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Schmidt K, Fitzgerald E, Keel P. Suicidal thoughts and attempts in a transdiagnostic eating disorder sample: Do diagnostic severity criteria predict risk? EUROPEAN EATING DISORDERS REVIEW 2024; 32:952-962. [PMID: 38760944 DOI: 10.1002/erv.3104] [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: 11/01/2023] [Revised: 04/19/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE Eating disorders (EDs) are associated with elevated suicide. Low body mass index (BMI) and frequency of purging and binge eating represent severity criteria for EDs and distinguish full-threshold EDs from other specified feeding and eating disorders (OSFED). However, no work has taken a transdiagnostic approach to studying whether severity of these or other features is associated with suicidal ideation (SI) and attempts. METHOD We examined diagnostic status, ED features, and SI and attempts in a large, transdiagnostic, community sample of 257 women with EDs and 45 controls without a current or past ED in the United States using the EDs Examination interview and the Structured Clinical Interview for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). RESULTS SI and suicide attempts (SA) were elevated in OSFED compared to controls but did not differ between OSFED and full-threshold EDs. Higher BMI predicted increased SI. Number of purging methods, but not frequency, was related to history of SA. Binge episode frequency and size were not significant predictors. CONCLUSIONS OSFED presents with elevated SI and SA, and ED severity criteria that distinguish OSFED from full-threshold EDs do not predict SI or SA. Suicide risk assessments should be implemented universally across EDs in clinical practice.
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Affiliation(s)
| | | | - Pamela Keel
- Florida State University, Tallahassee, Florida, United States
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2
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Haas M, Ackerman RA, Kouros CD, Papp LM. COVID-19 and changes in young adults' weight concerns. J Behav Med 2024; 47:743-750. [PMID: 38491336 PMCID: PMC11290978 DOI: 10.1007/s10865-024-00481-7] [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: 06/16/2022] [Accepted: 02/20/2024] [Indexed: 03/18/2024]
Abstract
The COVID-19 pandemic introduced fundamental challenges to nearly all aspects of college students' lives, yet changes in key domains of their health, including weight concerns, remain untested. The current study utilized a longitudinal project comprised of 355 young-adult college students (Mage=19.5, 66.8% female, 33.2% male) oversampled for recent substance use behavior. Participants completed multiple assessments (mode = 5) from September 2017 to September 2021. Piecewise growth-curve models tested whether COVID-19 onset was associated with changes in the trajectories of young adults' weight concerns. Analyses also examined participants' sex as a moderator of these trajectories. On average, participants reported a significant increase in weight concern levels around the start of COVID-19, although weight concern slopes were not significantly different before and after COVID-19. Additionally, moderation analyses showed that females (but not males) had a significant increase in weight concern levels after COVID-19 onset.
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Affiliation(s)
- Megan Haas
- Department of Human Development and Family Studies, University of Wisconsin-Madison, 1300 Linden Drive, Madison, WI, 53706, USA
| | - Robert A Ackerman
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, USA
| | | | - Lauren M Papp
- Department of Human Development and Family Studies, University of Wisconsin-Madison, 1300 Linden Drive, Madison, WI, 53706, USA.
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3
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Palermo M, Rancourt D. Examining compulsive exercise as a risk factor for eating disorder symptoms in first-year college students using a latent change score modeling approach. Int J Eat Disord 2024; 57:1680-1690. [PMID: 38619370 DOI: 10.1002/eat.24219] [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: 11/21/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Research suggests that both compulsive exercise and eating disordered behaviors increase during college. Despite strong cross-sectional associations between compulsive exercise and eating disorders, it is unknown if compulsive exercise is a variable risk factor for eating disorders or simply a correlate. It was hypothesized that increases in compulsive exercise would significantly and prospectively predict increases in overall number of eating disorder symptoms over the study period. METHOD A total of 265 first year college students who did not meet criteria for a full or subthreshold eating disorder diagnosis at Time 1 (age M = 18.15; SD = 0.42; 122 female [46%] at Time 1) completed reports of compulsive exercise and eating disorder symptoms via online questionnaires at four timepoints over the 9-month 2021-2022 academic year (76% retention rate). Hypotheses were tested using a bivariate latent change score model. RESULTS Hypotheses were not supported. Change in compulsive exercise did not predict change in number of eating disorder symptoms. Change in number of eating disorder symptoms also did not predict change in compulsive exercise. CONCLUSIONS Compulsive exercise did not emerge as a variable risk factor for the development of eating disorder symptoms among first year college students. The relationship between these behaviors should be investigated at different developmental timepoints, such as early adolescence, and potential third variables that may explain the observed co-occurrence should be explored. PUBLIC SIGNIFICANCE This study investigated whether increases in compulsive exercise predicted increases in number of eating disorder symptoms among first year college students. Compulsive exercise did not significantly predict number of eating disorder symptoms. Additional research is warranted to clarify the relationship between compulsive exercise and eating disorder symptoms.
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Affiliation(s)
- Madeline Palermo
- Department of Psychology, University of South Florida, Tampa, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, USA
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4
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Pacella KAC, Richson BN, Short NA, Bottera AR, Irish LA, Perko VL, Forbush KT. Using item response theory to identify key symptoms of insomnia in a sample of university students with probable eating disorders. Eat Weight Disord 2024; 29:49. [PMID: 39068613 PMCID: PMC11284188 DOI: 10.1007/s40519-024-01679-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 07/12/2024] [Indexed: 07/30/2024] Open
Abstract
PURPOSE Researchers have theorized that interactions between appetitive and circadian disruptions result in increased eating disorder (ED) symptoms and insomnia. However, it is unclear how specific insomnia symptoms present among people with EDs and if the latent structure of insomnia in this population is similar to that of people with insomnia disorder. METHODS We conducted a secondary analysis of data collected on ED and insomnia symptoms using a subset of students (N = 547; 79.52% female) with probable EDs at a large Midwestern American university. Item response theory (IRT) for polytomous items was performed to identify item difficulty, discrimination, and information parameters for the Insomnia Severity Index (ISI). IRT parameters were compared to those established in a 2011 study of people diagnosed with insomnia disorder by Morin and colleagues. RESULTS Clinically significant insomnia symptoms were common among students with ED pathology and symptom endorsement for each ISI item ranged from 40.77 to 86.65%. ISI items assessing insomnia-related impairment and distress showed better discriminative capacities and had higher item information than items assessing sleep behavior alterations (i.e., difficulties falling asleep, difficulties maintaining sleep, waking too early). Item discrimination was largely similar among the ED sample compared to previous IRT analyses in an insomnia disorder sample. CONCLUSION Insomnia symptoms are common among university students with probable EDs and similar to those reported by people with insomnia disorder. When considering insomnia assessment, items assessing sleep behaviors alone are likely inadequate to provide information about insomnia severity among people with EDs. LEVEL V Evidence obtained from a cross-sectional descriptive study.
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Affiliation(s)
| | | | - Nicole A Short
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Angeline R Bottera
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd, Lawrence, KS, 66045, USA
| | - Leah A Irish
- Center for Biobehavioral Research, Sanford Research, Fargo, ND, USA
- Department of Psychology, North Dakota State University, Fargo, ND, USA
| | | | - Kelsie T Forbush
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd, Lawrence, KS, 66045, USA.
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5
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Peng J, Xu T, Tan X, He Y, Zeng Y, Tang J, Sun M. Eating Styles Profiles and Correlates in Chinese Postpartum Women: A Latent Profile Analysis. Nutrients 2024; 16:2299. [PMID: 39064741 PMCID: PMC11280277 DOI: 10.3390/nu16142299] [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: 06/02/2024] [Revised: 06/27/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Postpartum women present a high risk of disordered eating behaviors, but the heterogeneity between groups was not identified. This cross-sectional study aimed to identify eating styles profiles in postpartum women and explore the correlates based on demographic characteristics and psychosocial factors. Questionnaires were administered to 507 Chinese postpartum women. Latent profile analysis (LPA) was conducted to identify eating styles profiles. Multinomial logistic regression was used to investigate the correlates of these profiles among postpartum women. The LPA identified three eating styles profiles: postpartum women with low emotional, external, and restrained eating (Profile 1, 6.9%); postpartum women with medium emotional, external, and restrained eating (Profile 2, 66.1%); and postpartum women with high emotional, external, and restrained eating (Profile 3, 27.0%). Compared to Profile 1, higher postpartum depression (PPD) and body mass index (BMI) were more likely to be associated with Profile 2 and Profile 3, whereas higher postpartum weight retention (PPWR) was more likely to be associated with Profile 1. Compared to Profile 2, higher PPD and BMI were more likely associated with Profile 3. Disordered eating behaviors in postpartum women with three eating styles were associated with BMI, PPD, and PPWR. This study can guide healthcare professionals in developing targeted interventions to improve maternal and child health globally.
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Affiliation(s)
- Jiayuan Peng
- Xiangya School of Nursing, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha 410013, China; (J.P.); (T.X.); (Y.H.); (Y.Z.); (J.T.)
| | - Tian Xu
- Xiangya School of Nursing, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha 410013, China; (J.P.); (T.X.); (Y.H.); (Y.Z.); (J.T.)
| | - Xiangmin Tan
- School of Rural Health, Monash University, 15 Sargeant Street, Warragul, VIC 3820, Australia;
| | - Yuqing He
- Xiangya School of Nursing, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha 410013, China; (J.P.); (T.X.); (Y.H.); (Y.Z.); (J.T.)
| | - Yi Zeng
- Xiangya School of Nursing, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha 410013, China; (J.P.); (T.X.); (Y.H.); (Y.Z.); (J.T.)
| | - Jingfei Tang
- Xiangya School of Nursing, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha 410013, China; (J.P.); (T.X.); (Y.H.); (Y.Z.); (J.T.)
| | - Mei Sun
- Xiangya School of Nursing, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha 410013, China; (J.P.); (T.X.); (Y.H.); (Y.Z.); (J.T.)
