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Prevalence of binge-eating disorder among children and adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2021; 32:549-574. [PMID: 34318368 DOI: 10.1007/s00787-021-01850-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/18/2021] [Indexed: 12/16/2022]
Abstract
The objective is to estimate the prevalence of binge-eating disorder (BED) and subclinical BED in children and adolescents. Relevant articles were searched in the databases of PubMED and PsycINFO. Articles were included if they measured BED, subclinical BED, binge eating and/or loss of control (LOC) eating in samples of up to 20 years of age or with a mean age below 20 years. Subclinical BED covers participants with < 4 OBEs but ≥ 1 OBE pr. month and studies measuring subclinical DSM-IV/DSM-5 BED, but where all criteria were not met. All study types and measuring methods were accepted, but studies were excluded if they did not assess and exclude cases of recurrent compensatory behaviors. Meta-analyses were used to obtain an overall estimate of the prevalence of BED and subclinical BED, while stratified meta-analyses were used to assess sources of heterogeneity. 39 studies measuring BED, subclinical BED and/or a low frequency of binge eating were included. Two meta-analyses resulted in an overall estimated prevalence of 1.32% BED and 3.0% subclinical BED in children and adolescents. The results were influenced by high heterogeneity. Potential sources to heterogeneity in the BED result were weight of participants and sample types as well as level of risk of bias in the included studies. BED seems to be as frequent in children and adolescents as anorexia nervosa and bulimia nervosa. Hence, treatment of BED and BED symptoms in younger populations should be prioritized on the same terms as anorexia and bulimia nervosa.
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Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. Am J Clin Nutr 2019; 109:1402-1413. [PMID: 31051507 DOI: 10.1093/ajcn/nqy342] [Citation(s) in RCA: 605] [Impact Index Per Article: 121.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 10/30/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern. OBJECTIVES The aim of this study was to give an exhaustive view of the studies reporting the prevalence of the different EDs or total EDs and to study their evolution. METHODS A literature search following PRISMA Guidelines and limited to studies in English or French published between 2000 and 2018 was performed and relevant studies were included in this systematic review on the prevalence of EDs. The literature search revealed 94 studies with accurate ED diagnosis and 27 with broad ED diagnosis. RESULTS In 94 studies with accurate ED diagnosis, the weighted means (ranges) of lifetime ED were 8.4% (3.3-18.6%) for women and 2.2% (0.8-6.5%) for men. The weighted means (ranges) of 12-month ED prevalence were 2.2% (0.8-13.1%) for women and 0.7% (0.3-0.9%) for men. The weighted means (ranges) of point prevalence were 5.7% (0.9-13.5%) for women and 2.2% (0.2-7.3%) for men. According to continents, the weighted means (ranges) of point prevalence were 4.6% (2.0-13.5%) in America, 2.2% (0.2-13.1%) in Europe, and 3.5% (0.6-7.8%) in Asia.In addition to the former, 27 other studies reported the prevalence of EDs as broad categories resulting in weighted means (ranges) of total point prevalence of any EDs of 19.4% (6.5-36.0%) for women and 13.8% (3.6-27.1%) for men. CONCLUSIONS Despite the complexity of integrating all ED prevalence data, the most recent studies confirm that EDs are highly prevalent worldwide, especially in women. Moreover, the weighted means of point ED prevalence increased over the study period from 3.5% for the 2000-2006 period to 7.8% for the 2013-2018 period. This highlights a real challenge for public health and healthcare providers.
