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Al-Shoaibi AAA, Lavender JM, Kim SJ, Shao IY, Ganson KT, Testa A, He J, Glidden DV, Baker FC, Nagata JM. Association of body mass index with progression from binge-eating behavior into binge-eating disorder among adolescents in the United States: A prospective analysis of pooled data. Appetite 2024; 200:107419. [PMID: 38759754 DOI: 10.1016/j.appet.2024.107419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/11/2024] [Accepted: 05/10/2024] [Indexed: 05/19/2024]
Abstract
The association between body mass index (BMI) and binge-eating disorder (BED) is well-established. However, data on the extent to which BMI is associated with progression from binge-eating behavior into BED among adolescents are limited, which was the aim of this investigation. Participants were 9964 U.S. adolescents from the Adolescent Brain Cognitive Development (ABCD) Study, aged 9-13 at the time of study enrollment. A computerized parent-reported assessment was used to establish adolescents' binge-eating behaviors and BED. Cox proportional hazards models adjusting for sociodemographic covariates were used to examine prospective associations between BMI and likelihood of BED onset among a) adolescents with binge-eating behavior, and b) adolescents with no binge-eating behavior. Of 975 adolescents who met the study criteria for binge-eating behavior, 89 (9.1%) subsequently met the study criteria for BED. Of 8989 adolescents with no binge-eating behavior, 82 (0.9%) subsequently met the study criteria for BED. BMI percentile was significantly associated with the likelihood of BED onset in participants with (adjusted HR = 1.03, 95% confidence interval [CI] 1.00, 1.06) and participants without (adjusted HR = 1.05, 95% CI 1.03, 1.07) binge-eating behavior. Results were also significant when examining BMI as a dichotomous predictor (above and below 85th percentile) among those with (adjusted HR = 2.60, 95% CI 1.00, 6.68) and those without (adjusted HR = 6.01, 95% CI 3.90, 11.10) binge-eating behavior. Overall, results indicate that elevated BMI is prospectively associated with a greater risk for BED onset among U.S. adolescents with or without binge-eating behavior. Adolescents with a higher BMI may benefit from screening for binge eating, and prevention/early intervention strategies to mitigate the risk for developing BED.
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Affiliation(s)
- Abubakr A A Al-Shoaibi
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA.
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research Program (MiCOR), Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA; The Metis Foundation, 84 NE Interstate 410 Loop # 325, San Antonio, TX 78216, USA.
| | - Sean J Kim
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA.
| | - Iris Yuefan Shao
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA.
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON M5S 1V4, Canada.
| | - Alexander Testa
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030, USA.
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, 2001 Longxiang Boulevard, Longgang District, Shenzhen 518172, China.
| | - David V Glidden
- Department of Epidemiology & Biostatistics, University of California, 550 16th Street, 2nd Floor, Box 0560, San Francisco, CA 94158-2549, USA.
| | - Fiona C Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA.
| | - Jason M Nagata
- Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA.
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Zhang Z, Robinson L, Campbell I, Irish M, Bobou M, Winterer J, Zhang Y, King S, Vaidya N, Broulidakis MJ, van Noort BM, Stringaris A, Banaschewski T, Bokde ALW, Brühl R, Fröhner JH, Grigis A, Garavan H, Gowland P, Heinz A, Hohmann S, Martinot JL, Martinot MLP, Nees F, Orfanos DP, Paus T, Poustka L, Sinclair J, Smolka MN, Walter H, Whelan R, Schumann G, Schmidt U, Desrivières S. Distinct personality profiles associated with disease risk and diagnostic status in eating disorders. J Affect Disord 2024; 360:146-155. [PMID: 38810783 DOI: 10.1016/j.jad.2024.05.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/13/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Personality traits have been associated with eating disorders (EDs) and comorbidities. However, it is unclear which personality profiles are premorbid risk rather than diagnostic markers. METHODS We explored associations between personality and ED-related mental health symptoms using canonical correlation analyses. We investigated personality risk profiles in a longitudinal sample, associating personality at age 14 with onset of mental health symptoms at ages 16 or 19. Diagnostic markers were identified in a sample of young adults with anorexia nervosa (AN, n = 58) or bulimia nervosa (BN, n = 63) and healthy controls (n = 47). RESULTS Two significant premorbid risk profiles were identified, successively explaining 7.93 % and 5.60 % of shared variance (Rc2). The first combined neuroticism (canonical loading, rs = 0.68), openness (rs = 0.32), impulsivity (rs = 0.29), and conscientiousness (rs = 0.27), with future onset of anxiety symptoms (rs = 0.87) and dieting (rs = 0.58). The other, combined lower agreeableness (rs = -0.60) and lower anxiety sensitivity (rs = -0.47), with future deliberate self-harm (rs = 0.76) and purging (rs = 0.55). Personality profiles associated with "core psychopathology" in both AN (Rc2 = 80.56 %) and BN diagnoses (Rc2 = 64.38 %) comprised hopelessness (rs = 0.95, 0.87) and neuroticism (rs = 0.93, 0.94). For BN, this profile also included impulsivity (rs = 0.60). Additionally, extraversion (rs = 0.41) was associated with lower depressive risk in BN. LIMITATIONS The samples were not ethnically diverse. The clinical cohort included only females. There was non-random attrition in the longitudinal sample. CONCLUSIONS The results suggest neuroticism and impulsivity as risk and diagnostic markers for EDs, with neuroticism and hopelessness as shared diagnostic markers. They may inform the design of more personalised prevention and intervention strategies.
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Affiliation(s)
- Zuo Zhang
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Lauren Robinson
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Iain Campbell
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Madeleine Irish
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Marina Bobou
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Jeanne Winterer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Yuning Zhang
- Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, United Kingdom
| | - Sinead King
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom; School of Medicine, Center for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI) Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
| | - M John Broulidakis
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA
| | - Betteke Maria van Noort
- Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany
| | - Argyris Stringaris
- Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, United Kingdom
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rüdiger Brühl
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, United Kingdom
| | - Andreas Heinz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U 1299 "Trajectoires développementales & psychiatrie", University Paris-Saclay, CNRS, Ecole Normale Supérieure Paris-Saclay, Centre Borelli, Gif-sur-Yvette, and AP-HP, Sorbonne University, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Frauke Nees
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany
| | | | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Julia Sinclair
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Ulrike Schmidt
- Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Sylvane Desrivières
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom.
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3
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Lin BY, Moog D, Xie H, Sun CF, Deng WY, McDaid E, Liebesny KV, Kablinger AS, Xu KY. Increasing prevalence of eating disorders in female adolescents compared with children and young adults: an analysis of real-time administrative data. Gen Psychiatr 2024; 37:e101584. [PMID: 39105108 PMCID: PMC11298723 DOI: 10.1136/gpsych-2024-101584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/19/2024] [Indexed: 08/07/2024] Open
Affiliation(s)
- Binx Yezhe Lin
- Department of Psychiatry and Behavioral Medicine, Carilion Clinic-Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Dominic Moog
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Hui Xie
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Ching-Fang Sun
- Department of Psychiatry and Behavioral Medicine, Carilion Clinic-Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | | | - Erin McDaid
- Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, Virginia, USA
| | - Katherine V Liebesny
- Department of Psychiatry and Behavioral Medicine, Carilion Clinic-Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Anita S Kablinger
- Department of Psychiatry and Behavioral Medicine, Carilion Clinic-Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Kevin Young Xu
- Health and Behavior Research Center, Division of Addiction Science, Prevention and Treatment, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Croci MS, Brañas MJAA, Javaras KN, Dechant E, Jurist J, Steigerwald G, Choi-Kain LW. General Psychiatric Management for Adolescents With Borderline Personality Disorder and Eating Disorders. Am J Psychother 2024:appipsychotherapy20230045. [PMID: 39083007 DOI: 10.1176/appi.psychotherapy.20230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
Borderline personality disorder and eating disorders frequently co-occur among youths. These disorders emerge in adolescence, during the critical developmental period of building an independent sense of self and the capacity to relate to one's community. Because of core differences in the development and psychopathology of borderline personality disorder and eating disorders, adjustments are required when treating these disorders when they co-occur. Few established treatment approaches can address these disorders simultaneously. Evidence-based psychotherapies for borderline personality disorder, such as dialectical behavior therapy and mentalization-based treatment, have been adapted to accommodate the shared vulnerabilities and features of the two disorders. However, these approaches are specialized, intensive, and lengthy and are therefore poorly suited to implementation in general psychiatric or primary health care, where most frontline mental health care is provided. Generalist approaches can fill this public health gap, guiding nonspecialists in structuring informed clinical management for these impairing and sometimes fatal disorders. In this overview, the authors describe the adjustment of good (or general) psychiatric management (GPM) for adolescents with borderline personality disorder to incorporate the prevailing best practices for eating disorder treatment. The adjusted treatment relies on interventions most clinicians already use (diagnostic disclosure, psychoeducation, focusing on life outside treatment, managing patients' self-destructive behaviors, and conservative psychopharmacology with active management of comorbid conditions). Limitations of the adjusted treatment, as well as guidelines for referring patients to specialized and general medical treatments and for returning them to primary generalist psychiatric care, are discussed.
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Affiliation(s)
- Marcos S Croci
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Marcelo J A A Brañas
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Kristin N Javaras
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Esther Dechant
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Julia Jurist
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Georgia Steigerwald
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
| | - Lois W Choi-Kain
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, and National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil (Croci, Brañas); Division of Women's Mental Health (Javaras), Klarman Eating Disorders Center (Dechant), and Gunderson Personality Disorders Institute (Jurist, Steigerwald, Choi-Kain), McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston (Javaras, Dechant, Choi-Kain); Department of Psychology, Harvard University, Cambridge, Massachusetts (Steigerwald)
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5
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Wang C, Tong Y, Tang T, Wang X, Fang L, Wen X, Su P, Wang J, Wang G. Association between adolescent depression and adult suicidal behavior: A systematic review and meta-analysis. Asian J Psychiatr 2024; 100:104185. [PMID: 39106588 DOI: 10.1016/j.ajp.2024.104185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/29/2024] [Accepted: 07/27/2024] [Indexed: 08/09/2024]
Abstract
This meta-analysis aims to estimate the association between adolescent depression and adult suicidal behavior, while systematically evaluating gender differences reported in literature. A random-effects model was used to determine the pooled association, reporting odds ratios (ORs) with corresponding 95 % confidence intervals (CIs). Nine articles comprising over 6084 adolescents together showed that people with a history of depression in adolescence are more likely to gain suicidal behaviors during adulthood (OR = 3.97, 95 % Cl: 2.79, 5.63). Sex-specific analysis indicated that males who experienced depression in adolescence developed a higher incidence of suicidal behavior in adulthood compared to females with a similar history (Males: OR = 3.61, 95 % Cl: 1.02, 12.78; Females: OR = 3.56, 95 % Cl: 1.71, 7.43). Furthermore, suicide attempts emerged as the predominant outcome among various suicidal behaviors (OR = 3.43, 95 % Cl: 1.75, 6.71). This meta-analysis provides robust evidence that depression in adolescence significantly increases the risk of suicidal behavior in adulthood.
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Affiliation(s)
- Cong Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China
| | - Yingying Tong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China
| | - Ting Tang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China
| | - Xinhui Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China
| | - Lulu Fang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China
| | - Xue Wen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, Anhui 230032, China
| | - Jun Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, Anhui 230032, China.
| | - Gengfu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui 230032, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei, Anhui 230032, China.
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6
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Petersen L, Christiansen G, Chatwin H, Yilmaz Z, Schendel D, Bulik C, Grove J, Brikell I, Semark B, Holde K, Abdulkadir M, Hubel C, Albiñana C, Vilhjálmsson B, Borglum A, Demontis D, Mortensen P, Larsen J. The role of co-occurring conditions and genetics in the associations of eating disorders with attention-deficit/hyperactivity disorder and autism spectrum disorder. RESEARCH SQUARE 2024:rs.3.rs-4236554. [PMID: 39070652 PMCID: PMC11275993 DOI: 10.21203/rs.3.rs-4236554/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Eating disorders (EDs) commonly co-occur with other psychiatric and neurodevelopmental disorders including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); however, the pattern of family history and genetic overlap among them requires clarification. This study investigated the diagnostic, familial, and genetic associations of EDs with ADHD and ASD. The nationwide population-based cohort study included all individuals born in Denmark, 1981-2008, linked to their siblings and cousins. Cox regression was used to estimate associations between EDs and ADHD or ASD, and mediation analysis was used to assess the effects of intermediate mood or anxiety disorders. Polygenic scores (PGSs) were used to investigate the genetic association between anorexia nervosa (AN) and ADHD or ASD. Significantly increased risk for any ED was observed following an ADHD [hazard ratio = 1.97, 95% confidence interval = 1.75-2.22] or ASD diagnosis [2.82, 2.48-3.19]. Mediation analysis suggested that intermediate mood or anxiety disorders could account for 44-100% of the association between ADHD or ASD and ED. Individuals with a full sibling or maternal halfsibling with ASD had increased risk of AN [1.54, 1.33-1.78; 1.45, 1.08-1.94] compared to those with siblings without ASD. A positive association was found between ASD-PGS and AN risk [1.06, 1.02-1.09]. In this study, positive phenotypic associations between EDs and ADHD or ASD, mediation by mood or anxiety disorder, and a genetic association between ASD-PGS and AN were observed. These findings could guide future research in the development of new treatments that can mitigate the development of EDs among individuals with ADHD or ASD.
