Potential pitfalls regarding future trials on AN are discussed. Trial registration number ISRCTN 12106530. Retrospectively registered 08/06/2016.
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Affiliation(s)
- Thomas Parling
- Department of Psychology, Uppsala University, P.O. Box 1225, SE-75142, Uppsala, Sweden.
| | - Martin Cernvall
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | | | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Larsson E, Lloyd S, Westwood H, Tchanturia K. Patients’ perspective of a group intervention for perfectionism in anorexia nervosa: A qualitative study. J Health Psychol 2016; 23:1521-1532. [DOI: 10.1177/1359105316660183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study aimed to explore the experiences of adults with anorexia nervosa who took part in a perfectionism group intervention in an inpatient setting. Thematic analysis was used to explore patient feedback collected in focus groups. Patient feedback was generally positive and centred around three main themes: perceived benefits of the group, the content of the group and suggested improvements. The findings suggest that a brief perfectionism group intervention is an acceptable treatment with a range of perceived benefits for patients with severe anorexia nervosa. Understanding patients’ experiences of the intervention can provide further important information to maximise therapeutic impact of the group in inpatient settings.
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Affiliation(s)
| | | | | | - Kate Tchanturia
- King’s College London, UK
- South London and Maudsley NHS Foundation Trust, UK
- Ilia State University, Georgia
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215
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Ceccarini J, Weltens N, Ly HG, Tack J, Van Oudenhove L, Van Laere K. Association between cerebral cannabinoid 1 receptor availability and body mass index in patients with food intake disorders and healthy subjects: a [(18)F]MK-9470 PET study. Transl Psychiatry 2016; 6:e853. [PMID: 27404285 PMCID: PMC5545708 DOI: 10.1038/tp.2016.118] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 04/25/2016] [Indexed: 01/15/2023] Open
Abstract
Although of great public health relevance, the mechanisms underlying disordered eating behavior and body weight regulation remain insufficiently understood. Compelling preclinical evidence corroborates a critical role of the endocannabinoid system (ECS) in the central regulation of appetite and food intake. However, in vivo human evidence on ECS functioning in brain circuits involved in food intake regulation as well as its relationship with body weight is lacking, both in health and disease. Here, we measured cannabinoid 1 receptor (CB1R) availability using positron emission tomography (PET) with [(18)F]MK-9470 in 54 patients with food intake disorders (FID) covering a wide body mass index (BMI) range (anorexia nervosa, bulimia nervosa, functional dyspepsia with weight loss and obesity; BMI range=12.5-40.6 kg/m(2)) and 26 age-, gender- and average BMI-matched healthy subjects (BMI range=18.5-26.6 kg/m(2)). The association between regional CB1R availability and BMI was assessed within predefined homeostatic and reward-related regions of interest using voxel-based linear regression analyses. CB1R availability was inversely associated with BMI in homeostatic brain regions such as the hypothalamus and brainstem areas in both patients with FID and healthy subjects. However, in FID patients, CB1R availability was also negatively correlated with BMI throughout the mesolimbic reward system (midbrain, striatum, insula, amygdala and orbitofrontal cortex), which constitutes the key circuit implicated in processing appetitive motivation and hedonic value of perceived food rewards. Our results indicate that the cerebral homeostatic CB1R system is inextricably linked to BMI, with additional involvement of reward areas under conditions of disordered body weight.
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Affiliation(s)
- J Ceccarini
- Division of Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - N Weltens
- Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - H G Ly
- Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
| | - J Tack
- Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
- Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium
| | - L Van Oudenhove
- Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
- Liaison Psychiatry, University Psychiatric Center Campus Gasthuisberg, University Hospitals Leuven, Leuven, Belgium
| | - K Van Laere
- Division of Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Leuven Institute for Neurobiology and Disease, KU Leuven, Leuven, Belgium
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216
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Dorard G, Khorramian-Pour M. [Binge eating disorder: Links with personality and emotionality]. Encephale 2016; 43:114-119. [PMID: 27374156 DOI: 10.1016/j.encep.2016.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 06/08/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Our two objectives were: (1) to investigate the relationship between binge eating disorder, dimensions of personality (according to the Big Five model of Costa and McCrae) and those of emotionality in the "tripartite" model of emotions of Watson and Clark; (2) to evaluate the correspondence between the Binge Eating Scale (BES) and the Eating Disorder Inventory (EDI-2) scores. METHOD Four self-administered questionnaires were completed on a shared doc website: the EDI-2, the BES, the BFI-Fr (Big Five Inventory-French version) and the EPN-31 (Positive and Negative Emotionality Scale). The analyses were conducted in a sample of 101 participants (36 men and 65 women), aged 20-59 years (mean age=35.28±9.76) from the general population. RESULTS We found that 11% of the participants had moderate to severe binge eating disorder. Among them, nearly 4% were overweight and 4% were obese. The correlations analyses indicated that binge eating disorder was associated with two dimensions of personality, the neuroticism (P=0.001) and the consciousness (P=0.010), and with the emotions of joy (P=0.008), tenderness (P=0.036), fear (P=0.011), shame (P<0.001) and sadness (P=0.009). From a comparative perspective, participants with binge eating disorder get higher scores on EDI-2 subscales: search for thinness (P=0.001), bulimia (P<0.001), dissatisfaction with the body (P<0.001) and interceptive awareness (P<0.001). CONCLUSION These results suggest that binge eating disorder is associated with negative affectivity both as a personality dimension and as an emotional feeling. The patterns of associations, observed with the EDI scale, seem to confirm the good convergent validity of the Binge Eating Scale. Thus, like other eating disorders, emotional functioning should be a prime target for prevention and treatment.
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Affiliation(s)
- G Dorard
- Laboratoire de psychopathologie et processus de santé, EA 4057, IUPDP, institut Henri-Piéron, université Paris Descartes, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France.
| | - M Khorramian-Pour
- Laboratoire de psychopathologie et processus de santé, EA 4057, IUPDP, institut Henri-Piéron, université Paris Descartes, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France
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217
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Gorwood P, Blanchet-Collet C, Chartrel N, Duclos J, Dechelotte P, Hanachi M, Fetissov S, Godart N, Melchior JC, Ramoz N, Rovere-Jovene C, Tolle V, Viltart O, Epelbaum J. New Insights in Anorexia Nervosa. Front Neurosci 2016; 10:256. [PMID: 27445651 PMCID: PMC4925664 DOI: 10.3389/fnins.2016.00256] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 05/23/2016] [Indexed: 12/18/2022] Open
Abstract
Anorexia nervosa (AN) is classically defined as a condition in which an abnormally low body weight is associated with an intense fear of gaining weight and distorted cognitions regarding weight, shape, and drive for thinness. This article reviews recent evidences from physiology, genetics, epigenetics, and brain imaging which allow to consider AN as an abnormality of reward pathways or an attempt to preserve mental homeostasis. Special emphasis is put on ghrelino-resistance and the importance of orexigenic peptides of the lateral hypothalamus, the gut microbiota and a dysimmune disorder of neuropeptide signaling. Physiological processes, secondary to underlying, and premorbid vulnerability factors-the "pondero-nutritional-feeding basements"- are also discussed.