- School of Nursing, Xinjiang Medical University, No.168 Youyi South Road, Urumqi 830054, China
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Qeadan F, Ross S, Barbeau WA, Madden EF, English K. Suicidal ideation, suicide attempt, and self-injury among American Indian, Alaskan Native, and Native Hawaiian college students in the United States from 2015 to 2019. Health Sci Rep 2024; 7:e2139. [PMID: 39015421 PMCID: PMC11250395 DOI: 10.1002/hsr2.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 11/20/2023] [Accepted: 04/11/2024] [Indexed: 07/18/2024] Open
Abstract
Background Suicide is a major driver of mortality among college students and is the leading cause of death among American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) young adults. Methods Data on suicidal ideation, suicide attempt, and self-injury among AI/AN/NH college students (n = 8103) were analyzed via multivariable logistic regressions employing the American College Health Association National College Health Assessment survey from 2015 to 2019. Adjusted odds ratios (aORs) were used to assess how opioid misuse may act as a risk or protective factor for suicidality and self-injury. Results Between 2015 and 2019, suicidal ideation was the most prevalent dimension of suicidality affecting AI/AN/NH college students (ranges from 12.69% to 18.35%), followed by self-injury (7.83%-11.41%) and suicide attempt (2.40%-4.10%). AI/AN/NH college students who reported opioid misuse were significantly more likely to experience suicidal ideation (aOR: 1.417; 95% confidence interval [CI]: 1.154-1.740) and self-injury (aOR: 1.684; 95% CI: 1.341-2.116) than those who did not engage in such behavior. Conclusions We identified opioid misuse as a potential risk factor for suicidal ideation and intentional self-injury among populations of AI/AN/NH college students. Programs seeking to reduce suicide prevalence among Indigenous college students may benefit from the inclusion of evidence-based interventions that prevent and treat issues related to opioid use.
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Affiliation(s)
- Fares Qeadan
- Department of Public Health, Parkinson School of Health Sciences and Public HealthLoyola University ChicagoMaywoodIllinoisUSA
| | - Sydney Ross
- Department of Public Health, Parkinson School of Health Sciences and Public HealthLoyola University ChicagoMaywoodIllinoisUSA
| | - William A. Barbeau
- Department of Public Health, Parkinson School of Health Sciences and Public HealthLoyola University ChicagoMaywoodIllinoisUSA
| | - Erin F. Madden
- Department of Family Medicine and Public Health SciencesWayne State UniversityDetroitMichiganUSA
| | - Kevin English
- Albuquerque Area Southwest Tribal Epidemiology CenterAlbuquerqueNew MexicoUSA
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7
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Szmajda R, Mokros Ł, Szmajda-Krygier D, Gmitrowicz A. Factors associated with suicide attempt risk in adolescent inpatient psychiatric care: toward a practical model. Eur Child Adolesc Psychiatry 2024; 33:1875-1881. [PMID: 37668697 PMCID: PMC11211099 DOI: 10.1007/s00787-023-02272-y] [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: 02/15/2023] [Accepted: 07/29/2023] [Indexed: 09/06/2023]
Abstract
Suicide is an important social and medical problem, particularly among children and adolescents. The aim of the study was to determine the association of the psychiatric diagnosis and selected psychosocial factors with the risk of suicide attempts among patients of an adolescent psychiatric unit. A retrospective analysis was performed on a database of consecutive N = 1311 patients aged 13-18 years of the adolescent psychiatric ward. A hierarchical logistic regression analysis was performed to assess the predictive value of the main psychiatric diagnosis, for factors selected from the database to determine their influence on the relative risk of a suicide attempt. Primary diagnoses of mood disorders and emotional and behavioral disorders were associated with an increased risk of a current admission after a suicidal attempt, a history of past suicidal attempts and non-suicidal self-harm (NSSI). History of NSSI was associated with a fourfold increase probability of a suicide attempt. Truancy, sexual abuse, heartbreak and frequent conflicts were related to a rise in suicidal attempt risk. Learning difficulties were found to be linked to increased probability of suicidal attempt, but only among women. The current study confirms that the primary diagnosis, NSSI and well-recognized psychosocial factors (including family- and school-related factors) may prove useful in the assessment of suicidal risk among adolescents admitted to a psychiatric ward.
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Affiliation(s)
| | - Łukasz Mokros
- Institute of Psychiatry and Neurology, Warsaw, Poland
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8
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Coop A, Clark A, Morgan J, Reid F, Lacey JH. The use and misuse of the SCOFF screening measure over two decades: a systematic literature review. Eat Weight Disord 2024; 29:29. [PMID: 38652332 PMCID: PMC11039549 DOI: 10.1007/s40519-024-01656-6] [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: 09/03/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested. METHODS The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors. RESULTS 180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use. CONCLUSION This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Amy Coop
- Schoen Clinic Newbridge, Birmingham, UK
| | | | - John Morgan
- St George's, University of London, London, UK
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9
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Gómez-Romero MR, Montoro-Pérez N, Martín-Baena D, Talavera-Ortega M, Montejano-Lozoya R. A descriptive cross-sectional study on eating disorders, suicidal thoughts, and behaviors among adolescents in the Valencian community (Spain). The pivotal role of school nurses. J Pediatr Nurs 2024; 75:1-7. [PMID: 38091926 DOI: 10.1016/j.pedn.2023.11.027] [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: 06/01/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE The aims of this study were: 1) to describe the rates of risk of having an Eating Disorder (ED) and the rates of suicidal thoughts and behaviors, and 2) to examine the relationship between the risk of having an ED with suicidal thoughts and behaviors in adolescents enrolled in educational centers in the Community of Valencia (Spain). DESIGN AND METHODS A cross-sectional study was conducted with 718 adolescents between September 2019 and July 2020 in five schools in the Community of Valencia (Spain). RESULTS The adolescents studied, mostly females, are at risk of having an ED (18.6% to 30.8%) and experiencing suicidal thoughts (23% to 30.7%) and behaviors (2.2% to 6.2%). A strong association was found between EDs and suicidal thoughts and behaviors in both sexes. This association was higher in females with positive EAT-26 scores (OR: 2.09; 95% CI: 1.35-3.24) and in males with positive SCOFF scores (OR: 4.66; 95% CI: 2.40-9.02). Suicidal behaviors were positively associated with both EAT-26 (OR: 2.58; 95% CI: 1.17-5.67) and SCOFF (OR: 1.89; 95% CI: 1.21-2.26) scores in females. CONCLUSIONS A considerable number of adolescents, females in particular, are at risk of having an ED and of experiencing suicidal thoughts and behaviors, establishing a strong link between EDs and suicidal tendencies. PRACTICAL IMPLICATIONS The study highlights the importance of establishing national and regional regulations to ensure the availability of school nurses in the Community of Valencia (Spain). Collaboration between school nurses, educators, and policy makers is critical to the early detection of problems and the provision of support to both adolescents and families.
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Affiliation(s)
| | - Néstor Montoro-Pérez
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Nursing, Faculty of Health Sciences, Person-centred Care and Health Outcomes Innovation Group, University of Alicante, Spain.
| | - David Martín-Baena
- GREIACC Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Marta Talavera-Ortega
- Department of Didactics of Experimental and Social Sciences, Faculty of Teaching, University of Valencia, Valencia, Spain
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10
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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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11
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Berny LM, Mojekwu F, Nichols LM, Tanner-Smith EE. Investigating the Interplay Between Mental Health Conditions and Social Connectedness on Suicide Risk: Findings from a Clinical Sample of Adolescents. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01659-x. [PMID: 38308712 DOI: 10.1007/s10578-023-01659-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 02/05/2024]
Abstract
This study examined whether school and community connectedness buffer the relationships between mental health conditions and suicide risk in a clinical sample of adolescents with histories of substance use disorders. Data from 294 adolescents were examined, with approximately 58% reporting lifetime suicidal ideation and/or prior attempts. Multinomial logistic regression was used to examine main and interaction effects on a three-category measure of suicide risk. Depression severity and panic disorder were associated with elevated suicidal ideation risk, whereas disordered eating was associated with elevated risk of attempts. Higher school-based positive peer interactions, school safety, and neighborhood social connection levels were associated with reduced suicide attempt risk. Moderation analyses revealed that high neighborhood social connection levels may partially mitigate the elevated likelihood of attempting suicide associated with disordered eating. Findings suggest clinical populations of adolescents may benefit from approaches aiming to promote social connectedness, further supporting a comprehensive approach to suicide prevention.
