Mental Pain in Eating Disorders: An Exploratory Controlled Study

Distorted Body Image and Mental Pain in Anorexia Nervosa

(1) Background: Body image is being defined as the picture of our own body in our mind with its size and shape, and with a perceptive and attitudinal evaluation of this body. It appears to be a complex clinical construct predisposing an individual to developing and maintaining anorexia nervosa (AN), as well as having considerable impact on prolonging the duration of this illness and its relapse risk. The aim of the research work was to assess whether the symptomatology of eating disorders, level of depression, and mental pain are associated with body image, and examine the influence of a distorted body image as well as eating disorders and depression symptoms on mental pain in AN; (2) Methods: A total of 36 women diagnosed with AN and 69 healthy controls (HC) participated in this study. All participants completed a battery of the following scales: EAT-26, BSQ-34, BIDQ, BDD-YBOCS, CESDR, and the Mental Pain Scale; (3) Results: Results show statistically significantly greater body image disturbances and higher level of depression and mental pain intensity in the AN compared to the HC group. Regression analysis indicates a greater impact of distorted body image, eating disorders, and depression symptoms on mental pain in AN; (4) Conclusions: As assumed, distorted body image and mental pain are central components of AN that should be especially emphasized in the therapeutical process of treating AN. Future research should focus on the etiopathogenesis of distorted body image in relation to the chronicity of mental pain and depression in AN, and address these outcomes in clinical practice to minimize suicide risk in this high-risk group of patients.

Psychiatric disorders and pain: The recurrence of a comorbidity

Painful conditions are probably among the most frequent reasons for seeking medical advice and assistance. Although pain is a common complaint among psychiatric patients, clinicians generally separate its presence from the background mental disorder and downplay its importance, trying primarily to control the psychiatric symptomatology. As a sensory modality, the presence of pain and its importance account for an impressive body of scholarly research. Cartesian methodology considered sensations of all modalities in a mechanistic form, which actually sounds obsolete. However, authors have continuously been faced with the same dilemmas plaguing scholars for centuries. We assume that a large portion of the sensory inputs might be generators of distorted perceptions, which subsequently lead to psychopathology. Auditory and visual hallucinations are incontestable examples. Somaesthetic hallucinations also exist, but pain hardly deserves such a denomination. Nevertheless, chronic pain and psychiatric comorbidity is a reality that needs explanation. Painkillers are not effective in treating psychiatric disorders, and antipsychotics do very little, perhaps nothing, to relieve pain. The pharmacological approach opens one door on the horizon and closes many others, while clinicians continue to face a high prevalence of comorbid pain and mental health issues. However, attempts to correlate altered body schemata (as distorted as it may be, for example, in phantom limb pain) with somatic delusions can simplify all these dilemmas, and the basket of psychophysiology, in fact, might be bigger than presumed.