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Affiliation(s)
- Philip Gorwood
- Centre Hospitalier Sainte-Anne (CMME)Paris, France; UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France
| | | | - Nicolas Chartrel
- Institut National de la Santé et de la Recherche Médicale U982, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Institute for Research and Innovation in BiomedicineRouen, France; Normandy UniversityCaen, France; University of RouenRouen, France
| | - Jeanne Duclos
- Adolescents and Young Adults Psychiatry Department, Institut Mutualiste MontsourisParis, France; CESP, Institut National de la Santé et de la Recherche Médicale, Université Paris-Descartes, USPCParis, France; University Reims, Champagne-Ardenne, Laboratoire Cognition, Santé, Socialisation (C2S)-EA 6291Reims, France
| | - Pierre Dechelotte
- Institut National de la Santé et de la Recherche Médicale U1073 IRIB Normandy UniversityRouen, France; Faculté de Médecine-PharmacieRouen, France
| | - Mouna Hanachi
- Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale U1179, équipe Thérapeutiques Innovantes et Technologies Appliquées aux Troubles Neuromoteurs, UFR des Sciences de la Santé Simone VeilMontigny-le-Bretonneux, France; Département de Médecine (Unité de Nutrition), Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de ParisGarches, France
| | - Serguei Fetissov
- Institut National de la Santé et de la Recherche Médicale U1073 IRIB Normandy University Rouen, France
| | - Nathalie Godart
- Adolescents and Young Adults Psychiatry Department, Institut Mutualiste MontsourisParis, France; CESP, Institut National de la Santé et de la Recherche Médicale, Université Paris-Descartes, USPCParis, France
| | - Jean-Claude Melchior
- Université de Versailles Saint-Quentin-en-Yvelines, Institut National de la Santé et de la Recherche Médicale U1179, équipe Thérapeutiques Innovantes et Technologies Appliquées aux Troubles Neuromoteurs, UFR des Sciences de la Santé Simone VeilMontigny-le-Bretonneux, France; Département de Médecine (Unité de Nutrition), Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de ParisGarches, France
| | - Nicolas Ramoz
- UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France
| | - Carole Rovere-Jovene
- Institut de Pharmacologie Moléculaire et Cellulaire, UMR6097, Centre National de la Recherche Scientifique Valbonne, France
| | - Virginie Tolle
- UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France
| | - Odile Viltart
- Université Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer Lille, France
| | - Jacques Epelbaum
- UMR-S 894, Institut National de la Santé et de la Recherche Médicale, Centre de Psychiatrie et NeurosciencesParis, France; Université Paris Descartes, Sorbonne Paris CitéParis, France
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218
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Machado BC, Gonçalves SF, Martins C, Brandão I, Roma-Torres A, Hoek HW, Machado PP. Anorexia nervosa versus bulimia nervosa: differences based on retrospective correlates in a case-control study. Eat Weight Disord 2016; 21:185-97. [PMID: 26506924 DOI: 10.1007/s40519-015-0236-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/15/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study is the result of two Portuguese case-control studies that examined the replication of retrospective correlates and preceding life events in anorexia nervosa (AN) and bulimia nervosa (BN) development. This study aims to identify retrospective correlates that distinguish AN and BN METHOD: A case-control design was used to compare a group of women who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AN (N = 98) and BN (N = 79) with healthy controls (N = 86) and with other psychiatric disorders (N = 68). Each control group was matched with AN patients regarding age and parental social categories. Risk factors were assessed by interviewing each person with the Oxford Risk Factor Interview. RESULTS Compared to AN, women with BN reported significantly higher rates of paternal high expectations, excessive family importance placed on fitness/keeping in shape, and negative consequences due to adolescent overweight and adolescent objective overweight. DISCUSSION Overweight during adolescence emerged as the most relevant retrospective correlate in the distinction between BN and AN participants. Family expectations and the importance placed on keeping in shape were also significant retrospective correlates in the BN group.
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Affiliation(s)
- Bárbara C Machado
- Faculty of Education and Psychology, Catholic University of Portugal, Rua Diogo Botelho, 1327, 4169-005, Porto, Portugal. .,Psychotherapy and Psychopathology Research Unit-CIPsi, School of Psychology, University of Minho, Campus de Gualtar, P-4710, Braga, Portugal.
| | - Sónia F Gonçalves
- Psychotherapy and Psychopathology Research Unit-CIPsi, School of Psychology, University of Minho, Campus de Gualtar, P-4710, Braga, Portugal
| | - Carla Martins
- Psychotherapy and Psychopathology Research Unit-CIPsi, School of Psychology, University of Minho, Campus de Gualtar, P-4710, Braga, Portugal
| | - Isabel Brandão
- Psychiatry Department, Faculty of Medicine, Hospital of S. João, Braga, Portugal
| | - António Roma-Torres
- Psychiatry Department, Faculty of Medicine, Hospital of S. João, Braga, Portugal
| | - Hans W Hoek
- Parnassia Bavo Academy, Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Epidemiology, Columbia University, New York, NY, USA.,Department of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - Paulo P Machado
- Psychotherapy and Psychopathology Research Unit-CIPsi, School of Psychology, University of Minho, Campus de Gualtar, P-4710, Braga, Portugal.
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219
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Amianto F, Bertorello A, Migliore F, Abbate-Daga G, Fassino S. Alexithymia in anorexia and bulimia: Ubiquitous and primary trait? COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1185994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- F. Amianto
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - A. Bertorello
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - F. Migliore
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - G. Abbate-Daga
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - S. Fassino
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
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220
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Sidani JE, Shensa A, Hoffman B, Hanmer J, Primack BA. The Association between Social Media Use and Eating Concerns among US Young Adults. J Acad Nutr Diet 2016; 116:1465-1472. [PMID: 27161027 DOI: 10.1016/j.jand.2016.03.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 03/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The etiology of eating concerns is multifactorial, and exposure to media messages is considered to be a contributor. Although traditional media, such as television and magazines, have been examined extensively in relation to eating concerns risk, the influence of social media has received relatively less attention. OBJECTIVE To examine the association between social media use and eating concerns in a large, nationally representative sample of young adults. DESIGN Cross-sectional survey. PARTICIPANTS/SETTING Participants were 1,765 young adults aged 19 to 32 years who were randomly selected from a national probability-based online nonvolunteer panel. OUTCOME MEASURES An eating concerns scale was adapted from two validated measures: the SCOFF Questionnaire and the Eating Disorder Screen for Primary Care. Social media use (including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit) was assessed using both volume (time per day) and frequency (visits per week). STATISTICAL ANALYSES To examine associations between eating concerns and social media use, ordered logistic regression was used, controlling for all covariates. RESULTS Compared with those in the lowest quartile, participants in the highest quartiles for social media volume and frequency had significantly greater odds of having eating concerns (adjusted odds ratio 2.18, 95% CI 1.50 to 3.17 and adjusted odds ratio 2.55, 95% CI 1.72 to 3.78, respectively). There were significant positive overall linear associations between the social media use variables and eating concerns (P<0.001). CONCLUSIONS The results from this study indicate a strong and consistent association between social media use and eating concerns in a nationally representative sample of young adults aged 19 to 32 years. This association was apparent whether social media use was measured as volume or frequency. Further research should assess the temporality of these associations. It would also be useful to examine more closely the influence of specific characteristics of social media use, including content-related and contextual features.
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221
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Peterson CB, Becker CB, Treasure J, Shafran R, Bryant-Waugh R. The three-legged stool of evidence-based practice in eating disorder treatment: research, clinical, and patient perspectives. BMC Med 2016; 14:69. [PMID: 27081002 PMCID: PMC4832531 DOI: 10.1186/s12916-016-0615-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/08/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Evidence-based practice in eating disorders incorporates three essential components: research evidence, clinical expertise, and patient values, preferences, and characteristics. Conceptualized as a 'three-legged stool' by Sackett et al. in 1996 (BMJ), all of these components of evidence-based practice are considered essential for providing optimal care in the treatment of eating disorders. However, the extent to which these individual aspects of evidence-based practice are valued among clinicians and researchers is variable, with each of these stool 'legs' being neglected at times. As a result, empirical support and patient preferences for treatment are not consistently considered in the selection and implementation of eating disorder treatment. In addition, clinicians may not have access to training to provide treatments supported by research and preferred by patients. Despite these challenges, integrating these three components of evidence-based practice is critical for the effective treatment of eating disorders. DISCUSSION Current research supports the use of several types of psychotherapies, including cognitive-behavioral, interpersonal, and family-based therapies, as well as certain types of medications for the treatment of eating disorders. However, limitations in current research, including sample heterogeneity, inconsistent efficacy, a paucity of data, the need for tailored approaches, and the use of staging models highlight the need for clinical expertise. Although preliminary data also support the importance of patient preferences, values, and perspectives for optimizing treatment, enhancing treatment outcome, and minimizing attrition among patients with eating disorders, the extent to which patient preference is consistently predictive of outcome is less clear and requires further investigation. All three components of evidence-based practice are integral for the optimal treatment of eating disorders. Integrating clinical expertise and patient perspective may also facilitate the dissemination of empirically-supported and emerging treatments as well as prevention programs. Further research is imperative to identify ways in which this three-legged approach to eating disorder treatment could be most effectively implemented.