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Affiliation(s)
- Lauren M Berny
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA.
| | - Frank Mojekwu
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA
| | - Lindsey M Nichols
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA
| | - Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, 5251 University of Oregon, Eugene, OR, 97403, USA
- Prevention Science Institute, University of Oregon, Eugene, USA
- HEDCO Institute for Evidence-Based Educational Practice, University of Oregon, Eugene, USA
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12
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Sonneville KR, Thurston IB, Gordon AR, Richmond TK, Weeks HM, Lipson SK. Weight Stigma Associated With Mental Health Concerns Among College Students. Am J Prev Med 2024; 66:260-268. [PMID: 37758003 DOI: 10.1016/j.amepre.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Weight stigma is widespread and exists across numerous domains including health care, educational institutions, workplaces, mass media, and interpersonal relationships. Weight stigma experienced during the college years may be particularly consequential because the college years are a period of increased vulnerability for the development of mental health concerns. The purpose of the present study was to examine how experiences of weight stigma relate to mental health concerns, including symptoms of eating disorders, anxiety, and depression, among college students. METHODS Prevalence of interpersonal and anticipated weight stigma was examined among 2,707 students participating in the 2018-2019 and 2019-2020 Healthy Minds Study and tested for differences in prevalence across student characteristics. Logistic regression was used to explore relationships between measures of weight stigma and student mental health. Analyses were conducted in 2021-2023. RESULTS Interpersonal and anticipated weight stigma were reported by 12.3% and 15.3% of students, respectively. Experiences of interpersonal and anticipated weight stigma were generally lowest among cisgender male students, heterosexual students, those with the fewest financial concerns, and those who did not perceive themselves to be "overweight." Both interpersonal and anticipated weight stigma were associated with elevated odds of high weight concerns, past-month binge eating, past-month purging, high eating disorder risk, moderate/severe anxiety symptoms, and moderate/severe depressive symptoms. CONCLUSIONS Findings implicate interpersonal and anticipated weight stigma as potential risk factors for a range of mental health concerns. Weight stigma is an under-recognized and under-funded public health problem.
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Affiliation(s)
- Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Idia B Thurston
- Departments of Health Sciences and Applied Psychology, Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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13
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Liu D, Zhang M, Ding L, Huang J, Wang Y, Su Y, Chen Z, Cai Y, He S, Peng D. Relationship between biological rhythm dysregulation and suicidal ideation in patients with major depressive disorder. BMC Psychiatry 2024; 24:87. [PMID: 38297264 PMCID: PMC10832079 DOI: 10.1186/s12888-024-05528-2] [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: 08/10/2023] [Accepted: 01/16/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Although the disturbance of circadian rhythms represents a significant clinical feature of major depressive disorder (MDD), the relationship between biological rhythm disturbances and the severity of suicidal ideation in individuals with MDD remains unclear. We aimed to explore the characteristics of different biological rhythm dimensions in MDD and their association with the severity of depressive symptoms and suicidal ideation. METHODS A total of 50 MDD patients and 50 healthy controls were recruited and their general information was collected. The severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HDRS17). The intensity of suicidal ideation was evaluated with the Beck Scale for Suicide Ideation (BSS). The Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scale was utilized to assess the participants' biological rhythm dysregulation. Multiple logistic regression analysis was conducted to explore the relationship between biological rhythm and the risk of MDD. Multiple linear regression analysis was performed in the MDD group to investigate the relationship between different biological rhythm dimensions and suicide ideation. RESULTS Significant differences were observed between the MDD group and the control group in total BRIAN score (Z=-5.41, P < 0.001) as well as scores for each dimension. After adjusting for confounding factors, multiple logistic regression analysis revealed a significant association between total BRIAN score and the presence of MDD (OR = 1.20, 95% CI = 1.10-1.29, P < 0.001), as well as between scores in different BRIAN dimensions and the presence of MDD (activity: OR = 1.47, 95% CI = 1.24-1.74, P < 0.001; sleep: OR = 1.52, 95% CI = 1.28-1.79, P < 0.001; social: OR = 1.80, 95% CI = 1.32-2.46, P < 0.001; eating pattern: OR = 1.34, 95% CI = 1.12-1.60, P = 0.001). In patients with MDD, linear regression analysis demonstrated a positive relationship between BSS scores and BRIAN eating pattern scores (β = 0.34, P = 0.022), even after adjusting for demographic factors and the severity of depression. CONCLUSIONS Patients with MDD exhibited significantly higher levels of dysregulation in all four biological rhythm dimensions compared to healthy controls and the degree of dysregulation was associated with the severity of depression. More importantly, dysregulation of eating pattern may increase the intensity of suicidal ideation in MDD, thus elevating the risk of suicide.
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Affiliation(s)
- Dan Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Min Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Lei Ding
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Jia Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Yousong Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Zheng Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Yiyun Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China
| | - Shen He
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China.
| | - Daihui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, 200030, Shanghai, People's Republic of China.
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14
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Schmidt K, Smith AR, Bodell LP. Influence of nonsuicidal self-injury functions on suicide risk in individuals with eating disorders. Suicide Life Threat Behav 2023; 53:1055-1062. [PMID: 37804065 DOI: 10.1111/sltb.13006] [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: 02/16/2023] [Revised: 07/27/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE Individuals with eating disorders (EDs) display elevated rates of suicidality (i.e., suicidal ideation and behaviors) as well as nonsuicidal self-injury (NSSI) (e.g., self-harm behaviors without intent to die). NSSI-and particularly the functions of NSSI-predict suicidal ideation in general samples; however, to our knowledge, the relation between NSSI functions and suicidal ideation in ED populations has been unexplored. METHOD This study examined whether specific functions of NSSI are relevant to suicidal ideation in a treatment-seeking sample of women with EDs (n = 100). Participants completed self-report measures of suicidal ideation, NSSI, and related psychopathology upon intake to an ED treatment program. RESULTS Using the four-function model of NSSI, we found that intrapersonal and interpersonal-negative reinforcement, but not interpersonal-positive reinforcement functions, were related to suicidal ideation in women with EDs. Contrary to expectations, we did not find that endorsement of multiple NSSI functions was related to increased suicide risk. DISCUSSION Findings imply that some, but not all, functions of NSSI may be relevant to suicide risk in individuals with EDs. Implications for further research are discussed.
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Affiliation(s)
- Kendall Schmidt
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - April R Smith
- Department of Psychology, Auburn University, Auburn, Alabama, USA
| | - Lindsay P Bodell
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
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15
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Barnard-Brak L, Yang Z. A 4pL item response theory examination of perceived stigma in the screening of eating disorders with the SCOFF among college students. Eat Weight Disord 2023; 28:79. [PMID: 37792143 PMCID: PMC10550868 DOI: 10.1007/s40519-023-01604-w] [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] [Accepted: 08/27/2023] [Indexed: 10/05/2023] Open
Abstract
We examined the psychometric properties of the SCOFF, a screening instrument for eating disorders, with consideration of the perceived stigma of items that can produce socially desirable responding among a sample of college students. The results of the current study suggest evidence of the sufficient psychometric properties of the SCOFF in terms of confirmatory factor and item response theory analyses. However, two items of the SCOFF revealed that individuals who otherwise endorsed other items of the SCOFF were less likely to endorse the items of Fat and Food. It is hypothesized that this is the result of perceived stigma regarding those two items that prompts individuals to respond in a socially desirable way. A weighted scoring procedure was developed to counteract the performance of these two items, but the psychometric performance was only slightly better and there would be a clear tradeoff of specificity over sensitivity if utilized. Future research should consider other ways to counteract such perceived stigma.Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
| | - Zhanxia Yang
- Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
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16
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Duriez P, Goueslard K, Treasure J, Quantin C, Jollant F. Risk of non-fatal self-harm and premature mortality in the three years following hospitalization in adolescents and young adults with an eating disorder: A nationwide population-based study. Int J Eat Disord 2023; 56:1534-1543. [PMID: 37092760 DOI: 10.1002/eat.23974] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Eating disorders (ED) are associated with high rates of suicide attempts and premature mortality. However, data in large samples of adolescents and young adults are limited. This study aims to assess the risk of self-harm and premature mortality in young people hospitalized with an ED. METHODS Individuals aged 12 to 25 years old hospitalized in 2013-2014 in France with anorexia nervosa and/or bulimia nervosa as a primary or associated diagnosis were identified from French national health records. They were compared to two control groups with no mental disorders, and with any other mental disorder than ED. The main outcomes were any hospitalization for deliberate self-harm and mortality in the 3 years following hospitalization. Logistic regression models were used. RESULTS This study included 5, 452 patients hospitalized with an ED, 14,967 controls with no mental disorder, and 14,242 controls with a mental disorder other than an ED. During the three-year follow-up, 13.0% were hospitalized for deliberate self-harm (vs. 0.2 and 22.0%, respectively) and 0.8% died (vs. 0.03 and 0.4%). After adjustment, hospitalization with an ED was associated with more self-harm hospitalizations (hazard ratio [HR] = 46.0, 95% confidence interval [32.3-65.3]) and higher all-cause mortality (HR = 12.6 [4.3-37.3]) relative to youths without any mental disorder; less self-harm hospitalizations (HR = 0.5 [0.5-0.6]) but higher mortality (HR = 1.6 [1.0-2.4]) when compared to youths with any other mental disorder. CONCLUSION Young patients hospitalized with an ED are at high risk of self-harm and premature mortality. It is urgent to evaluate and implement the best strategies for post-discharge care and follow-up. PUBLIC SIGNIFICANCE We found that the risk of being hospitalized for a suicide attempt is 46 times higher and mortality 13 times higher than the general population in adolescents and young adults during the 3 years following hospitalization with an eating disorder. Eating disorders are also associated with a 1.5 higher risk of premature mortality relative to other mental disorders. This risk is particularly high in the 6 months following hospitalization. It is therefore crucial to implement careful post-discharge follow-up in patients hospitalized for eating disorders.
