Qualidade de vida e transtornos alimentares: uma revisão sistemática

Quality of life and eating attitudes of health care students

OBJECTIVE

To assess the quality of life and eating attitudes of health care students of the undergraduate programs of a public university.

METHOD

Observational, cross-sectional, and quantitative study performed in a federal university. Three questionnaires were used for data collection: a socio-demographic and academic, the WHOQOL-BREF and the Eating Attitudes Test (EAT-26).

RESULT

399 students participated in this study, most women, average age of 22 years, average scores of EAT-26 of 15.12 and quality-of-life averages above 60 points in all domains. The students of the undergraduate program in Nutrition presented more inappropriate eating attitudes than other health care students; as the age evolves, vulnerability to inadequate eating attitudes increases; and the family income influenced negatively the quality of life in Physical and Social domains.

CONCLUSIONS

Inadequate eating attitude diminishes the quality of life of health care students in all domains of the WHOOQOL-BREF.

Qualidade de Vida em Pacientes com Anorexia e Bulimia Nervosa

RESUMO Este estudo teve por objetivo avaliar a qualidade de vida relacionada à saúde (QVRS) de pacientes com transtornos alimentares (TAs). A amostra foi composta por 40 pacientes consecutivos, em sua maioria mulheres jovens e adultas, com diagnóstico de Anorexia Nervosa e em tratamento ambulatorial. A coleta de dados foi realizada por meio da aplicação de um instrumento de QVRS (SF-36) e do Teste de Atitudes Alimentares (EAT-26). Os resultados evidenciaram QVRS rebaixada, especialmente nos Componentes Mentais. Constatou-se prejuízo em seis dos oito domínios de QV avaliados naqueles pacientes com maior pontuação no EAT-26, em cinco domínios nos pacientes com idade acima de 22 anos, nos domínios Estado Geral de Saúde (p = 0,02) e Saúde Mental (p = 0,03) naqueles pacientes com menos de cinco anos de tratamento e no domínio Aspectos Físicos (p = 0,02) naqueles que receberam diagnóstico de Bulimia Nervosa.

The effects of repetitive transcranial magnetic stimulation in obese females with binge eating disorder: a protocol for a double-blinded, randomized, sham-controlled trial

BACKGROUND

Binge eating disorder is a new category in DSM-5 and highly associated with higher body mass index. The neural mechanisms that underlie binge eating are of great interest in order to improve treatment interventions. Brain mechanisms underlying drug and food craving are suggested to be similar: for example, both are reported to be associated with increased neural activity in the orbitofrontal and anterior cingulate cortex, and a diminished regulatory influence from lateral prefrontal circuits. Several studies have begun to assess the potential benefits of brain stimulation in reducing craving and addictive behaviors. Data from a study of a one-off session of transcranial magnetic stimulation in healthy women identified as strong cravers and of individuals with bulimic-type eating disorders, reported a reduction in food craving and binge eating episodes. This provides support for a more extensive investigation of the potential therapeutic benefits of transcranial magnetic stimulation. Lastly, brain imaging studies and a dimensional approach, will improve understanding of the neural correlates of the disorders and of the mode of action of transcranial magnetic stimulation.

METHODS/DESIGN

Sixty eligible obese females, with binge eating disorder, will be randomly allocated to receive 20 sessions of transcranial magnetic stimulation intervention (n = 30) or the sham transcranial magnetic stimulation intervention (n = 30) scattered 3 days/week. Thirty eligible controls will complete the baseline assessment. The primary outcome (number of binge eating episodes) will be assed at each treatment sessions, and 8 weeks after intervention completion (follow-up). It is hypothesized that mean weekly binge-eating episodes will be reduced in the intervention group, compared to the sham group, and that the effect will be maintained at follow-up.

DISCUSSION

Despite the severity associated with Binge Eating Disorder, there are limited treatment options. This study is an important step in the development of more effective treatments. Importantly, the study is the first to investigating binge eating disorder using a dimensional approach, by looking at the different aspects of the disorder, such as behavioral factors, biological factors, brain circuits and chemistry.

TRIAL REGISTRATION

Clinical Trials NCT02180984 . Registered in July 2014.