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Affiliation(s)
- Carol B. Peterson
- />Department of Psychiatry, University of Minnesota Medical School, F282/2A West, 2450 Riverside Avenue South, Minneapolis, MN 55454 USA
- />The Emily Program, St. Paul, MN USA
| | | | - Janet Treasure
- />Department of Psychological Medicine, IOPPN, King’s College, London, UK
| | - Roz Shafran
- />Institute of Child Health, University College, London, UK
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222
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Karjalainen L, Gillberg C, Råstam M, Wentz E. Eating disorders and eating pathology in young adult and adult patients with ESSENCE. Compr Psychiatry 2016; 66:79-86. [PMID: 26995240 DOI: 10.1016/j.comppsych.2015.12.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/31/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Little is known about the prevalence and incidence of traditional eating disorders (EDs, e.g., anorexia nervosa (AN), bulimia nervosa and binge eating disorder (BED)) in individuals with childhood onset neuropsychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). The aim of the present study was to examine the prevalence of EDs and eating pathology in young adults and adults with ADHD and/or ASD, and to investigate the relationship between EDs and associated symptoms, on the one hand, and other psychiatric disorders, intelligence, and BMI, on the other hand, in this population. METHODS In an outpatient setting, 228 consecutively referred adults were neuropsychiatrically evaluated and assessed with regard to intelligence (WAIS-III), psychiatric comorbidities (SCID-I), personality disorders (SCID-II), eating disorders (SCID-I) and eating pathology (Eating Attitudes Test (EAT)). RESULTS For the entire sample, a total of 18 individuals (7.9%) had a current or previous eating disorder, with AN and BED being the most frequent. The male:female ratio was 1:2.5. According to EAT, 10.1% of the individuals scored within the range of severely disturbed eating behavior, and 13% moderately disturbed eating behavior. Individuals with ADHD more often affirmed eating pathology such as focusing on thoughts of calories and body dissatisfaction compared to individuals with ASD. CONCLUSIONS Eating disorder symptomatology seems to be overrepresented in adults with neuropsychiatric disorders compared with the general population. The gender ratio for EDs in adults with neuropsychiatric disorders is not nearly as skewed as in the general population.
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Affiliation(s)
- Louise Karjalainen
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden.
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden; Department of Child and Adolescent Psychiatry, Strathclyde University, Yorkhill Hospital, Glasgow, UK; Institute of Child Health, University College London, London, UK
| | - Maria Råstam
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Elisabet Wentz
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden
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223
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Fogarty S, Smith CA, Hay P. The role of complementary and alternative medicine in the treatment of eating disorders: A systematic review. Eat Behav 2016; 21:179-88. [PMID: 26970732 DOI: 10.1016/j.eatbeh.2016.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 02/23/2016] [Accepted: 03/01/2016] [Indexed: 11/19/2022]
Abstract
This systematic review critically appraises the role of complementary and alternative medicine in the treatment of those with an eating disorder. Sixteen studies were included in the review. The results of this review show that the role of complementary and alternative medicine in the treatment of those with an eating disorder is unclear and further studies should be conducted. A potential role was found for massage and bright light therapy for depression in those with Bulimia Nervosa and a potential role for acupuncture and relaxation therapy, in the treatment of State Anxiety, for those with an eating disorder. The role of these complementary therapies in treating eating disorders should only be provided as an adjunctive treatment only.
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Affiliation(s)
- Sarah Fogarty
- National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia; School of Medicine, University of Western Sydney, Australia.
| | - Caroline A Smith
- National Institute of Complementary Medicine, Western Sydney University, Sydney, Australia.
| | - Phillipa Hay
- School of Medicine, University of Western Sydney, Australia.
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224
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Smink FRE, van Hoeken D, Donker GA, Susser ES, Oldehinkel AJ, Hoek HW. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa. Psychol Med 2016; 46:1189-1196. [PMID: 26671456 DOI: 10.1017/s003329171500272x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. METHOD A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. RESULTS The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. CONCLUSIONS The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.
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Affiliation(s)
- F R E Smink
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - D van Hoeken
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - G A Donker
- NIVEL Primary Care Database, Sentinel Practices,Utrecht,The Netherlands
| | - E S Susser
- Department of Epidemiology,Columbia University,Mailman School of Public Health,New York,USA
| | - A J Oldehinkel
- Department of Psychiatry,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute,The Hague,The Netherlands
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225
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Psychometric properties of a short version of the Eating Attitudes Test (EAT-8) in a German representative sample. Eat Behav 2016; 21:198-204. [PMID: 26978119 DOI: 10.1016/j.eatbeh.2016.03.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 02/19/2016] [Accepted: 03/01/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Disordered eating is common for all ages and sexes in the general population. However, only some individuals are known to develop clinically relevant eating disorders. There is a critical need of efficient, reliable and valid screening instruments to measure disordered eating for the general population. The Eating Attitudes Test was shortened into an 8-item-version to screen individuals at high risk of developing clinical eating disorders in a general population sample. METHODS Psychometric properties (Cronbach's α, construct and concurrent validity and factor structure), cutoff scores (with sensitivity, specificity, positive and negative predictive value) and norms were determined in a representative sample of the German population (N=2527). Factorial validity was investigated using item response modeling. RESULTS Results confirmed reliability and validity of the questionnaire. Internal consistency and convergent validity were good. Analysis revealed different cutoff points for male and female participants. Values for sensitivity and specificity were satisfying and the positive predictive value was higher compared to other short screening instruments for disordered eating. Factorial analysis revealed a one-factor solution with an excellent model fit. The elimination of one item was discussed. Gender- and age-specific norms are reported. CONCLUSIONS Overall results indicated that the EAT-8 is an efficient instrument suitable for screening purposes in large general population samples.
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226
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Fogarty S, Ramjan L, Hay P. A systematic review and meta-synthesis of the effects and experience of mentoring in eating disorders and disordered eating. Eat Behav 2016; 21:66-75. [PMID: 26761787 DOI: 10.1016/j.eatbeh.2015.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/11/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
Abstract
In this review, we aimed to explore the benefits, effects and experiences of mentoring on those with an eating disorder or disordered eating. After a systematic search of the literature, four papers were included in the review. A qualitative analysis of the papers identified three key themes. The themes were (1) diverse benefits (mentees), (2) finding comfort in belonging (mentees), and (3) affirmation of the transformation they have made (mentors). The experience of mentoring was shown to have value for both mentors and mentees. Mentorship should be further utilized in the areas of eating disorders and disordered eating, as it shows promising reciprocal benefits for both mentor and mentee.
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Affiliation(s)
| | - Lucie Ramjan
- School of Nursing and Midwifery, University of Western Sydney, Australia; Centre for Applied Nursing Research (CANR), Ingham Institute of Applied Medical Research, Australia.
| | - Phillipa Hay
- School of Medicine, University of Western Sydney, Australia.
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227
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Dalmaso M, Castelli L, Scatturin P, Carli L, Todisco P, Palomba D, Galfano G. Altered social attention in anorexia nervosa during real social interaction. Sci Rep 2016; 6:23311. [PMID: 26984784 PMCID: PMC4794739 DOI: 10.1038/srep23311] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/29/2016] [Indexed: 11/09/2022] Open
Abstract
The capacity to devote attentional resources in response to body-related signals provided by others is still largely unexplored in individuals with Anorexia Nervosa (AN). Here, we tested this capacity through a novel paradigm that mimics a social interaction with a real partner. Healthy individuals (Experiment 1) and individuals with AN (Experiment 2) completed a task with another person which consisted in performing, alternatively, rapid aiming movements to lateralised targets. Generally, this task leads to a form of Inhibition of Return (IOR), which consists of longer reaction times when an individual has to respond to a location previously searched by either himself (individual IOR) or by the partner (social IOR) as compared to previously unexplored locations. IOR is considered as an important attentional mechanism that promotes an effective exploration of the environment during social interaction. Here, healthy individuals displayed both individual and social IOR that were both reliable and of the same magnitude. Individuals with AN displayed a non-significant individual IOR but a reliable social IOR that was also significantly stronger than individual IOR. These results suggest the presence of a reduced sensitivity in processing body-related stimuli conveyed by oneself in individuals with AN which is reflected in action-based attentional processes.