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Affiliation(s)
- Philibert Duriez
- CMME, Sainte-Anne Hospital, GHU Paris Psychiatrie et Neurosciences, Paris, France
- UMR_S1266, Institut de Psychiatrie et Neurosciences de Paris (IPNP), Inserm, Paris, France
- Faculty of Medicine, Université de Paris, Paris, France
| | - Karine Goueslard
- Service de Biostatistiques et d'Information Médicale (DIM), CHRU Dijon, Dijon, France
| | - Janet Treasure
- Psychology and Neuroscience, Section of Eating Disorders, Institute of Psychiatry, London, UK
| | - Catherine Quantin
- CIC 1432, INSERM, Dijon, France
- Clinical Epidemiology Clinical Trials Unit, Clinical Investigation Center, CHU Dijon, Dijon, France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - Fabrice Jollant
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Department of Psychiatry, CHU Bicêtre, Le Kremlin-Bicêtre, France
- Department of Psychiatry, CHU de Nîmes, Nîmes, France
- Department of Psychiatry, Faculty of Medicine, and McGill Group For Suicide Studies, McGill University, Montréal, Québec, Canada
- Team MOODS, Centre de recherche en Épidémiologie et Santé des Populations (CESP), Inserm, Université Paris-Saclay, Le Kremlin-Bicêtre, France
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17
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Abanobi AN, Itacy S, Coleman CM, Harlow BL. Association between eating disorders and sleep duration among college students: Findings from the National Healthy Minds study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-7. [PMID: 37463502 DOI: 10.1080/07448481.2023.2225616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 04/21/2023] [Accepted: 06/01/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Explore associations between eating disorders (EDs) and sleep duration and the impact of depression symptoms (DSs) in American college students. PARTICIPANTS College students from 2018 to 2019 Healthy Minds Study. METHODS Multivariate logistic regression evaluated associations between EDs (bulimia, anorexia, binge eating [BED]) and sleep duration. Stratified analyses assessed effect modification by DSs and gender. RESULTS Students reporting any eating disorder had no greater risk of not recommended sleep duration during weekdays compared to those with no eating disorder history (Adjusted OR = 0.99, 95% CI: 0.89-1.13). However, subjects reporting BED were at greater risk of deficient sleep during weekends compared to those with no EDs (Adjusted OR = 1.26, 95% CI: 1.01-1.58). This association was not impacted by DSs. However, all EDs were associated with not-recommended sleep duration among those who identified as other gender identity in comparison to those with no EDs. CONCLUSION Health educators should monitor academic performance in students with EDs for adequate sleep duration.
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Affiliation(s)
- Amarachi N Abanobi
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Sarah Itacy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Chad M Coleman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Bernard L Harlow
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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18
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Clapham R, Laves E, Fergerson A, Nichols P, Brausch A. Interoceptive deficits moderate the relationship between bulimia symptoms and suicide risk. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1612-1621. [PMID: 34242545 PMCID: PMC8742842 DOI: 10.1080/07448481.2021.1944165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/14/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
Objective: Interoceptive deficits have been linked to suicidality and eating disorders. The relationship between disordered eating symptoms and suicidality may depend on the level of interoceptive deficits. It was expected that interoceptive deficits would moderate the relationship between disordered eating symptoms (oral control, dieting, and bulimia) and suicidality (suicide attempts, ideation, and communication) when interoceptive deficits were high. Methods: University students (N = 417, Mage = 19.75, 78.2% white, 72.4% female) completed self-report measures that assessed disordered eating, interoceptive deficits, and suicide history. Results: Interoceptive deficits emerged as a significant moderator only in the association between bulimia symptoms and suicidality, when interoceptive deficits were high. Conclusions: The results of this study indicate that bulimia symptoms may have a unique interaction with interoceptive deficits and suicidality. Future research should focus on targeting interoceptive deficits in treatment to help reduce disordered eating symptoms and suicide risk, particularly for students with bulimia symptoms.
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Affiliation(s)
- Rebekah Clapham
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY
| | - Eliza Laves
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY
| | - Ava Fergerson
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY
- Ava Fergerson is now in the School of Psychology, University of Southern Mississippi, Hattiesburg, MS
| | - Paige Nichols
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY
| | - Amy Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY
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Fruehwirth JC, Mazzolenis ME, Pepper MA, Perreira KM. Perceived stress, mental health symptoms, and deleterious behaviors during the transition to college. PLoS One 2023; 18:e0287735. [PMID: 37368921 PMCID: PMC10298772 DOI: 10.1371/journal.pone.0287735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND This study examined associations between different sources of chronic perceived stress and deleterious behaviors (eating disorder symptoms, insufficient sleep, and insufficient vigorous physical activity) among first-year college students. METHODS The study used data on 885 first-year students (ages 18-20) at a large public university in North Carolina. The prevalence of deleterious behaviors was evaluated. Associations were estimated between different sources of chronic perceived stress (academic, future, peers, friendships, romantic, appearance, health, chronic illness, financial, work, family) and health behaviors after controlling for psychosocial supports and demographics. Moderating effects of gender and moderate-severe anxiety/depression symptoms were also tested. RESULTS 19% of first-year student reported symptoms of eating disorders, 42% insufficient sleep, and 43% insufficient vigorous physical activity. Perceived chronic stress increased the odds of reporting these deleterious behaviors. These effects were not moderated by gender or moderate-severe anxiety/depression symptoms. Appearance- and health-related stress were associated with eating disorder symptoms; health- and romantic-related stress were associated with insufficient sleep; and health-related stress was associated with insufficient vigorous physical activity. LIMITATIONS Outcomes were survey-based. The study was based on cross-sectional data from a single university, so the direction of causality cannot be determined, and more work needs to be done to determine whether this would extend to other populations.
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Affiliation(s)
- Jane Cooley Fruehwirth
- Department of Economics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - M. Emilia Mazzolenis
- Data Science, Harvard University, Cambridge, Massachusetts, United States of America
| | - Mollie A. Pepper
- Federal Reserve Bank of San Francisco, San Francisco, California, United States of America
| | - Krista M. Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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20
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Otterman LS. Research into Psychedelic-Assisted Psychotherapy for Anorexia Nervosa Should be Funded. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:31-39. [PMID: 36534233 PMCID: PMC9761643 DOI: 10.1007/s11673-022-10220-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/06/2022] [Indexed: 05/04/2023]
Abstract
Eating disorders are debilitating diseases that have twin impacts on the body and mind and are associated with a number of physiological and psychological comorbidities (Blinder, Cumella, and Sanathara 2006; Casiero and Frishman 2006), including increased suicide risk (Arcelus et al. 2011; Lipson and Sonneville 2020). In addition, eating disorders are growing in prevalence (Gilmache et al. 2019) and impact women at much higher rates than men (Bearman, Martinez, and Stice 2006), especially in adolescence (Spriggs, Kettner, and Carhart-Harris 2021). Anorexia nervosa (AN) is a particularly devastating eating disorder, with one of the highest mortality rates of any psychiatric disorder (Sullivan 1995). Despite the severity of the condition, current treatments for AN are limited in their efficacy (Khalsa et al. 2017). Based on the growing body of evidence demonstrating the short-term and long-term efficacy of psychedelic-assisted psychotherapy for the treatment of other mental illnesses, I argue that research into psychedelic-assisted psychotherapy for AN should be funded.
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Affiliation(s)
- Lauren S Otterman
- University of Otago Bioethics Centre, 71 Frederick Street, Dunedin, 9016, New Zealand.
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21
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Jin L, Han W, Zheng Z. Attentional vigilance of food information in disordered eating behaviors. Front Psychiatry 2023; 14:1108995. [PMID: 36873197 PMCID: PMC9974645 DOI: 10.3389/fpsyt.2023.1108995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Disordered eating behaviors (DEBs) are very common among female college students, which seriously endanger their health and well-being. Therefore, the study of the mechanism of DEBs can provide effective evidence for early detection and intervention. METHODS In total of 54 female college students were recruited and assigned to DEB group (n = 29) and healthy control (HC) group (n = 25) according to their scores in the Eating Attitudes Test-26 (EAT-26). Then, the Exogenous Cueing Task (ECT) was used to evaluate their reaction time (RT) to the location of a target dot preceded by a food or neutral cue. RESULTS The study found that compared with HC group, DEB group showed more attentional engagement to food stimuli, indicating that attentional vigilance to food information could be considered as a specific attentional bias of DEBs. DISCUSSION Our findings not only provide evidence of the potential mechanism of DEBs from the perspective of attentional bias, but also can be considered as an effective and objective indicator for early screening of subclinical eating disorders (EDs).