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7
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Field AE, Ziobrowski HN, Eddy KT, Sonneville KR, Richmond TK. Who gets treated for an eating disorder? Implications for inference based on clinical populations. BMC Public Health 2024; 24:1758. [PMID: 38956563 PMCID: PMC11218409 DOI: 10.1186/s12889-024-19283-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The minority of people with an eating disorder receive treatment. Little is known about predictors of receiving treatment. METHODS Using data from the Growing Up Today Study we identified correlates of receiving treatment for an eating disorder among the 1237 U.S. women who answered questions on treatment history in 2013 and reported meeting criteria for subthreshold eating disorder in ≥ 1 year between 1996 and 2013. Logistic regression models using generalized estimating equations were used to estimate the relative odds of receiving treatment. RESULTS Approximately 11% of the women reported receiving treatment for an eating disorder. Independent of type of eating disorder, those who had received a diagnosis of depression or anxiety were more likely (odds ratio (OR) = 3.05 95% confidence interval (CI) 1.87-4.97) to receive treatment for an eating disorder. Women with obesity were approximately 85% less likely to receive treatment (OR = 0.13, 95% CI 0.04-0.46) regardless of their type of eating disorder or history of depression of anxiety diagnosis. CONCLUSIONS Most women meeting criteria for an eating disorder do not receive treatment. Women with BED or obesity are the least likely to receive treatment.
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Affiliation(s)
- Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, Providence, RI, 02912, USA
| | - Hannah N Ziobrowski
- Department of Epidemiology, Brown University School of Public Health, Box G-S121-2, Providence, RI, 02912, USA.
| | - Kamryn T Eddy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
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8
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Myntti WW, Parnell L, Valledor V, Chow CM. Adolescent-perceived parent-child negative body talk and disordered eating: Evidence for behavior-specific affective mediators. J Adolesc 2024; 96:1126-1136. [PMID: 38594877 DOI: 10.1002/jad.12323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION This study examined the mediating role of general negative affect and body-specific negative affect between the association between negative body talk occurring within the mother-daughter relationship and restrained and disinhibited disordered eating. METHODS Adolescent girls (N = 100; Mage = 14.25; 49.5% White) completed self-report measures of general negative affect (depression and anxiety), body-specific negative affect (body dissatisfaction), and perceptions of the frequency that negative body talk occurred in interactions with their mother (initiated by the mother or daughter) as part of a cross-sectional study. While the same set of questionnaires was administered to both mothers and daughters, only the data reported by the daughters were analyzed and included in this study. Data were gathered in the Ann Arbor/Ypsilanti area of Michigan, USA, around the year 2015. RESULTS Path analysis showed that general negative affect, but not body-specific negative affect, mediated the association from mother-daughter negative body talk to disinhibited eating behaviors (emotional and external eating). Conversely, body-specific negative affect, but not general negative affect, mediated the association from negative body talk to restrained eating behaviors. CONCLUSIONS Our findings suggest there are distinct affective mechanisms that mediate the relationship between mother-daughter negative body talk and restrained versus disinhibited eating behavior. Future work should continue to explicate the role of general and body-related negative affect in different eating behaviors.
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Affiliation(s)
- Warner W Myntti
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Lucas Parnell
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Valerie Valledor
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
| | - Chong Man Chow
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan, USA
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Eating Disorders: Updates and Innovations. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:369-371. [PMID: 38988466 PMCID: PMC11231473 DOI: 10.1176/appi.focus.24022009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
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10
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Steiner MA, Botticelli L, Bergamini G, Micioni Di Bonaventura E, Gatfield J, Williams JT, Treiber A, Vaillant C, Cifani C, Micioni Di Bonaventura MV. Evaluating the efficacy of the selective orexin 1 receptor antagonist nivasorexant in an animal model of binge-eating disorder. Int J Eat Disord 2024; 57:1418-1432. [PMID: 38456603 DOI: 10.1002/eat.24181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Test the efficacy of the selective orexin 1 receptor (OX1R) antagonist (SO1RA) nivasorexant in an animal model of binge-eating disorder (BED) and study its dose-response relationship considering free brain concentrations and calculated OX1R occupancy. Compare nivasorexant's profile to that of other, structurally diverse SO1RAs. Gain understanding of potential changes in orexin-A (OXA) neuropeptide and deltaFosB (ΔFosB) protein expression possibly underlying the development of the binge-eating phenotype in the rat model used. METHOD Binge-like eating of highly palatable food (HPF) in rats was induced through priming by intermittent, repeated periods of dieting and access to HPF, followed by an additional challenge with acute stress. Effects of nivasorexant were compared to the SO1RAs ACT-335827 and IDOR-1104-2408. OXA expression in neurons and neuronal fibers as well as ΔFosB and OXA-ΔFosB co-expression was studied in relevant brain regions using immuno- or immunofluorescent histochemistry. RESULTS All SO1RAs dose-dependently reduced binge-like eating with effect sizes comparable to the positive control topiramate, at unbound drug concentrations selectively blocking brain OX1Rs. Nivasorexant's efficacy was maintained upon chronic dosing and under conditions involving more frequent stress exposure. Priming for binge-like eating or nivasorexant treatment resulted in only minor changes in OXA or ΔFosB expression in few brain areas. DISCUSSION Selective OX1R blockade reduced binge-like eating in rats. Neither ΔFosB nor OXA expression proved to be a useful classifier for their binge-eating phenotype. The current results formed the basis for a clinical phase II trial in BED, in which nivasorexant was unfortunately not efficacious compared with placebo. PUBLIC SIGNIFICANCE Nivasorexant is a new investigational drug for the treatment of binge-eating disorder (BED). It underwent clinical testing in a phase II proof of concept trial in humans but was not efficacious compared with placebo. The current manuscript investigated the drug's efficacy in reducing binge-like eating behavior of a highly palatable sweet and fat diet in a rat model of BED, which initially laid the foundation for the clinical trial.
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Affiliation(s)
| | - Luca Botticelli
- Pharmacology Unit, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Giorgio Bergamini
- CNS Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | | | - John Gatfield
- CNS Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | - Jodi T Williams
- CNS Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | - Alexander Treiber
- CNS Pharmacology, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | | | - Carlo Cifani
- Pharmacology Unit, School of Pharmacy, University of Camerino, Camerino, Italy
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Matheson BE. Bulimia Nervosa and Binge-Eating Disorder Across the Lifespan. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:278-287. [PMID: 38988471 PMCID: PMC11231461 DOI: 10.1176/appi.focus.20240001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
This article aims to review the current evidence-based psychotherapy and psychopharmacological treatments for adults and youths with bulimia nervosa (BN) and binge-eating disorder (BED). Treatments for adults and for children and adolescents are discussed separately, including developmental considerations in the management of these disorders among youths. Although several evidence-based psychotherapy and psychopharmacological treatment options have been established for adults with BN or BED, there is much less empirical support for the management of these eating disorders among children and adolescents. This review concludes by discussing promising modalities and innovations, highlighting the potential utility of integrating technology into treatment approaches. Despite decades of treatment development and testing, a sizable proportion of individuals with BN or BED do not respond to the current evidence-based treatments, highlighting the need for continued research in these domains. Future research should focus on testing psychotherapy treatments among diverse samples in large, randomized controlled trials, as well as on treatments that can be easily scaled and implemented in community settings.
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Affiliation(s)
- Brittany E Matheson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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Spinner H, Thompson KA, Bauman V, Lavender JM, Thorstad I, Schrag R, Sbrocco T, Schvey NA, Ford B, Ford C, Wilfley DE, Jorgensen S, Klein DA, Quinlan J, Yanovski JA, Haigney M, Tanofsky-Kraff M. Emotional dysregulation moderates the relation between perceived stress and emotional eating in adolescent military dependents. Int J Eat Disord 2024; 57:1609-1615. [PMID: 38600832 PMCID: PMC11262967 DOI: 10.1002/eat.24217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/29/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE Adolescent children of US service members (i.e., military-dependent youth) face unique stressors that increase risk for various forms of disinhibited eating, including emotional eating. Difficulties with adaptively responding to stress and aversive emotions may play an important role in emotional eating. This study examined emotion dysregulation as a potential moderator of the association between perceived stress and emotional eating in adolescent military dependents. METHOD Participants were military-dependent youth (N = 163, 57.7% female, Mage = 14.5 ± 1.6, MBMI-z = 1.9 ± 0.4) at risk for adult binge-eating disorder and high weight enrolled in a randomized controlled prevention trial. Prior to intervention, participants completed questionnaires assessing perceived stress and emotional eating. Parents completed a questionnaire assessing their adolescent's emotion dysregulation. Moderation analyses were conducted using the PROCESS macro in SPSS and adjusted for theoretically relevant sociodemographic covariates. RESULTS The interaction between adolescent perceived stress and emotion dysregulation (parent-reported about the adolescent) in relation to adolescent emotional eating was found to be significant, such that higher emotion dysregulation magnified the association between perceived stress and emotional eating (p = .010). Examination of simple slopes indicated that associations between perceived stress and emotional eating were strongest for youth with above-average emotion dysregulation, and non-significant for youth with average or below-average emotion dysregulation. DISCUSSION Findings suggest that greater emotion dysregulation may increase risk for emotional eating in response to stress among military-dependent youth at risk for binge-eating disorder or high weight. Improving emotion regulation skills may be a useful target for eating disorder prevention among youth who are at risk for emotional eating. PUBLIC SIGNIFICANCE Prior research has shown that adolescent military dependents are at increased risk for eating disorders and high weight. The current study found that emotion dysregulation moderated the relationship between perceived stress and emotional eating among military-dependent youth. There may be clinical utility in intervening on emotion regulation for adolescent dependents at particular risk for emotional eating and subsequent eating disorders.
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Affiliation(s)
- Holly Spinner
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Katherine A. Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Viviana Bauman
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Jason M. Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Isabel Thorstad
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Ruby Schrag
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- The Metis Foundation, 300 Convent St #1330, San Antonio, TX 78205, USA
| | - Tracy Sbrocco
- Department of Medical and Clinical Psychology, USU, USA
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
- Department of Medical and Clinical Psychology, USU, USA
| | | | - Caitlin Ford
- Department of Family Medicine, Fort Belvoir Community Hospital, USA
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, USA
| | - Sarah Jorgensen
- Department of Family Medicine, University of Iowa Hospitals & Clinics, USA
| | - David A. Klein
- Department of Family Medicine, USU, USA
- Department of Pediatrics, USU, USA
| | - Jeffrey Quinlan
- Department of Family Medicine, University of Iowa Hospitals & Clinics, USA
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
| | - Mark Haigney
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- Department of Medicine, Uniformed Services University of the Health Sciences (USU), USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, USA
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
- Department of Medical and Clinical Psychology, USU, USA
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Tanner AB, Richmond TK. Assessing growth in children and adolescents with Avoidant/Restrictive Food Intake Disorder. J Eat Disord 2024; 12:82. [PMID: 38877582 PMCID: PMC11177361 DOI: 10.1186/s40337-024-01034-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 05/28/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Although growth delays and disruption are a well described medical complication of restrictive eating disorders in children and young adolescents, this complication has received less attention in patients with Avoidant/Restrictive Food Intake Disorder (ARFID). Patients with ARFID have challenges with adequacy of food volume and variety that are not related to body image but are instead related to lack of interest in eating, sensory concerns, and/or fears of aversive consequences. Because onset of ARFID is commonly before puberty, concerns regarding growth adequacy may present an additional treatment challenge and a unique opportunity for support. REVIEW Child and adolescent patients with other restrictive eating disorders are at risk of irreversible deleterious impact on growth and development, particularly when onset is before or around puberty. Although faltering growth is a defining feature of ARFID, less attention has been paid to methods for examining growth concerns in young patients with ARFID and training providers to assess growth adequacy when prepubertal and peripubertal patients present with this diagnosis. Providers working with patients under 18 years of age with eating disorders will benefit from the tools discussed in this narrative review to adequately assess growth and development against genetic potential, recognize alterations in growth that are a result of nutritional deficiencies, and support and maximize catch-up growth and development when it has been impaired. CONCLUSION Established pediatric growth monitoring tools and techniques to assess adequacy of growth can be applied to child and adolescent patients presenting with ARFID. These tools can improve long term outcomes in linear height for these patients and allow for monitoring during and after treatment until growth and development is complete. Medical providers caring for patients presenting with ARFID will need to establish best practices for assessing and monitoring growth.