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Affiliation(s)
- Mario Dalmaso
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Italy
| | - Luigi Castelli
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Italy.,Centro di Neuroscienze Cognitive, Università di Padova, Italy
| | - Pietro Scatturin
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Italy
| | - Lorenza Carli
- Centro per i Disturbi del Comportamento Alimentare, Casa di Cura Villa Margherita, Arcugnano, Italy
| | - Patrizia Todisco
- Centro per i Disturbi del Comportamento Alimentare, Casa di Cura Villa Margherita, Arcugnano, Italy
| | - Daniela Palomba
- Dipartimento di Psicologia Generale, Università di Padova, Italy.,Centro di Neuroscienze Cognitive, Università di Padova, Italy
| | - Giovanni Galfano
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Italy.,Centro di Neuroscienze Cognitive, Università di Padova, Italy
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228
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Elzakkers IFFM, Danner UN, Hoek HW, van Elburg AA. Mental capacity to consent to treatment in anorexia nervosa: explorative study. BJPsych Open 2016; 2:147-153. [PMID: 27703767 PMCID: PMC4998943 DOI: 10.1192/bjpo.bp.115.002485] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/03/2016] [Accepted: 02/11/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental capacity to consent to treatment in anorexia nervosa is a neglected area in clinical decision-making. AIMS To examine clinical and neuropsychological parameters associated with diminished mental capacity in anorexia nervosa. METHOD An explorative study was conducted in 70 adult female patients with severe anorexia nervosa. Mental capacity to consent to treatment was assessed by experienced psychiatrists. Further measurements included the MacCAT-T (to assess mental capacity status), a range of clinical measures (body mass index (BMI) and comorbidity) and neuropsychological tests assessing decision-making, central coherence and set-shifting capacity. RESULTS Diminished mental capacity occurs in a third of patients with severe anorexia nervosa and is associated with a low BMI, less appreciation of illness and treatment, previous treatment for anorexia nervosa, low social functioning and poor set shifting. CONCLUSIONS Assessment of diminished mental capacity in anorexia nervosa requires careful evaluation of not only BMI, but also the degree of appreciation of illness and treatment, history and the tendency to have a rigid thinking style. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
| | - Unna N Danner
- , PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
| | - Hans W Hoek
- , MD, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Annemarie A van Elburg
- , MD, PhD, Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands; Department of Social Sciences, Utrecht University, Utrecht, The Netherlands
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229
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Punzi EH. Excessive behaviors in clinical practice--A state of the art article. Int J Qual Stud Health Well-being 2016; 11:30055. [PMID: 26880343 PMCID: PMC4754017 DOI: 10.3402/qhw.v11.30055] [Citation(s) in RCA: 4] [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] [Accepted: 12/04/2015] [Indexed: 11/17/2022] Open
Abstract
This paper concerns difficulties with excessive food intake, sexual activities, romantic relationships, gambling, Internet use, shopping, and exercise—behaviors that might cause considerable suffering. Excessive behaviors are seen as expressions of underlying difficulties that often co-occur with other psychological difficulties, and behaviors may accompany or replace each other. Moreover, they might pass unnoticed in clinical practice. Given the complexity of excessive behaviors, integrated and individualized treatment has been recommended. This paper presents an overview of the terminology concerning excessive behaviors, and the impact of naming is acknowledged. Thereafter, methods for identification and assessment, as well as treatment needs are discussed. Because identification, assessment, and treatment occur in an interaction between client and practitioner, this paper presents a discussion of the need to empower practitioners to identify and assess excessive behaviors and provide an integrated treatment. Moreover, the need to support practitioners’ capacity to handle and tolerate the overwhelming suffering and the negative consequences connected to excessive behaviors is discussed. Qualitative studies are suggested in order to understand the meaning of excessive behaviors, treatment needs, and the interaction between client and practitioner.
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Affiliation(s)
- Elisabeth H Punzi
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden;
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230
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Fontana R, Della Torre S. The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients 2016; 8:87. [PMID: 26875986 PMCID: PMC4772050 DOI: 10.3390/nu8020087] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/21/2016] [Accepted: 02/02/2016] [Indexed: 01/01/2023] Open
Abstract
In female mammals, mechanisms have been developed, throughout evolution, to integrate environmental, nutritional and hormonal cues in order to guarantee reproduction in favorable energetic conditions and to inhibit it in case of food scarcity. This metabolic strategy could be an advantage in nutritionally poor environments, but nowadays is affecting women's health. The unlimited availability of nutrients, in association with reduced energy expenditure, leads to alterations in many metabolic pathways and to impairments in the finely tuned inter-relation between energy metabolism and reproduction, thereby affecting female fertility. Many energetic states could influence female reproductive health being under- and over-weight, obesity and strenuous physical activity are all conditions that alter the profiles of specific hormones, such as insulin and adipokines, thus impairing women fertility. Furthermore, specific classes of nutrients might affect female fertility by acting on particular signaling pathways. Dietary fatty acids, carbohydrates, proteins and food-associated components (such as endocrine disruptors) have per se physiological activities and their unbalanced intake, both in quantitative and qualitative terms, might impair metabolic homeostasis and fertility in premenopausal women. Even though we are far from identifying a "fertility diet", lifestyle and dietary interventions might represent a promising and invaluable strategy to manage infertility in premenopausal women.
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Affiliation(s)
- Roberta Fontana
- Department of Pharmacological and Biomolecular Sciences, University of Milan, via Balzaretti 9, Milan 20133, Italy.
- Department of Drug Discovery and Development, Italian Institute of Technology, via Morego 30, Genova 16163, Italy.
| | - Sara Della Torre
- Department of Pharmacological and Biomolecular Sciences, University of Milan, via Balzaretti 9, Milan 20133, Italy.
- Center of Excellence of Neurodegenerative Diseases, University of Milan, via Balzaretti 9, Milan 20133, Italy.
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231
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Austin SB. Accelerating Progress in Eating Disorders Prevention: A Call for Policy Translation Research and Training. Eat Disord 2016; 24:6-19. [PMID: 25880718 DOI: 10.1080/10640266.2015.1034056] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The public health burden of eating disorders is well documented, and over the past several decades, researchers have made important advances in the prevention of eating disorders and related problems with body image. Despite these advances, however, several critical limitations to the approaches developed to date leave the field far from achieving the large-scale impact that is needed. This commentary provides a brief review of what achievements in prevention have been made and identifies the gaps that limit the potential for greater impact on population health. A plan is then offered with specific action steps to accelerate progress in high-impact prevention, most compellingly by promoting a shift in priorities to policy translation research and training for scholars through the adoption of a triggers-to-action framework. Finally, the commentary provides an example of the application of the triggers-to-action framework as practiced at the Strategic Training Initiative for the Prevention of Eating Disorders, a program based at the Harvard T. H. Chan School of Public Health and Boston Children's Hospital. Much has been achieved in the nearly 30 years of research carried out for the prevention of eating disorders and body image problems, but several critical limitations undermine the field's potential for meaningful impact. Through a shift in the field's priorities to policy translation research and training with an emphasis on macro-environmental influences, the pace of progress in prevention can be accelerated and the potential for large-scale impact substantially improved.
