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Brytek-Matera A, Touyz S, Hay P. Comparative utility of the DSM-5 and ICD-11 diagnostic classifications of eating disorders of recurrent binge eating in an Australian community-based sample. Eur Eat Disord Rev 2024; 32:524-531. [PMID: 38291344 DOI: 10.1002/erv.3068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 12/24/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE The present study aimed to compare the estimated prevalence, sociodemographic features and impacts of Bulimia Nervosa (BN), Binge Eating Disorder (BED) and Other Specified Feeding or Eating Disorder (OSFED; BN or BED of low frequency and/or limited duration) when comparing the DSM-5 with the broader ICD-11 diagnostic criteria for size and specifiers of binge-eating episodes in a general population epidemiological sample. METHODS 2977 individuals (1524 women and 1453 men) aged ≥15 years from randomly selected households in South Australia were interviewed in person. Participants were asked questions relating to sociodemographic features, symptoms of eating disorder pathology, physical and mental health-related quality of life (HRQoL; SF-12) and role impairment. RESULTS The estimated prevalence of only one diagnosis, namely BED, was lower when applying DSM-5 criteria than when applying ICD-11 criteria, largely due to the Criterion B binge-eating specifiers of the DSM-5. There were no significant differences in participants' demographic features, HRQoL, or role impairment between the comparable diagnosis of either scheme. CONCLUSIONS There were few differences in distribution and similar levels of health impacts when applying either diagnostic scheme in this epidemiological study. However, cases of BED may be missed when using the stricter criteria of DSM-5 in epidemiological surveys. Further studies are needed to assess the clinical utility of the DSM-5 and ICD-11 diagnostic specifiers of binge-eating.
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Affiliation(s)
- Anna Brytek-Matera
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Stephen Touyz
- Faculty of Medicine and Health, InsideOut Institute for Eating Disorders, Sydney, New South Wales, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
- Mental Health Services, SWSLHD, Sydney, New South Wales, Australia
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Vaysi A, Nazarpour P, Kiani Z, Maleki M, Hamzehei M, Amianto F, Sellbom M, Komasi S. Replicability of the five-factor structure of DSM-5 and ICD-11 trait systems and their associations with binge eating and bipolar spectrum psychopathology. Personal Ment Health 2024; 18:122-137. [PMID: 38031321 DOI: 10.1002/pmh.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/21/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
Since the research on contemporary personality models-and psychopathology-mainly originate from the Western world, we aimed to test the factorial structure of two trait systems assessed with the Personality Inventory for DSM-5 (PID-5) in a non-Western sample and to compare the extracted models' relative associations with binge eating disorder (BED) and bipolar spectrum disorder (BSD) symptoms. A community sample (N = 516; 72% female) was administered the PID-5, which can operationalize both the DSM-5 and ICD-11 systems. The factor structures of both systems were tested using exploratory structural equation modeling (ESEM). The congruence coefficients of all factor loadings with international studies were calculated. The Binge Eating Scale (BES), Bipolar Spectrum Diagnostic Scale (BSDS), and Hypomania Checklist-32-Revised (HCL-32) were used to measure the criterion variables. Linear regression models were used for comparing the DSM-5 and ICD-11 systems in predicting the BED and BSD. The findings supported five-factor solutions for both trait systems. Both systems significantly predicted dimensional measures of both BED and BSD (all p < 0.001). The present findings support an acceptable five-factor structure for both personality systems in the non-Western sample. Different algorithms of maladaptive domains on both systems are related to binge eating and bipolar spectrum psychopathology.
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Affiliation(s)
- Anis Vaysi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Parisa Nazarpour
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Zhaleh Kiani
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Mahtab Maleki
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Maryam Hamzehei
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Federico Amianto
- Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Saeid Komasi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
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Krug I, Dang AB, Hughes EK. There is nothing as inconsistent as the OSFED diagnostic criteria. Trends Mol Med 2024; 30:403-415. [PMID: 38395717 DOI: 10.1016/j.molmed.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Abstract
Atypical anorexia nervosa (AAN), purging disorder (PD), night eating syndrome (NES), and subthreshold bulimia nervosa and binge-eating disorder (Sub-BN/BED) are the five categories that comprise the 'Other Specified Feeding or Eating Disorder' (OSFED) category in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). In this review, we examine problems with the diagnostic criteria that are currently proposed for the five OSFED types. We conclude that the existing diagnostic criteria for OSFED are deficient and fall short of accurately describing the complexity and individuality of those with these eating disorders (EDs). Therefore, to enhance the quality of life of people with OSFED, diagnostic criteria for the condition should be applied uniformly in clinical and research settings.
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Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - An Binh Dang
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Elizabeth K Hughes
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Forney KJ, Rezeppa TL, Hill NG, Bodell LP, Brown TA. Examining the placement of atypical anorexia nervosa in the eating disorder diagnostic hierarchy relative to bulimia nervosa and binge-eating disorder. Int J Eat Disord 2024; 57:839-847. [PMID: 38164071 DOI: 10.1002/eat.24122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Some individuals meet the criteria for atypical anorexia nervosa and another eating disorder simultaneously. The current study evaluated whether allowing a diagnosis of atypical anorexia nervosa to supersede a diagnosis of bulimia nervosa (BN) or binge-eating disorder (BED) provided additional information on psychological functioning. METHODS Archival data from 650 university students (87.7% female, 69.4% white) who met Eating Disorder Diagnostic Survey for DSM-5 eating disorder criteria and completed questionnaires assessing quality of life, eating disorder-related impairment, and/or eating pathology at a single time point. Separate regression models used diagnostic category to predict quality of life and impairment. Two diagnostic schemes were used: the DSM-5 diagnostic scheme and an alternative scheme where atypical anorexia nervosa superseded all diagnoses except anorexia nervosa. Model fit was compared using the Davidson-Mackinnon J test. Analyses were pre-registered (https://osf.io/2ejcd). RESULTS Allowing an atypical anorexia nervosa diagnosis to supersede a BN or BED diagnosis provided better fit to the data for eating disorder-related impairment (p = .02; n = 271), but not physical, psychological, or social quality of life (p's ≥ .33; n = 306). Allowing an atypical anorexia nervosa diagnosis to supersede a BN or BED diagnosis provided a better fit in cross-sectional models predicting purging (p = .02; n = 638), but not body dissatisfaction, binge eating, restricting, or excessive exercise (p's ≥ .08; n's = 633-647). DISCUSSION The current data support retaining the DSM-5 diagnostic scheme. More longitudinal work is needed to understand the predictive validity of the atypical anorexia nervosa diagnosis. PUBLIC SIGNIFICANCE The current study examined how changes to the diagnostic categories for eating disorders may change how diagnoses are associated with quality of life and impairment. Overall, findings suggest that the diagnostic hierarchy should be maintained.
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Affiliation(s)
- K Jean Forney
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | - Naomi G Hill
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Lindsay P Bodell
- Department of Psychology, Western University, London, Ontario, Canada
| | - Tiffany A Brown
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
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Öcalan S, Kovancı MS, Hiçdurmaz D. 'It is not a mannequin disease': A lived experience narrative of living with bulimia nervosa. J Psychiatr Ment Health Nurs 2024; 31:174-180. [PMID: 37650476 DOI: 10.1111/jpm.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Bulimia nervosa is characterized by recurrent episodes of binge eating, inappropriate compensatory behaviours to prevent weight gain and excessive mental preoccupation with body weight and shape. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized. This paper offers advice to patients, relatives and healthcare professionals in recognizing and treating bulimia nervosa. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should organize training, seminars and conferences to raise awareness of society against bulimia nervosa, which is defined as a mannequin disease and therefore creates a positive perception. Mental health nurses, an essential part of the health system, should raise awareness of individuals and families about recognizing, monitoring and supporting the early symptoms of bulimia nervosa. ABSTRACT INTRODUCTION: Bulimia nervosa is one of the areas where mental health professionals have difficulties due to its nature and course. It is important to understand the factors related to this problem in-depth to discover the dynamics unique to the individual that causes the difficulty, identify new perspectives on these dynamics and identify alternative behaviours, stop stubborn binge-eating attacks and prevent relapse. AIM It is aimed to provide an in-depth insight into the nature, course and treatment processes of bulimia nervosa through the narrative of the lived experience of an individual living with this problem. IMPLICATION FOR PRACTICE The perception of beauty seriously impacts the onset and later course of bulimia nervosa and draws attention to the fact that mental health professionals and media workers have important duties to change the concept of beauty equals being skinny, created in society and the media. Quality of perceived social support is very important in preventing, treating and rehabilitating bulimia nervosa. Adopting a more objective approach, which will prevent the positive or negative stigmatization of the disease in explaining bulimia nervosa to the public, should be adopted.
