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Radden J. Capturing the anorexia nervosa phenotype: Conceptual and normative issues in ICD-11. J Eval Clin Pract 2022; 28:807-813. [PMID: 34121277 DOI: 10.1111/jep.13586] [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: 04/10/2021] [Accepted: 05/04/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION ICD-11's diagnostic definition possesses conceptual lacunae and normative implications calling for further attention. METHOD Assumptions underlying it and their ethical implications, are examined employing philosophical analysis; particularly, these are (1) changes to eliminate implications of voluntary agency to caloric restriction; (2) definitions of "dangerously low weight;" and (3) disorder boundaries as stated in qualifications and exclusions. RESULTS (1) The extent to which AN behaviour can be acknowledged to be driven by forces out of, or limiting, voluntary control is unresolved; this is illustrated using the contested part played by excessive exercise, clarification of which requires understanding of AN motivation. (2) AN's uncertain aetiology leaves doubt over the sub-threshold state. This affects not only when treatment is appropriate, but how definitions of morbidly low body weight are determined, putting individuals with prodromal symptoms at the social risks associated with "medicalizing" normal variation. Concluded here is not that ICD-11's conservative definition is mistaken but that since false positives are common, they must be factored into the complex cost-risk assessments involved. (3) ICD-11 efforts to minimize reliance on subjective motivation reveal limitations in exclusion criteria. Were AN motivation itself better understood, it would be possible to deal with non-anorexic motivation by exclusion. But the history of "fat fears" illustrates that uncertainty attaches to interpretations of AN motivation. Neither AN motivation nor cultural norms around other forms of self-starvation admit of clear characterization, leaving an impasse. DISCUSSION At least with present day medical and scientific knowledge, a complete characterization of the AN phenotype cannot be achieved without reference to psychological states of motivation. And more research, not only clinical, genetic and neurobiological but also conceptual and ethical, will be required to resolve the challenges presented by AN.
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Affiliation(s)
- Jennifer Radden
- Philosophy Department, University of Massachusetts Boston, Boston, Massachusetts, USA
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2
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Skin signs in eating disorders: a literature review. Eat Weight Disord 2022; 27:867-879. [PMID: 34142354 DOI: 10.1007/s40519-021-01241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To summarize and describe the available knowledge on dermatological manifestation of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders IV-TR and 5th edition. METHODS We searched in PubMed, Scopus and Web of Science databases from January 1, 1980 through May 1, 2020 for papers in English language on the skin manifestation of eating disorders. Results were screened using the PRISMA tool. RESULTS The study yielded 207 results. According with PRISMA guidelines, 26 papers were included in the review. More than 73% of screened papers (19/26) were case reports. Cross-sectional studies represented the 19.2% of screened papers (5/26). Each eligible study has been screened and analyzed. CONCLUSION Huge heterogeneity of skin signs of eating disorders were identified. The number of controlled studies available is very limited, and most papers of interest are case reports or narrative review articles. Larger, more methodologically rigorous studies to evaluate the presence of dermatological issue in eating disorder patients are needed. LEVEL OF EVIDENCE Level IV. Evidence obtained from multiple time series analysis such as case studies.
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3
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Sharan P, Hans G. Cultural Issues Related to ICD-11 Mental, Behavioural and Neurodevelopmental Disorders. CONSORTIUM PSYCHIATRICUM 2021; 2:7-15. [PMID: 39070734 PMCID: PMC11272311 DOI: 10.17816/cp67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Indexed: 11/08/2022] Open
Abstract
The challenge of producing a classificatory system that is truly representative of different regions and cultural variations is difficult. This can be conceptualized as an ongoing process, achievable by constant commitment in this regard from various stakeholders over successive generations of the classificatory systems. The objective of this article is to conduct a qualitative review of the process and outcome of the efforts that resulted in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders becoming a global classification. The ICD-11 represents an important, albeit iterative, advance in the classification of mental, behavioural and neurodevelopmental disorders. Significant changes have been incorporated in this regard, such as the introduction of new, culturally-relevant categories, modifications of the diagnostic guidelines, based on culturally informed data and the incorporation of culture-related features for specific disorders. Notwithstanding, there are still certain significant shortcomings and areas for further improvement and research. Some of the key limitations of ICD-11 relate to the paucity of research on the role of culture in the pathogenesis of illnesses. To ensure a classificatory system that is fair, reliable and culturally useful, there is a need to generate empirical evidence on diversity in the form of illnesses, as well as mechanisms that explain these in all the regions of the world. In this review, we try to delineate the various cultural challenges and their influences in the formulation of ICD-11, along with potential shortcomings and areas in need of more improvement and research in this regard.
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Sahlan RN, Saunders JF, Perez M, Blomquist KK, Fitzsimmons-Craft EE, Bodell LP. The validation of a Farsi version of the Loss of Control over Eating Scale (F-LOCES) among Iranian adolescent boys and girls. Eat Behav 2021; 41:101502. [PMID: 33812127 DOI: 10.1016/j.eatbeh.2021.101502] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Few studies have been conducted on disordered eating in Iran, with limited research on loss of control (LOC) eating in adolescents. The purpose of the current study was to evaluate the validation of a Farsi version of the Loss of Control over Eating Scale (F-LOCES) among Iranian adolescents. METHOD Participants were 504 boys (Age mean = 15.35; Body Mass Index [zBMI] mean = 0.01) and 607 girls (Age mean = 15.71; zBMI mean = -0.01) who completed a battery of questionnaires including the F-LOCES. RESULTS Confirmatory Factor Analysis (CFA) and bi-factor model indicated that the F-LOCES had good fit to the data and supported a three-factor model. Additionally, the scale was invariant across all the groups. Girls had higher scores than boys on the behavioral subscale. Additionally, individuals with elevated eating pathology and zBMI endorsed higher LOC eating. As expected, the F-LOCES scores were positively associated with zBMI, disordered eating symptoms, and depression, and negatively associated with self-esteem. DISCUSSION Findings suggest that the F-LOCES is a reliable and valid measure of LOC eating in Iranian adolescents. The availability of the F-LOCES will enable researchers to examine the developmental trajectories, predictors, and outcomes of LOC eating.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Jessica F Saunders
- Department of Psychological Science, Georgia College and State University, Milledgeville, GA, USA
| | - Marisol Perez
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | | | | | - Lindsay P Bodell
- Department of Psychology, University of Western Ontario, London, Ontario, Canada.
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5
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Gradl-Dietsch G, Herpertz-Dahlmann B, Degenhardt F, Hebebrand J. [Feeding and eating disorders in ICD-11]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 49:443-452. [PMID: 33287577 DOI: 10.1024/1422-4917/a000772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Feeding and eating disorders in ICD-11 Abstract. Innovations in ICD-11 include the adoption of a lifespan approach and culture-related guidance for each disorder. We describe the changes made to the chapter Feeding and Eating Disorders and compared them to the ICD-10. In addition to illustrating the revision of the guidelines for each disorder, we also comment on the inclusion of a new set of diagnoses, avoidant/restrictive food intake disorder (ARFID) and binge-eating disorder (BED).
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Affiliation(s)
- Gertraud Gradl-Dietsch
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters; Universitätsklinikum Essen, Universität Duisburg-Essen
| | - Beate Herpertz-Dahlmann
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, RWTH Aachen
| | - Franziska Degenhardt
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters; Universitätsklinikum Essen, Universität Duisburg-Essen
| | - Johannes Hebebrand
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters; Universitätsklinikum Essen, Universität Duisburg-Essen
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6
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Ishitsuka K, Yamawaki K, Horikawa M, Nakadate H, Nagai A, Ishiguro A. Clinical Prognostic Factors in Pediatric Patients With Orthostatic Intolerance. Glob Pediatr Health 2020; 7:2333794X20971980. [PMID: 33241086 PMCID: PMC7672775 DOI: 10.1177/2333794x20971980] [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: 03/12/2020] [Revised: 10/09/2020] [Accepted: 10/16/2020] [Indexed: 11/15/2022] Open
Abstract
Midodrine is widely used for orthostatic intolerance (OI); however, little is known about the prognostic factors of OI after midodrine treatment. We retrospectively reviewed electronic medical charts to investigate clinical prognostic factors of OI on 159 OI patients aged 7 to 18 years who were treated with midodrine at a children's hospital. Logistic regression was conducted to clarify predictors for improving symptoms at the first month of the treatment. Patients with orthostatic uncomfortable feeling or fainting were significantly more likely to improve symptoms at the first month of the treatment (odds ratio [OR], 3.48; 95% confidence interval [95%CI], 1.36-8.89), but patients with underweight were significantly less likely to improve symptoms (OR, 0.19; 95%CI, 0.06-0.56). Our results suggest that predictive factors for OI by midodrine treatments are orthostatic symptoms and underweight in pediatric patients. These findings are useful to develop further studies for OI treatments.