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Affiliation(s)
- Anna B Tanner
- Department of Pediatrics, Emory University, Atlanta, GA, 30322, USA.
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
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Accurso EC, Cordell KD, Guydish J, Snowden LR. Exploring Demographic and Clinical Characteristics of Racially and Ethnically Diverse Youth With Eating Disorders Using California Medicaid Claims Data. J Am Acad Child Adolesc Psychiatry 2024; 63:615-623. [PMID: 37992854 DOI: 10.1016/j.jaac.2023.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/07/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To explore the scope of diagnosed eating disorders among Medicaid-insured youth in California, and to describe the demographic characteristics of this population in a repeated annual cross-sectional study design. METHOD California Medicaid claims data were extracted for youth aged 7 to 18 years between January 2014 and December 2016. Participants included all youth who received an eating disorder diagnosis at any point in the study period (N = 8,075). Additional analyses compared youth with eating disorders who were continuously enrolled across all 3 years (n = 4,500) to random subsamples of continuously enrolled youth diagnosed with a mood or anxiety disorder (n = 4,128), a disruptive behavior disorder (n = 4,599), or a psychotic disorder (n = 4,290). RESULTS About one-half of youth with eating disorders were Latinx (58.5%, n = 2,634) and indicated Spanish as their preferred language (48.9%, n = 2,199). About one-half (51%, n = 2,301) of eating disorder diagnoses were unspecified. Latinx ethnicity and Spanish language were significantly more frequent among youth with eating disorders than among those with other disorders (F11.97, F362.75, p values <.0005). CONCLUSION The first examination of publicly insured youth with eating disorders revealed a highly diverse group of individuals among whom Latinx youth were particularly prevalent. However, past-year national prevalence estimates suggest that most eating disorder cases were undiagnosed. PLAIN LANGUAGE SUMMARY Eating disorders affect approximately 10% of the US population and lead to serious mental health and medical problems. This study used California Medicaid claims data from 2014 to 2016 to characterize the population of youth aged 7 to 18 years with diagnosed with an eating disorder (N = 8,075). The authors found the prevalence of eating disorders among youth aged 13 to 18 years was about 0.20% across all 3 years of the study, which is far below the expected prevalence and suggests that most eating disorders in youth go undiagnosed. About half of eating disorder diagnoses provided to youth with Medicaid insurance are unspecified, which may hinder receipt of appropriate treatment. Of youth with an eating disorder, about half were Latinx and reported Spanish as their preferred language. The authors also found differences in the prevalences of eating disorder diagnoses when analyzing youth by age, sex, and ethnicity. These results suggest that more standardized screening and assessment is needed to improve eating disorders detection and diagnosis, particularly for minoritized youth.
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Affiliation(s)
| | - Kate Duggento Cordell
- Opeeka, Folsom, California; Center for Innovation in Population Health, University of Kentucky, Lexington, Kentucky; Social Policy Institute, San Diego State University, San Diego, California
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco
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Corberán M, Arnáez S, Saman Y, Pascual-Vera B, García-Soriano G, Roncero M. Cognitive training via mobile app for addressing eating disorders' cognitions in adolescents: a randomized control trial protocol. BMC Psychol 2024; 12:268. [PMID: 38745260 PMCID: PMC11092152 DOI: 10.1186/s40359-024-01772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
During adolescence, individuals are particularly vulnerable to developing eating disorders (EDs). To address the dysfunctional beliefs linked to these disorders, a new mobile app has been developed. This app, called GG eating disorders-Adolescents (GGED-AD), was created based on CBT to help adolescents work on their self-dialogue related to the core beliefs of eating disorders. The objective is to present the protocol for a randomized controlled trial to explore the efficacy of GGED-AD.Methods The study will be carried out in adolescents aged 13 to 16 from an educational center in the Valencian Community. The participants will be randomized into two groups: the experimental group will use the GGED-AD app during 14 consecutive days for approximately 5 min each day; and the control group will use a neutral app (GGNEUTRAL) during the same time. Both groups will complete instruments that assess dysfunctional beliefs related to eating disorders, eating symptoms, symptoms of depression and anxiety, body satisfaction and self-esteem before and after the intervention. A follow-up will be conducted one month later.Results A decrease in the degree of ascription to dysfunctional beliefs associated with eating disorders and eating symptomatology is expected, as well as an increase in body satisfaction and the self-esteem of the participants of the experimental group.Discussion The app in this study could help tackle and prevent ED-related symptoms in adolescents.Trial registration NCT06039514.
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Affiliation(s)
- Marta Corberán
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología y Logopedia, Universitat de València, Av. Blasco Ibañez, 21, Valencia, 46010, Spain
| | - Sandra Arnáez
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología y Logopedia, Universitat de València, Av. Blasco Ibañez, 21, Valencia, 46010, Spain
| | - Yuliya Saman
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología y Logopedia, Universitat de València, Av. Blasco Ibañez, 21, Valencia, 46010, Spain
| | - Belén Pascual-Vera
- Departamento Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, UNED, C/Juan Rosal, 10, Madrid, 28040, Spain
| | - Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología y Logopedia, Universitat de València, Av. Blasco Ibañez, 21, Valencia, 46010, Spain
| | - María Roncero
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología y Logopedia, Universitat de València, Av. Blasco Ibañez, 21, Valencia, 46010, Spain.
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Sim L, Fahrenkamp A, Geske JR, Lebow J, Thilges H, Peterson CB, Matthews A, Harbeck-Weber C. Screening for eating disorders in adolescents with chronic pain: the Eating Attitudes Test-16-Chronic Pain. J Eat Disord 2024; 12:56. [PMID: 38730431 PMCID: PMC11084020 DOI: 10.1186/s40337-024-01014-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Few measures have been validated to screen for eating disorders (ED) in youth with chronic pain. We conducted confirmatory (CFA) of two established factor structures of the Eating Attitudes Test-26 (EAT-26) in a sample of youth with chronic pain attending an intensive interdisciplinary pain treatment (IIPT) program and examined the validity of the best-fitting model in predicting ED diagnoses in this sample. METHODS Participants were 880 adolescents (M age = 16.1, SD = 2.1) consecutively admitted into an IIPT program who completed the EAT-26 upon admission. CFA was conducted and in the case of inadequate fit, EFA was planned to identify alternative models. Factors of the best-fitting model were included in a logistic regression analysis to predict ED diagnoses. RESULTS The TLIs (0.70; 0.90), RMSEAs (0.09; 0.07) and CFIs (0.73; 0.92) suggested poor fit of one model and adequate of the second model. Goodness of fit indices from EFA (TLI:0.85, RMSEA:0.06) did not outperform the fit of the second CFA. As such, the second model was retained with the exception of one factor. The items loaded onto a 16-item, five factor model: Fear of Getting Fat, Social Pressure to Gain Weight, Eating-Related Control, Eating-Related Guilt and Food Preoccupation. Based on chart review, 19.1% of the participants were diagnosed with an eating disorder. Logistic regression analyses indicated the new 16-item measure and Fear of Getting Fat, significantly predicted an ED diagnosis that did not include avoidant restrictive food intake disorder (ARFID) and Social Pressure to Gain Weight significantly predicted a diagnosis of ARFID. CONCLUSIONS An alternative 16-item, 5-factor structure of the EAT-26 should be considered in screening for EDs with youth with chronic pain.
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Affiliation(s)
- Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Amy Fahrenkamp
- Pain, Palliative Care, and Integrative Medicine Department, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Jennifer R Geske
- Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Hope Thilges
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Abigail Matthews
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA
| | - Cynthia Harbeck-Weber
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA
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Bartone PT, Tripp KH. Stress, hardiness and eating disorder symptoms in military academy cadets. Eat Disord 2024:1-24. [PMID: 38709164 DOI: 10.1080/10640266.2024.2346681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Eating disorders are a persistent and debilitating problem, especially among college age men and women. This problem is exacerbated in occupations such as the military, where maintenance of strict standards regarding weight, fitness and appearance is important for job retention and promotion. Also, previous research confirms that stress is a contributing element to eating disorders. It is thus important to identify factors that may assist individuals to remain resilient and avoid stress-related health and eating difficulties. The present study utilizes historical data to examine the impact of stress on health and eating disorder symptoms in a representative sample of West Point military academy cadets, while testing the role of gender and hardiness as stress moderators in this relation. A survey containing measures of stress, hardiness and eating disorders symptoms was completed by 387 cadets in the fall and spring of 2000-2001. Moderation effects were tested with advanced conditional process analysis procedures developed recently by Hayes (2022). Results show that hardiness was a significant moderator, with cadets low in hardiness showing increased eating disorder symptoms and more general health symptoms. While gender was not a significant moderator with respect to eating disorder symptoms, it was significant for general health symptoms; female cadets showed more stress-related health symptoms than their male counterparts. These results suggest that eating disorder symptoms in military academy cadets and college students more generally may be reduced through programs aimed at developing hardiness attitudes and stress coping approaches.
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Affiliation(s)
- Paul T Bartone
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kimberly H Tripp
- Emergency Medicine Department, St. Joseph Health Regional Hospital, Bryan, Texas, USA
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Cohen CT, Powers JM. Nutritional Strategies for Managing Iron Deficiency in Adolescents: Approaches to a Challenging but Common Problem. Adv Nutr 2024; 15:100215. [PMID: 38556251 PMCID: PMC11070695 DOI: 10.1016/j.advnut.2024.100215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
Iron deficiency (ID) is a common and challenging problem in adolescence. In order to prevent, recognize, and treat ID in this age range, it is critical to understand the recommended daily intake of iron in relation to an adolescent's activity, dietary habits, and basal iron losses. Adolescents following vegetarian or vegan diets exclusively rely on plant-based, nonheme iron, which has decreased bioavailability compared with heme iron and requires increased total iron intake. Individuals with disordered eating habits, excessive menstrual blood loss, and certain chronic health conditions (including inflammatory bowel disease and heart failure) are at high risk of ID and the development of symptomatic iron deficiency anemia (IDA). Adolescent athletes and those with sleep and movement disorders may also be more sensitive to changes in iron status. Iron deficiency is typically treated with oral iron supplementation. To maximize iron absorption, oral iron should be administered no more than once daily, ideally in the morning, while avoiding foods and drinks that inhibit iron absorption. Oral iron therapy should be provided for ≥3 mo in the setting of ID to reach a ferritin of 20 ng/mL before discontinuation. Intravenous iron is being increasingly used in this population and has demonstrated efficacy and safety in adolescents. It should be considered in those with persistent ID despite a course of oral iron, severe and/or symptomatic IDA, and chronic inflammatory conditions characterized by decreased gastrointestinal iron absorption.
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Affiliation(s)
- Clay T Cohen
- Division of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Cancer and Hematology Center, Texas Children's Hospital, Houston, TX, United States
| | - Jacquelyn M Powers
- Division of Hematology/Oncology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Cancer and Hematology Center, Texas Children's Hospital, Houston, TX, United States.
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Generoso RA, Bauer KW, Sonneville KR, Hahn SL. Identifying methods used to manage weight and shape by first year university students: A qualitative analysis. Eat Behav 2024; 53:101885. [PMID: 38772294 DOI: 10.1016/j.eatbeh.2024.101885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To identify current strategies used by first-year university students to lose weight, maintain weight, or change their body shape. METHODS First-year university students (n = 661) completed an open-ended, web-based survey. Cross-sectional data were analyzed qualitatively using a reflexive thematic approach to identify strategies used to lose weight, maintain weight, or alter body shape/composition. Thematic maps were constructed for each weight- and shape-related goal. RESULTS Four main types of strategies were used to achieve all three weight or shape-related goals among first-year college students: changes in diet, changes in exercise, self-monitoring, and disordered eating. One behavioral strategy observed across all weight-related goals was prioritizing protein consumption, including protein gained from supplementation. However, there were also differences in strategies by weight- or shape-related goal. For example, only participants aiming to lose or maintain weight reported mindful strategies for monitoring diet. Individuals aiming to alter body composition reported heterogeneity in goal-related intentions, targeting specific body parts through exercise, and extensive supplement use. CONCLUSIONS First-year college students use a variety of strategies to manage their weight and shape. Some strategies were observed across goals, whereas others are specific to the weight- or shape-related goal. More research is needed to understand the impacts, both positive and negative, of using the strategies identified in the present study.