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Affiliation(s)
- Sinem Öcalan
- Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Mustafa Sabri Kovancı
- Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Duygu Hiçdurmaz
- Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
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Aloi M, Liuzza MT, Rania M, Carbone EA, de Filippis R, Gearhardt AN, Segura-Garcia C. Using latent class analysis to identify different clinical profiles according to food addiction symptoms in obesity with and without binge eating disorder. J Behav Addict 2024; 13:262-275. [PMID: 38276994 PMCID: PMC10988405 DOI: 10.1556/2006.2023.00074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/14/2023] [Accepted: 12/03/2023] [Indexed: 01/27/2024] Open
Abstract
Background and aims Existing research suggests that food addiction (FA) is associated with binge eating disorder (BED) and obesity, but the clinical significance of this relationship remains unclear. This study aims to investigate the different clinical profiles of FA symptoms among patients who have obesity with/without BED using latent class analysis (LCA). Methods 307 patients (n = 152 obesity and BED, n = 155 obesity without BED) completed a battery of self-report measures investigating eating psychopathology, depression, emotional dysregulation, alexithymia, schema domains, and FA. LCA and ANOVAs were conducted to identify profiles according to FA symptoms and examine differences between classes. Results LCA identified five meaningful classes labeled as the "non-addicted" (40.4%), the "attempters" (20.2%), the "interpersonal problems" (7.2%), the "high-functioning addicted" (19.5%) and the "fully addicted" (12.7%) classes. Patients with BED and obesity appeared overrepresented in the "high-functioning addicted" and "fully addicted" classes; conversely, patients with obesity without BED were most frequently included in the "non-addicted" class. The most significant differences between the "high-functioning addicted" and "fully addicted" classes versus the "non-addicted" class regarded heightened severity of eating and general psychopathology. Discussion and conclusions The results bring to light distinct clinical profiles based on FA symptoms. Notably, the "high-functioning addicted" class is particularly intriguing as its members demonstrate physical symptoms of FA (i.e., tolerance and withdrawal) and psychological ones (i.e., craving and consequences) but are not as functionally impaired as the "fully addicted" class. Identifying different profiles according to FA symptoms holds potential value in providing tailored and timely interventions.
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Affiliation(s)
- Matteo Aloi
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, Italy
| | - Marco Tullio Liuzza
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Italy
| | - Marianna Rania
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Italy
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
| | - Renato de Filippis
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, Italy
| | | | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, Italy
- Outpatient Unit for Clinical Research and Treatment of Eating Disorders, University Hospital Mater Domini, Catanzaro, Italy
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Nakai Y, Nin K, Noma S, Teramukai S. Onset patterns and clinical features of binge-eating disorder in a Japanese clinical sample. Int J Eat Disord 2024; 57:740-744. [PMID: 38293891 DOI: 10.1002/eat.24148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE This study aimed to investigate the clinical presentation of binge-eating disorder (BED) in a Japanese sample and to examine the relationship between subtypes of BED differing in onset patterns and those differing in prior history of another eating disorder (ED). METHODS The study participants were 137 adults who met the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for BED. We subtyped participants based on prior history of another ED: 55 (40.1%) participants with a history of another ED (BED ED+) and 82 participants without such a history (BED ED-). RESULTS Unlike in some Western studies, approximately three quarters of participants had a body mass index of <25 kg/m2 . None of the participants reported a history of another ED with purging or excessive exercise. All BED ED+ participants transitioned to BED from anorexia nervosa restricting type (AN-R) or from atypical AN-R. BED ED+ participants reported more severe psychopathology than BED ED-participants. Only 20% had a treatment history for BED. Dieting preceded their first binge eating in 55 participants (DIET-first BED), and binge eating preceded their first dieting in 82 participants (BINGE-first BED). Regarding the relationship between the two different subtypes, all DIET-first BED participants were in the BED ED+ group, whereas all BINGE-first BED participants were in the BED ED-group. DISCUSSION Present findings revealed the clinical presentation of BED in a Japan-based study and suggested that subtypes of BED differing in the prior history of another ED yielded an accurate prediction of onset patterns (dieting first vs. binge eating first). PUBLIC SIGNIFICANCE This study highlights the need for clinicians to consider subtype differences in onset patterns and clinical features of BED to treat and prevent this disorder. This study revealed that, although individuals with BED in Japan have severe symptoms and a long duration of illness, only 20% have received BED treatment. The results indicate a need to disseminate knowledge about BED to the Japanese public and healthcare providers.
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Affiliation(s)
| | - Kazuko Nin
- Human Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Shun'ichi Noma
- Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
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MacDonald DE, Trottier K, Cao L, Crosby RD, Wonderlich SA, Engel SG, Olmsted MP. Momentary skills use predicts decreased binge eating and purging early in day treatment: An ecological momentary assessment study. Int J Eat Disord 2024; 57:548-557. [PMID: 38189475 DOI: 10.1002/eat.24128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Emerging research indicates that skills acquisition may be important to behavior change in cognitive behavior therapy (CBT) for eating disorders. This study investigated whether skills use assessed in real time during the initial 4 weeks of CBT-based day treatment was associated with momentary eating disorder behavior change and rapid response to treatment. METHODS Participants with DSM-5 bulimia nervosa or purging disorder (N = 58) completed ecological momentary assessments (EMA) several times daily for the first 28 days of treatment. EMA assessed skills use, the occurrence of binge eating and/or purging, and state negative affect. Rapid response was defined as abstinence from binge eating and/or purging in the first 4 weeks of treatment. RESULTS Greater real-time skills use overall, and use of "planning ahead," "distraction," "social support," and "mechanical eating" skills in particular, were associated with a lower likelihood of engaging in binge eating or purging during the same period. After controlling for baseline group differences in overall difficulties with emotion regulation, rapid and non-rapid responders did not differ in overall skills use, or skills use at times of higher negative affect, during the EMA period. DISCUSSION Momentary use of skills appears to play an important role in preventing binge eating and purging, and certain skills appear to be particularly helpful. These findings contribute to the literature elucidating the processes by which CBT treatments for eating disorders work by providing empirical evidence that skills use helps to prevent binge eating and purging behaviors. PUBLIC SIGNIFICANCE Individuals with eating disorders learn new skills during treatment to help them improve their symptoms. This study shows that for people with eating disorders, using skills helps prevent eating disorder behaviors in the moment. Certain skills may be particularly helpful, including planning ahead, distracting activities, support from others, and focusing on eating meals and snacks regardless of how one is feeling. These findings help us better understand how treatments work.
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Affiliation(s)
- Danielle E MacDonald
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Kathryn Trottier
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Li Cao
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Stephen A Wonderlich
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Scott G Engel
- Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA
| | - Marion P Olmsted
- Centre for Mental Health, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Charrat JP, Massoubre C, Gay A, Ravey B, Germain N, Galusca B. The value of a multidisciplinary consensus meeting in achieving agreement on eating disorders diagnosis at a specialized referral center. Int J Eat Disord 2024; 57:463-469. [PMID: 38135878 DOI: 10.1002/eat.24114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE This study aimed to evaluate the concordance of eating disorders (EDs) diagnoses within a multidisciplinary team in a specialized hospital unit dedicated to the medical care of ED. METHODS The study analyzed data from 608 female patients who sought consultation at the Eating Disorders Referral Center between 2017 and 2021. The diagnoses were established according to the DSM-5 criteria by endocrinologists, psychiatrists, and finally confirmed or discussed within a monthly multidisciplinary consensus meeting (MCM). Fleiss' Kappa tests were conducted to assess inter-raters' agreement. RESULTS Overall, substantial agreement was observed between endocrinologists and psychiatrists and the MCM. A more detailed analysis revealed variations in agreement across different disorders. Certain EDs demonstrated substantial agreement (e.g., anorexia nervosa restrictive subtype), while others approached near-perfect agreement (e.g., binge-eating disorder). In contrast, agreement was fair to poor for anorexia nervosa binge-purge subtype (ANBP) and slight for other specified feeding and ED. A period of temporary disagreement was noted for ANBP, partially attributed to practitioner turnover. An improvement in interdisciplinary agreement was observed for all ED diagnoses by the end of the study period. DISCUSSION Variations or lower levels of inter-rater agreement may stem from atypical cases that fall on the border between two diagnoses or complex cases, as well as fluctuating symptoms. The progress observed throughout the study can be attributed in part to interdisciplinary learning, particularly facilitated by the MCM. The findings underscore the significance of striving for optimal concordance among different medical specialties to enhance patient care in ED treatment. PUBLIC SIGNIFICANCE This study scrutinizes the agreement levels of ED diagnoses among endocrinologists and psychiatrists within a multidisciplinary team at an Eating Disorders Referral Center. While substantial overall agreement was achieved, disparities or lower agreement levels were evident for certain diagnoses such as anorexia nervosa binge-purge subtype. However, collaborative meetings led to a progressive enhancement in agreement over time. This research underscores the crucial role of a multidisciplinary team working collectively to ensure precise diagnoses and improved care for patients with EDs.
