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Liao Z, Birgegård A, Monell E, Borg S, Bulik CM, Mantilla EF. Maladaptive exercise in eating disorders: lifetime and current impact on mental health and treatment seeking. J Eat Disord 2024; 12:86. [PMID: 38915052 PMCID: PMC11194861 DOI: 10.1186/s40337-024-01048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Many patients with eating disorders report exercise as a central symptom of their illness-as a way to compensate for food intake, prevent weight-gain, and/or reduce negative affect. Previous findings show associations between maladaptive exercise and more severe eating disorder pathology, higher risk for relapse, other co-morbid symptoms, and worse treatment outcome. METHODS In this study, we included 8252 participants with eating disorders and investigated associations between maladaptive exercise (both lifetime and current) and ED pathology, illness duration, depression, anxiety, self-harm and suicidal ideation, and treatment seeking patterns in individuals with lifetime maladaptive exercise. Participants were included via the Swedish site of the large global study The Eating Disorders Genetics Initiative (EDGI) and completed measures of both lifetime and current symptomatology. RESULTS Results indicate that lifetime maladaptive exercise is associated with higher prevalence of lifetime depression and anxiety and with patients more often receiving treatment, although these results need to be investigated in future studies. Current maladaptive exercise was associated with more severe ED symptoms, and higher levels of depression, anxiety, obsessive-compulsive traits, and suicidal ideation. CONCLUSIONS Our findings point to the complexities of exercise as an eating disorder symptom and the need for clearly assessing and acknowledging this, as well as tailoring interventions to treat this symptom to achieve sustainable recovery.
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Affiliation(s)
- Zhenxin Liao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden.
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
| | - Elin Monell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
- Stockholm County Council, Stockholms Centrum för ätstörningar, Wollmar Yxkullsgatan 27, Stockholm, 118 50, Sweden
| | - Stina Borg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC, 27599-716, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-716, USA
| | - Emma Forsén Mantilla
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
- The Swedish School of Sport and Health Sciences, GIH, Lidingövägen 1, Box 5626, Stockholm, 114 86, Sweden
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Nguyen N, Woodside DB, Lam E, Quehenberger O, German JB, Shih PAB. Fatty Acids and Their Lipogenic Enzymes in Anorexia Nervosa Clinical Subtypes. Int J Mol Sci 2024; 25:5516. [PMID: 38791555 PMCID: PMC11122126 DOI: 10.3390/ijms25105516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Disordered eating behavior differs between the restricting subtype (AN-R) and the binging and purging subtype (AN-BP) of anorexia nervosa (AN). Yet, little is known about how these differences impact fatty acid (FA) dysregulation in AN. To address this question, we analyzed 26 FAs and 7 FA lipogenic enzymes (4 desaturases and 3 elongases) in 96 women: 25 AN-R, 25 AN-BP, and 46 healthy control women. Our goal was to assess subtype-specific patterns. Lauric acid was significantly higher in AN-BP than in AN-R at the fasting timepoint (p = 0.038) and displayed significantly different postprandial changes 2 h after eating. AN-R displayed significantly higher levels of n-3 alpha-linolenic acid, stearidonic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid, and n-6 linoleic acid and gamma-linolenic acid compared to controls. AN-BP showed elevated EPA and saturated lauric acid compared to controls. Higher EPA was associated with elevated anxiety in AN-R (p = 0.035) but was linked to lower anxiety in AN-BP (p = 0.043). These findings suggest distinct disordered eating behaviors in AN subtypes contribute to lipid dysregulation and eating disorder comorbidities. A personalized dietary intervention may improve lipid dysregulation and enhance treatment effectiveness for AN.