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Affiliation(s)
- Luyao Jin
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenyue Han
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Changzhou Vocational Institute of Textile and Garment, Changzhou, China
| | - Zheng Zheng
- School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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22
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Benjet C, Borges G, Miah S, Albor Y, Gutiérrez-García RA, Zavala Berbena A, Guzmán R, Vargas-Contreras E, Hermosillo de la Torre AE, Hernández Uribe PC, Quevedo G, Covarrubias Díaz A, Martínez Ruiz S, Valdés-García KP, Martínez Jerez AM, Mortier P. One-year incidence, predictors, and accuracy of prediction of suicidal thoughts and behaviors from the first to second year of university. Depress Anxiety 2022; 39:727-740. [PMID: 35980836 DOI: 10.1002/da.23278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 06/01/2022] [Accepted: 06/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Research is scarce on the prospective predictors of first onset suicidal thoughts and behaviors (STB) and the accuracy of these predictors in university students, particularly in low-and-middle income countries. Therefore, we assessed the 1-year incidence of STB among first-year students, a broad range of prospective predictors of STB incidence, and evaluated the prediction accuracy of a baseline multivariate risk prediction model to identify students at highest risk for STB onset over the subsequent 12 months. METHODS Students (n = 3238) from 13 universities in Mexico completed an online survey developed for the World Mental Health International College Student Surveys in their first year and again 12 months after. We ran generalized linear models and receiver operator curves. RESULTS The 1-year incidence of suicidal ideation, plan and attempt was 8.53%, 3.75%, and 1.16%, respectively. Predictors in final models were female sex (ideation only), minority sexual orientation (ideation only), depression, eating disorders, ADHD (ideation and plan), ongoing arguments or breakup with a romantic partner (ideation only), emotional abuse (ideation only), parental death (ideation, plan), not Catholic/Christian (ideation, plan), not having someone to rely on, psychotic experiences (plan only), and insufficient sleep (attempt only). Prediction accuracy for ideation, plan and attempt was area under the curve = 0.76, 0.81 and 0.78, respectively. Targeting the top 10% of students at highest risk could reduce STB in the subsequent year up to 36%. CONCLUSIONS By assessing these risk/protective factors in incoming students we identified students at greatest risk for developing STB to whom suicide prevention strategies could be targeted.
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Affiliation(s)
- Corina Benjet
- Epidemiological and Psychosocial Research, Center for Global Mental Health, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Guilherme Borges
- Epidemiological and Psychosocial Research, Center for Global Mental Health, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Sumaiya Miah
- Department of Biostatistics and Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Yesica Albor
- Escuela de Educación a Distancia, Universidad Cuauhtémoc, plantel Aguascalientes, Aguascalientes, Mexico
| | - Raúl A Gutiérrez-García
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, campus Salamanca, Salamanca, Mexico
| | - Alicia Zavala Berbena
- Dirección de Investigación, Universidad De La Salle Bajío, campus Campestre, León, Mexico
| | - Rebeca Guzmán
- Instituto de Ciencias de la Salud y Coordinación de Investigación, Universidad Autónoma del Estado de Hidalgo, Pachuca, Mexico
| | - Eunice Vargas-Contreras
- Facultad de Ciencias Administrativas y Sociales, Universidad Autónoma de Baja California, Ensenada, Mexico
| | | | | | - Guillermo Quevedo
- Coordinación de psicología, Universidad La Salle Cancún, Cancún, Mexico
| | | | | | | | - Ana María Martínez Jerez
- Unidad Académica de Ciencias Jurídicas y Sociales, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Mexico
| | - Philippe Mortier
- Health Services Research Unit, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.,Epidemiología y Salud Pública, CIBER, Madrid, Spain
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23
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Ganson KT, Lisi NE, O'Connor J, Nagata JM. Association between binge eating and physical violence perpetration among U.S. college students. J Eat Disord 2022; 10:171. [PMID: 36397125 PMCID: PMC9673326 DOI: 10.1186/s40337-022-00700-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To date, no known research has explored the link between binge eating and physical violence perpetration despite overlapping psychological constructs that underpin these behaviors (i.e., emotion regulation difficulties, impulsivity). Therefore, this study aimed to determine the association between binge eating and self-reported physical violence perpetration. METHODS Cross-sectional data from four survey years (2016-2020) of the national (U.S.) Healthy Minds Study (N = 6210) were analyzed. Unadjusted (Independent samples t test) and adjusted (logistic regression) analyses were conducted to determine the associations between binge eating in the past four weeks and violence perpetration in the past 12 months, while adjusting for potential confounders. RESULTS The unadjusted mean number of days of binge eating was significantly higher among participants who reported physical violence perpetration (M = 2.6, SD = 5.2) compared to those who did not (M = 1.8, SD = 3.7). Logistic regression analysis demonstrated that each additional day of binge eating was associated with 5% higher odds (95% confidence interval 1.02-1.09) of self-reported physical violence perpetration, while adjusting for potential confounders. CONCLUSIONS Results from this study are the first known to identify an association between binge eating and physical violence perpetration among U.S. college students. Findings are supported by the potential mechanistic overlap of emotion regulation and impulsivity associated with both binge eating and violence perpetration, underscoring the need for more research.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Nicole E Lisi
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Julia O'Connor
- School of Social Work, University of Central Florida, Orlando, FL, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16Th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA.
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24
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Edlund K, Johansson F, Lindroth R, Bergman L, Sundberg T, Skillgate E. Body image and compulsive exercise: are there associations with depression among university students? Eat Weight Disord 2022; 27:2397-2405. [PMID: 35179726 PMCID: PMC9556381 DOI: 10.1007/s40519-022-01374-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/29/2022] [Indexed: 10/31/2022] Open
Abstract
PURPOSE Mental health problems among university students have been reported to be significantly increasing and suggested to be associated with college drop-out. Body dissatisfaction and compulsive exercise are both constructs relevant for mental health problems in general and eating disorders in particular. This study examined associations between body dissatisfaction, compulsive exercise and self-reported symptoms of depression among Swedish university students. METHODS Participants (n = 4262) are students in an ongoing cohort study, and data from the baseline assessment were used. Four linear regression models were built to explore the associations between body dissatisfaction, compulsive weight control exercise and depressive symptoms. RESULTS Our findings showed that females reported higher levels of body dissatisfaction than males. Body dissatisfaction and compulsive exercise were associated with self-reported symptoms of depression in this non-clinical population. Results showed that compulsive exercise was negatively associated with reported symptoms of depression, while body dissatisfaction was positively associated with symptoms of depression. CONCLUSION In line with previous research, there was a gender difference in body dissatisfaction where females displayed higher levels of dissatisfaction than males. Body dissatisfaction was positively associated with reported symptoms of depression, suggesting support of previous research indicating body dissatisfaction to increase mental health problems. Compulsive exercise was negatively associated with symptoms of depression suggesting a behavior negatively reinforced, supporting both constructs to be of interest for reported symptoms of depression in a non-clinical population of Swedish university students. LEVEL OF EVIDENCE III, cohort study. TRIAL REGISTRATION http://clinicaltrials.gov/ID : NCT04465435.
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Affiliation(s)
- Klara Edlund
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden. .,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Fred Johansson
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Louise Bergman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Tobias Sundberg
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Skillgate
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sophiahemmet Högskola, Box 5605, 114 86, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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25
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Wu O, Lu X, Yeo KJ, Xiao Y, Yip P. Assessing Prevalence and Unique Risk Factors of Suicidal Ideation among First-Year University Students in China Using a Unique Multidimensional University Personality Inventor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10786. [PMID: 36078501 PMCID: PMC9517881 DOI: 10.3390/ijerph191710786] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/25/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND University students with suicidal ideation are at high risk of suicide, which constitutes a significant social and public health problem in China. However, little is known about the prevalence and associated risk factors of suicidal ideation among first-year university students in China, especially during the COVID-19 pandemic. OBJECTIVES To investigate the prevalence of suicidal ideation and its factors in first-year Chinese university students from a vocational college in Zhejiang during the COVID-19 pandemic. METHODS Using a cluster sampling technique, a university-wide survey was conducted of 686 first-year university students from Hangzhou in March 2020 using University Personality Inventory (UPI). UPI includes an assessment for suicidal ideation and possible risk factors. Suicidal ideation prevalence was calculated for males and females. Univariate analysis and multivariable logistic regression models were conducted, adjusting for age and sex. Analyses were carried out using the SPSS version 22.0 software. RESULTS The prevalence of 12-month suicidal ideation among first-year university students during March 2020 was 5.2%, and there was no significant difference between males and females (4.8% vs. 6.0%, x2 = 0.28, p = 0.597). Multivariable logistic regression analysis identified social avoidance (B = 0.78, OR = 2.17, p < 0.001) and emotional vulnerability (B = 0.71, OR = 2.02, p < 0.001) as positively associated with suicidal ideation. CONCLUSIONS Social avoidance and emotional vulnerabilities are unique factors associated with greater suicidal ideation among first-year university students during the COVID-19 pandemic. UPI serves as a validated tool to screen suicide risks among Chinese university students. Encouraging social engagement and improving emotional regulation skills are promising targets to reduce suicidal ideation among first-year university students.