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Affiliation(s)
- Kazue Ishitsuka
- National Center for Child Health and Development, Tokyo, Japan
| | - Kaori Yamawaki
- National Center for Child Health and Development, Tokyo, Japan.,Kyushu University, Fukuoka, Japan
| | - Miwako Horikawa
- National Center for Child Health and Development, Tokyo, Japan
| | - Hisaya Nakadate
- National Center for Child Health and Development, Tokyo, Japan
| | - Akira Nagai
- National Center for Child Health and Development, Tokyo, Japan
| | - Akira Ishiguro
- National Center for Child Health and Development, Tokyo, Japan
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Zheng Y, Kang Q, Huang J, Jiang W, Liu Q, Chen H, Fan Q, Wang Z, Xiao Z, Chen J. The classification of eating disorders in China: A categorical model or a dimensional model. Int J Eat Disord 2019; 52:712-720. [PMID: 30883838 PMCID: PMC6618033 DOI: 10.1002/eat.23069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 02/07/2019] [Accepted: 02/22/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE According to the ICD-10 and DSM-5, eating disorders (EDs) are classified using a categorical model that assumes the subtypes are qualitatively different from one another. However, it is still intensely debated that a dimensional model is more suitable. The aim of this study is to examine whether EDs have a categorical or dimensional latent structure using a sample of Chinese ED patients. METHOD The sample included 322 patients, diagnosed with an ED from 2010 to 2017 in the Shanghai Mental Health Center, and comparison participants (N = 850), recruited from undergraduate students in one university in Shanghai. Participants were evaluated with the Eating Disorder Inventory-2 (EDI-2) questionnaire and another questionnaire developed by the researchers. Three taxometric procedures (MAXimum EIGenvalue [MAXEIG], latent-mode factor analysis [L-Mode], and Mean Above Minus Below A Cut [MAMBAC]) were applied, respectively, to analyze the patients' clinical symptoms data. RESULTS Patients were divided into three groups according to their clinical diagnosis. The plots of the three taxometric analysis procedures supported the categorical construct in anorexia nervosa, binge-eating/purging group, and bulimia nervosa group. The Comparison Curve Fit Indices of the MAXEIG, L-Mode, and MAMBAC procedures were 0.694, 0.709, 0.704 in the AN-BP group and 0.727, 0.67, 0.62 in the BN group, respectively, which also support the categorical construct. DISCUSSION The results support two distinct classes of ED subtypes among Chinese sample. Further work on applying hybrid model in analysis has been discussed.
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Affiliation(s)
- Yuchen Zheng
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Qing Kang
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jiabin Huang
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Wenhui Jiang
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Qiang Liu
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Han Chen
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Qing Fan
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Zhen Wang
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Zeping Xiao
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - Jue Chen
- Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
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8
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Claudino AM, Pike KM, Hay P, Keeley JW, Evans SC, Rebello TJ, Bryant-Waugh R, Dai Y, Zhao M, Matsumoto C, Herscovici CR, Mellor-Marsá B, Stona AC, Kogan CS, Andrews HF, Monteleone P, Pilon DJ, Thiels C, Sharan P, Al-Adawi S, Reed GM. The classification of feeding and eating disorders in the ICD-11: results of a field study comparing proposed ICD-11 guidelines with existing ICD-10 guidelines. BMC Med 2019; 17:93. [PMID: 31084617 PMCID: PMC6515596 DOI: 10.1186/s12916-019-1327-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/16/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) International Classification of Diseases and Related Health Problems (ICD) is used globally by 194 WHO member nations. It is used for assigning clinical diagnoses, providing the framework for reporting public health data, and to inform the organization and reimbursement of health services. Guided by overarching principles of increasing clinical utility and global applicability, the 11th revision of the ICD proposes major changes that incorporate empirical advances since the previous revision in 1992. To test recommended changes in the Mental, Behavioral, and Neurodevelopmental Disorders chapter, multiple vignette-based case-controlled field studies have been conducted which examine clinicians' ability to accurately and consistently use the new guidelines and assess their overall clinical utility. This manuscript reports on the results from the study of the proposed ICD-11 guidelines for feeding and eating disorders (FEDs). METHOD Participants were 2288 mental health professionals registered with WHO's Global Clinical Practice Network. The study was conducted in Chinese, English, French, Japanese, and Spanish. Clinicians were randomly assigned to apply either the ICD-11 or ICD-10 diagnostic guidelines for FEDs to a pair of case vignettes designed to test specific clinical questions. Clinicians selected the diagnosis they thought was correct for each vignette, evaluated the presence of each essential feature of the selected diagnosis, and the clinical utility of the diagnostic guidelines. RESULTS The proposed ICD-11 diagnostic guidelines significantly improved accuracy for all FEDs tested relative to ICD-10 and attained higher clinical utility ratings; similar results were obtained across all five languages. The inclusion of binge eating disorder and avoidant-restrictive food intake disorder reduced the use of residual diagnoses. Areas needing further refinement were identified. CONCLUSIONS The proposed ICD-11 diagnostic guidelines consistently outperformed ICD-10 in distinguishing cases of eating disorders and showed global applicability and appropriate clinical utility. These results suggest that the proposed ICD-11 guidelines for FEDs will help increase accuracy of public health data, improve clinical diagnosis, and enhance health service organization and provision. This is the first time in the revision of the ICD that data from large-scale, empirical research examining proposed guidelines is completed in time to inform the final diagnostic guidelines.
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Affiliation(s)
- Angélica M Claudino
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, SP, 04017-030, Brazil.
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, Unit 9 Room 5808, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, NSW Campbelltown, Australia
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Box 842018, Richmond, VA, 23284, USA
| | - Spencer C Evans
- Department of Psychology, Harvard University, 33 Kirkland St, 1040 William James Hall, Cambridge, MA, 02138, USA
| | - Tahilia J Rebello
- Global Mental Health Program, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, Mailman School of Public Health, 722 West 168th, Floor R2, R-233, New York, NY, 10032, USA
| | - Rachel Bryant-Waugh
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH, UK
| | - Yunfei Dai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Chihiro Matsumoto
- National Study Coordinator for ICD-11 Field Studies, ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, 2-38-4, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Cecile Rausch Herscovici
- International Life Sciences Institute (ILSI, Argentina), J. Salguero 2745, Buenos Aires, 1425, CABA, Argentina
| | - Blanca Mellor-Marsá
- Department of Psychiatry, Faculty of Medicine, Universidad Autónoma de Madrid, Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental, 2ª Planta Norte, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
| | - Anne-Claire Stona
- Ministry for Solidarity and Health, Avenue Duquesne, 75350, Paris, France
| | - Cary S Kogan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON, K1N 6N5, Canada
| | - Howard F Andrews
- Departments of Biostatistics and Psychiatry and New York State Psychiatric Institute, Columbia University, Vagelos College of Physicians and Surgeons, Unit 47, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Palmiero Monteleone
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.,Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, via Allende, Baronissi, 84081, Salerno, Italy
| | - David Joseph Pilon
- Nova Scotia Health Authority, Dalhousie University, LeMarchant Place, 2nd Floor, Rm 2121, 1246 LeMarchant Street, Halifax, NS, B3H 4R2, Canada
| | - Cornelia Thiels
- Department of Social Studies, University of Applied Sciences Bielefeld, Kissinger Str. 14, D-12157, Berlin, Germany
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, P.C. 123, Al Khoud, Muscat, Sultanate of Oman
| | - Geoffrey M Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.,Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, Unit 9 Room 5816, 1051 Riverside Drive, New York, NY, 10032, USA
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9
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Reed GM, First MB, Kogan CS, Hyman SE, Gureje O, Gaebel W, Maj M, Stein DJ, Maercker A, Tyrer P, Claudino A, Garralda E, Salvador‐Carulla L, Ray R, Saunders JB, Dua T, Poznyak V, Medina‐Mora ME, Pike KM, Ayuso‐Mateos JL, Kanba S, Keeley JW, Khoury B, Krasnov VN, Kulygina M, Lovell AM, de Jesus Mari J, Maruta T, Matsumoto C, Rebello TJ, Roberts MC, Robles R, Sharan P, Zhao M, Jablensky A, Udomratn P, Rahimi‐Movaghar A, Rydelius P, Bährer‐Kohler S, Watts AD, Saxena S. Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry 2019; 18:3-19. [PMID: 30600616 PMCID: PMC6313247 DOI: 10.1002/wps.20611] [Citation(s) in RCA: 305] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Following approval of the ICD-11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD-10 to the ICD-11, with reporting of health statistics based on the new system to begin on January 1, 2022. The WHO Department of Mental Health and Substance Abuse will publish Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders following ICD-11's approval. The development of the ICD-11 CDDG over the past decade, based on the principles of clinical utility and global applicability, has been the most broadly international, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders. Innovations in the ICD-11 include the provision of consistent and systematically characterized information, the adoption of a lifespan approach, and culture-related guidance for each disorder. Dimensional approaches have been incorporated into the classification, particularly for personality disorders and primary psychotic disorders, in ways that are consistent with current evidence, are more compatible with recovery-based approaches, eliminate artificial comorbidity, and more effectively capture changes over time. Here we describe major changes to the structure of the ICD-11 classification of mental disorders as compared to the ICD-10, and the development of two new ICD-11 chapters relevant to mental health practice. We illustrate a set of new categories that have been added to the ICD-11 and present the rationale for their inclusion. Finally, we provide a description of the important changes that have been made in each ICD-11 disorder grouping. This information is intended to be useful for both clinicians and researchers in orienting themselves to the ICD-11 and in preparing for implementation in their own professional contexts.