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Affiliation(s)
- Marie Galmiche
- TargEDys SA, Rouen, France.,Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,Department of Nutrition, Rouen University Hospital, Rouen, France
| | - Pierre Déchelotte
- Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,Department of Nutrition, Rouen University Hospital, Rouen, France
| | | | - Marie Pierre Tavolacci
- Inserm UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy Rouen University, France.,ClC-CRB 1404, Rouen University Hospital, Rouen, France
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Naessén S, Söderqvist G, Carlström K. So similar and so different: Circulating androgens and androgen origin in bulimic women. J Steroid Biochem Mol Biol 2019; 185:184-188. [PMID: 30172682 DOI: 10.1016/j.jsbmb.2018.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 07/27/2018] [Accepted: 08/29/2018] [Indexed: 11/16/2022]
Abstract
Hyper androgen state frequently can be diagnosed in bulimic women. Eating disorder not otherwise specified (EDNOS) recognized as a less severe form of bulimia nervosa (BN). The objective of the study was to determine whether androgen levels and androgen origin differs in bulimic women compared to control subjects. Forty-six women with bulimia nervosa (BN), 31 with eating disorder not otherwise specified, purging type (EDNOS P) and 56 matched healthy controls were studied with respect to serum testosterone (T), 5alpha-dihydrotestosterone (DHT), sex hormone-binding globulin (SHBG), deyhydroepiahndrosterone sulfate (DHEAS) and luteinizing hormone (LH) and to ovarian morphology. Despite all groups had almost identical androgen and SHBG levels; there were differences in the origin of circulating T and DHT. Correlation analysis suggest major differences in the formation of circulating testosterone (T) and 5α-dihydrotestosterone (DHT) with BN being more like the control subjects with peripheral formation from 4-androsterne-3,17-dione (A-4), dehydroepiandrosterone sulfate (DHEAS) and also from T. While in EDNOS group a possible direct ovarian T secretion and a DHEAS modulating action of androgens on pituitary gonadotropin secretion is present. The origin of circulating T and DHT differs between bulimics. Our findings do probably not reflect direct actions of circulating DHT on pituitary LH secretion in the women with EDNOS, but rather the effect of A-4, T via conversion to DHT in the central nervous system, indicating psych/endocrine differences between the two groups of bulimic women.
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Affiliation(s)
- Sabine Naessén
- Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
| | - Gunnar Söderqvist
- Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Kjell Carlström
- Department of Women's and Children's Health, Division of Obstetrics and Gynaecology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Prevalence of Primary and Secondary Exercise Dependence and Its Correlation with Drive for Thinness in Practitioners of Different Sports and Physical Activities. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-017-9867-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ernst V, Bürger A, Hammerle F. Prevalence and severity of eating disorders: A comparison of DSM-IV and DSM-5 among German adolescents. Int J Eat Disord 2017; 50:1255-1263. [PMID: 28963857 DOI: 10.1002/eat.22780] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 08/29/2017] [Accepted: 09/03/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Changes in the DSM-5 eating disorders criteria sought to increase the clarity of the diagnostic categories and to decrease the preponderance of nonspecified eating disorders. The first objective of this study was to analyze how these revisions affect threshold and EDNOS/OSFED eating disorder diagnoses in terms of prevalence, sex ratios, and diagnostic distribution in a student sample. Second, we aimed to compare the impairment levels of participants with a threshold, an EDNOS/OSFED and no diagnosis using both DSM-IV and DSM-5. METHOD A sample of 1654 7th and 8th grade students completed self-report questionnaires to determine diagnoses and impairment levels in the context of an eating disorder prevention program in nine German secondary schools. Height and weight were measured. RESULTS The prevalence of threshold disorders increased from .48% (DSM-IV) to 1.15% (DSM-5). EDNOS disorders increased from 2.90 to 6.23% when using OSFED-categories. A higher proportion of girls was found throughout all the diagnostic categories, and the sex ratios remained stable. The effect sizes of DSM-5 group differences regarding impairment levels were equal to or larger than those of the DSM-IV comparisons, ranging from small to medium. DISCUSSION We provide an in-depth overview of changes resulting from the revisions of DSM eating disorder criteria in a German adolescent sample. Despite the overall increase in prevalence estimates, the results suggest that the DSM-5 criteria differentiate participants with threshold disorders and OSFED from those no diagnosis as well as or even more distinctly than the DSM-IV criteria.
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Affiliation(s)
- Verena Ernst
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arne Bürger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Cella S, Cipriano A, Iannaccone M, Cotrufo P. Identifying Predictors Associated with the Severity of Eating Concerns in Females with Eating Disorders. ACTA ACUST UNITED AC 2017; 20:199. [PMID: 32913728 PMCID: PMC7451376 DOI: 10.4081/ripppo.2017.199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 11/08/2016] [Accepted: 12/09/2016] [Indexed: 11/30/2022]
Abstract
Considering how to improve efficacy of therapeutic strategies, the overall objective of the present study was to investigate the extent of eating concerns and to identify predictors associated with the severity of disordered eating symptomatology among people with eating pathologies. We screened 80 female eating disordered patients, ranging from 13 to 40 years, by means of self-report measures of parental behavior as perceived by the offspring, self-esteem, perfectionism, body shame and eating disorder severity. Self-reported weight and height were obtained. The diagnosis of bulimia nervosa resulted to be associated with a greater severity of the eating symptomatology. Maladaptive perfectionism, body shame and self-esteem, significantly predicted the level of eating concerns. The recognition of potential maintaining factors may support the choice of particular therapeutic strategies to improve the treatment of eating pathologies and their outcomes.