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Affiliation(s)
- Ou Wu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou 310009, China
| | - Xi Lu
- Mental Health Education & Counseling Center, Hangzhou Vocational and Technical College, Hangzhou 314423, China
| | - Kee Jiar Yeo
- School of Education, University Teknologi, Johor Bahru 81310, Malaysia
| | - Yunyu Xiao
- Department of Population Health Science, Weill Cornell Medicine, NewYork-Presbyterian Hospital, Cornell University, New York, NY 10021, USA
| | - Paul Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR 999077, China
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR 999077, China
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Murga C, Cabezas R, Mora C, Campos S, Núñez D. Examining associations between symptoms of eating disorders and symptoms of anxiety, depression, suicidal ideation, and perceived family functioning in university students: A brief report. Int J Eat Disord 2022; 56:783-789. [PMID: 35906992 DOI: 10.1002/eat.23787] [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: 12/09/2021] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We examined the relationships between eating disorders symptoms (EDs), suicidal ideation, depressive and anxiety symptoms, and perceived family functioning in a sample of university students aged 18-25 years (N = 397). METHOD Assessment of symptoms was carried out with the Eating Disorder Diagnostic Scale, Beck Anxiety Inventory and Beck Depression Inventory, among others. We explored the associations between the domains using network analysis. RESULTS We found that physical anxiety symptoms, followed by cognitive and physical depressive symptoms showed the greatest centrality in the current network. Perceived family functioning was negatively related to eating disorder symptoms. DISCUSSION We provide evidence regarding the relevant role of anxiety and depression symptoms in the presentation of ED symptoms in university students. These findings provide new insights to improve preventive interventions to timely reduce symptoms and risk factors associated with EDs. PUBLIC SIGNIFICANCE Using a network approach, we found specific associations between physical anxiety symptoms, cognitive and physical depressive symptoms, eating disorders symptoms, suicidal ideation and perceived family functioning in university students. These variables can be potential targets to develop evidence-based preventive strategies in this population. A better understanding of these complex associations and the role of family variables could enhance the effectiveness of interventions in both clinical and educational settings.
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Affiliation(s)
- Camila Murga
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Ruth Cabezas
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Carolina Mora
- Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Susana Campos
- ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile
| | - Daniel Núñez
- Faculty of Psychology, Universidad de Talca, Talca, Chile.,ANID, Millennium Science Initiative Program, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, Santiago, Chile.,Associative Research Program, Research Center of Cognitive Sciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
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27
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Withers M, Jahangir T, Kubasova K, Ran MS. Reducing stigma associated with mental health problems among university students in the Asia-Pacific: A video content analysis of student-driven proposals. Int J Soc Psychiatry 2022; 68:827-835. [PMID: 33827300 DOI: 10.1177/00207640211007511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Studies have demonstrated that mental health problems among university students may be increasing in both prevalence and severity. This study aimed to identify ways to reduce stigma and improve students' utilization of mental health services. METHODS We performed a content analysis on video proposals to address stigma and mental health at universities, submitted by 15 teams from nine Asian-Pacific countries as part of a case competition. We examined five domains: (1) tone; (2) cultural context; (3) mental health issue of focus; (4) prevention versus secondary prevention; and (5) main intervention strategies. RESULTS Five main intervention strategies emerged: (1) educational campaigns; (2) peer interaction and support; (3) counseling; (4) screening; and (5) self-management. The results suggest that mental health literacy is low among students. Educational campaigns and events to increase awareness and reduce stigma were the most commonly incorporated strategy, through film screenings, mental health days, and social media. Building empathy through personal stories from celebrities and other students was also highly recommended. Second, counseling was incorporated in 80% of proposals, with a preference for peers and staff support, and web-based therapy over professional counselors, except in severe cases. Programs to increase social contact were the third most common strategy, suggesting students may feel isolated and disconnected. Creating common spaces for students to interact and pairing of students with and without mental health issues were widely suggested. The use of technology was recommended for self-management of mental health and for mandatory mental health screening, which was generally only recommended for incoming students. CONCLUSIONS Our analysis provides insight into student-generated intervention approaches to prevent and address stigma associated with mental health issues among students. A greater university commitment is needed to provide a range of resources, including education and counseling, to leverage technology, and to foster stronger support networks among students.
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Affiliation(s)
- Mellissa Withers
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Tasfia Jahangir
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA
| | - Ksenia Kubasova
- School of Global Studies, Thammasat University, Pathum Thani, Thailand
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, China
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28
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Li S, Cui G, Yin Y, Tang K, Chen L, Liu X. Prospective Association Between Problematic Mobile Phone Use and Eating Disorder Symptoms and the Mediating Effect of Resilience in Chinese College Students: A 1-Year Longitudinal Study. Front Public Health 2022; 10:857246. [PMID: 35570941 PMCID: PMC9092370 DOI: 10.3389/fpubh.2022.857246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/24/2022] [Indexed: 12/19/2022] Open
Abstract
A previous cross-sectional study found that problematic mobile phone use (PMPU) was associated with students' eating disorder symptoms. However, since the cross-sectional study cannot infer the causality and the direction of effect, the longitudinal relationship between the two and the mechanism behind this relationship are unclear. Therefore, the present study explores the prospective association between PMPU and eating disorder symptoms and related mediation mechanisms using a 1-year longitudinal study of 1,181 college students (from December 2019 [T1] to December 2020 [T2]). Survey tools used include the Mobile Phone Addiction Tendency Scale, the 10-item Connor-Davidson resilience scale, and the 12 item Short Form of the Eating Disorder Examination Questionnaire. The longitudinal relationship between PMPU and eating disorder symptoms and the mediating effect of resilience was analyzed using a cross-lagged model. The results showed that PMPU (β = 0.086, P < 0.01) and resilience (β = -0.145, P < 0.01) at T1 predicted eating disorder symptoms at T2, but not vice versa. PMPU was bidirectionally associated with resilience, and the prediction effect of PMPU at T1 to resilience at T2 (β = -0.151, P < 0.001) was higher than the prediction effect of resilience at T1 to PMPU at T2 (β = -0.134, P < 0.001). The standardized indirect effect of PMPU at T1 on eating disorder symptoms at T2 via resilience was significant (β = 0.022, 95% CI = 0.010~0.040, P < 0.001). Therefore, PMPU and resilience were predictive for eating disorder symptoms in college students, and resilience may play a mediating role in the prospective association between PMPU and eating disorder symptoms. This study provides new ideas and higher-level evidence for the development of prevention and intervention measures for college students' eating disorder symptoms.
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Affiliation(s)
- Shaojie Li
- Shandong University of Traditional Chinese Medicine, Jinan, China
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Guanghui Cui
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yongtian Yin
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Kaixuan Tang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lei Chen
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinyao Liu
- Shandong University of Traditional Chinese Medicine, Jinan, China
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Ganson KT, Cuccolo K, Nagata JM. Associations between psychosis symptoms and eating disorders among a national sample of U.S. college students. Eat Behav 2022; 45:101622. [PMID: 35255356 DOI: 10.1016/j.eatbeh.2022.101622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 11/03/2022]
Abstract
This study aimed to determine the associations between psychosis symptoms and eating disorders among a national sample of college and university students ages 18 to 26 years. Data from the 2020-2021 Healthy Minds Study (United States) were analyzed (N = 96,791). Multiple modified Poisson regression analyses were conducted to estimate the association between four self-reported lifetime psychosis symptoms and a positive eating disorder screen (measured using the SCOFF) and any self-reported lifetime eating disorder diagnosis, while adjusting for demographic and confounding variables. Participants who reported all four lifetime psychosis symptoms were more likely to screen positive for an eating disorder, while participants who reported three lifetime psychosis symptoms were more likely to report any lifetime eating disorder diagnosis. Those who reported a higher cumulative number of lifetime psychosis symptoms and reported any psychosis symptoms in the past 12 months were more likely to screen positive for an eating disorder and report any lifetime eating disorder diagnosis. Psychosis symptoms were associated with eating disorders among a national sample of college students. Health care professionals should be aware of the relationship between psychosis symptoms and eating disorders to ensure effective screening and early-intervention.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Kelly Cuccolo
- Department of Psychology, Alma College, Alma, MI, United States
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
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30
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The influence of diagnosed mental health conditions and symptoms of depression and/or anxiety on suicide ideation, plan, and attempt among college students: Findings from the Healthy Minds Study, 2018-2019. J Affect Disord 2022; 298:464-471. [PMID: 34774646 DOI: 10.1016/j.jad.2021.11.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Approximately 11% of 18-25 year-olds report thoughts of suicide. Additionally, suicide is the second leading cause of death in college student populations. We sought to evaluate the relationship between diagnosed mental health conditions and current symptoms of depression and/or anxiety and suicidality in the past year. METHODS Healthy Minds Study (HMS) 2018-2019 data from 38,757 college students were analyzed. The PHQ-9, GAD-7, and prior mental health condition diagnoses were used to create a suicidality severity index and we determined how these associations varied by race/ethnicity, gender, and sexual orientation. We also assessed non-suicidal self-injury (NSSI) outcomes in the past year. RESULTS Students with both a mental health condition diagnosis and current moderate/severe symptoms of depression and/or anxiety had a higher prevalence of NSSI, 10 times the odds (95% CI 9.4-11.5) of suicide ideation, 28 times the odds (95% CI 23.8-33.1) of suicide ideation, with planning or attempt, and 47 times the odds (95% CI 31.1-71.4) of suicide ideation, with planning and attempt, compared to students with none/minimal depression and/or anxiety symptoms and no mental health condition diagnosis. LIMITATIONS We could not clinically confirm depression or anxiety diagnoses nor infer causality of associations in this cross-sectional study. Future longitudinal studies are needed to establish temporality. CONCLUSIONS Mental health condition diagnoses and moderate/severe symptoms of depression and/or anxiety were strongly associated with suicidality among college students. These findings identify potential opportunities to further understand and address the mental health needs of college students.