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Affiliation(s)
- Jean Philippe Charrat
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
| | - Catherine Massoubre
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Psychiatry Department, Saint Etienne University Hospital, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
| | - Aurelia Gay
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Psychiatry Department, Saint Etienne University Hospital, Saint Etienne, France
| | - Baptiste Ravey
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Psychiatry Department, Saint Etienne University Hospital, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
| | - Natacha Germain
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
- Endocrinology Department, Saint Etienne University Hospital, Saint Etienne, France
| | - Bogdan Galusca
- TAPE (Eating Disorders, Addictions & Extreme Bodyweight) Laboratory, University Jean Monnet, Saint Etienne, France
- Referral Center for Eating Disorders, Saint Etienne University Hospital, Saint Etienne, France
- Endocrinology Department, Saint Etienne University Hospital, Saint Etienne, France
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10
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Kirkpatrick RH, Breton E, Biorac A, Munoz DP, Booij L. Non-suicidal self-injury among individuals with an eating disorder: A systematic review and prevalence meta-analysis. Int J Eat Disord 2024; 57:223-248. [PMID: 38041221 DOI: 10.1002/eat.24088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE This study aimed to quantify the prevalence of non-suicidal self-injury across eating disorders (EDs) and within diagnostic categories through systematic review and proportional, or so-called prevalence, meta-analysis. METHOD Included studies had to contain individuals with a verified diagnosis of an ED. The last literature search was conducted on September 11, 2023, for studies published on or before September 2023 without a restriction on earliest publication year. Results were synthesized and analyzed using the "metaprop" package in R and presented using forest plots. Bias was assessed by a Peters' regression test and funnel plot. RESULTS 79 studies published between 1985 and 2023 were included encompassing 32,334 individuals with an ED. Importantly, 42 studies were not included in any other meta-analyses on self-injury in EDs to date. Overall prevalence of non-suicidal self-injury was 34.59% (95%CI = 30.49-38.81). Prevalence in anorexia nervosa restrictive type, binge/purge type, bulimia nervosa, binge eating disorder and other specified feeding/eating disorder were 23.19% (95%CI = 16.96-30.03%), 41.98% (95%CI = 32.35-51.91%), 36.97% (95%CI = 30.69-43.46%), 21.21% (95%CI = 14.93-28.12%) and 37.65% (95%CI = 28.59-47.09%), respectively. Prevalence estimations could not be estimated for other ED categories due to lack of a sufficient number of studies. DISCUSSION Non-suicidal self-injury is prevalent across both binge/purge and restrictive EDs. Considering the transdiagnostic nature of self-injurious behaviors in ED, the results highlight the importance of assessment and monitoring of self-injury in people with ED, irrespective of specific diagnoses. The method of determining self-injury varied across studies and may limit this study. PUBLIC SIGNIFICANCE This study highlights the prevalence of self-injury across eating disorders irrespective of diagnosis and within specific EDs. While diagnoses known to exhibit self-injurious behaviors (e.g., bulimia nervosa, anorexia nervosa binge/purge subtype) demonstrated the highest prevalence of self-injury, all diagnoses were found to have a prevalence greater than 20%. These findings suggest the importance of assessing and monitoring all individuals with an eating disorder for the presence of self-injury.
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Affiliation(s)
- Ryan H Kirkpatrick
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Edith Breton
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, University of Oslo & Oslo University Hospital, Oslo, Norway
| | - Aleksandar Biorac
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Linda Booij
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated Health and Social Services Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Quebec, Canada
- Research Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
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11
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Manasse SM, Russon J, Lampe EW, King A, Abber SR, Trainor C, Gillikin LM, Levy S, Diamond G. Attachment-Based Family Therapy to Improve Family Functioning in Adolescent Binge-Spectrum Eating Disorders: An Initial Evaluation Via Case Series Design. Clin Child Psychol Psychiatry 2024; 29:45-62. [PMID: 37384823 DOI: 10.1177/13591045231187433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Binge-spectrum eating disorders (EDs; bulimia nervosa, binge eating disorder) often develop during adolescence and are associated with serious psychological and physical consequences. Current treatments for adolescents are highly behavioral in nature and while efficacious, many patients do not reach remission indicating that current treatments fail to target a key maintenance factor for EDs. One potential maintenance factor is poor family functioning (FF). In particular, high family conflict (e.g., arguing, critical comments) and low family cohesion (e.g., warmth, support) are known to maintain ED behaviors. Poor FF can (1) cause or exacerbate an adolescent's use of ED behaviors to cope with life stress and/or (2) inhibit parents from being a resource to adolescents during ED treatment. Attachment-Based Family Therapy (ABFT) is specifically designed to improve FF, and thus may be a promising adjunct to behavioral ED intervention strategies. ABFT, however, has not been tested in adolescents with binge-spectrum EDs. Thus, the current study is the first to evaluate a 16-week adapted ABFT treatment for adolescents with EDs (N = 8, Mage = 16.00, 71.43% female, 71.43% White) fusing together behavioral treatment for EDs with ABFT for highest possible impact. Eight families were treated in an open pilot trial to examine treatment feasibility, acceptability, and preliminary efficacy on FF and eating pathology. Overall, findings were promising. ABFT + B treatment was feasible and acceptable and showed preliminary evidence that it could improve FF and ED behaviors. Future research will test this intervention in a larger sample and further examine the role of FF in maintaining ED symptoms.
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Affiliation(s)
- Stephanie M Manasse
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Jody Russon
- Department of Human Development & Family Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Elizabeth W Lampe
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | - Allie King
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
| | - Sophie R Abber
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Claire Trainor
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
- Department of Psychology, Drexel University, Philadelphia, PA, USA
| | | | - Suzanne Levy
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
| | - Guy Diamond
- Center for Family Intervention Science, Drexel University, Philadelphia, PA, USA
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12
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Messer M, Eckley T, Milesi M, Storey L, Linardon J. An inflexible adherence to food rules mediates the longitudinal association between shape/weight overvaluation and binge eating. J Psychiatr Res 2024; 169:378-381. [PMID: 38163406 DOI: 10.1016/j.jpsychires.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
Understanding factors that account for the persistence of binge eating is necessary for developing effective early intervention and treatment approaches. The cognitive-behavioral model of eating disorders proposes that judgements of self-worth contingent upon weight and shape encourage adoption of multiple demanding rules related to food, eating and dieting, in turn increasing vulnerability to binge eating. However, there is limited longitudinal evidence supporting this hypothesized sequence of events. This study tested whether the longitudinal association between shape/weight overvaluation and binge eating is mediated by an inflexible adherence to food rules. Participants were 1760 adult women recruited from an online eating disorder platform who were invited to complete study measures at baseline (T1), 3-month follow-up (T2), and 6-month follow-up (T3). Path analysis was conducted to test the hypothesized associations. Missing data were handled using multiple imputation techniques. A significant indirect effect emerged, in that higher overvaluation scores at T1 predicted increased inflexible adherence to food rules at T2, which in turn predicted increased binge eating symptoms at T3. Findings offer support for the predictions outlined by the cognitive-behavioral model of eating disorders and highlight clear targets for early intervention and treatment.