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Affiliation(s)
- Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania, Luigi Vanvitelli, Caserta, Italy
| | - Annarosa Cipriano
- Observatory on Eating Disorders, Department of Psychology, University of Campania, Luigi Vanvitelli, Caserta, Italy
| | - Mara Iannaccone
- Observatory on Eating Disorders, Department of Psychology, University of Campania, Luigi Vanvitelli, Caserta, Italy
| | - Paolo Cotrufo
- Observatory on Eating Disorders, Department of Psychology, University of Campania, Luigi Vanvitelli, Caserta, Italy
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Hammerle F, Huss M, Ernst V, Bürger A. Thinking dimensional: prevalence of DSM-5 early adolescent full syndrome, partial and subthreshold eating disorders in a cross-sectional survey in German schools. BMJ Open 2016; 6:e010843. [PMID: 27150185 PMCID: PMC4861098 DOI: 10.1136/bmjopen-2015-010843] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Investigating for the first time in Germany Diagnostic and Statistical Manual Fifth Edition (DSM-5) prevalences of adolescent full syndrome, Other Specified Feeding or Eating Disorder (OSFED), partial and subthreshold anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). METHOD A national school-based cross-sectional survey with nine schools in Germany was undertaken that was aimed at students from grades 7 and 8. Of the 1775 students who were contacted to participate in the study, 1654 participated (participation rate: 93.2%). The sample consisted of 873 female and 781 male adolescents (mean age=13.4 years). Prevalence rates were established using direct symptom criteria with a structured inventory (SIAB-S) and an additional self-report questionnaire (Eating Disorder Inventory 2 (EDI-2)). RESULTS Prevalences for full syndrome were 0.3% for AN, 0.4% for BN, 0.5% for BED and 3.6% for OSFED-atypical AN, 0% for BN (low frequency/limited duration), 0% for BED (low frequency/limited duration) and 1.9% for purging disorder (PD). Prevalences of partial syndrome were 10.9% for AN (7.1% established with cognitive symptoms only, excluding weight criteria), 0.2% for BN and 2.1% for BED, and of subthreshold syndrome were 0.8% for AN, 0.3% for BN and 0.2% for BED. Cases on EDI-2 scales were much more pronounced with 12.6-21.1% of the participants with significant sex differences. CONCLUSIONS The findings were in accordance with corresponding international studies but were in contrast to other German studies showing much higher prevalence rates. The study provides, for the first time, estimates for DSM-5 prevalences of eating disorders in adolescents for Germany, and evidence in favour of using valid measures for improving prevalence estimates. TRIAL REGISTRATION NUMBER DRKS00005050; Results.
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Affiliation(s)
- Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Verena Ernst
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arne Bürger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Wuerzburg, Germany
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Naor-Ziv R, Glicksohn J. Investigating Cognitive Deficits as Risk Factors for Developing Eating Disorders During Adolescence. Dev Neuropsychol 2016; 41:107-24. [PMID: 27135707 DOI: 10.1080/87565641.2016.1170129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Adolescents with eating disorders (ED) suffer from deficits in executive functions and "theory of mind." It is unclear whether these indicate state or trait characteristics. We examined cognitive functioning in 150 adolescents, comparing those at high risk and those not at risk for ED. Deficits in set shifting and in theory of mind were found in all high-risk groups. Adolescents at high risk for bulimia were found to be higher in impulsivity and in theory of mind deficits, compared to adolescents at high risk for anorexia. These are trait characteristics rather than state vulnerabilities and preexist the development of ED.