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Affiliation(s)
- Nhien Nguyen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, USA
| | - D. Blake Woodside
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Eileen Lam
- Centre for Mental Health, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Oswald Quehenberger
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA
| | - J. Bruce German
- Department of Food Science & Technology, University of California, Davis, Davis, CA 95616, USA;
| | - Pei-an Betty Shih
- Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, USA
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Dang AB, Kiropoulos L, Anderluh M, Collier D, Fernandez-Aranda F, Karwautz A, Treasure J, Wagner G, Krug I. Do risk factors differentiate DSM-5 and drive for thinness severity groups for anorexia nervosa? J Eat Disord 2024; 12:5. [PMID: 38212857 PMCID: PMC10785425 DOI: 10.1186/s40337-024-00966-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The current study examined whether risk factors for anorexia nervosa (AN) were related to different levels of severity based on (a) the DSM-5/body mass index (BMI) and (b) drive for thinness (DT) severity ratings. METHODS The sample comprised 153 pairs of individuals with a lifetime diagnosis AN per DSM-IV criteria and their non-ED sisters (N = 306, mean age = 26.53; mean current BMI = 20.42 kg/m2). The Oxford risk factor interview was used to establish AN-related risk factors. Individuals were categorised into the DSM-5 severity groups based on their lowest BMI, while the DT subscale from the eating disorder inventory-2 was used to classify individuals with AN into low and high DT groups. RESULTS Multinominal regression models showed similar risk factors (e.g., perfectionism, having a history of being teased about weight and shape) contributed to the development of AN using the DSM-5 and DT severity ratings. Follow-up analyses across the severity groups for both indices revealed that only childhood perfectionism was found to be more common in the extreme severe DSM-5 BMI severity group compared to the severe DSM-5 group. CONCLUSION Overall, this study found little evidence for AN risk factors being related to the DSM-5 and DT severity ratings. However, given the novelty of this study, replication of the current results is warranted.
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Affiliation(s)
- An Binh Dang
- Melbourne School of Psychological Sciences, The University of Melbourne, Redmond Barry Building, Level 7, Room 707, Melbourne, VIC, Australia.
| | - Litza Kiropoulos
- Melbourne School of Psychological Sciences, The University of Melbourne, Redmond Barry Building, Level 7, Room 707, Melbourne, VIC, Australia
| | - Marija Anderluh
- University Children's Hospital, University Medical Center Ljubljana SI, Ljubljana, Slovenia
| | - David Collier
- Eating Disorders Unit and SGDP Research Centre, Institute of Psychiatry, King's College, London, UK
| | | | - Andreas Karwautz
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gudrun Wagner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Redmond Barry Building, Level 7, Room 707, Melbourne, VIC, Australia
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4
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Ranzenhofer LM, Jablonski M, Davis L, Posner J, Walsh BT, Steinglass JE. Early Course of Symptom Development in Anorexia Nervosa. J Adolesc Health 2022; 71:587-593. [PMID: 35973892 PMCID: PMC10375485 DOI: 10.1016/j.jadohealth.2022.06.010] [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: 02/15/2022] [Revised: 05/26/2022] [Accepted: 06/13/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Anorexia nervosa (AN) commonly begins in adolescence; however, detailed knowledge of symptom trajectories, including their temporal sequence, is less well elucidated. The purpose of the present study is to describe the onset and duration of disordered eating behaviors prior to a diagnosis of AN, examine concordance between child and parent report, and examine the relationships between timing of symptom onset and illness severity. METHODS Seventy-one adolescents (ages 12-18 years) and their parents were interviewed about dieting, restriction, loss of control/binge eating, purging, excessive/compulsive exercise, weight history, and amenorrhea. Body mass index percentiles were calculated, and adolescents completed the Eating Disorder Examination-Questionnaire. RESULTS Restriction, being underweight, dieting, and excessive exercise were reported by most of the sample; purging, loss-of-control eating, and having been overweight were reported by less than a third. Dieting typically emerged first, on average around age 14; the remainder of behaviors tended to emerge between ages 14 and 14½; and average age of formal diagnosis was slightly over 15 years. Dyads had good agreement regarding presence and timing of all behaviors except for dieting, for which children reported about 6 months earlier onset/longer duration, compared to parents. Although older age at interview was associated with lower body mass index percentile and higher EDE-Q score, neither age of onset nor duration was associated with severity when controlling for current age. DISCUSSION Teens and parents describe a similar sequence of behavior changes leading up to a diagnosis of AN that typically begins with dieting and occurs over an approximate 1- to 1½-year period. Querying teens and parents about eating behavior changes may aid in identification and early intervention in AN; adolescents with normal weight who engage in persistent dieting or restrictive eating may warrant more frequent weight monitoring.