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Affiliation(s)
- S Bryn Austin
- a Department of Social and Behavioral Sciences , Harvard T. H. Chan School of Public Health , Boston , Massachusetts , USA.,b Division of Adolescent and Young Adult Medicine, Boston Children's Hospital , Boston , Massachusetts , United States
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232
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Disentangling the Association Between Child Abuse and Eating Disorders: A Systematic Review and Meta-Analysis. Psychosom Med 2016; 78:79-90. [PMID: 26461853 DOI: 10.1097/psy.0000000000000233] [Citation(s) in RCA: 178] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to estimate the association between distinct types of child abuse--sexual (CSA), physical (CPA), and emotional (CEA)--and different eating disorders (EDs). METHODS Electronic databases were searched through January 2014. Studies reporting rates of CSA, CPA, and CEA in people with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), as compared with individuals without EDs, were included. Pooled analyses were based on odds ratios (ORs), with relevant 95% confidence intervals (CIs), weighting each study with inverse variance models with random effects. Risk of publication bias was estimated. RESULTS Thirty-two of 1714 studies assessed for eligibility met the inclusion criteria, involving more than 14,000 individuals. The association between EDs and any child abuse showed a random-effects pooled OR of 3.21 (95% CI = 2.29-4.51, p < .001) with moderate heterogeneity (I2 = 57.2%, p = .005), whereas for CSA, this was 1.92 (95% CI = 1.13-3.28, p = .017), 2.73 (95% CI = 1.96-3.79, p < .001), and 2.31 (95% CI = 1.66-3.20, p < .001), for AN, BN, and BED, respectively. However, adjusting for publication bias, the estimate for CSA and AN was not significant (OR = 1.06, 95% CI = 0.59-1.88, p = .85). Although CPA was associated with AN, BN, and BED, CEA was associated just with BN and BED. CONCLUSIONS BN and BED are associated with childhood abuse, whereas AN shows mixed results. Individuals with similar trauma should be monitored for early recognition of EDs. TRIAL REGISTRATION The protocol was registered in PROSPERO (an international prospective register of systematic reviews) with the reference number CRD42014007360.
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233
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Fogelkvist M, Parling T, Kjellin L, Gustafsson SA. A qualitative analysis of participants' reflections on body image during participation in a randomized controlled trial of acceptance and commitment therapy. J Eat Disord 2016; 4:29. [PMID: 27999670 PMCID: PMC5151132 DOI: 10.1186/s40337-016-0120-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 10/09/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Negative body image is a risk factor for development and relapse in eating disorders (ED). Many patients continue to be dissatisfied with their body shape or weight after treatment. This study presents a qualitative analysis of written reflections on body image from patients with an ED and a negative body image before and after an Acceptance and Commitment Therapy group treatment at a specialized ED-unit. METHOD Before and after the treatment participants (n = 47) answered a questionnaire with open ended questions on their thoughts on body image. Data were analyzed through conventional content analysis. RESULTS Body image meant different things for different participants. For some it had to do with how you evaluate your body, whereas others focused on whether their body image was realistic or not. Some emphasized their relationship with their body, while some described body image as strongly related to global self-esteem. These different views on the concept of body image affected the participants' descriptions of their own body image, and how they wanted it to change. Body image was considered a state that fluctuated from day to day. After treatment the participants described changes in their body image, for instance perceiving oneself as less judgmental towards one's body, and a shift in focus to the important things in life. CONCLUSIONS The participants had different views on body image and how they wished it to change. Thus treatment interventions targeting negative body image needs to address various aspects of this complex construct. TRIAL REGISTRATION This study is part of an RCT registered 02/06/2014 in Clinical Trials, registration number: NCT02058121.
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Affiliation(s)
- Maria Fogelkvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, S-huset, vån 2, Box 1613, 701 16 Örebro, Sweden
| | - Thomas Parling
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, S-huset, vån 2, Box 1613, 701 16 Örebro, Sweden
| | - Sanna Aila Gustafsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, S-huset, vån 2, Box 1613, 701 16 Örebro, Sweden
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234
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Rosling A, Salonen Ros H, Swenne I. One-year outcome and incidence of anorexia nervosa and restrictive eating disorders among adolescent girls treated as out-patients in a family-based setting. Ups J Med Sci 2016; 121:50-9. [PMID: 26915921 PMCID: PMC4812058 DOI: 10.3109/03009734.2016.1141810] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aims To study the 1-year outcome and to analyse predictors of outcome of a cohort of adolescent girls with anorexia nervosa (AN) or restrictive eating disorders not otherwise specified (EDNOSr) treated as out-patients in a family-based programme at a specialized eating disorder service. To calculate the incidence of anorexia nervosa among treatment-seeking girls younger than 18 in Uppsala County from 2004 to 2006. Methods A total of 168 female patients were offered treatment, and 141 were followed-up 1 year after starting treatment, 29 with AN and 112 with EDNOSr. Results Of the 29 girls who initially had AN, 6 (20%) had a good outcome and were free of any form of eating disorder at follow-up; only 1 (3%) had AN. Of the patients with EDNOSr, 54 (48%) had a good outcome and were free of eating disorders. Three (3%) had a poor outcome and had developed AN. The incidence of AN was 18/100,000 person-years in girls younger than 12 and 63/100,000 in girls younger than 18. Conclusion Restrictive eating disorders, including AN, in children and adolescents can be successfully treated in a family-based specialized out-patient service without in-patient care.
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Affiliation(s)
- Agneta Rosling
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University Hospital, Uppsala, Sweden
- CONTACT Agneta Rosling, MD Department of Child and Adolescent Psychiatry, Uppsala University Hospital, S-751 85 Uppsala, Sweden
| | - Helena Salonen Ros
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University Hospital, Uppsala, Sweden
| | - Ingemar Swenne
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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235
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Su X, Liang H, Yuan W, Olsen J, Cnattingius S, Li J. Prenatal and early life stress and risk of eating disorders in adolescent girls and young women. Eur Child Adolesc Psychiatry 2016; 25:1245-1253. [PMID: 27083434 PMCID: PMC5083758 DOI: 10.1007/s00787-016-0848-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 04/06/2016] [Indexed: 12/24/2022]
Abstract
Females are more likely than males to develop eating disorders (EDs) in the adolescence and youth, and the etiology remains unclear. We aimed to estimate the effect of severe early life stress following bereavement, the death of a close relative, on the risk of EDs among females aged 10-26 years. This population-based cohort study included girls born in Denmark (from 1973 to 2000) or Sweden (from 1970 to 1997). Girls were categorized as exposed if they were born to mothers who lost a close relative 1 year prior to or during pregnancy or if the girl herself lost a parent or a sibling within the first 10 years of life. All other girls were included in unexposed group. An ED case was defined by a diagnosis of EDs at ages of 10-26 years, including broadly defined bulimia nervosa, broadly defined anorexia nervosa and mixed EDs. Poisson regression models were used to estimate the incidence rate ratio (IRR) between exposed group and unexposed group.A total of 64453 (3.05 %) girls were included in the exposed group. We identified 9477 girls with a diagnosis of EDs, of whom 307 (3.24 %) were from the exposed group. Both prenatal and postnatal exposure following bereavement by unexpected death was associated with an increased overall risk of EDs (IRRprenatal: 1.49, 95 % CI: 1.01-2.19 and IRRpostnatal: 1.34, 95 % CI: 1.05-1.71). We observed similar results for subtypes of broadly defined bulimia nervosa (IRR: 2.47, 95 % CI: 1.67-3.65) and mixed EDs (IRR: 1.45, 95 % CI: 1.02-2.07).Our findings suggest that prenatal and early postnatal life stress due to unexpected death of a close relative is associated with an increased overall risk of eating disorders in adolescent girls and young women. The increased risk might be driven mainly by differences in broadly defined bulimia nervosa and mixed eating disorders, but not broadly defined anorexia nervosa.
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Affiliation(s)
- Xiujuan Su
- Department of Women's and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200120, People's Republic of China.
| | - Hong Liang
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, 200032 People’s Republic of China
| | - Wei Yuan
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 8200 N Denmark
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 8200 N Denmark
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236
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Morita C, Tsuji H, Hata T, Gondo M, Takakura S, Kawai K, Yoshihara K, Ogata K, Nomoto K, Miyazaki K, Sudo N. Gut Dysbiosis in Patients with Anorexia Nervosa. PLoS One 2015; 10:e0145274. [PMID: 26682545 PMCID: PMC4687631 DOI: 10.1371/journal.pone.0145274] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/02/2015] [Indexed: 02/07/2023] Open
Abstract
Anorexia nervosa (AN) is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25), including restrictive (ANR, n = 14) and binge-eating (ANBP, n = 11) subtypes, with those of age-matched healthy female controls (n = 21) using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA–targeted RT–quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients.