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31
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Gómez Del Barrio A, Pardo de Santayana G, Ruiz Guerrero F, Benito Gonzalez P, Calcedo Giraldo G, González Gómez J, García-Unzueta MT. Suicidal ideation in a sample with a first-episode of restrictive eating disorders: The role of biomarkers. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2021.100305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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32
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Kenny B, Orellana L, Fuller-Tyszkiewicz M, Moodie M, Brown V, Williams J. Depression and eating disorders in early adolescence: A network analysis approach. Int J Eat Disord 2021; 54:2143-2154. [PMID: 34625986 DOI: 10.1002/eat.23627] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Eating disorders (EDs) and depression are among the most debilitating and pervasive mental illnesses. Although they often co-occur, the relationship between EDs and depression remains poorly understood. This study used network analysis to explore the symptom-level relationship between EDs and depression among a sample of Australian adolescents completing their first year of secondary school. METHOD Adolescents (N = 4,421) aged between 10 and 15 years completed the Centre for Epidemiological Depression Scale and the Eating Disorder Examination-Questionnaire. Network structure was estimated using the Gaussian graphical model and node centrality was assessed using one-step expected influence (EI) and bridge EI. RESULTS "Depressed," "lonely," and "low energy" were identified as core symptoms of depression. "Shape and weight dissatisfaction," "desire to lose weight," and "preoccupation with shape or weight" were identified as core ED symptoms. "Irritable," "social eating," and "depressed" were identified as the most important nodes connecting (i.e., bridging) symptoms of depression and EDs. DISCUSSION This study provides an important symptom-level conceptualization of the association between depression and ED symptoms in a community sample of adolescents. This preliminary evidence may guide the development of public health prevention and early intervention programs. Future research should be conducted to address the study limitations (e.g., cross-sectional design).
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Affiliation(s)
- Bridget Kenny
- Faculty of Health, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, Deakin University, Melbourne, Victoria, Australia.,Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Marj Moodie
- Faculty of Health, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Faculty of Health, Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Vicki Brown
- Faculty of Health, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Faculty of Health, Deakin Health Economics, Deakin University, Geelong, Victoria, Australia
| | - Joanne Williams
- Faculty of Health, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Identifying and Managing Eating Disorders in Persons Presenting for Addiction Treatment. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ganson KT, Rodgers RF, Murray SB, Nagata JM. Prevalence and demographic, substance use, and mental health correlates of fasting among U.S. college students. J Eat Disord 2021; 9:88. [PMID: 34289904 PMCID: PMC8293526 DOI: 10.1186/s40337-021-00443-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Fasting is an unhealthy behavior that has been frequently used as part of weight loss attempts. To date, little research has been conducted to determine the prevalence and substance use and mental health correlates of fasting among college students. Therefore, the aim of this study was to estimate the prevalence and associations between any (≥ 1 time) and regular (≥ 13 times) occurrences of fasting in the past 4 weeks and substance use and mental health correlates among a large sample of college students from 2016 to 2020. METHODS Data from four academic survey years (2016-2020; N = 8255) of the national (USA) Healthy Minds Study were analyzed. Unadjusted prevalence of any and regular fasting by survey year and gender was estimated. Multiple logistic regression analyses were conducted to estimate the associations between any and regular fasting and the demographic (age, body mass index, race/ethnicity, sexual orientation, highest parental education), substance use (cigarette use, marijuana use, other illicit drug use, alcohol use), and mental health (depression, anxiety, eating disorder symptoms, suicidal ideation, non-suicidal self-injury) correlates. RESULTS Any fasting in the past 4 weeks was common among both men (14.77%) and women (18.12%) and significantly increased from 2016 (10.30%) to 2020 (19.81%) only among men. Regular fasting significantly increased among both men and women from 2016 (men: 1.46%; women: 1.79%) to 2020 (men: 3.53%; women: 6.19%). Among men and women, both any and regular fasting in the past 4 weeks were associated with higher odds of all mental health symptoms, including a positive depression, anxiety, and eating disorder screen, suicidal ideation, and non-suicidal self-injury. Among women, but not men, any and regular fasting in the past 4 weeks were associated with higher odds of marijuana use and other illicit drug use (e.g., cocaine, ecstasy). CONCLUSIONS The results from this study underscore both the high and increasing prevalence of fasting among a national sample of college students, as well as the substance use and mental health symptoms associated with this behavior. Healthcare professionals both on and off campus should consider screening for fasting behaviors among college students and provide appropriate intervention when needed.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA.,Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
| | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, 550 16th Street, Box 0110, San Francisco, San Francisco, CA, 94158, USA.
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35
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Wu S, Adamsk K. Intervention effect of cognitive behaviour therapy under suicidology on psychological stress and emotional depression of college students. Work 2021; 69:697-709. [PMID: 34120946 DOI: 10.3233/wor-213510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The suicide of college students had been a social topic attracting people's attention, and the generation of suicidal ideation was an inevitable link in the psychological process of suicidal behavior. It was the focus of many researches whether the pressure of college students with suicidal ideation can be detected and relieved in time. OBJECTIVE The study aimed to analyze the therapeutic effect of cognitive behaviour therapy on psychological stress, depression, and other negative emotions of college students with suicide ideation. METHODS 114 people from 1,158 college students with suicide ideation in the Wuhan area were divided into an experimental group and a control group in this study. Students in the experimental group were given with the cognitive behaviour therapy, and students in the control group were not intervened in any way. The suicide ideation scale (despair, optimism, and sleep), psychological stress test rating, and self-reporting inventory (somatization, compulsion, interpersonal relationship, depression, anxiety, hostility, terror, delusion, and psychosis) were used to evaluate the objects in the pre-test stage, intermediate-test stage, and the tracking-test stage. The multivariate logistic regression was adopted to analyze the influencing factors of the suicide ideation of the college student. RESULTS The suicide ideation of the college student was significantly positively correlated with the psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis (P > 0.05); the total score of suicide ideation, despair, optimism, and sleep in the experimental group were lower than those in the control group (P < 0.05) in the intermediate-test stage and the tracking-test stage (P < 0.05); the psychological stress, depression, and anxiety of the college students in the experimental group in the intermediate-test and tracking-test stage were slighter than those in the control group (P < 0.05); the somatization, compulsion, and interpersonal relationship of students in the experimental group were significantly lower than those in the control group (P < 0.05). CONCLUSIONS The psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis were all risk factors for the college student to have suicide ideation. Negative emotions such as psychological stress, emotional depression, and anxiety of the college student with suicide ideation could be improved effectively by cognitive behaviour therapy, and the level of suicide ideation could be reduced finally.
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Affiliation(s)
- Shaofei Wu
- Hubei Province Key Laboratory of Intelligent Robots, Wuhan Institute of Technology, Wuhan, P.R. China.,School of Computer Science and Engineering, Wuhan Institute of Technology, Wuhan, P.R. China
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Xiao Y, Hinrichs R, Johnson N, McKinley A, Carlson J, Agley J, Yip PSF. Suicide Prevention Among College Students Before and During the COVID-19 Pandemic: Protocol for a Systematic Review and Meta-analysis. JMIR Res Protoc 2021; 10:e26948. [PMID: 33878016 PMCID: PMC8130819 DOI: 10.2196/26948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death for college-aged individuals worldwide and in the United States. Recent studies have identified preliminary evidence of widening disparities in suicidal behaviors across sex, sexual orientation, race/ethnicity, age, and socioeconomic status among college students. Few systematic reviews and meta-analyses offer a comprehensive understanding of on-campus and off-campus suicide interventions, nor is collated information available for different types of screening, assessment, treatment, and postvention plans. Further challenges have been identified since the COVID-19 pandemic, calling for cost-effective and innovative interventions to address increased rates of suicidal behaviors among college students facing unprecedented stressors. OBJECTIVE This research protocol describes the first systematic review and meta-analysis to identify the most effective and cost-effective intervention components for universal and targeted (indicated and selected) suicide prevention among college students in a global context. Special attention will be placed on disparities in suicide prevention across sociodemographic subgroups, inclusive interventions beyond campus, global context, and intervention responses to the COVID-19 pandemic. METHODS A sensitive search strategy will be executed across MEDLINE (Ovid), EMBASE, PsycINFO (EBSCO), ERIC (EBSCO), Cochrane Library, Dissertations and Theses Global (ProQuest), Scopus, Global Index Medicus, SciELO, African Journals Online, Global Health (CABI), and Google Scholar. Data extraction and evaluation will be conducted by three independent researchers. Risk of bias will be assessed. A multilevel meta-regression model and subgroup analysis will be used to analyze the data and estimate effect sizes. RESULTS The initial search was completed in December 2020 and updated with additional other-language studies in March 2020. We expect the results to be submitted for publication in mid-2021. CONCLUSIONS Despite increasing rates of suicidal behaviors among college students, few preventative efforts have targeted this population, and fewer focus on factors that might place specific demographic groups at heightened risk. The impact of COVID-19 on suicidal behaviors among college students highlights and exacerbates the urgent need for rapid and effective interventions that might differ from traditional approaches. This equity-focused study will address these gaps and provide a valuable analysis of the effectiveness of suicide prevention programs and interventions. Findings will inform clinicians, researchers, policy makers, families, and organizations about evidence-based interventions for reducing the gaps in the suicide crisis among college students from different sociodemographic groups. TRIAL REGISTRATION PROSPERO CRD42020225429; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225429. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/26948.