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Affiliation(s)
- Mariel Messer
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Tayla Eckley
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Mary Milesi
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Leanne Storey
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia; Center for Social and Early Emotional Development and School of Psychology, Deakin University, Burwood, VIC, Australia.
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13
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Lee G, Russell G, DeLucia B. Safe and Effective Treatment of Binge Eating Disorder With Lisdexamfetamine in a Patient With Co-occurring Bipolar II Disorder, Current Episode Depressed. J Clin Psychopharmacol 2024; 44:68-69. [PMID: 38100783 DOI: 10.1097/jcp.0000000000001799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
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14
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Caetano N, Costa AJRB, Pinto SL. Anxiety and Negative Body Image are Associated with Binge Eating in Patients Who Underwent Bariatric Surgery a Minimum of 2 Years. Obes Surg 2023; 33:4058-4064. [PMID: 37919533 DOI: 10.1007/s11695-023-06924-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE Bariatric surgery is an effective method for the treatment of severe obesity, however, binge eating disorder (BED) and negative body image can interfere with post-surgical evolution. OBJECTIVE To describe the factors associated with BED in bariatric patients with a minimum of 2 years post-surgery. MATERIALS AND METHODS A cross-sectional observational study conducted with patients who underwent bariatric surgery through the Unified Health System (Sistema Único de Saúde [SUS]) and presenting a minimum of 2 years post-surgery. BED, depression symptoms, anxiety symptoms, quality of life and body image concerns were assessed by the Binge Eating Scale, Beck Depression Inventory, Beck Anxiety Inventory, Bariatric Analysis and Reporting Outcome System, and Body Shape Questionnaire, respectively. Socioeconomic and anthropometric data were also collected. RESULTS Based on the ninety-two (92) patients evaluated, 83.7% were female, and had a mean age of 43.3 ± 9 years. Symptoms of depression (p = 0.002), anxiety (p = 0.000), body image concerns (p = 0.000), poor quality of life (p = 0.010), and obesity (p = 0.008) were associated with the presence of BED. All the anthropometric variables were higher in patients with BED, except excess weight loss. Regression analysis predicted BED through the presence of body image concern and anxiety symptoms. CONCLUSION Anxiety symptoms and body image concerns are associated with BED in patients who underwent bariatric surgery a minimum of 2 years.
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Affiliation(s)
- Nayara Caetano
- Nutrition Course of the Federal University of Tocantins / TO, Quadra 109 North, NS-15 Avenue, ALCNO-14, Block Bala2, North Director Plan, Palmas, Tocantins, CEP: 77001-090, Brazil.
| | - Ana Júlia R B Costa
- Postgraduate Program in Health Sciences of the Federal University of Tocantins / TO, Palmas, Brazil
| | - Sônia L Pinto
- Postgraduate Program in Health Sciences of the Federal University of Tocantins / TO, Palmas, Brazil
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15
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Abstract
ABSTRACT Binge-eating disorder (BED) has the highest prevalence of any eating disorder in the US today. However, the condition is frequently not recognized as an eating disorder by healthcare providers or patients. Patients with this diagnosis often have significant psychiatric and medical comorbidities that might respond to evidence-based treatments. NPs in primary care with awareness of the diagnostic criteria for BED and knowledge of its assessment and treatment options can coordinate care for patients experiencing this health challenge.
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16
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Forrer F, Rubo M, Meyer AH, Munsch S. Binge-eating adolescent treatment (BEAT) - findings from a pilot study on effects and acceptance of a blended treatment program for youth with loss of control eating. BMC Psychol 2023; 11:415. [PMID: 38012794 PMCID: PMC10683190 DOI: 10.1186/s40359-023-01429-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Loss of Control Eating (LOC) is the most prevalent form of eating disorder pathology in youth, but research on evidence-based treatment in this group remains scarce. We assessed for the first time the effects and acceptance of a blended treatment program for youth between 14 and 24 years with LOC (Binge-eating Adolescent Treatment, BEAT). METHODS Twenty-four youths (mean age 19.1 years) participated in an active treatment of nine-weeks including three face-to-face workshops and six weekly email-guided self-help sessions, followed by four email guided follow-up sessions, one, three, six and 12 months after the active treatment. All patients completed a two-weeks waiting-time period before treatment begin (within-subject waitlist control design). RESULTS The number of weekly LOC episodes substantially decreased during both the waiting-time (effect size d = 0.45) and the active treatment (d = 1.01) period and remained stable during the subsequent 12-months follow-up (d = 0.20). The proportion of patients with full-threshold binge-eating disorder (BED) diagnoses decreased and transformed into LOC during the study course, while the abstainer rate of LOC increased. Values for depressive symptoms (d = 1.5), eating disorder pathology (d = 1.29) and appearance-based rejection sensitivity (d = 0.68) all improved on average from pretreatment to posttreatment and remained stable or further improved during follow-up (d between 0.11 and 0.85). Body weight in contrast remained constant within the same period. Treatment satisfaction among completers was high, but so was the dropout rate of 45.8% at the end of the 12-months follow-up. CONCLUSIONS This first blended treatment study BEAT might be well suited to decrease core symptoms of LOC, depressive symptoms and appearance-based rejection sensitivity. More research is needed to establish readily accessible interventions targeted more profoundly at age-salient maintaining factors such as appearance-based rejection sensitivity, while at the same time keeping dropout rates at a low level. TRIAL REGISTRATION The trial was registered at the German Clinical Trials Register (ID: DRKS00014580; registration date: 21/06/2018).
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Affiliation(s)
- Felicitas Forrer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.-A.-de-Faucigny 2, Fribourg, 1700, Switzerland.
| | - Marius Rubo
- Department of Psychology, Cognitive Psychology, Perception and Research Methods, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Andrea H Meyer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.-A.-de-Faucigny 2, Fribourg, 1700, Switzerland
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 62A, Basel, 4055, Switzerland
| | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.-A.-de-Faucigny 2, Fribourg, 1700, Switzerland
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17
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D'Adamo L, Ghaderi A, Rohde P, Gau JM, Shaw H, Stice E. Evaluating whether a peer-led dissonance-based eating disorder prevention program prevents onset of each eating disorder type. Psychol Med 2023; 53:7214-7221. [PMID: 37039122 PMCID: PMC10564960 DOI: 10.1017/s0033291723000739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 02/10/2023] [Accepted: 03/06/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND This study tested whether the dissonance-based Body Project eating disorder prevention program reduced onset of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) over long-term follow-up. METHODS Data were combined from three prevention trials that targeted young women at high-risk for eating disorders (N = 1092; M age = 19.3). Participants were randomized to Body Project groups led by peer educators or expressive writing/educational controls and completed masked diagnostic interviews over 2- to 4-year follow-ups. Logistic regressions tested whether onset of each eating disorder over follow-up differed between Body Project and control participants. RESULTS Peer-led Body Project groups produced a 46% reduction in onset of subthreshold/threshold BN and a 62% reduction in onset of PD relative to controls over follow-up. Rates of onset of subthreshold/threshold AN and BED did not significantly differ between peer-led Body Project participants and control participants. CONCLUSIONS Results support the dissemination of the peer-led Body Project for reducing future onset of BN and PD. This study and recent research suggest that thin-ideal internalization, the risk factor for eating disorders targeted in the Body Project, may be more relevant for predicting onset of BN and PD compared to AN and BED. Findings support the development of a version of the Body Project aimed to reduce risk factors that have predicted future onset of all four types of eating disorders (e.g. overvaluation of weight/shape, fear of weight gain), which may more effectively prevent all eating disorder types.
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Affiliation(s)
- Laura D'Adamo
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychology and Center for Weight, Eating, and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Ata Ghaderi
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul Rohde
- Oregon Research Institute, Eugene, OR, USA
| | | | - Heather Shaw
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Eric Stice
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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18
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Schweckendiek D, Pauli D, Scharl M. [Eating disorders - what the gastroenterologist needs to know]. Z Gastroenterol 2023; 61:1484-1493. [PMID: 37156504 DOI: 10.1055/a-2010-3883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Eating disorders are potentially life-threatening disorders that go along with severe psychiatric and somatic comorbidities. It is expected that the number of patients will dramatically increase in the post COVID-19 pandemic era.Four main eating disorders are mentioned in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) and the International Classification of Diseases 11 (ICD-11): anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) und avoidant restrictive food intake disorder (ARFID). Many traditional assumptions in eating disorders are currently challenged due to recent research results. The gastroenterologist is usually not the first point of contact for patients with eating disorders. However, he is crucial, especially in the management of gastroenterologic complications of eating disorders.Focus of the overview will be on relevant gastroenterologic aspects and less on the psychiatric treatment. Basics of the most common eating disorders will be repeated, opportunities in diagnosing an eating disorder and the most relevant gastroenterologic complications will be described. Obesity and its management, an entity that often goes along with an eating disorder, is not in the spotlight of the review.