[Factors associated with the risk of eating disorders among academics in the area of health]

The object of this study was aimed at identifying factors associated with the risk of eating disorders in undergraduate students in the area of Health Sciences. It is a cross-sectional, quantitative and descriptive study carried out in Montes Clams, MG (Brazil), from August to October 2012. The profile of the university students was identified and the Eating Attitudes Test (EAT-26) applied. 200, students aged 23.4 +/- 6.13 years participated in the study, 76.5% of them females. A frequency of 4.0% of the students were at high risk of developing eating disorders, 21.0% at low risk and 75.0% had no risk factors. Various inadequate self-perceptions of the body, dietary practice, missed breakfasts and snacking during intervals were associated with factors for eating disorder risk (p < 0.05). For students with inadequate nutritional status, 34.4% were at risk of an eating disorder (p=0,004). The high risk of developing eating disorders among students in a nutritionally deficient condition indicates that they should receive preventive dietary advice.

Body image insatisfaction in students from the sixth grade of public schools in Caxias do Sul, Southern Brazil

OBJECTIVE

To estimate the prevalence of body image insatisfaction among schoolchildren aged 11 to 14 years from the municipality of Caxias do Sul, Southern Brazil, and to determine the possible associations with nutritional status, socioeconomic status, gender, and maternal education.

METHODS

A cross-sectional study was conducted and 1,417 children were evaluated regarding total body weight, height, and waist circumference. Obesity was defined based on the body mass index according to sex and age. Body image was evaluated using a nine-silhouette scale. A descriptive and bivariate analysis was carried out between the independent variables and the outcome.

RESULTS

The prevalence of body image insatisfaction was 71.5%. Gender (PR 0.77, 95%CI 0.60 - 0.98) and nutritional status (PR 3.84, 95%CI 2.72 - 5.41) were significantly associated with body image insatisfaction. Maternal education, socioeconomic level, and age did not present any association with body image insatisfaction.

CONCLUSIONS

The prevalence of body image insatisfaction in this population was high and should be a matter of concern to health professionals.

Exploring health-related quality of life in eating disorders by a cross-sectional study and a comprehensive review

BACKGROUND

People with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness' severity and its effects on cognitive performance. We aimed to analyze health-related quality of life (HRQoL) in subgroups of eating disorder (ED) patients by using the brief version of WHOQoL questionnaire (WHOQoL-BREF) before treatment administration. Moreover, in order to compare our findings with other published data, we carried out a comprehensive review of the literature on HRQoL in ED patients.

METHODS

Our review was carried out by means of an accurate data mining of PsychInfo and Medline databases and other available sources. In our cross-sectional study, eighty female ED patients (26 with bulimia nervosa, 33 with anorexia nervosa, 7 with binge eating disorder and 14 with ED not otherwise specified) completed the WHOQoL-BREF. HRQoL scores were compared among ED subgroups and clinical information (presence of previous contacts, length of illness, psychiatric comorbidity) was considered in the analysis.

RESULTS

Our review shows that with few exceptions ED patients have a poorer HRQoL than the healthy population of control and sometimes the mental component of HRQoL is the most involved dimension. Moreover, there are no differences in the HRQoL among ED groups, even if AN patients in some studies have a lower HRQoL scores. Furthermore, BED patients have a poorer HRQoL than obese patients who do not have binge episodes. Finally, all treatments were positively correlated with an improvement on general and specific QoL dimensions. In our sample, ED subgroups differed only for Psychological Health HRQoL scores (F = 4.072, df = 3; p = 0.01). No differences were found between inpatients and outpatients, treatment naïve and previously treated patients and patients with or without psychiatric comorbidity. Moreover, HRQoL scores were not correlated to length of illness within each ED subgroup.

CONCLUSIONS

The analysis of the literature adds some relevant information on HRQoL in ED and may address the future research toward the exploration of specific questions. One of these may be the prominent role of Psychological Health domain in HRQoL, since our study confirms that this component is able to differentiate eating disorders.

[Evidence-based practices published in Brazil: identification and analysis studies about human health prevention]

Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.

Quality of life in anorexia nervosa: a review of the literature

The aim of this study was to compare quality of life in anorexia nervosa patients to that of subjects without eating disorders, with other eating disorders, or with other psychiatric disorders. Results showed reduced quality of life for eating disorder patients, including anorexia nervosa, as compared to normal controls and individuals with other psychiatric disorders; however, whether anorexia nervosa treatment resulted in improved quality of life remains controversial. Furthermore, anorexia nervosa had a modest impact in the physical domain, although this may reflect self-report limitations as well as the psychopathology of the disorder rather than healthy functioning.

[Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches]

This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.