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Affiliation(s)
- Chihiro Morita
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Tomokazu Hata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shu Takakura
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Kawai
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | | | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
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237
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Longo MR, Mattioni S, Ganea N. Perceptual and Conceptual Distortions of Implicit Hand Maps. Front Hum Neurosci 2015; 9:656. [PMID: 26733842 PMCID: PMC4679851 DOI: 10.3389/fnhum.2015.00656] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/18/2015] [Indexed: 01/15/2023] Open
Abstract
Recent studies have revealed that human position sense relies on a massively distorted representation of hand size and shape. By comparing the judged location of landmarks on an occluded hand, Longo and Haggard (2010) constructed implicit perceptual maps of represented hand structure, showing large underestimation of finger length and overestimation of hand width. Here, we investigated the contribution of two potential sources of distortions to such effects: perceptual distortions reflecting spatial warping of the representation of bodily tissue itself, perhaps reflecting distortions of somatotopic cortical maps, and conceptual distortions reflecting mistaken beliefs about the locations of different landmarks within the body. In Experiment 1 we compared distorted hand maps to a task in which participants explicitly judged the location of their knuckles in a hand silhouette. The results revealed the conceptual distortions are responsible for at least part of the underestimation of finger length, but cannot explain overestimation of hand width. Experiment 2 compared distortions of the participant’s own hand based on position sense with a prosthetic hand based on visual memory. Underestimation of finger length was found for both hands, providing further evidence that it reflects a conceptual distortion. In contrast, overestimation of hand width was specific to representation of the participant’s own hand, confirming it reflects a perceptual distortion. Together, these results suggest that distorted body representations do not reflect a single underlying cause. Rather, both perceptual and conceptual distortions contribute to the overall configuration of the hand representation.
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Affiliation(s)
- Matthew R Longo
- Department of Psychological Sciences, Birkbeck University of London London, UK
| | - Stefania Mattioni
- Department of Psychological Sciences, Birkbeck University of LondonLondon, UK; Centre for Mind/Brain Sciences, University of TrentoTrento, Italy
| | - Nataşa Ganea
- Department of Psychological Sciences, Birkbeck University of London London, UK
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Serino S, Dakanalis A, Gaudio S, Carrà G, Cipresso P, Clerici M, Riva G. Out of body, out of space: Impaired reference frame processing in eating disorders. Psychiatry Res 2015; 230:732-4. [PMID: 26541204 DOI: 10.1016/j.psychres.2015.10.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/26/2015] [Accepted: 10/23/2015] [Indexed: 11/25/2022]
Abstract
A distorted body representation is a core symptom in eating disorders (EDs), though its mechanism is unclear. Allocentric lock theory, emphasising the role of reference frame processing in body image, suggests that ED patients may be (b)locked to an (allocentric) representation of their own body stored in long-term memory (e.g., my body is fat) that is not updated (modified) by the (real-time egocentric) perception-driven experience of the physical body. Employing a well-validated virtual reality-based procedure, relative to healthy controls, ED patients showed deficits in the ability to refer to and update a long-term stored (allocentric) representation with (egocentric) perceptual-driven inputs.
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Affiliation(s)
- Silvia Serino
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy.
| | - Antonios Dakanalis
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Department of Surgery and Interdisciplinary Medicine, University of Milano-Bicocca, Milan, Italy
| | - Santino Gaudio
- Centre for Integrated Research-Area of Diagnostic Imaging, University Campus Bio-Medico, Rome, Italy
| | - Giuseppe Carrà
- Division of Psychiatry, Faculty of Brain Sciences, University College of London, London, UK
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
| | - Massimo Clerici
- Department of Surgery and Interdisciplinary Medicine, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy; Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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239
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Wu M, Brockmeyer T, Hartmann M, Skunde M, Herzog W, Friederich HC. Reward-related decision making in eating and weight disorders: A systematic review and meta-analysis of the evidence from neuropsychological studies. Neurosci Biobehav Rev 2015; 61:177-96. [PMID: 26698021 DOI: 10.1016/j.neubiorev.2015.11.017] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 11/30/2015] [Indexed: 02/02/2023]
Abstract
Eating disorders (EDs) and overweight/obesity (OW/OB) are serious public health concerns that share common neuropsychological features and patterns of disturbed eating. Reward-related decision making as a basic neurocognitive function may trans-diagnostically underlie both pathological overeating and restricted eating. The present meta-analysis synthesizes the evidence from N=82 neuropsychological studies for altered reward-related decision making in all ED subtypes, OW and OB. The overall effect sizes for the differences between currently-ill ED patients and OW/OB people and controls were Hedge's g=-0.49 [CI: -0.63; -0.35], and Hedge's g=-0.39 [CI: -0.53; -0.25], respectively. Decision making was found to be altered to similar degrees in all ED subtypes and OB. Effect sizes, however, diverged for the different measures of decision making. Adolescents appear to be less affected than adults. When foods were used as rewarding stimuli, decision making was found to be intact in OB. The findings support that altered general reward-related decision making is a salient neuropsychological factor across eating and weight disorders in adulthood.
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Affiliation(s)
- Mudan Wu
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg Heidelberg, Germany; Department of Psychology, College of Education, Shanghai Normal University, Shanghai, China
| | - Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg Heidelberg, Germany.
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg Heidelberg, Germany
| | - Mandy Skunde
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg Heidelberg, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg Heidelberg, Germany; Department of Psychosomatic Medicine and Psychotherapy, LVR-Klinikum, University Duisburg-Essen, Essen, Germany
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240
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Zipfel S, Giel KE, Bulik CM, Hay P, Schmidt U. Anorexia nervosa: aetiology, assessment, and treatment. Lancet Psychiatry 2015; 2:1099-111. [PMID: 26514083 DOI: 10.1016/s2215-0366(15)00356-9] [Citation(s) in RCA: 432] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 02/07/2023]
Abstract
Anorexia nervosa is an important cause of physical and psychosocial morbidity. Recent years have brought advances in understanding of the underlying psychobiology that contributes to illness onset and maintenance. Genetic factors influence risk, psychosocial and interpersonal factors can trigger onset, and changes in neural networks can sustain the illness. Substantial advances in treatment, particularly for adolescent patients with anorexia nervosa, point to the benefits of specialised family-based interventions. Adults with anorexia nervosa too have a realistic chance of achieving recovery or at least substantial improvement, but no specific approach has shown clear superiority, suggesting a combination of re-nourishment and anorexia nervosa-specific psychotherapy is most effective. To successfully fight this enigmatic illness, we have to enhance understanding of the underlying biological and psychosocial mechanisms, improve strategies for prevention and early intervention, and better target our treatments through improved understanding of specific disease mechanisms.
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Affiliation(s)
- Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany.
| | - Katrin E Giel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Cynthia M Bulik
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Phillipa Hay
- School of Medicine and Centre for Health Research Western Sydney University, Penrith, NSW, Australia
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241
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Guillaume S, Gorwood P, Jollant F, Van den Eynde F, Courtet P, Richard-Devantoy S. Impaired decision-making in symptomatic anorexia and bulimia nervosa patients: a meta-analysis. Psychol Med 2015; 45:3377-3391. [PMID: 26497047 DOI: 10.1017/s003329171500152x] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impaired decision-making is a potential neurocognitive phenotype of eating disorders. It is therefore important to disentangle the decision-making deficits associated with the eating disorder subtypes and determine whether this putative impairment is a state or trait marker of the disease or more related to starvation. We systematically reviewed the literature on decision-making in eating disorders and conducted a meta-analysis to explore its role in anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating disorder (BED). METHOD A search of the Medline and EMBASE databases and article references was performed. A total of 23 studies (2044 participants) met the selection criteria. When the Iowa gambling task (IGT) was used in at least three of the studies, a meta-analysis was run. RESULTS IGT performance was significantly worse in patients with an eating disorder diagnosis (AN, BN or BED) compared with healthy controls, indicating that eating disorders have a negative effect on decision-making. Hedges' g effect sizes were moderate to large (-0.72 in AN, -0.62 in BN, and -1.26 in BED). Recovered AN patients had IGT scores similar to those of healthy controls. Restrictive AN patients had significantly lower IGT net scores than purging AN patients, and both AN subtypes had worse performances than healthy controls. Age and body mass index did not explain results. CONCLUSIONS Decision-making was significantly altered in patients with eating disorders. Poor decision-making was more pronounced during the acute phase than in the recovered state of AN. Nutritional status during the acute phase of the disease did not seem to influence decision-making skills.