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Affiliation(s)
- Rica A Generoso
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48858, USA.
| | - Katherine W Bauer
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Kendrin R Sonneville
- University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Samantha L Hahn
- Central Michigan University College of Medicine, 1280 East Campus Drive, Mount Pleasant, MI 48858, USA.
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20
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Esmaeili A, Esmaeeli ST. A life lost to anorexia nervosa: A case report of rapid progressive disease and its psychological aspects. Clin Case Rep 2024; 12:e8709. [PMID: 38566976 PMCID: PMC10985021 DOI: 10.1002/ccr3.8709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
The prevalence of anorexia nervosa has been on the rise. Exploring key factors in treating this condition as well as psychological factors influencing the onset and maintenance of the disorder can increase the chance of treatment success.
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Affiliation(s)
- Amirreza Esmaeili
- Department of Clinical Health Psychology, School of Behavioral Science and Mental HealthIran University of Medical SciencesTehranIran
| | - Soode Tajik Esmaeeli
- Fellowship of Psychosomatic Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of MedicineIran University of Medical SciencesTehranIran
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21
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Meneguzzo P, Ceccato E, Sala A, Santonastaso P. When time worsens framing: a longitudinal analysis of the psychological effects of the COVID-19 pandemic in women with an eating disorder and their healthy sisters. Arch Womens Ment Health 2024; 27:191-199. [PMID: 37964120 PMCID: PMC10933162 DOI: 10.1007/s00737-023-01398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/08/2023] [Indexed: 11/16/2023]
Abstract
The COVID-19 pandemic has profoundly affected individuals with eating disorders (ED), leading to an exacerbation of symptoms worldwide in 2020. However, there is a lack of longitudinal analyses of the psychological burdens experienced by this population. This study aims to longitudinally assess the psychological effects of the COVID-19 pandemic in people with ED and their healthy sisters (HS) 1 and 2 years after the onset of the crisis. A sample of 148 individuals, consisting of 73 with ED and 45 HS, was evaluated in spring 2021 and spring 2022 regarding their current psychological and behavioral states. Participants were also asked to reflect on their feelings and behaviors during the 2020 lockdown. General psychopathology, eating disorders, and trauma-related symptoms were evaluated using validated questionnaires. Both groups showed an overall improvement in psychopathological symptoms with time. Individuals with ED exhibited greater improvement compared to their HS, which may be attributed to their initially higher burden. Individuals with ED reported a negative reframe, characterized by internalizing negative emotions and behaviors related to the 2020 lockdown. This longitudinal evaluation revealed two distinct and contrasting effects. Both ED patients and their HS demonstrated psychological improvement over time. However, people with ED experienced a negative reframe that affected their memory of specific life events, subsequently affecting their psychological well-being. These findings shed light on the clinical severity observed in people with ED during these pandemic years.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
- Padova Neuroscience Center, University of Padova, Padova, Italy.
| | - Enrico Ceccato
- Vicenza Eating Disorders Center, Mental Health Department, Azienda ULSS8 "Berica", Vicenza, Italy
| | - Alessandra Sala
- Vicenza Eating Disorders Center, Mental Health Department, Azienda ULSS8 "Berica", Vicenza, Italy
| | - Paolo Santonastaso
- Department of Neuroscience, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
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22
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Camacho-Barcia L, Giel KE, Jiménez-Murcia S, Álvarez Pitti J, Micali N, Lucas I, Miranda-Olivos R, Munguia L, Tena-Sempere M, Zipfel S, Fernández-Aranda F. Eating disorders and obesity: bridging clinical, neurobiological, and therapeutic perspectives. Trends Mol Med 2024; 30:361-379. [PMID: 38485648 DOI: 10.1016/j.molmed.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 04/13/2024]
Abstract
Eating disorders (EDs) and obesity are complex health conditions sharing various risk and maintenance factors, intensified in cases of comorbidity. This review explores the similarities and connections between these conditions, examining different facets from a multidisciplinary perspective, among them comorbidities, metabolic and psychological factors, neurobiological aspects, and management and therapy implications. We aim to investigate the common characteristics and complexities of weight and EDs and explore their interrelationships in individuals who experience both. The rising prevalence of EDs in people with obesity necessitates integrated approaches to study this comorbidity and to identify and analyze both common and distinct features of these conditions. This review may offer new opportunities for simultaneous prevention and management approaches, as well as future lines of research.
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Affiliation(s)
- Lucia Camacho-Barcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Julio Álvarez Pitti
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain; Innovation in Paediatrics and Technologies-iPEDITEC- research group, Research Foundation, Consorcio Hospital General, University of Valencia, Valencia, Spain
| | - Nadia Micali
- Eating Disorders Research Unit, Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark; Great Ormond Street Institute of Child Health, University College London, London, UK; Institute of Biological Psychiatry, Psychiatric Center Sct. Hans, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Romina Miranda-Olivos
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucero Munguia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Tena-Sempere
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
| | - Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre of Excellence for Eating Disorders (KOMET), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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23
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Karakuş Aydos Y, Dövencioğlu D, Karlı Oğuz K, Özdemir P, Pehlivantürk Kızılkan M, Kanbur N, Ünal D, Nalbant K, Çetin Çuhadaroğlu F, Akdemir D. Neural correlates of distorted body images in adolescent girls with anorexia nervosa: How is it different from major depressive disorder? J Neuropsychol 2024; 18:154-172. [PMID: 37431063 DOI: 10.1111/jnp.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/18/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
Body image disturbance is closely linked to eating disorders including anorexia nervosa (AN). Distorted body image perception, dissatisfaction and preoccupation with weight and shape are often key factors in the development and maintenance of these disorders. Although the pathophysiological mechanism of body image disorder is not yet fully understood, aberrant biological processes may interfere with perceptive, cognitive and emotional aspects of body image. This study focuses on the neurobiological aspects of body image disturbance. The sample consisted of 12 adolescent girls diagnosed with AN, nine girls with major depressive disorder (MDD) and 10 without psychiatric diagnoses (HC, the healthy control group). We applied a block-design task in functional magnetic resonance imaging using participants' original and distorted overweight and underweight images. After imaging, the participants scored the images for resemblance, satisfaction and anxiety levels. The findings of this study demonstrate that overweight images elicited dissatisfaction and increased occipitotemporal activations across all participants. However, no difference was found between the groups. Furthermore, the MDD and HC groups showed increased activations in the prefrontal cortex and insula in response to underweight images compared to their original counterparts, whereas the AN group exhibited increased activations in the parietal cortex, cingulate gyrus and parahippocampal cortex in response to the same stimuli.
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Affiliation(s)
- Yağmur Karakuş Aydos
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Dicle Dövencioğlu
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Kader Karlı Oğuz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Pınar Özdemir
- Department of Bioistatistics, Hacettepe University, Ankara, Turkey
| | - Melis Pehlivantürk Kızılkan
- Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Dilek Ünal
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Füsun Çetin Çuhadaroğlu
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
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24
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Sim L, Witte MA, Lebow J, LeMahieu A, Geske J, Witte N, Whiteside S, Loth K, Harbeck Weber C. Disparities in Medical Assessment Practices for Adolescents at Risk for Eating Disorders. J Adolesc Health 2024; 74:591-596. [PMID: 38069936 PMCID: PMC10872284 DOI: 10.1016/j.jadohealth.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/29/2023] [Accepted: 10/04/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE The United States Preventative Services Task Force found insufficient evidence to support universal screening for eating disorders (EDs) but did recommend assessing high-risk adolescents through laboratory tests, close follow-up, and referrals to other specialties. Yet, it is unclear whether youth at high risk for EDs receive such assessment and whether patient characteristics influence such practices. METHODS Using the Rochester Epidemiological Project, we identified adolescents (13-18 years) at risk for EDs (i.e., weight loss, underweight, or loss of appetite not explained by a medical condition) who presented for a medical appointment between January 1, 2005 to December 31, 2017 (n = 662; M age = 15.8 years; 66% female; 76% white). Patient and visit characteristics, assessment practices (i.e., tests, referrals, and follow-up), and ED diagnoses within 5 years following index visit were extracted. RESULTS Adolescents who received referrals to other providers were 4 times more likely to be diagnosed with a future ED (p < .001) and were diagnosed 137.8 days sooner (Est = -137.8, p = .04) compared to those who did not receive referrals. Compared to males, females were 2.2 times more likely to receive referrals (p < .001). Compared to those presenting at a lower body mass index, adolescents with a higher body mass index were more likely to receive medical tests (HR = 1.0, p < .01) and less likely to receive recommendations to improve eating/weight (HR = 0.99, p < .01) or follow up visits (HR = 0.99, p < .01). DISCUSSION Disparities in assessment practices for adolescents at high-risk for EDs underscore the need for improved tools to enhance early detection and treatment.
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Affiliation(s)
- Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
| | - Micaela A Witte
- Department of Internal Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Allison LeMahieu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Jennifer Geske
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Nathaniel Witte
- Mayo Clinic Strategy Department, Mayo Clinic, Rochester, Minnesota
| | - Stephen Whiteside
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
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25
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Mitchell J, Tilbrook M, Kiropoulos L, Krug I. Australian elite sport coaches' mental health literacy of eating disorders, orthorexia, and muscle dysmorphia in athletes: A qualitative study. Body Image 2024; 48:101670. [PMID: 38150783 DOI: 10.1016/j.bodyim.2023.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023]
Abstract
Athletes have an increased risk of developing eating disorders (EDs) compared to non-athletes. Coaches are in a unique position to identify symptoms and promote timely support; however, research has not yet explored coaches' mental health literacy about DSM-5 EDs and related orthorexia and muscle dysmorphia conditions in elite athletes. Eighteen Australian elite sport coaches from aesthetic, weight-class, and endurance sports participated in individual semi-structured interviews to investigate their mental health literacy of EDs and related conditions. Four themes emerged from the data. Theme 1 (knowledge of EDs and related conditions) highlighted coaches' awareness of maladaptive perfectionism as a key risk factor, limited awareness of EDs without observable weight loss, and conceptualisation of EDs as a nutritional issue. Theme 2 (facilitators to managing EDs) highlighted the helpfulness of building trust with athletes, accessing support staff, emphasising body functionality, and lived experience. Theme 3 (barriers to managing EDs) highlighted coaches' challenges with communicating about body image, responding to denial, and funding constraints. Theme 4 (future ED education and training) highlighted coaches' desire for in-person, interactive training and to support junior-level coaches. These findings may assist in developing tailored educational resources to improve coaches' ability to identify and manage eating-related concerns in athletes.
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Affiliation(s)
- Jardine Mitchell
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia
| | - Molly Tilbrook
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia
| | - Litza Kiropoulos
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia
| | - Isabel Krug
- The University of Melbourne, Melbourne School of Psychological Sciences, Australia.
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26
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Friedlich CE, Park H, Duval CJ, Keshishian T, Murray SB. The prevalence of disordered eating in outpatient general psychiatry settings in publicly insured populations: a case series. Eat Disord 2024; 32:169-177. [PMID: 37933621 DOI: 10.1080/10640266.2023.2277055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
There is a dearth of research assessing the prevalence of eating disorders in publicly insured populations. While evidence shows that eating disorders affect people of all racial, ethnic, and socioeconomic backgrounds, research has neglected to focus on the rate at which they occur among those who have public health insurance. The present study indexes the prevalence of clinically significant disordered eating in a case series of 165 adults in a publicly insured sample at an outpatient general psychiatry clinic in Los Angeles, California. Results illustrate that 46 (27.8%) participants screened positive for clinically significant disordered eating with no significant differences relating to age or gender in those who screened positive versus those who did not (p > .05). This markedly elevated frequency of disordered eating presentations underscores the need for improved clinician training and education around disordered eating and eating disorder assessment as a whole. In addition, there is a critical need to study publicly insured populations so as to mitigate stereotypes about who has eating disorders and improve the likelihood of diagnosis and care.