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Affiliation(s)
- Lisa M Ranzenhofer
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York.
| | - Monica Jablonski
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York
| | - Lauren Davis
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychology, Rutgers University, Highland Park, New Jersey
| | - Jonathan Posner
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York; Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - B Timothy Walsh
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, New York State Psychiatric Institute (NYSPI), New York, New York; Department of Psychiatry, Columbia University Irving Medical Center (CUIMC), New York, New York
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Takakura S, Toda K, Yamashita M, Kitajima T, Suematsu T, Yokoyama H, Asou CS, Hata T, Sudo N. Potential impact of the COVID-19 pandemic on japanese patients with eating disorders -a cross-sectional study. Biopsychosoc Med 2022; 16:2. [PMID: 34991681 PMCID: PMC8733913 DOI: 10.1186/s13030-021-00232-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2023] Open
Abstract
Background The COVID-19 pandemic and associated lockdown had a considerable impact on eating disorders (EDs). We evaluated the clinical features of Japanese ED patients before and after the first COVID-19 outbreak-related state of emergency (April 7, 2020). Methods We studied 148 patients who were divided into two groups based on when they arrived at our clinic: before (Before group: n = 86) or after (After group: n = 62) the start of the first state of emergency. All patients completed the Japanese versions of the Eating Disorder Inventory (EDI) and Parental Bonding Instrument (PBI). Results The After group was substantially younger than the Before group (p = .0187). Regardless of the ED type, patients who developed an ED during the first state of emergency tended to be significantly younger than those who developed one before. Differences in EDI characteristics were observed between the two groups. The PBI care subscale was notably higher (p = .0177) in the After group. The PBI maternal care subscale was the only statistically significant factor associated with age (β = -0.35, p < .0001). Conclusions Home confinement associated with the COVID-19 pandemic and the ensuing increase in parent-child closeness may have influenced the decreased age of ED patients at their initial consultation. Treatment interventions should consider the differences in the clinical features of EDs.
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Affiliation(s)
- Shu Takakura
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan. .,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.
| | - Kenta Toda
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Makoto Yamashita
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan
| | - Tomoko Kitajima
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan
| | - Takafumi Suematsu
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Hiroaki Yokoyama
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Chie Suzuyama Asou
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
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6
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Roubalova R, Prochazkova P, Dvorak J, Hill M, Papezova H, Kreisinger J, Bulant J, Lambertova A, Holanova P, Bilej M, Tlaskalova-Hogenova H. Altered Serum Immunological and Biochemical Parameters and Microbiota Composition in Patients With AN During Realimentation. Front Nutr 2021; 8:680870. [PMID: 34409061 PMCID: PMC8365021 DOI: 10.3389/fnut.2021.680870] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/30/2021] [Indexed: 12/11/2022] Open
Abstract
Anorexia nervosa (AN) is a life-threatening psychiatric disorder with not well-described pathogenesis. Besides the genetic and sociological factors, autoimmunity is also considered to take part in AN pathogenesis. We evaluated general serological factors showing the physiological state of 59 patients with AN at hospital admission and their discharge. We detected the altered levels of some general biochemical and immunological parameters. We also detected decreased levels of appetite-regulating alpha-melanocyte stimulating hormone (α-MSH) in patients at hospital admission. Moreover, elevated anti-α-MSH IgM levels and decreased anti-α-MSH IgA levels were observed in patients with AN. Therefore, we analyzed the gut microbiota composition with special focus on α-MSH antigen-mimetic containing microbes from the Enterobacteriaceae family. We correlated gut bacterial composition with anti-α-MSH Ig levels and detected decreasing IgG levels with increasing alpha diversity. The upregulation of pro-inflammatory cytokines IL-6, IL-17, and TNF-α were detected in patients with AN both prior and after hospitalization. We also evaluated the treatment outcome and improvement was observed in the majority of patients with AN. We provide new data about various serum biochemical parameters and their changes during the patients' hospitalization, with emphasis on the immune system, and its possible participation in AN pathogenesis.