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Affiliation(s)
- Geoffrey M. Reed
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland,Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA
| | - Michael B. First
- Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA,New York State Psychiatric InstituteNew YorkNYUSA
| | - Cary S. Kogan
- School of PsychologyUniversity of OttawaOttawaONCanada
| | - Steven E. Hyman
- Stanley Center for Psychiatric ResearchBroad Institute of Harvard and Massachusetts Institute of TechnologyCambridgeMAUSA
| | - Oye Gureje
- Department of PsychiatryUniversity of IbadanIbadanNigeria
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical FacultyHeinrich‐Heine UniversityDüsseldorfGermany
| | - Mario Maj
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Dan J. Stein
- Department of PsychiatryUniversity of Cape Town, and South African Medical Research Council Unit on Risk and Resilience in Mental DisordersCape TownSouth Africa
| | | | - Peter Tyrer
- Centre for Mental HealthImperial CollegeLondonUK
| | - Angelica Claudino
- Department of PsychiatryUniversidade Federal de São Paulo (UNIFESP/EPM)São PauloBrazil
| | | | - Luis Salvador‐Carulla
- Research School of Population HealthAustralian National UniversityCanberraACTAustralia
| | - Rajat Ray
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - John B. Saunders
- Centre for Youth Substance Abuse ResearchUniversity of QueenslandBrisbaneQLDAustralia
| | - Tarun Dua
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland
| | | | - Kathleen M. Pike
- Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA
| | - José L. Ayuso‐Mateos
- Department of PsychiatryUniversidad Autonoma de Madrid; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Instituto de Investigación Sanitaria La PrincesaMadridSpain
| | | | - Jared W. Keeley
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Brigitte Khoury
- Department of PsychiatryAmerican University of Beirut Medical CenterBeirutLebanon
| | - Valery N. Krasnov
- Moscow Research Institute of PsychiatryNational Medical Research Centre for Psychiatry and NarcologyMoscowRussian Federation
| | - Maya Kulygina
- Moscow Research Institute of PsychiatryNational Medical Research Centre for Psychiatry and NarcologyMoscowRussian Federation
| | - Anne M. Lovell
- Institut National de la Santé et de la Recherche Médicale U988ParisFrance
| | - Jair de Jesus Mari
- Department of PsychiatryUniversidade Federal de São Paulo (UNIFESP/EPM)São PauloBrazil
| | | | | | - Tahilia J. Rebello
- Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA,New York State Psychiatric InstituteNew YorkNYUSA
| | - Michael C. Roberts
- Office of Graduate Studies and Clinical Child Psychology ProgramUniversity of KansasLawrenceKSUSA
| | - Rebeca Robles
- National Institute of Psychiatry Ramón de la Fuente MuñizMexico CityMexico
| | - Pratap Sharan
- Department of PsychiatryAll India Institute of Medical SciencesNew DelhiIndia
| | - Min Zhao
- Shanghai Mental Health Center and Department of PsychiatryShanghai Jiao Tong University School of MedicineShanghaiPeople's Republic of China
| | - Assen Jablensky
- Centre for Clinical Research in NeuropsychiatryUniversity of Western AustraliaPerthWAAustralia
| | - Pichet Udomratn
- Department of PsychiatryPrince of Songkla UniversityHat YaiThailand
| | - Afarin Rahimi‐Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical SciencesTehranIran
| | - Per‐Anders Rydelius
- Department of Child and Adolescent PsychiatryKarolinska InstituteStockholmSweden
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10
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Andersen SB, Lindgreen P, Rokkedal K, Clausen L. Grasping the weight cut-off for anorexia nervosa in children and adolescents. Int J Eat Disord 2018; 51:1346-1351. [PMID: 30548931 DOI: 10.1002/eat.22977] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The Diagnostic and Statistical Manual of Mental Disorders 5 suggests the 5th age-adjusted body mass index (BMI) percentile as the numeric cut-off for anorexia nervosa (AN) in children and adolescents. We aimed to investigate the degree to which the 5th age-adjusted percentile as the numeric cut-off for AN in youths reflects the clinical population of patients accepted for treatment. METHOD From a specialized eating disorder clinic, 305 patients with AN below 18 years of age were grouped according to age-adjusted BMI percentiles [below the 5th (low), above the 10th (high), and between the 5th and the 10th (medium)]. The distribution of eating disorder diagnoses and severity measured by the Eating Disorder Examination was compared. RESULTS Full-syndrome anorexia nervosa (F.50.0) was found in 182 (59.5%) patients and atypical anorexia nervosa (F.50.1) in 123 patients (40.5%). The number of patients in the low, medium, and high BMI percentile groups was 189 (62.0%), 34 (11.1%), and 82 (26.9%), respectively. Patients in the low BMI group differed from patients in the medium BMI group by a lower frequency of vomiting. The high BMI group presented with more weight and shape concern than the lower BMI group. Age was not a confounder of these associations. DISCUSSION We question the applicability of the 5th BMI percentile as a substantiated cut-off for the weight criterion in anorexia nervosa in youths and argue that the cut-off should not be ascribed great clinical importance as this may hinder early detection of illness and initiation of treatment.
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Affiliation(s)
- Susanne B Andersen
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark
| | - Pil Lindgreen
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark
| | - Kristian Rokkedal
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark
| | - Loa Clausen
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Risskov, Denmark.,Department of Psychology and behavioural sciences, Faculty of Business and Social Sciences, Aarhus University, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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11
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Palavras MA, Hay P, Claudino A. An Investigation of the Clinical Utility of the Proposed ICD-11 and DSM-5 Diagnostic Schemes for Eating Disorders Characterized by Recurrent Binge Eating in People with a High BMI. Nutrients 2018; 10:nu10111751. [PMID: 30428611 PMCID: PMC6265891 DOI: 10.3390/nu10111751] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 11/16/2022] Open
Abstract
The aims of this paper were to compare (1) the proportion of participants diagnosed with threshold or subthreshold Bulimia Nervosa (BN) and Binge Eating Disorder (BED) (clinical utility), and (2) the severity of participants’ clinical features and mental Health-Related Quality of Life (HRQoL) (convergent validity), when diagnosed according to either the Diagnostic and Statistical Manual of Mental Disorders—5th edition (DSM-5) or the proposed International Classification of Diseases 11th edition (ICD-11) schemes. One hundred and seven adult men and women, with a high Body Mass Index (BMI) were evaluated by interview to confirm their eating disorder diagnoses. All participants completed self-report assessments of current symptoms and mental HRQoL. The majority of participants in either diagnostic scheme were included in the main categories of BN or BED (102/107, 95% in the ICD-11 and 85/107, 79% in the DSM-5). Fewer individuals received a subthreshold other or unspecified diagnosis with the ICD-11 compared to the DSM-5 scheme (5% vs. 21%). No significant differences in demographic, clinical features or mental HRQoL of participants with complete or partial BN or BED were found between diagnostic categories. Compared to the DSM-5, the proposed ICD-11 was not over inclusive, i.e., it did not appear to include people with less severe and potentially less clinically relevant symptoms. These results support the greater clinical utility of the ICD-11 whilst both schemes showed convergent validity.
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Affiliation(s)
- Marly Amorim Palavras
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo 04017030, Brazil.
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney 2751, Australia.
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney 2751, Australia.
| | - Angélica Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo 04017030, Brazil.
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12
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Reas DL, Rø Ø. Time trends in healthcare-detected incidence of anorexia nervosa and bulimia nervosa in the Norwegian National Patient Register (2010-2016). Int J Eat Disord 2018; 51:1144-1152. [PMID: 30265747 DOI: 10.1002/eat.22949] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/04/2018] [Accepted: 08/05/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Few studies have investigated temporal trends in the incidence of eating disorders (EDs). This study investigated time trends in the age- and sex-specific incidence of healthcare-detected anorexia nervosa (AN) and bulimia nervosa (BN) from 2010 to 2016. METHODS Data were retrieved from the Norwegian National Patient Register as defined by the International Classification of Diseases (ICD-10): narrowly defined AN (F50.0), broadly defined AN (F50.0 + 50.1), narrowly defined BN (F50.2), and broadly defined BN (F50.2 + 50.3). The average annual percent changes (AAPCs) in incidence rates (IRs) were examined by Joinpoint regression analyses. RESULTS The overall (i.e., both genders, ages 10-49) rates of AN were stable across the 7-year period, with IRs ranging from 18.8 to 20.4 per 100,000 for narrowly defined AN and 33.2 to 39.5 per 100,000 for broadly defined AN, whereas overall rates of BN declined. Age- and gender-stratification revealed a significant average annual increase in AN (narrow and broad) among 10- to 14-year-old girls. The incidence of broadly defined AN also increased significantly among females aged 15-19 years between 2010 and 2012, before leveling off. Nearly universal declines in the incidence of narrowly and broadly defined BN among females occurred. IRs among males were stable and comparatively low, with no significant trends toward increasing or decreasing rates of AN or BN over time. DISCUSSION Although register-based studies provide an underestimate of the true incidence and may not accurately reflect population-level changes in true ED occurrence, this study extends our knowledge regarding trends in the detected incidence of EDs into the second decade of the 21st century.