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Affiliation(s)
- Cassandra E Friedlich
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Hyoungjin Park
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Christina J Duval
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Talene Keshishian
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
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27
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Sternheim LC, Bijsterbosch JM, Wever MCM, van Elburg AA, Frank GKW. Examining anxious temperament in anorexia nervosa: Behavioural inhibition and intolerance of uncertainty and their contribution to trait anxiety in adolescents with anorexia nervosa. J Affect Disord 2024; 348:116-123. [PMID: 38110154 DOI: 10.1016/j.jad.2023.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious and complex psychiatric disorder yet treatment results are suboptimal. Insight into the etiology of this illness is much needed. Research highlights the implication of anxiety-related traits in the development and maintenance of AN. This study investigates firstly, behavioural inhibition and intolerance for uncertainty (IU) in adolescents with and without AN, and secondly relations between these traits. METHODS In a cross-sectional study, 165 adolescent girls (AN = 94, HC = 71) completed questionnaires measuring behavioural inhibition, IU and trait anxiety. ANOVAs tested differences between AN and HC groups, and mediation models with IU as a mediator between behavioural inhibition and trait anxiety were run. RESULTS AN adolescents reported significantly higher levels of behavioural inhibition, IU and trait anxiety compared to their peers. In both AN and HC, a direct and a total effect of behavioural inhibition on trait anxiety was found. However, only in the AN group IU partially mediated the relation between behavioural inhibition and trait anxiety. LIMITATIONS Data is cross-sectional and longitudinal studies are required. A mean illness duration of nearly 2 years may mean early effects of malnourishment and habituation and future studies should include patients with shorter illness duration. CONCLUSIONS Results highlight that behavioural inhibition and IU may contribute to anxiety in AN whilst their peers may have developed better executive and social-emotional skills to manage uncertainty. Adolescents with AN may benefit from interventions targeting behavioural inhibition and IU.
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Affiliation(s)
- Lot C Sternheim
- Department of Clinical Psychology, Utrecht University, the Netherlands.
| | | | - Mirjam C M Wever
- Department of Clinical Psychology, Leiden University, the Netherlands
| | | | - Guido K W Frank
- Department of Psychiatry, University of California San Diego, USA
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28
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Harris HA, Kininmonth AR, Nas Z, Derks IPM, Quigley F, Jansen PW, Llewellyn C. Prospective associations between early childhood parental feeding practices and eating disorder symptoms and disordered eating behaviors in adolescence. Int J Eat Disord 2024; 57:716-726. [PMID: 38387486 DOI: 10.1002/eat.24159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Nonresponsive parental feeding practices are associated with poorer appetite self-regulation in children. It is unknown whether this relationship extends beyond childhood to be prospectively associated with the onset of eating disorder (ED) symptoms in adolescence. This exploratory study therefore investigated prospective associations between early childhood parental feeding practices and adolescent ED symptoms and disordered eating behaviors. METHODS Data were from two population-based cohorts with harmonized measures: Generation R (Netherlands; n = 4900) and Gemini (UK; n = 2094). Parents self-reported their pressure to eat, restriction and instrumental feeding (i.e., using food as a reward) at child age 4-5 years. Adolescents self-reported their compensatory behaviors (e.g., fasting, purging), binge-eating symptoms, restrained eating, uncontrolled eating, and emotional eating at 12-14 years. Associations between feeding practices and ED symptoms were examined separately in each cohort using generalized linear models. RESULTS In Gemini, pressure to eat in early childhood was associated with adolescents engaging in compensatory behaviors. In Generation R, parental restriction was associated with adolescents engaging in compensatory behaviors, restrained eating, uncontrolled eating, and emotional eating. Instrumental feeding was associated with uncontrolled eating and emotional eating in Generation R. DISCUSSION Nonresponsive parental feeding practices were associated with a greater frequency of specific ED symptoms and disordered eating in adolescence, although effect sizes were small and findings were inconsistent between cohorts. Potentially, the cultural and developmental context in which child-parent feeding interactions occur is important for ED symptoms. Further replication studies are required to better understand parents' role in the development and maintenance of ED-related symptoms. PUBLIC SIGNIFICANCE Prospective research examining how early childhood parental feeding practices might contribute to adolescent ED symptoms is limited. In two population-based cohorts, nonresponsive feeding practices (restriction, instrumental feeding, pressure to eat) predicted increased frequency of some ED symptoms and disordered eating behaviors in adolescence, although associations were small and further replication is required. Findings support the promotion of responsive feeding practices, which may benefit young children's developing relationship with food.
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Affiliation(s)
- Holly A Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Alice R Kininmonth
- School of Psychology, University of Leeds, Leeds, UK
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Zeynep Nas
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ivonne P M Derks
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Fiona Quigley
- Institute for Nursing and Health Research, Ulster University, Belfast, Northern Ireland
| | - Pauline W Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
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29
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Madigan S, Vaillancourt T, Dimitropoulos G, Premji S, Kahlert SM, Zumwalt K, Korczak DJ, von Ranson KM, Pador P, Ganshorn H, Neville RD. A Systematic Review and Meta-Analysis: Child and Adolescent Healthcare Utilization for Eating Disorders During the COVID-19 Pandemic. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00077-7. [PMID: 38431196 DOI: 10.1016/j.jaac.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/30/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE To conduct a meta-analysis documenting healthcare service utilization rates for pediatric (age <19 years) eating disorders during compared to before the COVID-19 pandemic. METHOD PsycINFO, MEDLINE, Embase, and Web of Science Core Collection were searched for studies published up to May 19, 2023. Studies with pediatric visits to primary care, inpatient, outpatient, and emergency department for eating disorders before and during the pandemic were included. This preregistered review (PROSPERO CRD42023413392) was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were analyzed with random-effects meta-analyses. RESULTS A total of 52 studies reporting >148,000 child and adolescent eating disorder-related visits to >300 health settings across 15 countries were included (mean age, 12.7 years; SD = 4.1 years; 87% girls). There was strong evidence of an increase in healthcare use for eating disorders during the pandemic (rate ratio [RR] = 1.54, 95% CI = 1.38-1.71). Moderator analysis revealed larger rate increases among girls (RR = 1.48, 95% CI = 1.28-1.71) compared to boys (RR = 1.24, 95% CI = 1.06-1.45) and for adolescents (age ≥12 to 19 years) (RR = 1.53, 95% CI = 1.29-1.81) compared to children (RR = 0.87, 95% CI = 0.53-1.43). Moderator analysis demonstrated strong evidence of increased use of emergency department (RR = 1.70, 95% CI = 1.48-1.97), inpatient (RR = 1.56, 95% CI = 1.33-1.84), and outpatient (RR = 1.62, 95% CI = 1.35-1.95) services, as well as strong evidence of increased rates of anorexia nervosa (RR = 1.48, 95% CI = 1.24-1.75). CONCLUSION Healthcare use for pediatric eating disorders increased substantially during the COVID-19 pandemic, particularly among girls and adolescents. It is important to continue to monitor whether changes in healthcare use associated with acute pediatric mental distress are sustained beyond the COVID-19 pandemic. STUDY PREREGISTRATION INFORMATION Risk factors for eating disorders for youth during the COVID-19 pandemic; https://www.crd.york.ac.uk/; CRD42023413392. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.
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Affiliation(s)
- Sheri Madigan
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
| | | | - Gina Dimitropoulos
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | | | | | | | - Daphne J Korczak
- Hospital for Sick Children, Toronto, Canada; and the University of Toronto, Toronto, Canada
| | - Kristin M von Ranson
- University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
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Lafta MS, Mwinyi J, Affatato O, Rukh G, Dang J, Andersson G, Schiöth HB. Exploring sex differences: insights into gene expression, neuroanatomy, neurochemistry, cognition, and pathology. Front Neurosci 2024; 18:1340108. [PMID: 38449735 PMCID: PMC10915038 DOI: 10.3389/fnins.2024.1340108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024] Open
Abstract
Increased knowledge about sex differences is important for development of individualized treatments against many diseases as well as understanding behavioral and pathological differences. This review summarizes sex chromosome effects on gene expression, epigenetics, and hormones in relation to the brain. We explore neuroanatomy, neurochemistry, cognition, and brain pathology aiming to explain the current state of the art. While some domains exhibit strong differences, others reveal subtle differences whose overall significance warrants clarification. We hope that the current review increases awareness and serves as a basis for the planning of future studies that consider both sexes equally regarding similarities and differences.
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Affiliation(s)
- Muataz S. Lafta
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Jessica Mwinyi
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
- Centre for Women’s Mental Health, Uppsala University, Uppsala, Sweden
| | - Oreste Affatato
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
- Centre for Women’s Mental Health, Uppsala University, Uppsala, Sweden
| | - Gull Rukh
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Junhua Dang
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Helgi B. Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
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Nawaz FA, Riaz MMA, Banday NUA, Singh A, Arshad Z, Derby H, Sultan MA. Social media use among adolescents with eating disorders: a double-edged sword. Front Psychiatry 2024; 15:1300182. [PMID: 38404474 PMCID: PMC10884122 DOI: 10.3389/fpsyt.2024.1300182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Eating disorders are on the rise with a significant impact on mental health. Misuse of social media platforms is likely a significant contributing factor. This trend is especially pronounced among adolescents, who are increasingly using social media platforms for communications, building relationships, learning and entertainment. The unsupervised sharing of social media content can have drastic consequences on the physical and psychological wellbeing of youth, which often takes the form of "thinspiration" or "fitspiration". This probably serves as a trigger for those already struggling with eating disorders. In addition, there is a lack of awareness among youth and adults on ideal knowledge-sharing practices related to an eating disorder. By addressing the unique challenges that social media presents for youth with eating disorders, communities can work towards creating a safer and more supportive online environment on a global scale. At this junction, this article aims to share the current challenges of social media use among adolescents with eating disorders and put forth recommendations for how social media could be used as a tool for positive impact in this population.
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Affiliation(s)
- Faisal A. Nawaz
- Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, United Arab Emirates
- Global Remote Research Scholars Program, St. Paul, MN, United States
| | | | | | - Aakanksha Singh
- Global Remote Research Scholars Program, St. Paul, MN, United States
| | - Zara Arshad
- Global Remote Research Scholars Program, St. Paul, MN, United States
- Shifa International Hospital, Islamabad, Pakistan
| | - Hanan Derby
- Mental Health Center of Excellence, Al Jalila Children’s Specialty Hospital, Dubai Health, Dubai, United Arab Emirates
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
| | - Meshal A. Sultan
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
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32
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Efe A, Tok A. Obsessive-Compulsive Symptomatology and Disgust Propensity in Disordered Eating Behaviors of Adolescents with Celiac Disease. Int J Behav Med 2024; 31:85-96. [PMID: 36781574 DOI: 10.1007/s12529-023-10163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Considering the importance of underlying psychopathological mechanisms that mediate maladaptive eating behaviors in celiac disease (CD) in the determination of cognitive-behavioral therapeutic approaches, we investigated the impact of obsessive-compulsive symptomatology and disgust propensity on disordered eating attitudes (DEA) and poor gluten-free diet (GFD) compliance in adolescents with CD. METHOD Adolescents with biopsy-proven CD (n = 148, aged 12-18 years) were compared with age- and sex-matched controls (n = 104) in terms of eating attitudes/behaviors, obsessive-compulsive symptoms, and disgust propensity, as well as depression and anxiety to rule out depression- and anxiety-related covariates. The clinical implications associated with poor GFD compliance were determined using between-subgroup analysis. Multivariate linear regression and multiple logistic regression were used to identify predictors of DEA and GFD noncompliance, respectively. RESULTS In adolescents with CD, DEA was remarkably associated with obsessive-compulsive symptom severity and disgust propensity, especially in contamination and core disgust sub-dimensions. Obsessionality and disgust propensity were independent predictors of DEA, of which the obsessive-compulsive symptom severity was the most decisive predictor of DEA. Higher DEA severity and lower body mass index were independent predictors of poor GFD compliance. CONCLUSION Higher obsessionality, accompanied by disgust-related evaluative conditioning processes, may contribute to constructing a cognitive network consisting of hypervigilance and catastrophic interpretations towards benign somatic stimulations, food-related preoccupations, and avoidant behaviors in the disordered eating of adolescents with CD. The reciprocal relationship between lifelong GFD and DEA, mediated by obsessionality and disgust propensity, was supported by current findings that could guide clinicians in the management of maladaptive eating behaviors in adolescents with CD.