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Affiliation(s)
- Radka Roubalova
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Petra Prochazkova
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Jiri Dvorak
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Martin Hill
- Department of Steroids and Proteohormones, Institute of Endocrinology, Prague, Czechia
| | - Hana Papezova
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Jakub Kreisinger
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
| | - Josef Bulant
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia.,Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Alena Lambertova
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Petra Holanova
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Martin Bilej
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
| | - Helena Tlaskalova-Hogenova
- Laboratory of Cellular and Molecular Immunology, Institute of Microbiology of the Czech Academy of Sciences, Prague, Czechia
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Lin JA, Jhe G, Vitagliano JA, Milliren CE, Spigel R, Woods ER, Forman SF, Richmond TK. The Association of Malnutrition, illness duration, and pre-morbid weight status with anxiety and depression symptoms in adolescents and young adults with restrictive eating disorders: a cross-sectional study. J Eat Disord 2021; 9:60. [PMID: 34001260 PMCID: PMC8127488 DOI: 10.1186/s40337-021-00415-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/28/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Restrictive eating disorders (EDs) are often comorbid with anxiety and depression symptoms, placing patients at risk for more severe disease, worse treatment outcomes, and higher rates of mortality. To identify risks for developing such co-morbidities, we assessed the association of malnutrition, ED illness duration, and pre-morbid weight status with symptoms of anxiety and depression in adolescents/young adults (AYAs) with EDs. METHODS 145 participants with restrictive EDs (anorexia nervosa [AN], other specified feeding and eating disorders [OSFED], avoidant restrictive food intake disorder [ARFID]) were included from the RECOVERY study, a longitudinal web-based registry of AYAs with EDs. We measured malnutrition as percent of expected body mass index (%eBMI), based on participants' pre-morbid growth trajectory. Outcomes were anxiety and depression scores from the Generalized Anxiety Disorder 7-item (GAD-7) and Center for Epidemiologic Studies Depression (CES-D) scales. We used multiple linear regression to examine the association of malnutrition, ED duration, and pre-morbid weight status with symptoms of anxiety and depression. RESULTS Mean (SD) age was 16.4(3.0) years; 87% were female; 89% white; 85% had AN, 6% OSFED, 10% ARFID. Of these, 2/3 had ED symptoms ≥1 year, 1/3 had previous higher level of ED care (HLOC), and half were taking psychiatric medications. Mean %eBMI was 90% (range 57-112%). Mean GAD-7 was 9.4(5.9) and CES-D was 24(13.8), indicating most participants had clinically significant anxiety and/or depression. Degree of malnutrition was not significantly associated with anxiety or depression adjusting for age, sex, sexual orientation, ED diagnosis, and use of psychiatric medication. Those with longer duration of ED symptoms had higher depression scores after adjusting for malnutrition, HLOC, length of ED symptoms, and time in our care (p = 0.038). Patients with pre-morbid BMIs ≥75th percentile had lower depression scores than those with pre-morbid BMIs <75th percentile (p = 0.014). CONCLUSIONS We find high degree of clinically relevant anxiety and depression symptoms in a population of AYAs with EDs. Our findings suggest that factors beyond malnutrition play a role in the co-morbid mood and anxiety disorders in this population. Overall, rapid ED diagnosis and comprehensive treatment for patients with EDs across the weight spectrum-and especially those with psychiatric co-morbidities-will likely aid in recovery.
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Affiliation(s)
- Jessica A Lin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA. .,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Grace Jhe
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Julia A Vitagliano
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Carly E Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Rebecca Spigel
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Elizabeth R Woods
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Sara F Forman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
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8
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Tran H, Poinsot P, Guillaume S, Delaunay D, Bernetiere M, Bégin C, Fourneret P, Peretti N, Iceta S. FOOD ADDICTION AS A PROXY FOR ANOREXIA NERVOSA SEVERITY: NEW DATA BASED ON THE YALE FOOD ADDICTION SCALE 2.0. Psychiatry Res 2020; 293:113472. [PMID: 33007684 DOI: 10.1016/j.psychres.2020.113472] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 09/19/2020] [Indexed: 12/12/2022]
Abstract
The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study investigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors. Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN.
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Affiliation(s)
- Helene Tran
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Pierre Poinsot
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Departement of Pediatric Nutrition, Hôpital Femme Mère Enfant, Univ Lyon, Hospice Civil de Lyon, Bron, F-69002, France
| | - Sebastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital CHRU Montpellier, Montpellier, F-34295, France; INSERM U1061, Montpellier, France; Université de Montpellier, Montpellier, F-34093 France
| | - Dominique Delaunay
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Marion Bernetiere
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC G1V 0A6, Canada; School of Psychology, Laval University, QC G1V 0A6, Canada.; Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada. School of Nutrition, Laval University, Québec, QC, G1V 0A6, Canada
| | - Pierre Fourneret
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France
| | - Noel Peretti
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Departement of Pediatric Nutrition, Hôpital Femme Mère Enfant, Univ Lyon, Hospice Civil de Lyon, Bron, F-69002, France
| | - Sylvain Iceta
- Referral Center for Eating Disorder, Hospices Civils de Lyon, F-69677 Bron, France; Univ Lyon, CarMeN laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, F-69310 Pierre-Benite, France; Quebec Heart and Lung Institute (IUCPQ), Québec, QC G1V 4G5, Canada. School of Nutrition, Laval University, Québec, QC, G1V 0A6, Canada.
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