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Affiliation(s)
- Deborah Lynn Reas
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
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13
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Ferrer-Garcia M, Pla-Sanjuanelo J, Dakanalis A, Vilalta-Abella F, Riva G, Fernandez-Aranda F, Forcano L, Riesco N, Sánchez I, Clerici M, Ribas-Sabaté J, Andreu-Gracia A, Escandón-Nagel N, Gomez-Tricio O, Tena V, Gutiérrez-Maldonado J. A Randomized Trial of Virtual Reality-Based Cue Exposure Second-Level Therapy and Cognitive Behavior Second-Level Therapy for Bulimia Nervosa and Binge-Eating Disorder: Outcome at Six-Month Followup. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2018; 22:60-68. [PMID: 30059240 DOI: 10.1089/cyber.2017.0675] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This article reviews the 6-month followup data of a randomized, multicenter, parallel-group study conducted at five clinical sites in three European cities, which compared two second-level treatments for bulimia nervosa (BN) and binge eating disorder (BED): virtual reality-based cue exposure therapy (VR-CET) versus additional cognitive behavioral therapy (A-CBT). Post-treatment outcomes of this study were previously published and details of its design can be found at clinicaltrials.gov (identifier: NCT02237300). This article focuses on the evolution of symptoms assessed after 6 months of followup in a subgroup of 58 patients from the original study. In this study 64 patients with eating disorders (EDs) (35 with BN and 29 with BED), who still showed active episodes of binge eating by the end of a structured CBT program (first-level treatment), were randomly assigned to one of two second-level treatments (A-CBT or VR-CET). Frequency of binge and purge episodes, and attitudinal features of binge-related EDs (bulimia, drive for thinness, and body dissatisfaction) were assessed before starting the second-level treatment (n = 64), at the end (n = 64), and at 6-month followup (n = 58). Mixed between-within subject analyses of variance were used to compare outcomes of both second-level treatments over time. Although both treatment conditions showed statistically significant improvements at the end and after 6-month followup, obtained reductions were greater after VR-CET, regarding binge and purge episodes, as well as the decrease of self-reported tendency to engage in overeating episodes. Accordingly, abstinence from binge episodes were higher in VR-CET than A-CBT at followup (70 percent vs. 26 percent, respectively; χ2 = 11.711, p = 0.001). These results provide further support for the use of VR-CET as an effective second-level intervention for BN and BED treatment-resistant patients.
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Affiliation(s)
- Marta Ferrer-Garcia
- 1 Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Joana Pla-Sanjuanelo
- 1 Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Antonios Dakanalis
- 2 Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.,3 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ferran Vilalta-Abella
- 1 Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Giuseppe Riva
- 3 Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,4 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,5 Department of Psychiatry and Mental Health, Igualada General Hospital, Barcelona, Spain.,6 Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain.,7 Department of Psychiatry, University Hospital Joan XXIII, Tarragona, Spain.,8 Unit of Eating Disorders, Centro ABB Tarragona, Tarragona, Spain.,9 Department of Psychology, Universidad Católica de Temuco, Temuco, Chile.,10 Department of Psychology, University Cattolica del Sacro Cuore, Milan, Italy
| | - Fernando Fernandez-Aranda
- 6 Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain
| | - Laura Forcano
- 6 Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain
| | - Nadine Riesco
- 6 Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain
| | - Isabel Sánchez
- 6 Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), ISCIII, Barcelona, Spain
| | - Massimo Clerici
- 4 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Joan Ribas-Sabaté
- 5 Department of Psychiatry and Mental Health, Igualada General Hospital, Barcelona, Spain
| | - Alexis Andreu-Gracia
- 5 Department of Psychiatry and Mental Health, Igualada General Hospital, Barcelona, Spain
| | | | - Osane Gomez-Tricio
- 7 Department of Psychiatry, University Hospital Joan XXIII, Tarragona, Spain
| | - Virginia Tena
- 8 Unit of Eating Disorders, Centro ABB Tarragona, Tarragona, Spain
| | - José Gutiérrez-Maldonado
- 1 Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
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14
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Sharan P, Keeley J. Cultural perspectives related to international classification of Diseases-11. INDIAN JOURNAL OF SOCIAL PSYCHIATRY 2018. [DOI: 10.4103/ijsp.ijsp_45_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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15
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Reas DL. Public and Healthcare Professionals' Knowledge and Attitudes toward Binge Eating Disorder: A Narrative Review. Nutrients 2017; 9:nu9111267. [PMID: 29160843 PMCID: PMC5707739 DOI: 10.3390/nu9111267] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/10/2017] [Accepted: 11/18/2017] [Indexed: 12/22/2022] Open
Abstract
Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress in the absence of inappropriate compensatory behaviors for weight control. BED is prevalent in men and women, is associated with elevated psychosocial and functional impairment, and is associated strongly with obesity and related medical comorbidities. The aim is to provide a brief, state-of-the-art review of the major and recent findings to inform educational and awareness campaigns, stigma reduction interventions, as well as current clinical practice and future research. A narrative approach was used to synthesize emerging literature on the public and healthcare professionals’ knowledge and attitudes toward individuals with BED in comparison to other eating disorders (EDs) or mental illness. A total of 13 articles were reviewed. Nine studies investigated community samples and four studies investigated healthcare professionals. The reviewed literature suggested that BED is perceived by the public as less impairing, less severe, and “easier-to-treat” than other EDs. Attitudes and beliefs reflecting perceived blameworthiness and lack of self-discipline were ascribed to vignettes with BED. Community studies indicated a low level of public awareness that BED constitutes a discreet eating disorder. The literature on healthcare professionals’ knowledge and attitudes toward BED remains very limited. The few existing studies suggest encouraging trends in recognition and diagnostic accuracy, yet there remains a need for increased clinical awareness of BED-associated medical complications and knowledge of full BED diagnostic criteria.
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Affiliation(s)
- Deborah Lynn Reas
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, N-0424 Oslo, Norway.
- Institute of Psychology, Faculty of Social Sciences, University of Oslo, N-0317 Oslo, Norway.
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16
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Ferrer-García M, Gutiérrez-Maldonado J, Pla-Sanjuanelo J, Vilalta-Abella F, Riva G, Clerici M, Ribas-Sabaté J, Andreu-Gracia A, Fernandez-Aranda F, Forcano L, Riesco N, Sánchez I, Escandón-Nagel N, Gomez-Tricio O, Tena V, Dakanalis A. A Randomised Controlled Comparison of Second-Level Treatment Approaches for Treatment-Resistant Adults with Bulimia Nervosa and Binge Eating Disorder: Assessing the Benefits of Virtual Reality Cue Exposure Therapy. EUROPEAN EATING DISORDERS REVIEW 2017; 25:479-490. [PMID: 28804985 DOI: 10.1002/erv.2538] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/25/2017] [Accepted: 07/10/2017] [Indexed: 12/22/2022]
Abstract
A question that arises from the literature on therapy is whether second-level treatment is effective for patients with recurrent binge eating who fail first-level treatment. It has been shown that subjects who do not stop binge eating after an initial structured cognitive-behavioural treatment (CBT) programme benefit from additional CBT (A-CBT) sessions; however, it has been suggested that these resistant patients would benefit even more from cue exposure therapy (CET) targeting features associated with poor response (e.g. urge to binge in response to a cue and anxiety experienced in the presence of binge-related cues). We assessed the effectiveness of virtual reality-CET as a second-level treatment strategy for 64 patients with bulimia nervosa and binge eating disorder who had been treated with limited results after using a structured CBT programme, in comparison with A-CBT. The significant differences observed between the two groups at post-treatment in dimensional (behavioural and attitudinal features, anxiety, food craving) and categorical (abstinence rates) outcomes highlighted the superiority of virtual reality-CET over A-CBT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Marta Ferrer-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Spain
| | | | - Joana Pla-Sanjuanelo
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Spain
| | | | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Italy
| | - Joan Ribas-Sabaté
- Department of Psychiatry and Mental Health, Igualada General Hospital, Spain
| | | | - Fernando Fernandez-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)-ISCIII, Spain
| | - Laura Forcano
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)-ISCIII, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)-ISCIII, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN)-ISCIII, Spain
| | | | | | | | - Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Italy
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17
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Rupp J, Bürger A, Hammerle F. [Facets of Body Image Disorder: A Differential Analysis of the TEK-KJ (Test for the Detection of Body Disorder in Children and Adolescents) for the Direct Measurement of Haptic-Perceptual Parts]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2017; 46:218-229. [PMID: 28791886 DOI: 10.1024/1422-4917/a000537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There is presently a lack of instruments that measure the haptic-perceptive component of body-image distortion – a central criterion for the eating disorders anorexia nervosa and bulimia nervosa. We present a differential analysis for the Test for Body Image Distortion in Children and Adolescents (BID-CA, German: TEK-KJ) using a large child and adolescents sample, including for the first time male participants. We analyze convergent validity with the Contour Drawing Rating Scale (CDRS) as well as differences between children and adolescents from different type of schools and different BMI percentile groups. The sample size was N = 1,654 pupils (873 females and 781 males) with an average age of 13.35 years (SD = 0.76). We calculated a substantial convergent validity with the CDRS. Significant differences between children and adolescents from different type of schools and different BMI percentile groups were detected, with increased values for children and adolescents attending high school and underweight participants. The TEK-KJ seems to be an appropriate additional instrument for detecting the haptic-perceptive component of body-image distortion. The normative data presented improves the standardization of this instrument.