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Affiliation(s)
- Revital Naor-Ziv
- a Department of Criminology , Bar-Ilan University , Ramat Gan , Israel
| | - Joseph Glicksohn
- a Department of Criminology , Bar-Ilan University , Ramat Gan , Israel
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Swenne I. Influence of premorbid BMI on clinical characteristics at presentation of adolescent girls with eating disorders. BMC Psychiatry 2016; 16:81. [PMID: 27030047 PMCID: PMC4815196 DOI: 10.1186/s12888-016-0788-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/18/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Considering the prevalence of obesity in society it can be expected that some adolescents with an eating disorder (ED) start weight loss from an overweight and present at a near-normal weight. Presently, the influence of premorbid BMI on clinical characteristics of adolescent girls presenting with an ED has ben studied. METHOD Premorbid growth charts were available for 275 postmenarcheal adolescent girls presenting with an ED (anorexia nervosa = 27, (subthreshold) bulimia nervosa = 9, restrictive EDNOS = 239). Initial assessment included measurement of weight and length, physical examination, blood sampling and administration of the Eating Disorder Examination-Questionnaire youth version (EDE-Q). RESULTS Despite greater weight loss girls with a high premorbid body mass index (BMI) had a higher BMI at presentation compared to those with a lower premorbid BMI. Although not underweight some presented with clinical and laboratory signs of starvation. These signs were related to not only low BMI but also to rapid and large weight loss. Their EDE-Q scores did not differ from those of girls who presented with an underweight. CONCLUSION Girls with a restrictive ED and premorbid overweight may present with a near-normal BMI. They can nevertheless be medically compromised and have eating disturbed cognitions at the level of underweight girls. They should not be regarded as having a less severe ED but merit full assessment and a start of treatment.
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Affiliation(s)
- Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University Uppsala, S-75185, Uppsala, Sweden.
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Gelin Z, Fuso S, Hendrick S, Cook-Darzens S, Simon Y. The effects of a multiple family therapy on adolescents with eating disorders: an outcome study. FAMILY PROCESS 2015; 54:160-172. [PMID: 25243337 DOI: 10.1111/famp.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.
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Affiliation(s)
- Zoé Gelin
- Systemic and Psychodynamic Clinical Psychology Department, University of Mons, Mons, Belgium
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Iannaccone M, Cella S, Manzi SA, Visconti L, Manzi F, Cotrufo P. My body and me: self-injurious behaviors and body modifications in eating disorders--preliminary results. Eat Disord 2013; 21:130-9. [PMID: 23421696 DOI: 10.1080/10640266.2013.761087] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We investigated self-injurious behaviors and body modification practices in eating disorder patients, considering different ED diagnoses and illness severities. Of the total sample, 50.9% showed at least one form of self-injury and 50.9% reported at least one tattoo, piercing, or both. Patients reporting only body modifications showed more positive feelings toward their bodies, higher levels of self-esteem, less impulsivity, depression, and anxiety, and lower levels of social dysfunction than those reporting only self-injury or both self-injury and body modifications. Self-injury was influenced by both diagnosis and severity of disorders.
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Affiliation(s)
- Mara Iannaccone
- Observatory on Eating Disorders, Department of Psychology, Second University of Naples, Caserta, Italy.
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Hamel AE, Zaitsoff SL, Taylor A, Menna R, Le Grange D. Body-related social comparison and disordered eating among adolescent females with an eating disorder, depressive disorder, and healthy controls. Nutrients 2012; 4:1260-72. [PMID: 23112914 PMCID: PMC3475236 DOI: 10.3390/nu4091260] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/28/2012] [Accepted: 08/29/2012] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12–18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others’. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.