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Affiliation(s)
- Ayşegül Efe
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Babür Cd., No: 41, Altındağ, 06080, Ankara, Turkey.
| | - Ayşegül Tok
- Department of Child Hepatology, Gastroenterology and Nutrition, University of Health Sciences, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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Pérez-Vázquez J, González-Roz A, Amigo-Vázquez I. Effectiveness of an e-Health Quasi-Randomized Controlled Universal Prevention Program for Eating Disorders in Spanish Adolescents. JOURNAL OF PREVENTION (2022) 2024; 45:87-105. [PMID: 37906405 PMCID: PMC10844343 DOI: 10.1007/s10935-023-00751-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/02/2023]
Abstract
Eating disorders (EDs) and sub-threshold conditions are prevalent in the adolescent population. Unfortunately, most preventive interventions have been targeted at emerging adults and the effectiveness of online prevention programs has yet to be determined in adolescents. This study sought to examine the short-term effectiveness of a universal e-Health psychoeducational prevention program for EDs compared to a control (non-intervention) group in Spanish adolescents. Using a quasi-randomized trial design, a total of 161 [% girls: 45.96; Mage(SD) = 12.43 (0.43)] adolescents from 5 participating schools were allocated to two intervention arms: (1) psychoeducational intervention (n = 79) and (2) wait-list control (n = 82). The intervention was delivered over 3 months through 3 modules that were accessible 24/7 and 3 school sessions guided by the students´ tutors focusing on nutrition, promoting a healthy lifestyle, mitigating body concerns, and social pressures. Participants completed an online assessment battery including the Eating Attitudes Test (EAT-26) and measures of self-esteem, family disruption, compliance with the Mediterranean diet, and lifestyle. Correlational analysis showed small to moderate relationships between self-esteem and family function (rho = 0.413, p = 0.001), BMI (body mass index) and the EAT-26 dieting subscale (rho = 0.417, p = 0.001), physical activity and the bulimia subscale (rho = - 0.237, p = 0.003), and self-esteem and the dieting subscale (rho = - 0.223, p = 0.004). At the post-intervention assessment, the intervention group showed a statistically significant reduction in ED risk (EAT-26) (d = - 0.323, p = 0.040) and the oral control subscale (d = 0.327, p = 0.038). The e-health intervention including tutor-led digital components was effective for reducing ED risk in children. Results must be interpreted with caution due to the low statistical power and the limited sample size. Large scale randomized controlled trials with longer follow-ups will be needed to bolster the evidence.
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Affiliation(s)
- Jorge Pérez-Vázquez
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain.
| | - Alba González-Roz
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain
| | - Isaac Amigo-Vázquez
- Department of Psychology, Faculty of Psychology, Plaza Feijoo S/N, 33003, Oviedo, Asturias, Spain
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34
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Mehta RK, Tyagi R. Managing Binge Eating Disorder in a Young Adolescent Female: Barriers to Treatment and Recommendations. Cureus 2024; 16:e54237. [PMID: 38371436 PMCID: PMC10869996 DOI: 10.7759/cureus.54237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 02/20/2024] Open
Abstract
Binge eating disorder (BED) is a behavioral disorder characterized by chronic and compulsive overeating. It is the most prevalent eating disorder in the USA, affecting almost 3% of the US population. In this study, we describe a case of BED in an adolescent Caucasian female who could not obtain specialized treatment because of financial constraints and saw a child and adolescent psychiatrist for medication management. Her treatment plan combined bupropion with family therapy and resulted in successful alleviation of her symptoms, allowing her to achieve a better quality of life. This case shows how pragmatism by PCPs can help manage patients who cannot obtain specialized care for their BED.
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Affiliation(s)
- Rajesh K Mehta
- Child and Adolescent Psychiatry, Case Western Reserve University, MetroHealth Medical Center, Cleveland, USA
| | - Rahul Tyagi
- Family Medicine, Leeds General Practitioner Confederation, Leeds, GBR
- Family Medicine, Royal College of General Practitioners, London, GBR
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Downey AE, Odette M, Sanders AE, Kuykendall M, Saunders E, Nagata JM, Forsberg S, Buckelew SM, Garber AK. What medical providers need to elevate outpatient care for adolescents and young adults with binge-eating disorder: A novel protocol. Int J Eat Disord 2024; 57:294-302. [PMID: 38130097 DOI: 10.1002/eat.24110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Binge-eating disorder (BED) in adolescents and young adults is underrecognized and understudied and no standardized guidelines exist for medical providers caring for this population. To highlight the lack of extant evidence, we examine the demographic characteristics of youth with BED in an academic eating disorders (EDs) program and primary care clinic and describe the needs of their medical care providers. METHOD A retrospective chart review was conducted for patients who met criteria for BED from July 2021 to June 2022. We surveyed their medical providers to understand their needs in caring for this population. A multidisciplinary team with expertise in the care of youth with EDs amalgamated current evidence in caring for youth with BED into a protocolized care schema designed for implementation in the outpatient medical setting. RESULTS Eighteen youth with BED were reviewed, 14 identified as female, 3 as male, and 1 as "Other." Average age was 15.4 (2.7) years old, and mean body mass index was 35.90 (8.25). 33.3% (6) patients identified as White/Caucasian, followed by 22.2% (4) Hispanic/Latinx. Eleven of 18 were privately insured. The most common medical recommendations were for regular meals and snacks and for individual psychotherapy. Medical providers desired more education about identification and management of youth with BED. CONCLUSIONS To address the lack of medical care guidelines for youth with BED, recommendations in this Forum include: increased education for medical providers, standardized medical monitoring, an emphasis on psychotherapy, and a weight-inclusive orientation. PUBLIC SIGNIFICANCE Adolescents and young adults with BED are underrecognized and undertreated. Little is known about the characteristics of these patients and the medical care these patients receive within academic EDs program. For the first time, preliminary recommendations for medical care are provided.
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Affiliation(s)
- Amanda E Downey
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Michelle Odette
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Austin E Sanders
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Mikayla Kuykendall
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Elizabeth Saunders
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Sarah Forsberg
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Sara M Buckelew
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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Huffman LG, Lawrence-Sidebottom D, Beam AB, Parikh A, Guerra R, Roots M, Huberty J. Improvements in Adolescents' Disordered Eating Behaviors in a Collaborative Care Digital Mental Health Intervention: Retrospective Observational Study. JMIR Form Res 2024; 8:e54253. [PMID: 38294855 PMCID: PMC10867747 DOI: 10.2196/54253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/14/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Young people today are exhibiting increasing rates of disordered eating behaviors, as well as eating disorders (EDs), alongside other mental and behavioral problems such as anxiety and depression. However, limited access to mental health care means that EDs, disordered eating behaviors, and comorbid mental health problems are often underdiagnosed and undertreated. Digital mental health interventions (DMHIs) offer accessible and scalable alternatives to traditional treatment modalities, but their effectiveness has not been well established among adolescents with EDs and disordered eating behaviors. OBJECTIVE This study uses data from a collaborative care pediatric DMHI to determine whether participation in a DMHI is associated with a reduction in adolescents' disordered eating behaviors. METHODS Adolescent members in care with Bend Health Inc completed the SCOFF questionnaire at baseline (before the start of care) and approximately every month during care to assess disordered eating behaviors. They also completed assessments of mental health symptoms at baseline. Member characteristics, mental health symptoms, and disordered eating behaviors of adolescents with elevated SCOFF scores at baseline (before the start of care) were compared to those of adolescents with nonelevated SCOFF scores at baseline. Members participated in web-based coaching or therapy sessions throughout the duration of mental health care. RESULTS Compared to adolescents with nonelevated SCOFF scores (n=520), adolescents with elevated SCOFF scores (n=169) were predominantly female and exhibited higher rates of elevated anxiety and depressive symptoms. SCOFF scores decreased over time in care with the DMHI for 61.4% (n=70) of adolescents with elevated SCOFF scores, and each additional month of participation was associated with greater improvements in disordered eating behaviors (F1,233=72.82; P<.001). CONCLUSIONS Our findings offer promising preliminary evidence that participation in mental health care with a collaborative care DMHI may be beneficial in the reduction of disordered eating symptoms in adolescents, including those who are experiencing comorbid anxiety and depressive symptoms.
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Affiliation(s)
| | | | | | | | | | | | - Jennifer Huberty
- Bend Health Inc, Madison, WI, United States
- FitMinded Inc LLC, Phoenix, AZ, United States
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Möllmann A, Heinrichs N, Herwig A. A conceptual framework on body representations and their relevance for mental disorders. Front Psychol 2024; 14:1231640. [PMID: 38250111 PMCID: PMC10796836 DOI: 10.3389/fpsyg.2023.1231640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Many mental disorders are accompanied by distortions in the way the own body is perceived and represented (e.g., eating disorders, body dysmorphic disorder including muscle dysmorphia, or body integrity dysphoria). We are interested in the way these distortions develop and aim at better understanding their role in mental health across the lifespan. For this purpose, we first propose a conceptual framework of body representation that defines this construct and integrates different perspectives (e.g., cognitive neuroscience, clinical psychology) on body representations. The framework consists of a structural and a process model of body representation emphasizing different goals: the structural model aims to support researchers from different disciplines to structure results from studies and help collectively accumulate knowledge about body representations and their role in mental disorders. The process model is reflecting the dynamics during the information processing of body-related stimuli. It aims to serve as a motor for (experimental) study development on how distorted body representations emerge and might be changed. Second, we use this framework to review the normative development of body representations as well as the development of mental disorders that relate to body representations with the aim to further clarify the potential transdiagnostic role of body representations.
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Affiliation(s)
- Anne Möllmann
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
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38
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Matheson BE, Bohon C, Le Grange D, Lock JD. Family-based treatment (FBT) for loss of control (LOC) eating in youth: Current knowledge and future directions. Eat Disord 2024; 32:1-12. [PMID: 38149636 PMCID: PMC10753090 DOI: 10.1080/10640266.2023.2229091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Loss of control (LOC) eating in youth is a common disordered eating behavior and associated with negative health and psychological sequalae. Family-based treatment (FBT) is an efficacious treatment for adolescent anorexia nervosa and bulimia nervosa (BN) but has not been formally evaluated for adolescents with LOC eating. This study is a secondary data analysis from a randomized controlled clinical trial (NCT00879151) testing FBT for 12-18-year-olds with BN. Data were reanalyzed to examine outcomes for LOC eating episodes, regardless of episode size. Abstinence rates, defined as zero LOC eating episodes (objective or subjective binge episodes) in the previous month, were calculated at the end-of-treatment (EOT), 6-month, and 12-month follow-up time points. Among 51 adolescent participants (M + SD: 15.94 + 1.53 y; 92% female; 23.5% Hispanic; 76.5% Caucasian), FBT significantly reduced LOC eating episodes, with 49% achieving LOC eating abstinence at EOT. At 6-month follow-up, 41% achieved LOC eating abstinence. Of those providing 12-month follow-up data, 73% achieved abstinence. This preliminary exploration suggests that FBT may be effective for youth with LOC eating, regardless of episode size. Additional research is needed to replicate these findings and extend treatments with developmental adaptations for younger children with LOC eating.
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Affiliation(s)
- Brittany E. Matheson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Equip Health, Inc., Carlsbad, CA, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago (Emeritus)
| | - James D. Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Dunlop R, Simonds LM, John M. Self-disclosure by adolescents in therapy for eating difficulties: A Q-Methodology study. Clin Child Psychol Psychiatry 2024; 29:90-102. [PMID: 37879067 PMCID: PMC10748442 DOI: 10.1177/13591045231209648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Facilitating client self-disclosure is essential to therapeutic effectiveness. Given the long-term consequences of eating difficulties for adolescents, there is a need for more research on self-disclosure in this group. This study investigated factors likely to influence adolescents' decisions to self-disclose during psychological therapy for eating difficulties using Q-methodology. Participants (n = 28), recruited through child and adolescent mental health services in the UK, completed a task that involved sorting 47 statements to represent their viewpoint on self-disclosure. The 28 completed sorts were subjected to a by-participant factor analysis in order to identify distinct viewpoints in the sample. Three distinct factors were extracted. One factor emphasised the importance of therapist self-disclosure on decisions to disclose. In contrast, another factor placed more emphasis on the influence of eating disorder identity and readiness to change on disclosure decisions. The third factor placed emphasis on the quality of the therapeutic relationship and readiness to change as having most influence. Given the absence of a unifying factor representing what influences the decision to disclose, clinicians should ensure they explore with young people what might influence their decision to disclose.