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Affiliation(s)
- Julian Rupp
- 1 Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - Arne Bürger
- 1 Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.,2 Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg
| | - Florian Hammerle
- 1 Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
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18
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Exploring Relationships between Recurrent Binge Eating and Illicit Substance Use in a Non-Clinical Sample of Women over Two Years. Behav Sci (Basel) 2017; 7:bs7030046. [PMID: 28718830 PMCID: PMC5618054 DOI: 10.3390/bs7030046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/03/2017] [Indexed: 01/19/2023] Open
Abstract
(1) Background: With the new edition of the Diagnostic and Statistical Manual of Mental disorders, 5th Edition (DSM-5), numerous parallels have been drawn between recurrent binge eating (RBE) and substance use disorders, with many authors examining RBE or binge eating disorder (BED) as a “food addiction”. The present study aims to clarify the relationship between recurrent binge eating (RBE) and illicit substance use (ISU) through investigating the temporal association between the two problems. (2) Methods: This study was embedded within a larger longitudinal study of non-clinical adult women recruited from Australian tertiary institutions. Participants responded at year 2 and year 4 of follow-up to the Eating Disorder Examination—Questionnaire. ISU was measured using a modified questionnaire taken from the Australian Longitudinal Study on Women’s Health. (3) Results: RBE and ISU co-morbidity was 5.88% in this non-clinical sample, and having one condition increased the likelihood of the other. The two conditions had a different trajectory over two years whereby ISU participants had significant risk of developing RBE in addition to or in place of their ISU but the reverse was not found for RBE participants. (4) Conclusion: This unidirectional relationship suggests that in spite of the similarities of RBE and ISU they may be distinct with respect to their co-morbidity over time.
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19
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Hay P, Mitchison D, Collado AEL, González-Chica DA, Stocks N, Touyz S. Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. J Eat Disord 2017; 5:21. [PMID: 28680630 PMCID: PMC5494787 DOI: 10.1186/s40337-017-0149-z] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 04/24/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Little is known about the epidemiology and health related quality of life (HRQoL) of the new DSM-5 diagnoses, Binge Eating Disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID) in the Australian population. We aimed to investigate the prevalance and burden of these disorders. METHODS We conducted two sequential population-based surveys including individuals aged over 15 years who were interviewed in 2014 (n = 2732) and 2015 (n =3005). Demographic information and diagnostic features of DSM-5 eating disorders were asked including the occurrence of regular (at least weekly over the past 3 months) objective binge eating with levels of distress, extreme dietary restriction/fasting for weight/shape control, purging behaviors, overvaluation of shape and/or weight, and the presence of an avoidant/restrictive food intake without overvaluation of shape and/or weight. In 2014 functional impact or role performance was measured with the 'days out of role' question and in 2015, Health Related Quality of Life (HRQoL) was assessed with the Short Form -12 item questionnaire (SF-12v1). RESULTS The 2014 and 2015 3-month prevalence of eating disorders were: anorexia nervosa-broad 0.4% (95% CI 0.2-0.7) and 0.5% (0.3-0.9); bulimia nervosa 1.1% (0.7-1.5) and 1.2% (0.9-1.7); ARFID 0.3% (0.1-0.5) and 0.3% (0.2-0.6). The 2015 3-month prevalence rates were: BED-broad 1.5% (1.1-2.0); Other Specified Feeding or Eating Disorder (OSFED) 3.2 (2.6-3.9); and Unspecified Feeding or Eating Disorder (UFED) 10.4% (0.9-11.5). Most people with OSFED had atypical anorexia nervosa and majority with UFED were characterised by having recurrent binge eating without marked distress. Eating disorders were represented throughout sociodemographic groups and those with bulimia nervosa and BED-broad had mean weight (BMI, kg/m2) in the obese range. Mental HRQoL was poor in all eating disorder groups but particularly poor for those with BED-broad and ARFID. Individuals with bulimia nervosa, BED-broad and OSFED-Purging Disorder also had poor physical HRQoL. ARFID and bulimia nervosa groups had lower role performance than those without an eating disorder. CONCLUSIONS Whilst full spectrum eating disorders, including ARFID, were less common than OSFED or UFED, they were associated with poor mental HRQoL and significant functional impairment. The present study supports the movement of eating disorders in to broader socio demographic groups including men, socio-economic disadvantaged groups and those with obesity.
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Affiliation(s)
- Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, NSW Australia
| | - Deborah Mitchison
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, NSW Australia
| | | | - David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA Australia
| | - Stephen Touyz
- School of Psychology, Faculty of Science, The University of Sydney, Camperdown, NSW 2006 Australia
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20
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Stefano EC, Wagner AF, Mond JM, Cicero DC, Latner JD. Loss of Control Over Eating Scale (LOCES): Validation in undergraduate men and women with and without eating disorder symptoms. Eat Behav 2016; 23:137-140. [PMID: 27679970 DOI: 10.1016/j.eatbeh.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022]
Abstract
The present study aimed to further validate the Loss of Control Over Eating Scale (LOCES) for use with undergraduate men and women with and without eating disorder (ED) symptoms. A total of 261 participants completed the LOCES and the Eating Disorder Examination - Questionnaire (EDE-Q) and were identified as non-clinical or having probable ED symptomatology based on previously used EDE-Q cutoff scores. Results indicated that the LOCES and its subscales were significantly associated with and a significant predictor of global ED pathology and binge episode frequency. The LOCES behavioral subscale appeared to be a stronger predictor of episode frequency compared to other subscales. The ED pathology groups reported significantly higher LOCES scores compared to the non-ED pathology groups. Binary logistic regression analyses revealed that the LOCES was able to accurately distinguish between those with ED pathology and those without ED pathology in the majority of cases. Findings from the present study suggest that the LOCES is highly predictive of ED pathology, strongly associated with ED cognitions and behaviors, and an accurate index for global eating disorder pathology. Future directions for research are discussed.
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Affiliation(s)
- Emily C Stefano
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States.
| | - Allison F Wagner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Jonathan M Mond
- Department of Psychology, Macquarie University, Sydney, Australia
| | - David C Cicero
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, United States
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21
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Tan JOA, Calitri R, Bloodworth A, McNamee MJ. Understanding Eating Disorders in Elite Gymnastics: Ethical and Conceptual Challenges. Clin Sports Med 2016; 35:275-92. [PMID: 26832977 DOI: 10.1016/j.csm.2015.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Eating disorders and disordered eating are more common in high performance sports than the general population, and particularly so in high performance aesthetic sports. This paper presents some of the conceptual difficulties in understanding and diagnosing eating disorders in high performance gymnasts. It presents qualitative and quantitative data from a study designed to ascertain the pattern of eating disorder symptoms, depressive symptoms and levels of self-esteem among national and international level gymnasts from the UK in the gymnastic disciplines of sport acrobatics, tumbling, and rhythmic gymnastics.