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Affiliation(s)
- Andrea E. Hamel
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada;
| | - Shannon L. Zaitsoff
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada;
- Author to whom correspondence should be addressed; ; Tel.: +1-778-782-8721; Fax: +1-778-782-3427
| | - Andrew Taylor
- Windsor Essex Community Health Centre, 1585 Ouellette Ave, Windsor, ON N8X 1K5, Canada;
| | - Rosanne Menna
- Department of Psychology, University of Windsor, 401 Sunset Avenue, Windsor, ON N9B 3P4, Canada;
| | - Daniel Le Grange
- Department of Psychiatry, The University of Chicago, 5841 South Maryland Avenue, MC3077, Chicago, IL 60637, USA;
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von Lojewski A, Boyd C, Abraham S, Russell J. Lifetime and recent DSM and ICD psychiatric comorbidity of inpatients engaging in different eating disorder behaviours. Eat Weight Disord 2012; 17:e185-93. [PMID: 23086254 DOI: 10.1007/bf03325346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Previous studies investigating psychiatric comorbidity in eating disorder (ED) patients compared groups according to ED diagnoses. The current paper compared groups according to ED behaviours: self-induced vomiting, objective binge eating, excessive exercising, and to body mass index (BMI, kg/m(2)) for selected psychiatric comorbidity using two systems: Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) and International Classification of Diseases - Tenth Revision (ICD-10) diagnoses. METHOD Two hundred and twenty-six patients admitted for treatment in a specialised Eating Disorders Unit completed the Composite International Diagnostic Interview (CIDI). Lifetime and recent (12 months) psychiatric diagnoses were produced according to DSM-IV and ICD-10. Associations between presence of ED behaviours or BMI and psychiatric comorbidity were investigated. RESULTS Eighty-eight percent of patients had a lifetime history (72% recent history) of at least one comorbid diagnosis (regardless of diagnostic system). Agreement between the systems was high for mood (affective) disorders and moderate for anxiety/somatoform disorders. Significantly more patients who vomit had lifetime and recent mood (affective) disorders (DSM-IV and ICD-10). Significantly more 'vomiters' had recent anxiety disorders (DSM-IV) and neurotic, stress-related and somatoform disorders (ICD-10) including post-traumatic stress disorder (PTSD; DSM-IV and ICD-10). More patients with BMI >17.5 kg/m(2) had lifetime and recent mood (affective) disorders and lifetime PTSD (DSM-IV and ICD-10). The results for 'excessive exercisers' varied and appeared inconsistent. There were no differences in any disorders for objective binge eaters. DISCUSSION Patients who induce vomiting have more psychiatric comorbidity than 'non-vomiters', both lifetime and recent, and may benefit from diagnostic recognition as a separate group, for example 'vomiting' or 'purging' ED, who can then receive specialist treatment for their comorbidity and associated problems.
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Affiliation(s)
- A von Lojewski
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia.
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Feldman MB, Meyer IH. Comorbidity and age of onset of eating disorders in gay men, lesbians, and bisexuals. Psychiatry Res 2010; 180:126-31. [PMID: 20483473 PMCID: PMC3726047 DOI: 10.1016/j.psychres.2009.10.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 10/19/2009] [Accepted: 10/20/2009] [Indexed: 11/19/2022]
Abstract
This study examines the prevalence of psychiatric disorders among lesbian, gay, and bisexual (LGB) men with eating disorders. A total of 388 white, black, and Latino LGB men and women were sampled from community venues. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. Gay and bisexual men with eating disorders were more likely to have an anxiety or substance abuse disorder than gay and bisexual men without eating disorders, whereas lesbian and bisexual women with eating disorders were more likely to have a mood disorder than lesbian and bisexual women without an eating disorder. For individuals diagnosed with an eating and anxiety or major depressive disorder, the onset of the psychiatric disorder was more likely to precede the onset of the eating disorder. Researchers should study potential explanations of the relationship between eating and psychiatric disorders among LGB men and women.
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Yeh HW, Tzeng NS, Chu H, Chou YH, Lu RB, O'Brien AP, Chang YC, Hsieh CJ, Chou KR. The risk of eating disorders among female undergraduates in Taiwan. Arch Psychiatr Nurs 2009; 23:430-40. [PMID: 19926025 DOI: 10.1016/j.apnu.2008.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Revised: 11/19/2008] [Accepted: 12/02/2008] [Indexed: 10/21/2022]
Abstract
The objective of this study was to investigate disordered eating among female college students. The study sought to establish a predictive model for the risk of eating disorders in young female university students in Taiwan. A group of 336 student participants were recruited with the results showing that more than one third (43.2%) of the college women surveyed were identified to be at risk for developing an eating disorder. The results of multiple logistic regression showed that bulimia score, elevated depression index, eating binges, the use of laxatives and medicine to control weight, and having lost 20 lb, or more, in the past 6 months were all considered to be risk factors for developing an eating disorder (the corresponding area under receiver operating characteristic curve = 0.905). The results demonstrate that unhealthy dietary behaviors are rapidly spreading among young Taiwanese female students. For the sample described in this article, 67.6% of the female college students had lost weight: 51% had dieted at least once to lose weight, 43% used exercise to lose weight, 24% used low-calorie diets to lose weight, 11% used healthy food to lose weight, 9.2% used rubber clothing and a diet patch to lose weight, 17.9% of the students used weight-loss drugs, and a few students sought medical assistance from weight-loss clinics or actually underwent liposuction (1.5%).