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Affiliation(s)
- S Guillaume
- Université Montpellier I & CHU Montpellier & Inserm,U1061,Montpellier,France
| | - P Gorwood
- CMME (Groupe Hospitalier Sainte-Anne),Université Paris Descartes,Paris,France
| | - F Jollant
- Department of Psychiatry & Douglas Mental Health University Institute,McGill Group for Suicide Studies,McGill University,Montréal (Québec),Canada
| | - F Van den Eynde
- Department of Psychiatry & Douglas Mental Health University Institute,McGill University,Montréal (Québec),Canada
| | - P Courtet
- Université Montpellier I & CHU Montpellier & Inserm,U1061,Montpellier,France
| | - S Richard-Devantoy
- Department of Psychiatry & Douglas Mental Health University Institute,McGill Group for Suicide Studies,McGill University,Montréal (Québec),Canada
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242
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The MABIC project: An effectiveness trial for reducing risk factors for eating disorders. Behav Res Ther 2015; 77:23-33. [PMID: 26708330 DOI: 10.1016/j.brat.2015.11.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 09/29/2015] [Accepted: 11/23/2015] [Indexed: 11/20/2022]
Abstract
Challenges in the prevention of disordered eating field include moving from efficacy to effectiveness and developing an integrated approach to the prevention of eating and weight-related problems. A previous efficacy trial indicated that a universal disordered eating prevention program, based on the social cognitive model, media literacy educational approach and cognitive dissonance theory, reduced risk factors for disordered eating, but it is unclear whether this program has effects under more real-world conditions. This effectiveness trial tested whether this program has effects when previously trained community providers in an integrated approach to prevention implement the intervention. The research design involved a multi-center non-randomized controlled trial with baseline, post-test and 1-year follow-up measures. The sample included girls in the 8th grade from six schools (n = 152 girls) in a city near Barcelona (intervention group), and from eleven schools (n = 413 girls) in four neighboring towns (control group). The MABIC risk factors of disordered eating were assessed as main outcomes. Girls in the intervention group showed significantly greater reductions in beauty ideal internalization, disordered eating attitudes and weight-related teasing from pretest to 1-year follow-up compared to girls in the control group, suggesting that this program is effective under real-world conditions.
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243
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Treasure J, Zipfel S, Micali N, Wade T, Stice E, Claudino A, Schmidt U, Frank GK, Bulik CM, Wentz E. Anorexia nervosa. Nat Rev Dis Primers 2015; 1:15074. [PMID: 27189821 DOI: 10.1038/nrdp.2015.74] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. AN predominantly develops in adolescence in the peripubertal period. Without early effective treatment, the course is protracted with physical, psychological and social morbidity and high mortality. Despite these effects, patients are noted to value the beliefs and behaviours that contribute to their illness rather than regarding them as problematic, which interferes with screening, prevention and early intervention. Involving the family to support interventions early in the course of the illness can produce sustained changes; however, those with a severe and/or protracted illness might require inpatient nursing support and/or outpatient psychotherapy. Prevention programmes aim to moderate the overvaluation of 'thinness' and body dissatisfaction as one of the proximal risk factors. The low prevalence of AN limits the ability to identify risk factors and to study the timing and sex distribution of the condition. However, genetic profiles, premorbid features, and brain structures and functions of patients with AN show similarities with other psychiatric disorders and contrast with obesity and metabolic disorders. Such studies are informing approaches to address the neuroadaptation to starvation and the other various physical and psychosocial deficits associated with AN. This Primer describes the epidemiology, diagnosis, screening and prevention, aetiology, treatment and quality of life of patients with AN.
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Affiliation(s)
- Janet Treasure
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London SE5 8AF, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tuebingen, Tuebingen, Germany
| | - Nadia Micali
- University College London, Institute of Child Health, Behavioural and Brain Sciences Unit, London, UK.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Tracey Wade
- School of Psychology, Flinders University, Adelaide, Australia
| | - Eric Stice
- Oregon Research Institute, Eugene, Oregon, USA
| | - Angélica Claudino
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Ulrike Schmidt
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London SE5 8AF, UK
| | - Guido K Frank
- Eating Disorder Centre of Denver, University of Colorado, Denver, Colorado, USA
| | - Cynthia M Bulik
- University of North Carolina at Chapel Hill, North Carolina, USA.,Karolinska Institutet, Stockholm, Sweden
| | - Elisabet Wentz
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg Sweden
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244
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Biomarkers of Eating Disorders Using Support Vector Machine Analysis of Structural Neuroimaging Data: Preliminary Results. Behav Neurol 2015; 2015:924814. [PMID: 26648660 PMCID: PMC4663371 DOI: 10.1155/2015/924814] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/18/2015] [Accepted: 09/28/2015] [Indexed: 11/18/2022] Open
Abstract
Presently, there are no valid biomarkers to identify individuals with eating disorders (ED). The aim of this work was to assess the feasibility of a machine learning method for extracting reliable neuroimaging features allowing individual categorization of patients with ED. Support Vector Machine (SVM) technique, combined with a pattern recognition method, was employed utilizing structural magnetic resonance images. Seventeen females with ED (six with diagnosis of anorexia nervosa and 11 with bulimia nervosa) were compared against 17 body mass index-matched healthy controls (HC). Machine learning allowed individual diagnosis of ED versus HC with an Accuracy ≥ 0.80. Voxel-based pattern recognition analysis demonstrated that voxels influencing the classification Accuracy involved the occipital cortex, the posterior cerebellar lobule, precuneus, sensorimotor/premotor cortices, and the medial prefrontal cortex, all critical regions known to be strongly involved in the pathophysiological mechanisms of ED. Although these findings should be considered preliminary given the small size investigated, SVM analysis highlights the role of well-known brain regions as possible biomarkers to distinguish ED from HC at an individual level, thus encouraging the translational implementation of this new multivariate approach in the clinical practice.
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245
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Hoodbhoy Z, Zahid N, Iqbal R. Eating disorders in South Asia: Should we be concerned? NUTR BULL 2015. [DOI: 10.1111/nbu.12177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Z. Hoodbhoy
- Department of Obstetrics and Gynaecology; The Aga Khan University; Karachi Pakistan
| | - N. Zahid
- Departments of Community Health Sciences and Medicine; The Aga Khan University; Karachi Pakistan
| | - R. Iqbal
- Departments of Community Health Sciences and Medicine; The Aga Khan University; Karachi Pakistan
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246
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Latzer Y, Weinberger-Litman SL, Gerson B, Rosch A, Mischel R, Hinden T, Kilstein J, Silver J. Negative Religious Coping Predicts Disordered Eating Pathology Among Orthodox Jewish Adolescent Girls. JOURNAL OF RELIGION AND HEALTH 2015; 54:1760-1771. [PMID: 25138248 DOI: 10.1007/s10943-014-9927-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Recent research suggests the importance of exploring religious and spiritual factors in relation to the continuum of disordered eating. This continuum ranges from mild disordered eating behaviors and attitudes to moderate levels of disordered eating pathology (DEP) through full-blown clinical levels of eating disorders (EDs). The current study is the first to explore the role that religious coping (both positive and negative) plays in the development DEP, which is considered a risk factor for the development of EDs. In addition, the study aims to describe levels of DEP among a non-clinical sample of 102 Orthodox Jewish adolescent females. Participants completed a questionnaire measuring religious coping strategies, DEP and self-esteem. Results indicated that greater use of negative religious coping was associated with higher levels of DEP. Mediation analyses suggested that greater negative religious coping is related to lower levels of self-esteem, which accounts for higher levels of DEP. Furthermore, findings revealed relatively lower overall levels of DEP among this sample, compared to similar populations in Israel and the USA. These results suggest that a strong religious and spiritual identity may serve as a protective factor against DEP.