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Affiliation(s)
- Rhiannon Dunlop
- Department of Psychological Interventions, University of Surrey, UK
- Solent East CAMHS Eating Disorder Service, Solent NHS Trust, UK
| | - Laura M Simonds
- Department of Psychological Interventions, University of Surrey, UK
| | - Mary John
- Department of Psychological Interventions, University of Surrey, UK
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Pehlivanturk-Kizilkan M, Campbell KA, White Zappitelli M. Undetected eating disorders among adolescent psychiatric inpatients. Early Interv Psychiatry 2024; 18:18-25. [PMID: 37041717 DOI: 10.1111/eip.13425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
AIM The aim of this study was to identify the prevalence of undetected eating disorders (EDs) among adolescent psychiatric inpatients and to investigate the association between clinical, psychiatric, and sociocultural factors and EDs. METHODS Between January and December 2018, patients aged 12-18 years, hospitalized for inpatient-level treatment were given the self-assessment questionnaires of the Eating Attitudes Test-26 (EAT-26), the Contour Drawing Figure Rating Scale (CDFRS), the Child Behaviour Check List, and Sociocultural Attitudes Toward Appearance Questionnaire-4 after their routine unstructured clinical diagnostic assessment on admission by a psychiatrist. Patients were reassessed after reviewing the psychometric assessment results. RESULTS The prevalence of EDs among 117 psychiatric inpatients was 9.4%, all were female and all diagnosed with unspecified feeding and eating disorder. We showed that 63.6% of patients with EDs was diagnosed after the screening and not with the routine clinical interview. EAT-26 scores were weakly correlated with affective (r = 0.314, p = .001), anxious (r = 0.231, p = .012), somatic (r = 0.258, p = .005), and impulsive maladaptive behaviours (r = 0.272, p = .003). A formal ED diagnosis was positively associated with media pressure, (OR:1.660, 95% CI: 1.105-2.495) and oppositional defiance (OR: 1.391, 95% CI: 1.005-1.926), and negatively with conduct problems (OR: 0.695, 95% CI: 0.500-0.964). The CDFRS results were not different between the ED and non-ED groups. CONCLUSIONS Our study suggests EDs remain a prevalent yet often overlooked diagnosis in adolescent psychiatric inpatients. Health care providers should screen for EDs in inpatient psychiatric settings as a part of routine assessment to improve the identification of disordered eating behaviours that often begin during adolescence.
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Affiliation(s)
- Melis Pehlivanturk-Kizilkan
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Faculty of Medicine, Altindag, Ankara, Turkey
| | - Kelly Anne Campbell
- Ascension Seton Shoal Creek Hospital, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Megan White Zappitelli
- Department of Psychiatry, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
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Anton-Păduraru DT, Trofin F, Nastase EV, Miftode RS, Miftode IL, Trandafirescu MF, Cojocaru E, Țarcă E, Mindru DE, Dorneanu OS. The Role of the Gut Microbiota in Anorexia Nervosa in Children and Adults-Systematic Review. Int J Mol Sci 2023; 25:41. [PMID: 38203211 PMCID: PMC10779038 DOI: 10.3390/ijms25010041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Among the factors incriminated in the appearance of eating disorders, intestinal microbiota has recently been implicated. Now there is evidence that the composition of gut microbiota is different in anorexia nervosa. We gathered many surveys on the changes in the profile of gut microbiota in patients with anorexia nervosa. This review comprehensively examines the contemporary experimental evidence concerning the bidirectional communication between gut microbiota and the brain. Drawing from recent breakthroughs in this area of research, we propose that the gut microbiota significantly contributes to the intricate interplay between the body and the brain, thereby contributing to overall healthy homeostasis while concurrently impacting disease risk, including anxiety and mood disorders. Particular attention is devoted to elucidating the structure and functional relevance of the gut microbiota in the context of Anorexia Nervosa.
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Affiliation(s)
- Dana-Teodora Anton-Păduraru
- Department of Mother and Child Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.-T.A.-P.); (D.E.M.)
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
| | - Felicia Trofin
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
| | - Eduard Vasile Nastase
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
- Department of Internal Medicine II—Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Radu Stefan Miftode
- Department of Internal Medicine I—Cardiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- “Sf. Spiridon” Clinical Hospital, 700111 Iasi, Romania
| | - Ionela-Larisa Miftode
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
- Department of Internal Medicine II—Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mioara Florentina Trandafirescu
- Department of Morphofunctional Sciences I—Histology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Elena Cojocaru
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
- Department of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Țarcă
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
- Department of Surgery II—Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dana Elena Mindru
- Department of Mother and Child Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (D.-T.A.-P.); (D.E.M.)
- “Sf. Maria” Children Emergency Hospital, 700309 Iasi, Romania; (E.C.); (E.Ț.)
| | - Olivia Simona Dorneanu
- Department of Preventive Medicine and Interdisciplinarity—Microbiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Clinical Hospital of Infectious Diseases “Sf. Parascheva”, 700116 Iasi, Romania;
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Korczynski S, Khiar Zerrouk A, Revah-Levy A, Sibeoni J, Lachal J. Issues around food in mixed families of adolescent girls with bulimia nervosa: A qualitative study with photo-elicitation. L'ENCEPHALE 2023; 49:606-611. [PMID: 36253177 DOI: 10.1016/j.encep.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Bulimia nervosa (BN) is a common psychiatric disorder among adolescent girls with potentially significant complications. Family relationships play a major role in the development and progression of this disorder. Studies in migrant populations suffering from eating disorders show contrasting results depending on the generation of migrants: first generation migrants have fewer eating disorders than the native population, while the prevalence of this disorder is more important than the latter among second and third generation migrants. In our clinical experience, we have frequently encountered so-called "mixed" families, which are families composed of one migrant parent and one non-migrant parent. Research focusing on this kind of family is scarce which is why we chose to explore their dynamic. METHODS This study explored the issues around food and family relationships of adolescent girls suffering from BN, a topic that, to date, has not yet been studied. Ten interviews were conducted with five adolescent girls with BN between the ages of 16 and 20 and their parents, using photo-elicitation to enrich the collected data. RESULTS The results were organized around two axes: (1) identity issues around food, that is the assimilation process described by both parents and adolescents concerning family meals and food habits, and how the adolescents struggle to manage this interbreeding; and (2) transmission issues with the consequences the migrant parent has to deal with to transmit his/her cultural identity with food while being far away from the homeland, and the difficulties between this parent and his/her child to share this heritage. Both issues, identity and transmission, appear to be central among these families. CONCLUSIONS Our results suggest a difficulty in mentalizing identity issues in adolescent girls; the function of appeasement around non-mentalized tensions was highlighted. In our opinion, in this particular context, BN acts as a means of expressing the difficulty of their mixed culture. This enables it to draw some clinical implications, especially using mentalization-based therapy which has already shown efficacy in adolescents with borderline personality disorder and ED.
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Affiliation(s)
- S Korczynski
- University of Lorraine, 54000 Nancy, France; Service of Adolescent Psychiatry, Hospital Center of Jury, Maison des Adolescents de Metz, 57000 Metz, France.
| | - A Khiar Zerrouk
- University of Lorraine, 54000 Nancy, France; Service of Adolescent Psychiatry, Hospital Center of Jury, Maison des Adolescents de Metz, 57000 Metz, France; Université de Lorraine, Laboratoire INTERPSY, UR 4432, Team PRISME, F- 54000 Nancy, France
| | - A Revah-Levy
- University Service of Adolescent Psychiatry, Argenteuil Hospital Centre, 69, rue du Lieutenant-Colonel Prud'hon, 95107 Argenteuil Cedex, France; ECSTRRA Team, UMR-1153, Inserm, université de Paris, 75010 Paris, France
| | - J Sibeoni
- University Service of Adolescent Psychiatry, Argenteuil Hospital Centre, 69, rue du Lieutenant-Colonel Prud'hon, 95107 Argenteuil Cedex, France; ECSTRRA Team, UMR-1153, Inserm, université de Paris, 75010 Paris, France
| | - J Lachal
- Child and Adolescent Psychiatry Service, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France; University of Clermont Auvergne, 63000 Clermont-Ferrand, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
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Smith S, Charach A, To T, Toulany A, Fung K, Saunders N. Pediatric Patients Hospitalized With Eating Disorders in Ontario, Canada, Over Time. JAMA Netw Open 2023; 6:e2346012. [PMID: 38048130 PMCID: PMC10696484 DOI: 10.1001/jamanetworkopen.2023.46012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Importance Understanding the evolving characteristics of pediatric patients hospitalized for eating disorders is important to ensure that services and treatments align with patient needs. Objective To examine temporal trends in the rates of hospitalizations for pediatric eating disorders by clinical and demographic characteristics in Ontario, Canada, over a 17-year period. Design, Setting, and Participants This population-based, repeated, cross-sectional study used linked health administrative and demographic databases in Ontario, Canada, to identify individuals aged 5 to 17 years hospitalized with eating disorder diagnoses from April 1, 2002, to March 31, 2020. Data analyses were performed from May 2021 to June 2023. Exposure Fiscal year (April 1-March 31) of eating disorder hospitalization. Main Outcomes and Measures Outcomes of interest were absolute and relative changes in pediatric eating disorder hospitalization rates overall and stratified by patient sex, age groups, and eating disorder diagnostic groups. Results Over the study period, there were 11 654 pediatric eating disorder hospitalizations, of which 5268 (45.2%) were for anorexia nervosa and 1374 (11.8%) were for bulimia nervosa. There were a total of 10 648 hospitalizations (91.4%) among female patients, and the median (IQR) age was 15.0 (14-0-16.0) years. Hospitalization rates increased 139% from 2002 to 2019, from 2.0 per 10 000 population to 4.8 per 10 000 population. The largest relative changes were observed among male patients (416%; from 0.2 per 10 000 population to 1.1 per 10 000 population), individuals aged 12 to 14 years (196%; from 2.2 per 10 000 population to 6.6 per 10 000 population), and individuals with eating disorders other than anorexia or bulimia nervosa (255%; from 0.6 per 10 000 population to 2.1 per 10 000 population). Male patients, younger adolescents, and individuals with other eating disorders also represented larger proportions of hospitalizations by fiscal 2019. Conclusions and Relevance In this cross-sectional study of eating disorder hospitalizations, pediatric hospitalizations increased over time, particularly among populations traditionally considered atypical. Existing eating disorder programs must adapt to accommodate changing patient presentations and increased volumes to ensure effective care delivery.
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Affiliation(s)
- Sarah Smith
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Alice Charach
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Teresa To
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Alene Toulany
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Edwin S. H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
| | | | - Natasha Saunders
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Edwin S. H. Leong Centre for Healthy Children, University of Toronto, Toronto, Canada
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Wisting L, Stice E, Ghaderi A, Dahlgren CL. Effectiveness of virtually delivered Body Project groups to prevent eating disorders in young women at risk: a protocol for a randomized controlled trial. J Eat Disord 2023; 11:209. [PMID: 38001544 PMCID: PMC10668509 DOI: 10.1186/s40337-023-00932-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are a group of mental illnesses associated with significant psychological and physiological consequences. Overall, only about one-fifth of individuals with EDs receive treatment and treatment is effective for only about one-third for those who receive care. The development and implementation of effective prevention approaches for those at risk is therefore pivotal. The Body Project is the most effective ED prevention program for at-risk women according to several meta-analyses, but reach is limited since delivery, traditionally, has been in-person. Moreover, peer-led Body Project groups have been reported to produce stronger effects than clinician-led Body Project groups when delivered in-person. This has not yet been examined for virtually delivered Body Project groups. This study therefore seeks to investigate the effect of virtual Body Project groups delivered by peers versus clinicians on ED risk factors, ED symptoms, and prospective ED onset. METHODS Young women with body image concerns aged 16-25 years (N = 441) will be included in the study and randomized to three conditions: (i) virtually delivered Body Project groups led by clinicians; (ii) virtually delivered Body Project groups led by peers; and (iii) psychoeducational control group. Participants will complete assessments at five timepoints over two years (pretest, posttest, 6-months, 1-year, and 2-years). DISCUSSION Further research is needed to examine approaches to increase the potential for broad implementation of prevention of EDs. The virtual modality of the Body Project could markedly expand the reach for young women at risk. If findings confirm that peers can deliver virtual Body Project groups as effectively as clinicians, this will further enhance the implementation potential. TRIAL REGISTRATION The present study has been registered on clinicaltrials.gov (NCT05993728).