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Affiliation(s)
- Hui-Wen Yeh
- Department of Nursing, Tri-Service General Hospital, National Defense Medical Center & Taipei Medical University, Taipei, Taiwan.
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Zaitsoff SL, Taylor A. Factors related to motivation for change in adolescents with eating disorders. EUROPEAN EATING DISORDERS REVIEW 2009; 17:227-33. [PMID: 19308946 DOI: 10.1002/erv.915] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To examine the association between motivation for change and eating disorder symptom severity, the quality of the parent-adolescent relationship and depressive symptom severity in adolescents with eating disorders. METHOD Fifty-four female adolescents with eating disorders (mean age = 15.8 years, SD = 1.6) participated in this research prior to beginning outpatient treatment. Participants completed the Motivational Stages of Change for Adolescents Recovering from an Eating Disorder, the Eating Disorders Inventory-2, the Relations with Parents scale from the Behavioral Assessment System for Children and Adolescents Self-report and the Child Depression Inventory. RESULTS Greater motivation for change was associated with less body dissatisfaction, more adaptive parent-adolescent relationships and fewer depressive symptoms. The association between motivation for change and adolescents' perception of their relationship with their parents remained significant even after controlling for age, body dissatisfaction and depressive symptoms. CONCLUSION Involvement of families in treatment for adolescents with eating disorders may serve to enhance their motivation to recover.
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Abstract
OBJECTIVE A systematic analysis of data collected with the Eating Disorder Inventory (EDI) was made. METHOD A literature search identified 94 sources in which the mean values of the EDI or EDI-2 subscales were reported, comprising 310 samples differing by sex, age, diagnosis, language, ethnicity, or some other relevant attribute. The total number of respondents was 43,722, from 25 different countries, having used the EDI in one of the 16 languages (1-94). RESULTS The factorial structure of the aggregate means of the EDI subscales, for both clinical versus nonclinical and Western versus non-Western samples, was almost identical suggesting generalizability across languages and cultures. Non-Western participants scored higher than Western participants on virtually all EDI subscales, both in normal and eating-disordered samples. It was shown that age is a risk factor when someone is already diagnosed with an eating disorder but, in the general population, increasing age reduces the likelihood of being afflicted by eating disorders. DISCUSSION Symptoms of eating disorders are more pronounced in non-Western than in Western samples.
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Affiliation(s)
- Iris Podar
- Department of Psychology, University of Tartu, Tartu, Estonia.
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18
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Sancho C, Arija MV, Asorey O, Canals J. Epidemiology of eating disorders: a two year follow up in an early adolescent school population. Eur Child Adolesc Psychiatry 2007; 16:495-504. [PMID: 17876510 DOI: 10.1007/s00787-007-0625-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aims of this study were to determine the prevalence of eating disorders (ED) in a representative school population of early adolescents of both sexes and to evaluate persistence and incidence after two years. METHOD An initial sample of 1336 (mean age = 11.37) was assessed in a two-phase design. The Children Eating Attitudes Test was used to select 258 participants (T1) from the initial sample who were followed-up two years later (T2; n = 200). Diagnoses of ED were obtained using the Diagnostic Interview for Children and Adolescents- Children and Parent Version (DICA-C and DICA-P) at T1, and Adolescent Version (DICA-A) at T2. At T2, participants were also assessed with the Eating Attitudes Test, the Bulimic Investigatory Test, and the Eating Disorders Inventory. The Body mass index (BMI) was obtained for all participants. RESULTS The estimated prevalence of any ED according to DICA-C (T1) and DICA-A was 3.44% and 3.81%, respectively. The most frequent diagnoses were syndromes that were not full-blown. Biannual incidence of any ED was 2.02%. Amongst those with an ED, 52.17% persisted. Females showed a higher incidence and persistence of any ED than males. Participants who had the highest BMI were those who had a persistent diagnosis of ED. CONCLUSION ED that began at early ages in less severe forms and in females often persisted with increasing severity.