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Affiliation(s)
- Jacinta Oon Ai Tan
- Institute of Life Sciences 2, College of Medicine, Swansea University, Room 306, Floor 3, Singleton Campus, Swansea SA2 8PP, UK.
| | - Raff Calitri
- Psychology Applied to Health, College House, University of Exeter Medical School, St. Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK
| | - Andrew Bloodworth
- Interprofessional Studies, College of Human and Health Sciences, Floor 7, Vivian Tower, Swansea University Singleton Campus, Swansea SA2 8PP, UK
| | - Michael J McNamee
- College of Engineering, Swansea University Bay Campus, Fabian Way, Swansea SA1 8EN, UK
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22
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Forney KJ, Bodell LP, Haedt-Matt AA, Keel PK. Incremental validity of the episode size criterion in binge-eating definitions: An examination in women with purging syndromes. Int J Eat Disord 2016; 49:651-62. [PMID: 26841103 PMCID: PMC4942344 DOI: 10.1002/eat.22508] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/21/2015] [Accepted: 12/28/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Of the two primary features of binge eating, loss of control (LOC) eating is well validated while the role of eating episode size is less clear. Given the ICD-11 proposal to eliminate episode size from the binge-eating definition, the present study examined the incremental validity of the size criterion, controlling for LOC. METHOD Interview and questionnaire data come from four studies of 243 women with bulimia nervosa (n = 141) or purging disorder (n = 102). Hierarchical linear regression tested if the largest reported episode size, coded in kilocalories, explained additional variance in eating disorder features, psychopathology, personality traits, and impairment, holding constant LOC eating frequency, age, and body mass index (BMI). Analyses also tested if episode size moderated the association between LOC eating and these variables. RESULTS Holding LOC constant, episode size explained significant variance in disinhibition, trait anxiety, and eating disorder-related impairment. Episode size moderated the association of LOC eating with purging frequency and depressive symptoms, such that in the presence of larger eating episodes, LOC eating was more closely associated with these features. Neither episode size nor its interaction with LOC explained additional variance in BMI, hunger, restraint, shape concerns, state anxiety, negative urgency, or global functioning. DISCUSSION Taken together, results support the incremental validity of the size criterion, in addition to and in combination with LOC eating, for defining binge-eating episodes in purging syndromes. Future research should examine the predictive validity of episode size in both purging and nonpurging eating disorders (e.g., binge eating disorder) to inform nosological schemes. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:651-662).
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Affiliation(s)
- K. Jean Forney
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Lindsay P. Bodell
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida,Correspondence to: Pamela K. Keel, Ph.D., Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306.
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23
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Mustelin L, Silén Y, Raevuori A, Hoek HW, Kaprio J, Keski-Rahkonen A. The DSM-5 diagnostic criteria for anorexia nervosa may change its population prevalence and prognostic value. J Psychiatr Res 2016; 77:85-91. [PMID: 27014849 DOI: 10.1016/j.jpsychires.2016.03.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/30/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
Abstract
The definition of anorexia nervosa was revised for the Fifth Edition of the Diagnostic and Statistical Manual (DSM-5). We examined the impact of these changes on the prevalence and prognosis of anorexia nervosa. In a nationwide longitudinal study of Finnish twins born 1975-1979, the women (N = 2825) underwent a 2-stage screening for eating disorders at mean age 24. Fifty-five women fulfilled DSM-IV criteria for lifetime anorexia nervosa. When we recoded the interviews using DSM-5 criteria, we detected 37 new cases. We contrasted new DSM-5 vs. DSM-IV cases to assess their clinical characteristics and prognosis. We also estimated lifetime prevalences and incidences and tested the association of minimum BMI with prognosis. We observed a 60% increase in the lifetime prevalence of anorexia nervosa using the new diagnostic boundaries, from 2.2% to 3.6%. The new cases had a later age of onset (18.8 y vs. 16.5, p = 0.002), higher minimum BMI (16.9 vs. 15.5 kg/m(2), p = 0.0004), a shorter duration of illness (one year vs. three years, p = 0.002), and a higher 5-year probability or recovery (81% vs. 67%, p = 0.002). Minimum BMI was not associated with prognosis. It therefore appears that the substantial increase in prevalence of anorexia nervosa is offset by a more benign course of illness in new cases. Increased diagnostic heterogeneity underscores the need for reliable indicators of disease severity. Our findings indicate that BMI may not be an ideal severity marker, but should be complemented by prognostically informative criteria. Future studies should focus on identifying such factors in prospective settings.
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Affiliation(s)
- Linda Mustelin
- Department of Public Health, University of Helsinki, Finland; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland.
| | - Yasmina Silén
- Department of Public Health, University of Helsinki, Finland; Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Anu Raevuori
- Department of Public Health, University of Helsinki, Finland; Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland; Institute of Clinical Medicine, Child Psychiatry, University of Turku, Finland; National Institute for Health and Welfare, Helsinki, Finland
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands; Department of Psychiatry, Groningen University, The Netherlands; Department of Epidemiology, Columbia University, New York, USA
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
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24
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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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25
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Santos Filho CAD, Tirico PP, Stefano SC, Touyz SW, Claudino AM. Systematic review of the diagnostic category muscle dysmorphia. Aust N Z J Psychiatry 2016; 50:322-33. [PMID: 26553217 DOI: 10.1177/0004867415614106] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES (1) To collect, analyze and synthetize the evidence on muscle dysmorphia diagnosis as defined by Pope et al. and (2) To discuss its appropriate nosology and inclusion as a specific category in psychiatric classificatory systems. METHOD A systematic search in the MEDLINE, the PsycNET, the LILACS and SciELO databases and in the International Journal of Eating Disorders was conducted looking for articles published between January 1997 and October 2014 and in EMBASE database between January 1997 and August 2013. Only epidemiological and analytical studies were considered for selection. The methodological quality of included studies was assessed according to the Evidence-Based Mental Health and the National Health and Medical Research Council's guidelines. The support for inclusion of muscle dysmorphia in psychiatric classificatory systems was examined against Blashfield et al.'s criteria. RESULTS Thirty-four articles were considered eligible out of 5136. Most of the studies were cross-sectional and enrolled small, non-clinical samples. The methodological quality of all selected papers was graded at the lowest hierarchical level due to studies' designs. Forty-one percent of the publications considered the available evidence insufficient to support the inclusion of muscle dysmorphia in any existing category of psychiatric disorders. The current literature does not fulfill Blashfield et al.'s criteria for the inclusion of muscle dysmorphia as a specific entity in psychiatric diagnostic manuals. CONCLUSION The current evidence does not ensure the validity, clinical utility, nosological classification and inclusion of muscle dysmorphia as a new disorder in classificatory systems of mental disorders.
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Affiliation(s)
| | | | | | - Stephen W Touyz
- School of Psychology, The University of Sydney, Sydney, Australia
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26
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Kurz S, van Dyck Z, Dremmel D, Munsch S, Hilbert A. Variants of early-onset restrictive eating disturbances in middle childhood. Int J Eat Disord 2016; 49:102-6. [PMID: 26356990 DOI: 10.1002/eat.22461] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 06/29/2015] [Accepted: 07/08/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study sought to determine the factor structure of the newly developed self-report screening questionnaire Eating Disturbances in Youth-Questionnaire (EDY-Q) as well as to report the distribution of variants of early-onset restrictive eating disturbances characteristic of avoidant/restrictive food intake disorder (ARFID) in a middle childhood population sample. METHOD Using the EDY-Q, a total of 1,444 children aged 8-13 years were screened in elementary schools in Switzerland via self-report. The factor analysis of the 12 items covering ARFID related symptoms was performed using a principal component analysis (PCA). RESULTS The PCA showed a four factor solution, with clear allocation to the scales covering three variants of early-onset restrictive eating disturbances and weight problems. Inadequate overall food intake was reported by 19.3% of the children, a limited accepted amount of food by 26.1%, and food avoidance based on a specific underlying fear by 5.0%. DISCUSSION The postulated factor structure of the EDY-Q was confirmed, further supporting the existence of distinct variants of early-onset restrictive eating disturbances. Avoidant/restrictive eating behavior seems to be a common experience in middle childhood, but results have to be confirmed using validated interviews.
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Affiliation(s)
- Susanne Kurz
- Department of Psychology, University of Fribourg, Rue P.-a. De Faucigny 2, Fribourg, Switzerland.,Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig, Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Medical Center, Leipzig, Germany
| | - Zoé van Dyck
- Institute for Health and Behavior, Research Unit inside, University of Luxembourg, Campus Walferdange, Esch-sur-Alzette, Luxemburg
| | - Daniela Dremmel
- Department of Psychology, University of Fribourg, Rue P.-a. De Faucigny 2, Fribourg, Switzerland
| | - Simone Munsch
- Department of Psychology, University of Fribourg, Rue P.-a. De Faucigny 2, Fribourg, Switzerland
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig, Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig, Germany.,Department of Medical Psychology and Medical Sociology, University of Leipzig, Medical Center, Leipzig, Germany
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27
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Editorial: globalisation and the journal of eating disorders. J Eat Disord 2016; 4:10. [PMID: 26981240 PMCID: PMC4791914 DOI: 10.1186/s40337-016-0099-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 02/25/2016] [Indexed: 11/10/2022] Open
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28
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Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial. Trials 2015; 16:578. [PMID: 26683478 PMCID: PMC4683762 DOI: 10.1186/s13063-015-1079-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/24/2015] [Indexed: 01/13/2023] Open
Abstract
Background Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed. HAPIFED integrates the leading evidence-based psychological therapies, cognitive behavioural therapy-enhanced (CBT-E) and behavioural weight loss treatment (BWLT) for binge eating disorder and obesity respectively. The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of HAPIFED versus CBT-E for people with bulimia nervosa and binge eating disorder who are overweight/obese. Method/Design A single-blind superiority RCT is proposed. One hundred Brazilian participants aged ≥ 18 years, with a diagnosis of bulimia nervosa or binge eating disorder, BMI > 27 to < 40 kg/m2, will be recruited from both community and clinics and individually randomised to a therapy arm. Five groups of ten participants will receive the experimental intervention (HAPIFED) and the other five groups of ten the control intervention (CBT-E). Both therapies are manualised, and in this RCT will comprise 1 individual session and 29 office-based group sessions over 6 months. Assessment points will be at baseline, end of therapy, and 6 and 12 months after end of therapy. The primary outcome of this intervention will be reduced weight. Secondary outcomes will be improved metabolic indicators of weight management, reduction in eating disorder symptoms including improved control over eating, improved adaptive function, physical and mental health-related quality of life, and reduced levels of depression and anxiety. Discussion This study will be the first to investigate a psychological therapy that aims to assist weight management in people with co-morbid overweight or obesity bulimia nervosa as well as with binge eating disorder. It will have the potential to improve health outcomes for the rapidly increasing number of adults with co-morbid obesity and binge eating disorder or bulimia nervosa. Trial registration US National Institutes of Health clinical trial registration number NCT02464345, date of registration 1 June 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-1079-1) contains supplementary material, which is available to authorized users.