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Affiliation(s)
| | - Dagmar Pauli
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Psychiatrische Universitatsklinik Zürich, Zürich, Schweiz
| | - Michael Scharl
- Klinik für Gastroenterologie und Hepatologie, Universitätsspital Zürich, Zürich, Schweiz
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19
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Davies HL, Peel AJ, Mundy J, Monssen D, Kakar S, Davies MR, Adey BN, Armour C, Kalsi G, Lin Y, Marsh I, Rogers HC, Walters JTR, Herle M, Glen K, Malouf CM, Kelly EJ, Eley TC, Treasure J, Breen G, Hübel C. The network structure of mania symptoms differs between people with and without binge eating. Bipolar Disord 2023; 25:592-607. [PMID: 37308319 PMCID: PMC10768381 DOI: 10.1111/bdi.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES People with bipolar disorder who also report binge eating have increased psychopathology and greater impairment than those without binge eating. Whether this co-occurrence is related to binge eating as a symptom or presents differently across full-syndrome eating disorders with binge eating is unclear. METHODS We first compared networks of 13 lifetime mania symptoms in 34,226 participants from the United Kingdom's National Institute for Health and Care Research BioResource with (n = 12,104) and without (n = 22,122) lifetime binge eating. Second, in the subsample with binge eating, we compared networks of mania symptoms in participants with lifetime anorexia nervosa binge-eating/purging (n = 825), bulimia nervosa (n = 3737), and binge-eating disorder (n = 3648). RESULTS People with binge eating endorsed every mania symptom significantly more often than those without binge eating. Within the subsample, people with bulimia nervosa most often had the highest endorsement rate of each mania symptom. We found significant differences in network parameter statistics, including network structure (M = 0.25, p = 0.001) and global strength (S = 1.84, p = 0.002) when comparing the binge eating with no binge-eating participants. However, network structure differences were sensitive to reductions in sample size and the greater density of the latter network was explained by the large proportion of participants (34%) without mania symptoms. The structure of the anorexia nervosa binge-eating/purging network differed from the bulimia nervosa network (M = 0.66, p = 0.001), but the result was unstable. CONCLUSIONS Our results suggest that the presence and structure of mania symptoms may be more associated with binge eating as a symptom rather than any specific binge-type eating disorder. Further research with larger sample sizes is required to confirm our findings.
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Affiliation(s)
- Helena L. Davies
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Alicia J. Peel
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Jessica Mundy
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Dina Monssen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Saakshi Kakar
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Molly R. Davies
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Brett N. Adey
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Chérie Armour
- Research Centre for Stress, Trauma and Related Conditions (STARC), School of PsychologyQueen's University Belfast (QUB)Belfast, Northern IrelandUK
| | - Gursharan Kalsi
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Yuhao Lin
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Ian Marsh
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Henry C. Rogers
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - James T. R. Walters
- Division of Psychiatry and Clinical Neurosciences, National Centre for Mental Health and MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUK
| | - Moritz Herle
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- Department of Biostatistics and Health InformaticsKing's College LondonLondonUK
| | - Kiran Glen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Chelsea Mika Malouf
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Emily J. Kelly
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Thalia C. Eley
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological MedicineInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- South London and Maudsley NHS Foundation TrustMaudsley HospitalLondonUK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry (SGDP) CentreInstitute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
- National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre, South London and Maudsley HospitalLondonUK
- National Centre for Register‐based Research, Aarhus Business and Social SciencesAarhus UniversityAarhusDenmark
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20
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Thompson KA, Bauman V, Sunderland KW, Thornton JA, Schvey NA, Moyer R, Sekyere NA, Funk W, Pav V, Brydum R, Klein DA, Lavender JM, Tanofsky-Kraff M. Incidence and prevalence of eating disorders among active duty US military-dependent youth from 2016 to 2021. Int J Eat Disord 2023; 56:1973-1982. [PMID: 37493029 DOI: 10.1002/eat.24025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/12/2023] [Accepted: 07/06/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE The offspring of US military service members may be at increased risk for eating disorders. However, no epidemiological studies to date have evaluated eating disorder incidence rates and prevalence estimates among military-dependent youth. METHOD This retrospective cohort study examined eating disorder diagnoses in the military healthcare system (MHS) from 2016 through 2021. Active duty and national guard military-dependent youth, aged 10-17 years, who received care in the MHS via TRICARE Prime insurance, were identified by one or more ICD-10 codes indicative of an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other-specified eating disorders). RESULTS During the 6-year surveillance period, 2534 dependents received incident diagnoses of eating disorders, with a crude overall incidence rate of 1.75 cases per 10,000 person-years. The most common diagnosis was other-specified eating disorder, followed by anorexia nervosa, bulimia nervosa, and binge-eating disorder. The crude annual incidence rate of all eating disorder diagnoses increased by nearly 65% from 2016 to 2021. Rates for all diagnoses were highest in 2020 and 2021. Period prevalence estimates were .08% for any eating disorder diagnosis, .01% for anorexia nervosa, .004% for bulimia nervosa, .004% for binge-eating disorder, and .06% for other-specified eating disorders. DISCUSSION The observed increase in eating disorder diagnoses during the surveillance period appeared to be driven by female dependents. More military dependents experienced a new-onset diagnosis during the COVID-19 pandemic compared to previous years. These findings highlight the need for eating disorder screening, identification, and treatment for dependents within the MHS. PUBLIC SIGNIFICANCE STATEMENT Children of US military service members may be at increased risk for eating disorders. Results indicate new-onset eating disorder cases increased 65% from 2016 to 2021, primarily among girls compared to boys. The most diagnosed and fastest growing diagnosis was other-specified eating disorder. Rates of anorexia nervosa increased following the COVID-19 pandemic. Findings highlight the need for eating disorder screening, identification, and treatment within the military healthcare system.
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Affiliation(s)
- Katherine A Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
| | - Vivian Bauman
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
| | - Kevin W Sunderland
- Clinical Investigation Facility, David Grant Medical Center, Travis Air Force Base, California, USA
- Ripple Effect, Rockville, Maryland, USA
| | - Jennifer A Thornton
- Clinical Investigation Facility, David Grant Medical Center, Travis Air Force Base, California, USA
- Ripple Effect, Rockville, Maryland, USA
| | - Natasha A Schvey
- Department of Medical and Clinical Psychology, USU, Bethesda, Maryland, USA
| | - Rachel Moyer
- Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, California, USA
| | - Nana Amma Sekyere
- Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, California, USA
| | - Wendy Funk
- Kennell and Associates Inc., Falls Church, Virginia, United States
| | - Veronika Pav
- Kennell and Associates Inc., Falls Church, Virginia, United States
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rick Brydum
- Kennell and Associates Inc., Falls Church, Virginia, United States
| | - David A Klein
- Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, California, USA
- Department of Family Medicine, USU, Bethesda, Maryland, USA
- Department of Pediatrics, USU, Bethesda, Maryland, USA
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Metis Foundation, San Antonio, Texas, USA
- Department of Medicine, USU, Bethesda, Maryland, USA
| | - Marian Tanofsky-Kraff
- Military Cardiovascular Outcomes Research (MiCOR) Program, USU, Bethesda, Maryland, USA
- Department of Medical and Clinical Psychology, USU, Bethesda, Maryland, USA
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21
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Andersen ST, Strandberg-Larsen K, Skovgaard AM, Rimvall MK, Meyer LB, Olsen EM. Comparison of prevalence and mental health problems across symptom frequency of self-reported symptoms of binge-eating disorder in a community sample of adolescents. Int J Eat Disord 2023; 56:1947-1960. [PMID: 37458303 DOI: 10.1002/eat.24023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 06/30/2023] [Accepted: 07/01/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Binge-eating disorder (BED) and subthreshold BED (SBED) are prevalent in adults and associated with mental health problems including depression, non-suicidal self-injury, lower quality of life, and suicidality. There is solid evidence that binge-eating behaviors are also prevalent in adolescence, but knowledge about mental health in community adolescents with BED of different frequency thresholds is more limited. We aimed to investigate the prevalence and mental health problems associated with SBED of low frequency and/or limited duration compared with BED in a Danish community sample of adolescents. METHODS We included 2509 adolescents who completed the online survey of the 16-17-year follow-up of the Copenhagen Child Cohort (CCC2000), including items on BED symptoms approximating the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, and items on mental health and quality of life. RESULTS The 1-year prevalence of SBED was 2.7% (95% confidence interval [CI]: 2.0%-3.3%) with a male:female ratio of 1:3.7; comparable to previous findings on BED in the same sample. SBED was also comparable to BED concerning cross-sectional associations with overall mental health problems, lower health-related quality of life, depressive symptoms, and suicidal ideation, whereas no associations were seen with non-suicidal self-injury after Holm-Bonferroni correction. In both groups, thoughts and behaviors concerning food and weight interfered significantly with daily life. DISCUSSION SBED and BED were equally prevalent in this adolescent community sample, and similarly associated with indicators of poor mental health. The findings indicate that community adolescents reporting symptoms approximating clinical criteria of BED need intervention irrespectively of symptom frequency or duration. PUBLIC SIGNIFICANCE This study adds knowledge to the field by comparing BED of low frequency and/or limited duration ("subthreshold BED," SBED) with full-syndrome BED in adolescents and showing that SBED in adolescence is both prevalent and associated with poor mental health to a similar extent as that of BED. Findings indicate that self-reported symptoms according to clinical criteria of SBED and BED alike constitute a public health problem and point to youngsters in need of intervention.