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Affiliation(s)
- Yael Latzer
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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247
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Dalmaso M, Castelli L, Franchetti L, Carli L, Todisco P, Palomba D, Galfano G. Altered orienting of attention in anorexia nervosa. Psychiatry Res 2015; 229:318-25. [PMID: 26184992 DOI: 10.1016/j.psychres.2015.06.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 06/05/2015] [Accepted: 06/27/2015] [Indexed: 01/11/2023]
Abstract
The study of cognitive processes in anorexia nervosa (AN) is largely unexplored, although recent evidence suggests the presence of impairments in both social cognition and attention processing. Here we investigated AN patients' ability to orient attention in response to social and symbolic visual stimuli. AN patients and matched controls performed a task in which gaze and pointing gestures acted as social directional cues for spatial attention. Arrows were also included as symbolic cue. On each trial, a centrally-placed cue appeared oriented rightwards or leftwards. After either 200 or 700ms, a lateralized neutral target (a letter) requiring a discrimination response appeared in a location either spatially congruent or incongruent with the directional cue. Controls showed a reliable orienting irrespective of both temporal interval and cue type. AN patients showed a reliable orienting at both temporal intervals only in response to pointing gestures. Both gaze and arrow cues failed to orient attention at the short temporal interval, that is when attention is under reflexive control, whereas a reliable orienting emerged at the long temporal interval. These results provide preliminary evidence of altered reflexive orienting of attention in AN patients that does not extend to body-related cues such as pointing gestures.
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Affiliation(s)
- Mario Dalmaso
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Via Venezia 8, 35131 Padova, Italy.
| | - Luigi Castelli
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Via Venezia 8, 35131 Padova, Italy; Centro di Neuroscienze Cognitive, Università di Padova, Padova, Italy
| | - Lorena Franchetti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Via Venezia 8, 35131 Padova, Italy
| | - Lorenza Carli
- Centro per i Disturbi del Comportamento Alimentare, Casa di Cura Villa Margherita, Arcugnano, Vicenza, Italy
| | - Patrizia Todisco
- Centro per i Disturbi del Comportamento Alimentare, Casa di Cura Villa Margherita, Arcugnano, Vicenza, Italy
| | - Daniela Palomba
- Centro di Neuroscienze Cognitive, Università di Padova, Padova, Italy; Dipartimento di Psicologia Generale, Università di Padova, Padova, Italy
| | - Giovanni Galfano
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Via Venezia 8, 35131 Padova, Italy; Centro di Neuroscienze Cognitive, Università di Padova, Padova, Italy
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248
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Su X, Xu B, Liang H, Olsen J, Yuan W, Cnattingius S, László KD, Li J. Prenatal maternal bereavement and risk of eating disorders in infants and toddlers: a population-based cohort study. BMC Psychiatry 2015; 15:229. [PMID: 26403981 PMCID: PMC4582887 DOI: 10.1186/s12888-015-0612-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 09/17/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Prenatal stress has been associated to a number of neuropsychiatric diseases but its role on the development of eating disorders (ED) remains unknown. Infants and toddlers with feeding or eating disorders are also at an increased risk of such diseases in later childhood and adolescence. We aimed to examine whether prenatal stress following maternal bereavement is associated with ED in infants and toddlers. METHODS This population-based cohort study included children born from 1977 to 2008 in Denmark (N = 2,127,126) and from 1977 to 2006 in Sweden (N = 2,974,908). Children were categorized as exposed if they were born to mothers who lost a close relative one year prior to or during pregnancy and were categorized as unexposed otherwise. They were followed until the age of 3 for a first diagnosis of ED. Poisson regression models were used to examine incidence rate ratio (IRR) between the exposed and the unexposed cohort. RESULTS A total of 9,403 ED cases were identified and 179 of whom were in the exposed cohort. Offspring born to mothers bereaved by loss of a core family member (older child or spouse) within the six months before pregnancy had a higher risk of ED than the unexposed offspring (IRR: 1.63, 95% confidence intervals (CI): 1.07-2.47). In stratified analyses, bereavement during the six months before pregnancy was associated with an increased risk of ED in boys (IRR: 2.21, 95% CI: 1.28-3.82), but not in girls (IRR: 1.18, 95% CI: 0.61-2.27). DISCUSSION This is the first population-based study to explore the association between prenatal stress and the risk of ED in infants and toddlers within two Nordic countries. This study added new evidence of early life stress for etiology of ED while the potential mechanism still needs further studies. CONCLUSIONS Prenatal stress following maternal bereavement by loss of a core family member is associated with an increased risk of ED among infants and toddlers. The six months before conception may be a susceptible time window, especially for boys.
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Affiliation(s)
- Xiujuan Su
- Department of Women's and Children's Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, PR China. .,Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, 8000, Denmark.
| | - Beibei Xu
- Medical Informatics Center, Peking University, Beijing, PR China.
| | - Hong Liang
- Department of Reproductive Epidemiology and Social Science, National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, 200032, PR China.
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, 8000, Denmark.
| | - Wei Yuan
- Department of Reproductive Epidemiology and Social Science, National Population and Family Planning Key Laboratory of Contraceptive Drugs and Devices, Shanghai Institute of Planned Parenthood Research, Shanghai, 200032, PR China.
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
| | - Krisztina D. László
- Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Jiong Li
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, 8000, Denmark.
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249
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Favaro A, Tenconi E, Degortes D, Manara R, Santonastaso P. Gyrification brain abnormalities as predictors of outcome in anorexia nervosa. Hum Brain Mapp 2015; 36:5113-22. [PMID: 26374960 DOI: 10.1002/hbm.22998] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 08/03/2015] [Accepted: 09/08/2015] [Indexed: 12/15/2022] Open
Abstract
Gyrification brain abnormalities are considered a marker of early deviations from normal developmental trajectories and a putative predictor of poor outcome in psychiatric disorders. The aim of this study was to explore cortical folding morphology in patients with anorexia nervosa (AN). A MRI brain study was conducted on 38 patients with AN, 20 fully recovered patients, and 38 healthy women. Local gyrification was measured with procedures implemented in FreeSurfer. Vertex-wise comparisons were carried out to compare: (1) AN patients and healthy women; (2) patients with a full remission at a 3-year longitudinal follow-up assessment and patients who did not recover. AN patients exhibited significantly lower gyrification when compared with healthy controls. Patients with a poor 3-year outcome had significantly lower baseline gyrification when compared to both healthy women and patients with full recovery at follow-up, even after controlling for the effects of duration of illness and gray matter volume. No significant correlation has been found between gyrification, body mass index, amount of weight loss, onset age, and duration of illness. Brain gyrification significantly predicted outcome at follow-up even after controlling for the effects of duration of illness and other clinical prognostic factors. Although the role of starvation in determining our findings cannot be excluded, our study showed that brain gyrification might be a predictor of outcome in AN. Further studies are needed to understand if brain gyrification abnormalities are indices of early neurodevelopmental alterations, the consequence of starvation, or the interaction between both factors.
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Affiliation(s)
- Angela Favaro
- Department of Neurosciences, University of Padova, Italy.,Centro Neuroscienze Cognitive, University of Padova, Italy.,Neuroradiology Unit, IRCSS San Camillo, Venice, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padova, Italy.,Centro Neuroscienze Cognitive, University of Padova, Italy
| | | | - Renzo Manara
- Department of Medicine, University of Salerno, Italy.,Neuroradiology Unit, IRCSS San Camillo, Venice, Italy
| | - Paolo Santonastaso
- Department of Neurosciences, University of Padova, Italy.,Centro Neuroscienze Cognitive, University of Padova, Italy
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250
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Yoshimura M, Uezono Y, Ueta Y. Anorexia in human and experimental animal models: physiological aspects related to neuropeptides. J Physiol Sci 2015; 65:385-95. [PMID: 26123258 PMCID: PMC10717229 DOI: 10.1007/s12576-015-0386-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/16/2015] [Indexed: 01/20/2023]
Abstract
Anorexia, a loss of appetite for food, can be caused by various physiological and pathophysiological conditions. In this review, firstly, clinical aspects of anorexia nervosa are summarized in brief. Secondly, hypothalamic neuropeptides responsible for feeding regulation in each hypothalamic nucleus are discussed. Finally, three different types of anorexigenic animal models; dehydration-induced anorexia, cisplatin-induced anorexia and cancer anorexia-cachexia, are introduced. In conclusion, hypothalamic neuropeptides may give us novel insight to understand and find effective therapeutics strategy essential for various kinds of anorexia.
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Affiliation(s)
- Mitsuhiro Yoshimura
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555 Japan
| | - Yasuhito Uezono
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo, 104-0045 Japan
| | - Yoichi Ueta
- Department of Physiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, 807-8555 Japan
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