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29
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Zipfel S, Giel KE, Bulik CM, Hay P, Schmidt U. Anorexia nervosa: aetiology, assessment, and treatment. Lancet Psychiatry 2015; 2:1099-111. [PMID: 26514083 DOI: 10.1016/s2215-0366(15)00356-9] [Citation(s) in RCA: 432] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/20/2015] [Accepted: 07/21/2015] [Indexed: 02/07/2023]
Abstract
Anorexia nervosa is an important cause of physical and psychosocial morbidity. Recent years have brought advances in understanding of the underlying psychobiology that contributes to illness onset and maintenance. Genetic factors influence risk, psychosocial and interpersonal factors can trigger onset, and changes in neural networks can sustain the illness. Substantial advances in treatment, particularly for adolescent patients with anorexia nervosa, point to the benefits of specialised family-based interventions. Adults with anorexia nervosa too have a realistic chance of achieving recovery or at least substantial improvement, but no specific approach has shown clear superiority, suggesting a combination of re-nourishment and anorexia nervosa-specific psychotherapy is most effective. To successfully fight this enigmatic illness, we have to enhance understanding of the underlying biological and psychosocial mechanisms, improve strategies for prevention and early intervention, and better target our treatments through improved understanding of specific disease mechanisms.
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Affiliation(s)
- Stephan Zipfel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany.
| | - Katrin E Giel
- Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany; Centre for Psychosocial Medicine, Department for General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Cynthia M Bulik
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Phillipa Hay
- School of Medicine and Centre for Health Research Western Sydney University, Penrith, NSW, Australia
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30
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Palavras MA, Hay PJ, Lujic S, Claudino AM. Comparing symptomatic and functional outcomes over 5 years in two nonclinical cohorts characterized by binge eating with and without objectively large episodes. Int J Eat Disord 2015; 48:1158-65. [PMID: 26414868 DOI: 10.1002/eat.22466] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 08/27/2015] [Accepted: 08/30/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim was to compare symptomatic and functional outcomes over 5 years in women with regular subjective (SBEs), objective (OBEs), and no regular binge eating episodes. METHOD Data were derived from two cohorts of 330 women with high levels of eating disorders symptoms followed over 5 years. Three groups were formed: (a) regular SBEs but no regular OBEs (N = 68), (b) regular OBEs with or without regular SBEs (N = 154), and (c) with no regular binge eating episodes (N = 108). RESULTS At baseline, the groups did not differ significantly in restraint scores and quality of life. People in the OBE group scored higher than those in the SBE group in body mass index (BMI). Those who had no regular binge eating had lower global Eating Disorder Examination Questionnaire (EDE-Q) and weight and shape concern scores than those with regular SBEs, and lower eating concern scores than either binge eating groups. Across the follow-up, there were no significant effects of being in either binge eating or the nonbinge eating group on the rates of change in BMI, general psychological distress, quality of life, or EDE-Q scores with the exception that OBE group had a significantly different rate of change in eating concern and psychological distress compared to the group without regular binge eating. DISCUSSION Individuals that report regular SBEs without regular OBEs represent a group with similar mental hardship and outcomes to those with regular OBEs. The findings support inclusion of regular SBEs in criteria for eating disorder diagnostic categories characterized by recurrent binge eating.
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Affiliation(s)
- Marly A Palavras
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.,Ministry of Education (CAPES) Foundation, São Paulo, Brazil.,School of Medicine, Western Sydney University, Sydney, Australia
| | - Phillipa J Hay
- School of Medicine, Western Sydney University, Sydney, Australia.,Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.,School of Medicine, James Cook University, Sydney, Australia
| | - Sanja Lujic
- Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.,Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Angélica M Claudino
- Eating Disorders Program (PROATA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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Abstract
PURPOSE OF REVIEW In this review, an overview of literature on picky eating is given, with the focus on recently published studies. RECENT FINDINGS Papers on picky eating published over the past 2 years broadly covered three themes: characterization of picky eating; factors contributing to the development of picky eating in children; and management of picky eating. Findings suggest that picky eating is a reasonably robust concept, comprising food neophobia, eating a limited variety of food, and other specific features related to food and eating (e.g. low enjoyment of food, slowness in eating, and higher satiety responsiveness). Picky eating has a higher prevalence in preschool children and seems to decrease thereafter. Studies investigating factors influencing the development of picky eating in childhood have examined a range of child factors, parent factors, and parent-child interactions. Only very limited guidance has emerged regarding the management of picky eating. SUMMARY Picky eating is a descriptive term with greater emerging clarity about its core characteristics and associations. Research remains limited with ongoing difficulties related to lack of standardized assessment measures, and poor ability to differentiate between normal and clinically significant picky eating.
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Affiliation(s)
- S Cardona Cano
- aParnassia Psychiatric Institute, The Hague bThe Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands cDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA dDepartment of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands eDepartment of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust fUniversity College London, Institute of Child Health, London, UK
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32
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Affiliation(s)
- Mario Luciano
- WHO Collaborating Centre for Research and Training in Mental HealthNaples, Italy
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33
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Affiliation(s)
- Gaia Sampogna
- WHO Collaborating Centre for Research and Training in Mental Health, University of Naples SUN, Naples, Italy
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34
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Kurz S, van Dyck Z, Dremmel D, Munsch S, Hilbert A. Early-onset restrictive eating disturbances in primary school boys and girls. Eur Child Adolesc Psychiatry 2015; 24:779-85. [PMID: 25296563 PMCID: PMC4490181 DOI: 10.1007/s00787-014-0622-z] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 09/28/2014] [Indexed: 11/21/2022]
Abstract
This study sought to determine the distribution of early-onset restrictive eating disturbances characteristic of the new DSM-5 diagnosis, avoidant/restrictive food intake disorder (ARFID) in middle childhood, as well as to evaluate the screening instrument, Eating Disturbances in Youth-Questionnaire (EDY-Q). A total of 1,444 8- to 13-year-old children were screened in regular schools (3rd to 6th grade) in Switzerland using the self-report measure EDY-Q, consisting of 12 items based on the DSM-5 criteria for ARFID. 46 children (3.2%) reported features of ARFID in the self-rating. Group differences were found for body mass index, with underweight children reporting features of ARFID more often than normal and overweight children. The EDY-Q revealed good psychometric properties, including adequate discriminant and convergent validity. Early-onset restrictive eating disturbances are commonly reported in middle childhood. Because of possible negative short- and long-term impact, early detection is essential. Further studies with structured interviews and parent reports are needed to confirm this study's findings.