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Affiliation(s)
- Sofie Thor Andersen
- The Danish Patient Association of Eating Disorders and Self-Harm, Valby, Denmark
| | - Katrine Strandberg-Larsen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Center, Mental Health Services, The Capital Region, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Roskilde, Denmark
| | - Lene Bomholt Meyer
- The Research Unit for General Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Else Marie Olsen
- Section for Epidemiology, Center for Clinical Research and Prevention, The Capital Region, Copenhagen, Denmark
- Outpatient Clinic for Eating Disorders in Adults, Psychiatric Centre Ballerup, The Capital Region, Copenhagen, Denmark
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22
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Presseller EK, Karbassi N, Gian C, Juarascio AS. Unequivocally large, but not enormous: An examination of the nutritional content of objective and subjective binge-eating episodes using ecological momentary assessment data. Int J Eat Disord 2023; 56:1991-1997. [PMID: 37345531 PMCID: PMC10592441 DOI: 10.1002/eat.24016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE This study compared the macronutrient profiles of subjective binge-eating episodes (SBEs), objective binge-eating episodes (OBEs), and typical eating episodes. METHOD Twenty-one adults with binge eating completed ecological momentary assessment of all eating episodes for 2 weeks, including detailed monitoring of food types and portions. Binge-eating episodes (N = 237) were coded as OBEs (n = 76) or SBEs (n = 161). Calories and macronutrients were computed using manufacturer information and USDA Food and Nutrient Database for Dietary Studies. Multilevel regression models compared the eating episode types on caloric and macronutrient content. RESULTS OBEs contained an average of 121.5 (95.1) g fat, 363.7 (289.1) g carbohydrates, 65.2 (38.2) g protein, 20.9 (16.4) g fiber, and 2856.2 (1869.2) calories. SBEs contained 31.6 (30.5) g fat, 76.5 (54.0) g carbohydrates, 20.5 (21.6) g protein, 5.3 (5.9) g fiber, and 695.1 (505.9) calories. Although OBEs contained significantly more calories and grams of all macronutrients than SBEs (p < .001), the macronutrient proportions of OBEs and SBEs did not differ. The proportions of carbohydrates (p = .005) and protein (p < .001) in SBEs significantly differed from typical eating episodes. DISCUSSION Our findings offer preliminary evidence that OBEs and SBEs are more comparable in macronutrient profile than typical eating episodes. PUBLIC SIGNIFICANCE STATEMENT The present study compared the calories and grams of macronutrients in objectively large binge-eating episodes, subjectively large binge-eating episodes, and typical meals and snacks. Results suggest that objectively and subjectively large binge-eating episodes demonstrate similar profiles of macronutrients, which are different from the macronutrient profile of meals and snacks. These results may help the eating disorder field better study the impact of subjectively large binge-eating episodes.
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Affiliation(s)
- Emily K Presseller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Nikoo Karbassi
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
| | - Christina Gian
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Nutrition Sciences Department, Drexel University, Philadelphia, Pennsylvania, USA
| | - Adrienne S Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, Pennsylvania, USA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, Pennsylvania, USA
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23
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Fornaro M, Mondin AM, Billeci M, Fusco A, De Prisco M, Caiazza C, Micanti F, Calati R, Carvalho AF, de Bartolomeis A. Psychopharmacology of eating disorders: Systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2023; 338:526-545. [PMID: 37393954 DOI: 10.1016/j.jad.2023.06.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 06/17/2023] [Accepted: 06/28/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND The concurrent assessment of weight and affective psychopathology outcomes relevant to the psychopharmacology of major eating disorders (EDs), namely anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), warrants systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS PubMed, Scopus, and ClinicalTrials.gov were inquired from inception through August 31st, 2022, for RCTs documenting any psychopharmacological intervention for EDs diagnosed according to validated criteria and reporting weight and psychopathology changes. Adopted keywords were: "anorexia nervosa," "bulimia nervosa," "binge eating disorder," "antidepressant," "antipsychotic," and "mood stabilizer." No language restriction applied. RESULTS 5122 records were identified, and 203 full-texts were reviewed. Sixty-two studies entered the qualitative synthesis (AN = 22, BN = 23, BED = 17), of which 22 entered the meta-analysis (AN = 9, BN = 10, BED = 3). Concerning BMI increase in AN, olanzapine outperformed placebo (Hedges'g = 0.283, 95%C·I. = 0.051-0.515, I2 = 0 %; p = .017), whereas fluoxetine failed (Hedges'g = 0.351, 95%C.I. = -0.248 to 0.95, I2 = 63.37 %; p = .251). Fluoxetine not significantly changed weight (Hedges'g = 0.147, 95%C.I. = -0.157-0.451, I2 = 0 %; p = .343), reducing binging (Hedges'g = 0.203, 95%C.I. = 0.007-0.399, I2 = 0 %; p = .042), and purging episodes (Hedges'g = 0.328, 95%C.I. = -0.061-0.717, I2 = 58.97 %; p = .099) in BN. Lisdexamfetamine reduced weight (Hedges'g = 0.259, 95%C.I. = 0.071-0.446, I2 = 0 %; p = .007) and binging (Hedges'g = 0.571, 95%C.I. = 0.282-0.860, I2 = 53.84 %; p < .001) in BED. LIMITATIONS Small sample size, short duration, and lack of reliable operational definitions affect most of the included sponsored RCTs. CONCLUSIONS The efficacy of different drugs varies across different EDs, warranting additional primary studies recording broad psychopathological and cardiometabolic outcomes besides weight, especially against established psychotherapy interventions.
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Affiliation(s)
- Michele Fornaro
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy.
| | - Anna Maria Mondin
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy
| | - Martina Billeci
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy
| | | | - Michele De Prisco
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy; Bipolar and Depressive Disorders Unit, IDIBAPS CIBERSAM, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Claudio Caiazza
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy
| | - Fausta Micanti
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy
| | - Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126 Milan, Italy; Department of Adult Psychiatry, Nîmes University Hospital, 4 Rue du Professeur Robert Debré, 30029 Nimes, France.
| | - André Férrer Carvalho
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, the Department of Psychiatry, The University of Melbourne, Melbourne, Australia; St Vincent's Mental Health Unit, Department of Psychiatry, University of Melbourne, Parkville, Melbourne, Australia
| | - Andrea de Bartolomeis
- Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy; Chair Staff for Health Education and Sustainable Development, UNESCO, Naples, Italy.