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Affiliation(s)
- Yunyu Xiao
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
- School of Social Work, Indiana University-Bloomington, Bloomington, IN, United States
| | - Rachel Hinrichs
- IUPUI University Library, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Nina Johnson
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Amanda McKinley
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Joan Carlson
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Jon Agley
- School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China (Hong Kong)
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Zelkowitz RL, Zerubavel N, Zucker NL, Copeland WE. Longitudinal associations of trauma exposure with disordered eating: Lessons from the Great Smoky Mountains Study. Eat Disord 2021; 29:208-225. [PMID: 34010107 PMCID: PMC8373713 DOI: 10.1080/10640266.2021.1921326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Disordered eating is prevalent among trauma survivors, yet little is known about mechanisms underlying this relation. We explored cross-sectional and longitudinal associations of trauma exposure and posttraumatic stress disorder symptoms (PTSD) with disordered eating among 1,420 community-based youth participating in the Great Smoky Mountain Study. Participants were interviewed about trauma exposure, PTSD symptoms, and disordered eating at regular intervals throughout childhood, adolescence, and early adulthood. Our findings confirmed associations of all forms of trauma exposure (violent, sexual, and other) with disordered eating symptoms in childhood and adulthood, although the pattern of results varied by disordered eating symptom and trauma exposure type. Only non-sexual, non-violent trauma exposure in childhood had significant associations with any disordered eating symptoms in adulthood. Within childhood, trauma exposures but not PTSD symptoms showed significant longitudinal associations with bulimia nervosa symptoms and sustained appetite changes and preoccupation with eating. In adulthood, PTSD symptoms but not trauma exposures showed significant longitudinal associations only with bulimia nervosa symptoms. The association of specific PTSD clusters on bulimia nervosa symptoms was significant for reexperiencing, whereas hyperarousal symptoms trended toward significance. The impact of trauma exposures on disordered eating may vary by developmental period.
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Affiliation(s)
- Rachel L Zelkowitz
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, United States
| | - Noga Zerubavel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States
| | - Nancy L Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States.,Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, United States
| | - William E Copeland
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States
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Barry MR, Sonneville KR, Leung CW. Students with Food Insecurity Are More Likely to Screen Positive for an Eating Disorder at a Large, Public University in the Midwest. J Acad Nutr Diet 2021; 121:1115-1124. [PMID: 33773946 DOI: 10.1016/j.jand.2021.01.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND College students experience a disproportionately high prevalence of both food insecurity and eating disorders. Food insecurity is associated with stress, irregular eating patterns, weight change, depression, and body dissatisfaction, making it a possible risk factor for the onset of eating disorders. However, the association between food insecurity and eating disorders among college students is not well understood. OBJECTIVE This study explored the relation between food insecurity and screening positive for an eating disorder among students attending a large, public Midwestern university. DESIGN Cross-sectional data were collected using an online survey administered from March through June 2018. PARTICIPANTS/SETTING Participants were recruited from a random sample of 2,000 students, with oversampling from the following groups: racial/ethnic minorities, first-generation students, and students from lower-income households. Of those sampled, 851 students (43%) responded. The final analytic sample comprised 804 students after excluding those with missing data. MAIN OUTCOME MEASURE The validated 5-item Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used to screen for the presence of an eating disorder. STATISTICAL ANALYSES PERFORMED Poisson regression was used to model prevalence ratios for positive SCOFF screens (≥2 affirmative responses) by levels of food security (ie, high, marginal, low, or very low). Models were adjusted for sex, age, race/ethnicity, degree type, financial aid, and first-generation student status. RESULTS Compared to students with high food security, a higher prevalence of positive SCOFF screens was found among students with marginal food security (prevalence ratio [PR], 1.83, 95% CI 1.26 to 2.65; P = 0.001), low food security (PR 1.72, 95% CI 1.16 to 2.54; P = 0.007), and very low food security (PR 2.83, 95% CI 2.01 to 3.97; P < .0001). CONCLUSIONS Students with food insecurity at any level were more likely to screen positive for an eating disorder via the SCOFF questionnaire. Prospective studies are needed to determine whether food insecurity is a risk factor for the onset of eating disorders among college students.
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Affiliation(s)
- Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI; Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor MI.
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI
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Falvey SE, Hahn SL, Anderson OS, Lipson SK, Sonneville KR. Diagnosis of Eating Disorders Among College Students: A Comparison of Military and Civilian Students. Mil Med 2021; 186:975-983. [PMID: 33686412 DOI: 10.1093/milmed/usab084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/01/2020] [Accepted: 02/20/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Eating disorders are often under-detected, which poses a serious threat to the health of individuals with eating disorder symptoms. There is evidence to suggest that the military represents a subpopulation that may be susceptible to high prevalence of eating disorders and vulnerable to their underdiagnosis. Underreporting of eating disorder symptoms in the military could lead to this underdiagnosis of individuals with eating disorder symptoms. The purpose of this study was to examine the association between military affiliation and eating disorder symptoms among college students and the likelihood of eating disorder diagnosis among those with eating disorder symptoms using a large, diverse college-aged sample of both military-involved and civilian students. MATERIALS AND METHODS Participants for this study were from the 2015-2016, 2016-2017, and 2017-2018 Healthy Minds Study (HMS). Healthy Minds Study is a large, cross-sectional cohort study of both undergraduate and graduate students from universities and colleges across the United States and Canada. The Healthy Minds Study survey questions include assessment of demographic information, military status, self-reported eating disorder symptoms using the SCOFF questionnaire, and self-reported eating disorder diagnosis. Univariate analysis, chi-square analysis, and logistic regression with an unadjusted and covariate adjusted model were used to examine the association between eating disorder symptoms and military affiliation. These analyses were also used to examine the association between eating disorder diagnosis among those with eating disorder symptoms and military affiliation. All analyses were conducted using SPSS. RESULTS The prevalence of eating disorder symptoms was high among both the civilian (20.4%) and military-involved (14.4%) students. Among females, there was a significantly higher (P value = .041) prevalence of eating disorder symptoms among civilian college students (24.7%) compared to military-involved students (21.3%). Among those with eating disorder symptoms, the prevalence of diagnosis was low in both military and civilian students. Specifically, the prevalence of diagnosis was significantly lower (P value = .032) among military-involved college students (10.8%) compared to civilian college students (16.4%). Differences in sociodemographic characteristics (e.g., gender, race/ethnicity, and age) among military-involved and civilian college students appear to explain this association. CONCLUSIONS The underdiagnosis of eating disorders is far too common, and this represents a threat to the health of military and civilian populations alike. Underdiagnosis of eating disorders within military environments may be due to underreporting, particularly among men and racial/ethnic minority groups.
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Affiliation(s)
- Sarah E Falvey
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
| | - Samantha L Hahn
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.,Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA.,Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN 55454, USA
| | - Olivia S Anderson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, MA 02118, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA
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Comparison between inpatients with anorexia nervosa with and without major depressive disorder: Clinical characteristics and outcome. Psychiatry Res 2021; 297:113734. [PMID: 33486276 DOI: 10.1016/j.psychres.2021.113734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/14/2021] [Indexed: 11/22/2022]
Abstract
Anorexia Nervosa (AN) and Major Depressive Disorder (MDD) are frequent comorbid conditions. It is unclear how MDD affects intensive emergency treatment and outcome. Eighty-seven AN inpatients were analyzed, twenty-two suffered also from MDD. Individuals with AN and MDD at admission had no remarkable differences in psychopathology, but a full diagnosis of MDD - and not just the presence of depressive symptoms - was associated with longer length of stay and worse clinical outcome (weight restoration, increase of caloric intake). Health care policies might consider that MDD comorbidity, regardless of AN clinical severity, affects the efficacy and timing of acute treatments.
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Himmerich H, Kan C, Au K, Treasure J. Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition and physical health consequences. Pharmacol Ther 2020; 217:107667. [PMID: 32858054 DOI: 10.1016/j.pharmthera.2020.107667] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
The pharmacological treatment of patients with an eating disorder (ED) often includes medications to treat their ED, comorbid mental health problems, malnutrition and the physical health problems resulting from it. The currently approved pharmacological treatment options for EDs are limited to fluoxetine for bulimia nervosa (BN) and - in some countries - lisdexamfetamine for binge eating disorder (BED). Thus, there are no approved pharmacological options for anorexia nervosa (AN), even though study results for olanzapine and dronabinol are promising. Topiramate might be an additional future option for the treatment of BN and BED. Selective serotonin reuptake inhibitors (SSRI), mirtazapine and bupropion could be considered for the treatment of comorbid unipolar depression. However, AN and BN are contraindications for bupropion. For ED patients with a manic episode, we recommend olanzapine in AN and risperidone in BN and BED; whereas for bipolar depression, olanzapine (plus fluoxetine) seems appropriate in AN and lamotrigine in BN and BED. Acute anxiety or suicidality may warrant benzodiazepine treatment with lorazepam. Proton-pump inhibitors, gastroprokinetic drugs, laxatives and hormones can alleviate certain physical health problems caused by EDs. Therapeutic drug monitoring, pharmacogenomic testing, a more restrictive use of "pro re nata" (PRN) medication, an interdisciplinary treatment approach, shared decision making (SDM) and the formulation of common treatment goals by the patients, their family or carers and clinicians could improve treatment success and safety. Novel genetic, immunological, microbiome and brain imaging research as well as new pharmacological developments like the use of psychedelics, stimulants, novel monoaminergic drugs, hormone analogues and drugs which enhance the effects of psychotherapy may extend our therapeutic options in the near future.
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Affiliation(s)
- Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK.
| | - Carol Kan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Katie Au
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
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