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Affiliation(s)
- Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4956, Nydalen, Oslo, 0424, Norway.
| | - Eric Stice
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, USA
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Varela C, Hoyo Á, Tapia-Sanz ME, Jiménez-González AI, Moral BJ, Rodríguez-Fernández P, Vargas-Hernández Y, Ruiz-Sánchez LJ. An update on the underlying risk factors of eating disorders onset during adolescence: a systematic review. Front Psychol 2023; 14:1221679. [PMID: 38023032 PMCID: PMC10663237 DOI: 10.3389/fpsyg.2023.1221679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Eating disorders (EDs) are serious psychological problems that affect not only the individual, but also their entire environment. The prevalence rates of EDs are higher among the adolescent population. A better understanding of ED risk factors is essential to design effective prevention and intervention programs that focus beyond the areas of weight and appearance. Methods The main objective of this systematic review was to identify the risk factors of EDs and provide a comprehensive approach, analyzing the interplay between individuals, their inner circle, and the society characteristics. The Web of Science, Scopus, CENTRAL and PsycInfo databases were searched. Results The initial search produced 8,178 references. After removing duplicates and performing the selection process by three independent reviewers, 42 articles were included in the systematic review according to the pre-specified inclusion criteria. The results suggest the relevance of society and the inner circle on the development of EDs. Discussion The internalization of the thin ideal, promoted by the current society, and living in an unsupportive, unaffectionate, non-cohesive environment were associated with the onset of EDs symptomatology. Other associated variables with this ED indicator were poor-quality relationships and feeling judged about appearance. These aspects seem to be essential for the development of individual characteristics like self-esteem or adaptative coping during adolescence. This systematic review has shown the complex etiology of EDs and the relevance of the interplay between the different areas involved. Furthermore, this information could be relevant to improve the design of innovative and more effective prevention and intervention programs. Systematic review registration PROSPERO, identifier CRD42022320881.
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Affiliation(s)
- Carmen Varela
- Universitat de Barcelona, Barcelona, Spain
- Departamento de Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad de Burgos, Burgos, Spain
- Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | - Ángela Hoyo
- Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | | | | | - Benito Javier Moral
- Área de Psicología, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
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Lim J, White J, Withington T, Catania S, Wilson D, Knight P, Rees B, Middeldorp C, Krishnamoorthy G. Family-based treatment takes longer for adolescents with mental health comorbidities: findings from a community mental health service. Eat Disord 2023; 31:588-609. [PMID: 37066723 DOI: 10.1080/10640266.2023.2201995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Children and adolescents diagnosed with an eating disorder often meet the diagnosis of another mental health disorder. In addition to eating disorders, individuals with comorbid disorders have higher suicide rates and more severe and chronic eating disorder symptoms. The present research aimed to investigate the influence of comorbid conditions on the treatment outcomes of children and adolescents that attended a public community mental health service. It was hypothesised that the patients with comorbidities would have a more extended treatment duration, slower rates of weight restoration, more hospital admissions for medical compromise, and poorer functioning than those without comorbidities. Data from 78 past patients at the Eating Disorder Program in Queensland, Australia, were analysed. Patients with comorbidities demonstrated similar recovery rates to those without comorbidities. However, those with comorbid conditions had longer episodes of treatment. The study's results support using Family Based Treatment for patients with and without comorbidities. The implications of the findings for public mental health services and directions for future research are discussed.
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Affiliation(s)
- Jacqueline Lim
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Jacinda White
- Child and Youth Mental Health Service, Children's Health Queensland, Ipswich, Australia
| | - Tania Withington
- Child and Youth Mental Health Service, Children's Health Queensland, Ipswich, Australia
- Child Health Research Center, University of Queensland, South Brisbane, Australia
| | - Salvatore Catania
- Child and Youth Mental Health Service, Children's Health Queensland, Ipswich, Australia
| | - Daniel Wilson
- Child and Youth Mental Health Service, Children's Health Queensland, Ipswich, Australia
- Child Health Research Center, University of Queensland, South Brisbane, Australia
| | - Penny Knight
- Child and Youth Mental Health Service, Children's Health Queensland, Ipswich, Australia
| | | | - Christel Middeldorp
- Child Health Research Center, University of Queensland, South Brisbane, Australia
| | - Govind Krishnamoorthy
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
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D'Adamo L, Ghaderi A, Rohde P, Gau JM, Shaw H, Stice E. Evaluating whether a peer-led dissonance-based eating disorder prevention program prevents onset of each eating disorder type. Psychol Med 2023; 53:7214-7221. [PMID: 37039122 PMCID: PMC10564960 DOI: 10.1017/s0033291723000739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 02/10/2023] [Accepted: 03/06/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND This study tested whether the dissonance-based Body Project eating disorder prevention program reduced onset of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) over long-term follow-up. METHODS Data were combined from three prevention trials that targeted young women at high-risk for eating disorders (N = 1092; M age = 19.3). Participants were randomized to Body Project groups led by peer educators or expressive writing/educational controls and completed masked diagnostic interviews over 2- to 4-year follow-ups. Logistic regressions tested whether onset of each eating disorder over follow-up differed between Body Project and control participants. RESULTS Peer-led Body Project groups produced a 46% reduction in onset of subthreshold/threshold BN and a 62% reduction in onset of PD relative to controls over follow-up. Rates of onset of subthreshold/threshold AN and BED did not significantly differ between peer-led Body Project participants and control participants. CONCLUSIONS Results support the dissemination of the peer-led Body Project for reducing future onset of BN and PD. This study and recent research suggest that thin-ideal internalization, the risk factor for eating disorders targeted in the Body Project, may be more relevant for predicting onset of BN and PD compared to AN and BED. Findings support the development of a version of the Body Project aimed to reduce risk factors that have predicted future onset of all four types of eating disorders (e.g. overvaluation of weight/shape, fear of weight gain), which may more effectively prevent all eating disorder types.
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Affiliation(s)
- Laura D'Adamo
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychology and Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul Rohde
- Oregon Research Institute, Eugene, OR, USA
| | | | - Heather Shaw
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Eric Stice
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Tokatly Latzer I, Richmond TK, Zhang B, Pearl PL. Eating disorders occur at high rates in adolescents with epilepsy and are associated with psychiatric comorbidities and suicidality. Epilepsia 2023; 64:2982-2992. [PMID: 37611929 DOI: 10.1111/epi.17759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To assess the occurrence rate, characteristics, and impact of eating disorders (EDs) in adolescents with epilepsy. METHODS In this observational study, adolescents with epilepsy seen in a single center between 2013 and 2022 who had comorbid EDs were compared to two control groups of adolescents with only epilepsy and only EDs. Patients with intellectual disability or autism spectrum disorder were excluded. Data retrieved included demographic and anthropometric details and clinical variables relating to seizure types, EDs, and psychiatric disorders and behaviors. RESULTS A total of 376 subjects were included in the study: 84 adolescents with both epilepsy and eating disorders, 135 with only epilepsy, and 157 with only EDs. The rate of EDs in adolescents with epilepsy was 7.0% (95% confidence interval [CI] 5.6%-8.5%) overall, 11.3% (95% CI 8.8%-14.3%) in females, and 3.1% (95% CI 1.9%-4.8%) in males. The median (interquartile range [IQR]) time difference between the onset of epilepsy to an ED was 1.6 (.5-3.6) years. Among adolescents with epilepsy, those with an ED were more likely to be female (p = .001) and have a lower body mass index z-score (zBMI) percentile (p < .001). Epilepsy type, seizure frequency, or seizure duration were not specific for having or not having EDs. Among adolescents with EDs, those with epilepsy had a younger onset of their EDs (p < .001), included relatively more males (p = .007), and consisted of more cases of anorexia-nervosa-restrictive type (p < .001), and fewer cases of bulimia nervosa (p = .04) and binge eating disorder (p = .003). Adolescents with epilepsy and a comorbid ED were more likely to have psychiatric comorbidities such as depression, anxiety, and suicidality than adolescents with only epilepsy or EDs. SIGNIFICANCE EDs should be suspected and screened for in intellectually intact female and male adolescents with epilepsy, irrespective of their epilepsy type. If disturbed eating behaviors or EDs are identified, further evaluation should be directed at detecting other psychopathologies, including suicidality.
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Bo Zhang
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Phillip L Pearl
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Dahlgren CL, Reneflot A, Brunborg C, Wennersberg AL, Wisting L. Estimated prevalence of DSM-5 eating disorders in Norwegian adolescents: A community based two-phase study. Int J Eat Disord 2023; 56:2062-2073. [PMID: 37530417 DOI: 10.1002/eat.24032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVE Little is known about the prevalence of DSM-5 eating disorders (EDs) in adolescents. In Norway, the most recent community-based prevalence study in adolescents was published more than 20 years ago. The aim of this study was to assess the prevalence of DSM-5 EDs in Norwegian adolescents using a two-phase design. METHOD A total of 1558 upper secondary school students (827 girls and 730 boys) (ages 16-19) were screened for at-risk ED pathology using the Eating Disorder Examination-Questionnaire short version (EDE-QS). A sub-sample of 99 adolescents (87 girls and 12 boys) subsequently participated in a clinical interview using the Eating Disorder Assessment for DSM-5 (EDA-5). RESULTS Eating pathology was common, with 19.9% of participants scoring at or above the applied EDE-QS cut-off. The estimated prevalence of any ED was 9.4% in the total sample, and 16.4% in girls. The number of boys who took part in the diagnostic interview was low, thus, diagnostic data from boys were not analyzed separately. Prevalence estimates of AN, BN, BED, and OSFED in girls were 2.7%, 1.1%, 1.9%, and 10.7%. Atypical AN was the most frequently assigned diagnosis in girls. DISCUSSION Sampling biases limit generalizability of results. Additional population-based studies are warranted to assess the prevalence of EDs in Norwegian youth. PUBLIC SIGNIFICANCE STATEMENT In this study, 1558 adolescents, aged 16-19, were screened for ED pathology. A subsample completed a diagnostic interview using DSM-5 criteria. Results showed that one in five adolescents displayed problematic eating behaviors and cognitions. The estimated prevalence rate of any ED was 9.4%. Sampling biases limit generalizability of results. Additional population-based studies are warranted to assess the prevalence of EDs in Norwegian youth.
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Affiliation(s)
- Camilla Lindvall Dahlgren
- Department of Psychology, Oslo New University College, Oslo, Norway
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål HF, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Anne-Louise Wennersberg
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål HF, Oslo, Norway
| | - Line Wisting
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål HF, Oslo, Norway
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Davies HL, Peel AJ, Mundy J, Monssen D, Kakar S, Davies MR, Adey BN, Armour C, Kalsi G, Lin Y, Marsh I, Rogers HC, Walters JTR, Herle M, Glen K, Malouf CM, Kelly EJ, Eley TC, Treasure J, Breen G, Hübel C. The network structure of mania symptoms differs between people with and without binge eating. Bipolar Disord 2023; 25:592-607. [PMID: 37308319 PMCID: PMC10768381 DOI: 10.1111/bdi.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES People with bipolar disorder who also report binge eating have increased psychopathology and greater impairment than those without binge eating. Whether this co-occurrence is related to binge eating as a symptom or presents differently across full-syndrome eating disorders with binge eating is unclear. METHODS We first compared networks of 13 lifetime mania symptoms in 34,226 participants from the United Kingdom's National Institute for Health and Care Research BioResource with (n = 12,104) and without (n = 22,122) lifetime binge eating. Second, in the subsample with binge eating, we compared networks of mania symptoms in participants with lifetime anorexia nervosa binge-eating/purging (n = 825), bulimia nervosa (n = 3737), and binge-eating disorder (n = 3648). RESULTS People with binge eating endorsed every mania symptom significantly more often than those without binge eating. Within the subsample, people with bulimia nervosa most often had the highest endorsement rate of each mania symptom. We found significant differences in network parameter statistics, including network structure (M = 0.25, p = 0.001) and global strength (S = 1.84, p = 0.002) when comparing the binge eating with no binge-eating participants. However, network structure differences were sensitive to reductions in sample size and the greater density of the latter network was explained by the large proportion of participants (34%) without mania symptoms. The structure of the anorexia nervosa binge-eating/purging network differed from the bulimia nervosa network (M = 0.66, p = 0.001), but the result was unstable. CONCLUSIONS Our results suggest that the presence and structure of mania symptoms may be more associated with binge eating as a symptom rather than any specific binge-type eating disorder. Further research with larger sample sizes is required to confirm our findings.
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Affiliation(s)
- Helena L. Davies
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Alicia J. Peel
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Dina Monssen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Saakshi Kakar
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Molly R. Davies
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Brett N. Adey
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Chérie Armour
- Research Centre for Stress, Trauma and Related Conditions (STARC), School of PsychologyQueen's University Belfast (QUB)Belfast, Northern IrelandUK
| | - Gursharan Kalsi
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Yuhao Lin
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Ian Marsh
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Henry C. Rogers
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - James T. R. Walters
- Division of Psychiatry and Clinical Neurosciences, National Centre for Mental Health and MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Moritz Herle
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- Department of Biostatistics and Health InformaticsKing's College LondonLondonUK
| | - Kiran Glen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Chelsea Mika Malouf
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Emily J. Kelly
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Thalia C. Eley
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological MedicineInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustMaudsley HospitalLondonUK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
- National Centre for Register‐based Research, Aarhus Business and Social SciencesAarhus UniversityAarhusDenmark
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