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24
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Quadflieg N, Voderholzer U, Meule A, Fichter MM. Comparing ICD-11 and DSM-5 eating disorder diagnoses with the Munich eating and feeding disorder questionnaire (ED-Quest). Int J Eat Disord 2023; 56:1826-1831. [PMID: 37309255 DOI: 10.1002/eat.24010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The new ICD-11 eating disorders (ED) guidelines are similar to the DSM-5 criteria. One difference to the DSM-5 is the inclusion of subjective binges in the definition of bulimia nervosa (BN) and binge-eating disorder (BED). The aim of this study was to identify differences between the ICD-11 guidelines and DSM-5 ED criteria, which could impact access to medical care and early treatment. METHOD Data of 3863 ED inpatients who completed the Munich Eating and Feeding Disorder Questionnaire were analyzed using standardized diagnostic algorithms for DSM-5 and ICD-11. RESULTS Agreement of diagnoses was high (Krippendorff's α = .88, 95% CI [.86, .89]) for anorexia nervosa (AN; 98.9%), BN (97.2%) and BED (100%), and lower for other feeding and eating disorders (OFED; 75.2%). Of the 721 patients with a DSM-5 OFED, 19.8% were diagnosed with AN, BN or BED by the ICD-11 diagnostic algorithm, reducing the number of OFED diagnoses. One-hundred and twenty-one patients received an ICD-11 diagnosis of BN or BED because of subjective binges. DISCUSSION For over 90% of patients, applying either DSM-5 or ICD-11 diagnostic criteria/guidelines resulted in the same full-threshold ED diagnosis. Sub-threshold and feeding disorders exhibited a discrepancy of 25%. PUBLIC SIGNIFICANCE STATEMENT For about 98% of inpatients, the ICD-11 and DSM-5 agree on the same specified eating disorder diagnosis. This is important when comparing diagnoses made by different diagnostic systems. Including subjective binges in the definition of bulimia nervosa and binge-eating disorder contributes to improved ED diagnoses. Clarifying the wording of diagnostic criteria at several places could further increase this agreement.
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Affiliation(s)
- Norbert Quadflieg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Freiburg, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Manfred Maximilian Fichter
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
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25
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Hacker KS, Salwen-Deremer JK. Comment on: Re-evaluating the binge eating scale cut-off using DSM-5 criteria: analysis and replication in presurgical metabolic and bariatric surgery samples. Surg Obes Relat Dis 2023; 19:950-951. [PMID: 37137802 DOI: 10.1016/j.soard.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Katrina S Hacker
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Jessica K Salwen-Deremer
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Department of Medicine, Section of Gastroenterology & Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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26
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Hübel C, Birgegård A, Johansson T, Petersen LV, Isomaa R, Herle M. Latent anxiety and depression dimensions differ amongst patients with eating disorders: A Swedish nationwide investigation. Int J Methods Psychiatr Res 2023; 32:e1961. [PMID: 36775941 PMCID: PMC10485306 DOI: 10.1002/mpr.1961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/02/2022] [Accepted: 12/17/2022] [Indexed: 02/14/2023] Open
Abstract
OBJECTIVE Anxiety and depression symptoms are common in individuals with eating disorders. To study these co-occurrences, we need high-quality self-report questionnaires. The 19-item self-rated Comprehensive Psychopathological Rating Scale for Affective Syndromes (CPRS-S-A) is not validated in patients with eating disorders. We tested its factor structure, invariance, and differences in its latent dimensions. METHOD Patients were registered by 45 treatment units in the Swedish nationwide Stepwise quality assurance database for specialised eating disorder care (n = 9509). Patients self-reported their anxiety and depression symptoms on the CPRS-S-A. Analyses included exploratory and confirmatory factor analyses (CFA) in split samples, and testing of invariance and differences in subscales across eating disorder types. RESULTS Results suggested a four-factor solution: Depression, Somatic and fear symptoms, Disinterest, and Worry. Multigroup CFA indicated an invariant factor structure. We detected the following differences: Patients with anorexia nervosa binge-eating/purging subtype scored the highest and patients with unspecified feeding and eating disorders the lowest on all subscales. Patients with anorexia nervosa or purging disorder show more somatic and fear symptoms than individuals with either bulimia nervosa or binge-eating disorder. CONCLUSION Our four-factor solution of the CPRS-S-A is suitable for patients with eating disorders and may help to identify differences in anxiety and depression dimensions amongst patients with eating disorders.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- UK National Institute for Health Research (NIHR) Biomedical Research Centre for Mental HealthSouth London and Maudsley HospitalLondonUK
- National Centre for Register‐based ResearchAarhus BSS Business and Social SciencesAarhus UniversityAarhusDenmark
- Department of Pediatric NeurologyCharité Universitätsmedizin BerlinBerlinGermany
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Therese Johansson
- Department of Immunology, Genetics and PathologyScience for Life LaboratoryUppsala UniversityUppsalaSweden
- Centre for Women's Mental Health During the Reproductive Lifespan—WomherUppsala UniversityUppsalaSweden
| | - Liselotte V. Petersen
- National Centre for Register‐based ResearchAarhus BSS Business and Social SciencesAarhus UniversityAarhusDenmark
| | - Rasmus Isomaa
- The Wellbeing Services County of OstrobothniaAboFinland
- Faculty of Education and Welfare StudiesÅbo Akademi UniversityVasaFinland
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Department of Biostatistics & Health InformaticsInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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27
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Butt M, Ssentongo P, Rogers AM, Rigby A. Associations of Food Addiction Symptomatology and Disordered Eating Behaviors in a Pre-Surgical Bariatric Population. Nutrients 2023; 15:3474. [PMID: 37571411 PMCID: PMC10421096 DOI: 10.3390/nu15153474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
The construct of food addiction (FA) has been highly debated in recent years particularly in the fields of disordered eating, medical weight management, and bariatric surgery. Some researchers have argued that FA symptoms are distinct, highly prevalent, and present a barrier for patients seeking medical treatment for obesity. The purpose of this study is to evaluate the cross-sectional associations between FA symptomatology, binge eating disorder (BED) and other appetitive traits, as well as dietary quality in a sample of adults with obesity seeking bariatric surgery. This post hoc analysis was conducted on a prospectively collected dataset from August 2020 to August 2022 at a single academic medical center. Descriptive statistics were used to characterize the sample. Additional analyses included: correlation coefficients, multivariable linear regression, and analysis of variance. A total of 587 patients were included in this analysis with low average scores for FA symptoms (mean: 1.48; standard deviation (SD): 2.15). Those with no BED symptoms had the lowest average FA symptoms scores (mean: 0.87; SD: 1.52) and those with both bingeing and LOCE had the highest average scores (mean: 3.35; SD: 2.81). This finding supports the hypothesis that, while related, FA and BED may represent different cognitions and behaviors.
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Affiliation(s)
- Melissa Butt
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA 17033, USA
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (P.S.); (A.R.)
| | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (P.S.); (A.R.)
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Ann M. Rogers
- Division of Minimally Invasive Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA;
| | - Andrea Rigby
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (P.S.); (A.R.)
- Division of Minimally Invasive Surgery, Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA;
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28
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Li Z, Leppanen J, Webb J, Croft P, Byford S, Tchanturia K. Analysis of symptom clusters amongst adults with anorexia nervosa: Key severity indicators. Psychiatry Res 2023; 326:115272. [PMID: 37276647 PMCID: PMC10790244 DOI: 10.1016/j.psychres.2023.115272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/07/2023]
Abstract
This study used cluster analysis to explore clinically relevant subgroups of adult patients with anorexia nervosa (AN). Patients were clustered based on their body mass index (BMI), eating disorder symptomatology, anxiety and depression symptoms and autistic characteristics. The difference between clusters in work and social functioning, duration of illness, bingeing and purging behaviour, previous hospitalisations and number of comorbidities was also investigated. Two meaningful clusters emerged: a higher symptoms cluster with more severe eating pathology, anxiety, depression, and more autistic traits, and a second cluster with lower symptoms. BMI did not make major contributions to cluster formation. The higher symptoms cluster also reported lower self-efficacy to change, more previous hospitalisations, comorbid diagnoses, binge eating and purging behaviours and use of psychotropic medication. Our findings suggest that weight alone may not be a significant severity indicator amongst inpatients with AN, and targeted treatment of AN should consider a broader range of symptom severity indicators.