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Affiliation(s)
- Susanne Kurz
- Department of Psychology, University of Fribourg, Rue P.-A. Faucigny 2, 1700, Fribourg, Switzerland,
| | - Zoé van Dyck
- Research Unit INSIDE, University of Luxembourg, Campus Walferdange, Route Diekirch, Walferdange, Luxemburg
| | - Daniela Dremmel
- Department of Psychology, University of Fribourg, Rue P.-A. Faucigny 2, 1700 Fribourg, Switzerland
| | - Simone Munsch
- Department of Psychology, University of Fribourg, Rue P.-A. Faucigny 2, 1700 Fribourg, Switzerland
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 27, Leipzig, Germany
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35
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Hay P, Girosi F, Mond J. Prevalence and sociodemographic correlates of DSM-5 eating disorders in the Australian population. J Eat Disord 2015; 3:19. [PMID: 25914826 PMCID: PMC4408592 DOI: 10.1186/s40337-015-0056-0] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/02/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND New DSM-5 diagnostic criteria for eating disorders were published in 2013. Adolescent cohort studies in the Australian community indicate that the point prevalence of DSM-5 eating disorders may be as high as 15% in females and 3% in males. The goal of the current study was to determine the 3-month prevalence of DSM-5 disorders in a representative sample of Australian older adolescents and adults. A secondary aim was to explore the demographic correlates of these disorders, specifically, age, gender, income, and educational attainment and presence of obesity. METHODS We conducted and merged sequential cross-sectional population survey data of adults (aged over 15 years) collected in 2008 and in 2009 (n = 6041). Demographic information and the occurrence of regular (at least weekly over the past 3 months) objective and subjective binge eating, extreme dietary restriction, purging behaviors, and overvaluation of weight and/or shape, were assessed. RESULTS The 3-month prevalence of anorexia nervosa and bulimia nervosa were both under 1% whereas the prevalence of binge eating disorder (BED) and sub-threshold BED were 5.6-6.9%. The prevalence of BED including overvaluation of weight/shape was 3%. Other specified and unspecified eating disorders including purging disorder were less common, under 1% to 1.4%. While people with eating disorders were generally younger than others, the mean age was in the fourth decade for anorexia nervosa and bulimia nervosa and in the fourth or fifth decade for all other disorders. Most people with eating disorders had similar household incomes and educational attainments to the general population. People with bulimia nervosa, BED and sub-threshold bulimia nervosa were more likely to be obese than people without an eating disorder. CONCLUSIONS The findings support the expanded demographic distribution of eating disorders. There is a relatively high prevalence of BED compared to anorexia nervosa and bulimia nervosa. As it is in BED, obesity is a very common co-morbidity in bulimia nervosa.
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Affiliation(s)
- Phillipa Hay
- Centre for Health Research, School of Medicine, University of Western Sydney, Sydney, New South Wales Australia ; School of Medicine, James Cook University, Townsville, Queensland Australia
| | - Federico Girosi
- Centre for Health Research, School of Medicine, University of Western Sydney, Sydney, New South Wales Australia
| | - Jonathan Mond
- Department of Psychology, Macquarie University, Sydney, Australia, and School of Medicine, University of Western Sydney, Sydney, New South Wales Australia
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Mitchison D, Mond J. Epidemiology of eating disorders, eating disordered behaviour, and body image disturbance in males: a narrative review. J Eat Disord 2015; 3:20. [PMID: 27408719 PMCID: PMC4940910 DOI: 10.1186/s40337-015-0058-y] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 05/04/2015] [Indexed: 11/10/2022] Open
Abstract
Challenges to epidemiological studies of eating and related body image disturbance disorders in males include, in addition to low base rates and the predominance of residual diagnostic categories, the female-centric nature of current classification schemes and the consequent lack of appropriate assessment instruments. In this narrative review, we summarise epidemiological data regarding the prevalence and correlates of eating disorders, related body image disturbance disorders, and eating disorder features in males. Attention is focused on disorders most likely to be observed among males, such as muscle dysmorphia and muscularity-oriented excessive exercise. It is argued that, given the multiple challenges involved in research of this kind, a focus on features is more likely to advance the field than a focus on diagnoses. In terms of correlates, we focus on impairment and help-seeking, since these issues are most relevant in informing public health burden, service provision, and related issues. We end with some thoughts about current gaps in the knowledge base and directions for future research that we consider to be most promising.
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Affiliation(s)
- Deborah Mitchison
- School of Medicine, University of Western Sydney, Sydney, Australia ; Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia
| | - Jonathan Mond
- School of Medicine, University of Western Sydney, Sydney, Australia ; Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, Australia ; Research School of Psychology, Australian National University, Sydney, Australia
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Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor L, Touyz S, Ward W. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Aust N Z J Psychiatry 2014; 48:977-1008. [PMID: 25351912 DOI: 10.1177/0004867414555814] [Citation(s) in RCA: 329] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. METHODS The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. RESULTS In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to guide practice. CONCLUSIONS Specific evidence based psychological and pharmacological treatments are recommended for most eating disorders but more trials are needed for specific therapies in AN, and research is urgently needed for all aspects of ARFID assessment and management. EXPERT REVIEWERS Associate Professor Susan Byrne, Dr Angelica Claudino, Dr Anthea Fursland, Associate Professor Jennifer Gaudiani, Dr Susan Hart, Ms Gabriella Heruc, Associate Professor Michael Kohn, Dr Rick Kausman, Dr Sarah Maguire, Ms Peta Marks, Professor Janet Treasure and Mr Andrew Wallis.
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Affiliation(s)
- Phillipa Hay
- Members of the CPG Working Group School of Medicine and Centre for Health Research, University of Western Sydney, Australia School of Medicine, James Cook University, Townsville, Australia
| | - David Chinn
- Members of the CPG Working Group Capital and Coast District Health Board, Wellington, New Zealand
| | - David Forbes
- Members of the CPG Working Group School of Pediatrics and Child Health, University of Western Australia, Perth, Australia
| | - Sloane Madden
- Members of the CPG Working Group Eating Disorders Service, Sydney Children's Hospital Network, Westmead, Australia; School of Psychiatry, University of Sydney, Australia
| | - Richard Newton
- Members of the CPG Working Group Mental Health CSU, Austin Health, Australia; University of Melbourne, Australia
| | - Lois Sugenor
- Members of the CPG Working Group Department of Psychological Medicine, University of Otago at Christchurch, New Zealand
| | - Stephen Touyz
- Members of the CPG Working Group School of Psychology and Centre for Eating and Dieting Disorders, University of Sydney, Australia
| | - Warren Ward
- Members of the CPG Working Group Eating Disorders Service Royal Brisbane and Women's Hospital; University of Queensland, Brisbane, Australia
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Jones A, Helverskov J, Rokkedal K, Clausen L. A comparison of eating disorder symptomatology in a clinical population of adolescents with subjective versus objective bulimic episodes. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/21662630.2014.969752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Latner JD, Mond JM, Kelly MC, Haynes SN, Hay PJ. The Loss of Control Over Eating Scale: development and psychometric evaluation. Int J Eat Disord 2014; 47:647-59. [PMID: 24862351 DOI: 10.1002/eat.22296] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/21/2014] [Accepted: 04/27/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study describes the development, content validity, and convergent validity of the Loss of Control over Eating Scale (LOCES). METHOD An initial pool of 56 items covering 13 facets of loss-of-control eating was assembled by reviewing qualitative literature, clinical descriptions, and research on binge eating. Eating disorder experts (n = 34) and eating disorder clients (n = 22) rated each proposed item's clarity and relevance to the construct of loss-of-control eating, rated 13 facets for their relevance to the construct, and provided open-ended feedback about the items and facets. Based on the experts' and clients' quantitative and qualitative feedback, scale items were clarified, 28 items were added, and 10 were deleted. University students (n = 476; 70% female, mean age = 20.4 years) completed the resulting 74-item questionnaire, rating how often they had the experience identified in the item while eating in the last 4 weeks. They also completed the measures of eating disturbance, general distress, functional impairment, and general self-control. RESULTS The resulting 24-item LOCES (Cronbach's α = .96) retained items with highest item-total correlations and coverage of the 12 construct facets that experts rated as important. The LOCES was significantly correlated with eating disturbances, general distress, functional impairment, and general self-control. Three subfactors were identified: behavioral, cognitive/dissociative, and positive/euphoric aspects of loss-of-control eating. A brief, seven-item version of the LOCES was developed and validated. DISCUSSION A thorough process of development, content validation, and psychometric evaluation in multiple samples yielded the multifaceted LOCES and its brief form. These instruments may be useful in assessing loss-of-control eating in both clinical and nonclinical settings.
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Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawai'i
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Birgegård A, Norring C, Clinton D. Binge Eating in Interview Versus Self-Report: Different Diagnoses Show Different Divergences. EUROPEAN EATING DISORDERS REVIEW 2014; 22:170-5. [DOI: 10.1002/erv.2289] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/19/2014] [Accepted: 02/25/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Andreas Birgegård
- Department of Clinical Neuroscience, Resource Center for Eating Disorders, Stockholm Center for Psychiatry Research and Education; Karolinska Institute and Stockholm County Council; Stockholm Sweden
| | - Claes Norring
- Department of Clinical Neuroscience, Resource Center for Eating Disorders, Stockholm Center for Psychiatry Research and Education; Karolinska Institute and Stockholm County Council; Stockholm Sweden
| | - David Clinton
- Department of Clinical Neuroscience, Resource Center for Eating Disorders, Stockholm Center for Psychiatry Research and Education; Karolinska Institute and Stockholm County Council; Stockholm Sweden
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Hay P, Touyz S. 2013 and 'DSMitis': implications for the Journal of Eating Disorders and its authors. J Eat Disord 2014; 2:3. [PMID: 24999426 PMCID: PMC4081735 DOI: 10.1186/2050-2974-2-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 01/03/2014] [Indexed: 11/23/2022] Open
Affiliation(s)
- Phillipa Hay
- School of Medicine, Centre for Health Research, University of Western Sydney, Sydney, Australia ; School of Medicine, James Cook University, Townsville, Australia
| | - Stephen Touyz
- Schools of Psychology and and Centre for Eating and Dieting Disorders (Boden Institute), University of Sydney, Sydney, Australia
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