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Affiliation(s)
- C Sancho
- Preventive Medicine and Public Health, Rovira i Virgili University, Tarragona, Spain
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19
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Abraham SF, Boyd C, Luscombe G, Hart S, Russell J. When energy in does not equal energy out: disordered energy control. Eat Behav 2007; 8:350-6. [PMID: 17606232 DOI: 10.1016/j.eatbeh.2006.11.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 06/21/2006] [Accepted: 11/09/2006] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To explore women's fear of loss of control and excessive inappropriate control of eating, exercise or their body in relation to patient/nonpatient status. To examine the utility of a concept of Disordered Energy Control (DEC). METHODS Comparison of the features of DEC of 169 female eating disorder, first admission inpatients, 61 previous inpatients ('recovering') and 225 female students who completed computer questions including the Quality of Life Eating Disorder (QOL ED). RESULTS Fear of loss of control was reported by 89% of inpatients, 36% of 'recovering' patients and 34% of students. Fear of loss of control or excessive controlling behaviour (defined as BMI <15.5, vomiting >7 days/month) was reported by 96% of inpatients (97% anorexia nervosa, 100% bulimia nervosa, 89% EDNOS), 51% of 'recovering' patients and 35% of students. There was significantly more impact on QOL ED psychological aspects, daily living, and acute medical health for student and patient groups reporting control issues compared to those who did not. DEC was present in 13% of students, 94% of inpatients and 28% of recovering patients. DISCUSSION The concept of disordered energy control warrants further investigation particularly in overweight and obese groups. A biological measure of inappropriate energy control associated with medical and psychological problems would be useful.
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Affiliation(s)
- Suzanne F Abraham
- Department of Psychological Medicine, University of Sydney, The Northside Clinic, NSW 2006, Australia.
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Abstract
OBJECTIVE This study examines the association between eating disorders and a history of childhood abuse in gay and bisexual men, and how substance abuse and depression might impact this relationship. METHOD 193 white, black, Latino gay, and bisexual men were sampled from community venues. DSM-IV diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. RESULTS Men with a history of childhood sexual abuse are significantly more likely to have subclinical bulimia or any current full-syndrome or subclinical eating disorder compared with men who do not have a history of childhood sexual abuse. A history of depression and/or substance use disorders did not mediate this relationship. CONCLUSION Researchers should study other potential explanations of the relationship between a history of childhood abuse and eating disorders in gay and bisexual men. Clinicians working with gay and bisexual men who have a history of childhood abuse should assess for disordered eating as a potential mechanism to cope with the emotional sequelae associated with abuse.
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Affiliation(s)
- Matthew B Feldman
- Medical and Health Research Association of New York City, Inc., New York, New York, USA.
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Abstract
OBJECTIVE This study estimates the prevalence of eating disorders in lesbian, gay, and bisexual (LGB) men and women, and examines the association between participation in the gay community and eating disorder prevalence in gay and bisexual men. METHOD One hundred and twenty six white heterosexuals and 388 white, black, Latino LGB men and women were sampled from community venues. DSM-IV diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. RESULTS Gay and bisexual men had significantly higher prevalence estimates of eating disorders than heterosexual men. There were no differences in eating disorder prevalence between lesbian and bisexual women and heterosexual women, or across gender or racial groups. Attending a gay recreational group was significantly related to eating disorder prevalence in gay and bisexual men. CONCLUSION Researchers should study the causes of the high prevalence of eating disorders among gay and bisexual men.
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Affiliation(s)
- Matthew B Feldman
- Medical and Health Research Association of New York City, Inc., New York, New York, USA.
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Munsch S, Becker E, Meyer A, Schneider S, Margraf J. Recurrent binge eating (RBE) and its characteristics in a sample of young women in Germany. EUROPEAN EATING DISORDERS REVIEW 2007; 15:385-99. [PMID: 17701943 DOI: 10.1002/erv.783] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the characteristics of recurrent binge eating (RBE) in a non-treatment-seeking sample from the general population. RBE individuals are described in terms of socio-economic status, general psychopathology, and comorbidity rates of mental disorders. METHOD Participants were 1877 German females aged 18-24 years from a population-based epidemiological study. RESULTS/DISCUSSION The point prevalence of RBE in our sample was 0.9% (N = 17). Compared to healthy women, subjects with RBE suffered more often from comorbid mental disorders and also exhibited more general psychopathology: They were similar to women with other mental disorders and other eating disorders (EDs). RBE seems to be a syndrome of clinical significance itself and might be an important risk factor for the development of further EDs, especially binge eating disorder (BED) and other mental disorders.
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Affiliation(s)
- Simone Munsch
- Department of Psychology and Psychotherapy, University of Basel, Basel, Switzerland.
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