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Affiliation(s)
- Zhuo Li
- King's College London, London, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, UK
| | - Jenni Leppanen
- Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Jessica Webb
- National Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Philippa Croft
- National Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Sarah Byford
- King's Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kate Tchanturia
- King's College London, London, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, UK; National Eating Disorders Service, South London and Maudsley NHS Foundation Trust, London, UK; Psychological Set Research and Correction Center, Tbilisi State Medical University, Tbilisi, Georgia.
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29
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Palmieri S, Mansueto G, Marchant AP, Sassaroli S, Caselli G, Ruggiero GM, Spada MM. The Metacognitions about Binge Eating Questionnaire: Investigation of the association between specific metacognitions and Binge Eating Disorder. Clin Psychol Psychother 2023; 30:780-794. [PMID: 36754777 DOI: 10.1002/cpp.2839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023]
Abstract
Literature suggested that metacognitions are involved in eating problems and may be relevant to the understanding of Binge Eating Disorder (BED). The goal of the current studies was to develop the first self-report instrument on metacognitions about binge eating. In Study 1, a community sample completed the Metacognitions about Binge Eating Questionnaire (MBEQ); an Exploratory Factor Analysis (EFA) was performed. In study 2, a community sample completed the MBEQ and measures assessing severity of binge eating, irrational food beliefs, anxiety, depression, impulsiveness. A Confirmatory Factor Analysis (CFA) was performed. Concurrent and incremental validity were assessed. In study 3, a clinical sample of participants with a diagnosis of BED completed the MBEQ and other measures. Bivariate correlational analysis and hierarchical linear regression were performed. Participants from the general population and participants with a diagnosis of BED were compared. EFA and CFA supported a two-factor solution consisting of positive and negative metacognitions about binge eating. Concurrent and incremental validity were acceptable. The metacognitions factors correlated positively with anxiety, depression, irrational food beliefs, impulsiveness in the community sample, and anxiety, irrational food beliefs, impulsiveness in clinical sample. The metacognitions factors contributed to the prediction of BEDs symptoms, in community and clinical samples, over and above age, gender, impulsiveness, anxiety, depression, irrational food beliefs. The MBEQ possesses good psychometric properties and appears a reliable and valid measure of positive and negative metacognitions about binge eating. Metacognitions about binge eating could be a therapeutic target to reduce the severity of binge eating episodes.
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Affiliation(s)
- S Palmieri
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G Mansueto
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - A P Marchant
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - S Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G M Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - M M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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30
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Linardon J, Messer M, Shatte A, Skvarc D, Rosato J, Rathgen A, Fuller-Tyszkiewicz M. Targeting dietary restraint to reduce binge eating: a randomised controlled trial of a blended internet- and smartphone app-based intervention. Psychol Med 2023; 53:1277-1287. [PMID: 34247660 DOI: 10.1017/s0033291721002786] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Existing internet-based prevention and treatment programmes for binge eating are composed of multiple distinct modules that are designed to target a broad range of risk or maintaining factors. Such multi-modular programmes (1) may be unnecessarily long for those who do not require a full course of intervention and (2) make it difficult to distinguish those techniques that are effective from those that are redundant. Since dietary restraint is a well-replicated risk and maintaining factor for binge eating, we developed an internet- and app-based intervention composed solely of cognitive-behavioural techniques designed to modify dietary restraint as a mechanism to target binge eating. We tested the efficacy of this combined selective and indicated prevention programme in 403 participants, most of whom were highly symptomatic (90% reported binge eating once per week). METHOD Participants were randomly assigned to the internet intervention (n = 201) or an informational control group (n = 202). The primary outcome was objective binge-eating frequency. Secondary outcomes were indices of dietary restraint, shape, weight, and eating concerns, subjective binge eating, disinhibition, and psychological distress. Analyses were intention-to-treat. RESULTS Intervention participants reported greater reductions in objective binge-eating episodes compared to the control group at post-test (small effect size). Significant effects were also observed on each of the secondary outcomes (small to large effect sizes). Improvements were sustained at 8 week follow-up. CONCLUSIONS Highly focused digital interventions that target one central risk/maintaining factor may be sufficient to induce meaningful change in core eating disorder symptoms.
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Affiliation(s)
- Jake Linardon
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Mariel Messer
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Adrian Shatte
- School of Science, Engineering & Information Technology, Federation University, Melbourne, Australia
| | - David Skvarc
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - John Rosato
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - April Rathgen
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Victoria 3125, Australia
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Mellowspring A. Eating Disorders in the Primary Care Setting. Prim Care 2023; 50:103-117. [PMID: 36822720 DOI: 10.1016/j.pop.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Eating disorders are mental health disorders with complicating medical, psychiatric, and nutritional comorbidities. Common eating disorder diagnoses include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, and other specified feeding or eating disorder. Unspecified feeding or eating disorder is most applicable in brief acute care settings. Eating disorders occur across age, gender, racial, ethnic, and socioeconomic variables. Effective assessment, intervention, and collaborative treatment are needed to decrease risk factors and increase opportunities for recovery.
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Pawar PS, Thornton LM, Flatt RE, Sanzari CM, Carrino EA, Tregarthen JP, Argue S, Bulik CM, Watson HJ. Binge-eating disorder with and without lifetime anorexia nervosa: A comparison of sociodemographic and clinical features. Int J Eat Disord 2023; 56:428-438. [PMID: 36448187 PMCID: PMC9904171 DOI: 10.1002/eat.23858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/21/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To compare individuals who have experienced binge-eating disorder (BED) and anorexia nervosa (AN) (BED AN+) to those who have experienced BED and not AN (BED AN-). METHOD Participants (N = 898) met criteria for lifetime BED and reported current binge eating. Approximately 14% had a lifetime diagnosis of AN. Analyses compared BED AN+ and BED AN- on sociodemographic variables and clinical history. RESULTS The presence of lifetime AN was associated with more severe eating disorder symptoms, including earlier onset, more frequent, more chronic, and more types of eating disorder behaviors over the lifetime, as well as a higher lifetime prevalence of bulimia nervosa (BN). Participants with lifetime AN reported being more likely to have received treatments for BED or BN, had significantly lower minimum, current, and maximum BMIs, had more severe general anxiety, and were significantly more likely to be younger and female. In the full sample, the lifetime prevalence of unhealthy weight control behaviors was high and treatment utilization was low, despite an average 15-year history since symptom onset. Gastrointestinal disorders and comorbid anxiety, depression, and attention-deficit/hyperactivity disorder symptoms were prevalent. DISCUSSION Individuals fared poorly on a wide array of domains, yet those with lifetime AN fared considerably more poorly. All patients with BED should be screened for mental health and gastrointestinal comorbidities and offered referral and treatment options. PUBLIC SIGNIFICANCE Individuals experiencing binge-eating disorder have severe symptomology, but those who have experienced binge-eating disorder and anorexia nervosa fare even more poorly. Our study emphasizes that patients with binge-eating disorder would benefit from being screened for mental health and gastrointestinal comorbidities, and clinicians should consider history of unhealthy weight control behaviors to inform treatment and relapse prevention.
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Affiliation(s)
- Pratiksha S. Pawar
- Department of Biotechnology, Dr D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Rachael E. Flatt
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States
| | | | - Emily A. Carrino
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, United States
| | | | | | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Nutrition, University of North Carolina at Chapel Hill, United States
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hunna J. Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Discipline of Psychology, School of Population Health, Curtin University, Australia
- Division of Paediatrics, School of Medicine, The University of Western Australia, Australia
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Suchta K, Smolarczyk R, Czajkowski K, Rudnicka E, Kokoszka A. Binge Eating Disorder-The Point Prevalence among Polish Women with Polycystic Ovary Syndrome and Validity of Screening Tool for This Population. Int J Environ Res Public Health 2022; 20:546. [PMID: 36612867 PMCID: PMC9819692 DOI: 10.3390/ijerph20010546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders which is associated with an increased risk of metabolic dysregulation. The elevated prevalence of obesity has been observed in women with PCOS. Since obesity is commonly associated with eating disturbances, including the binge eating disorder (BED), and since the hormonal changes in PCOS patients could influence the food intake model, we decided to estimate the prevalence of BED in PCOS patients and to assess the sensitivity and specificity of the Questionnaire for Binge Eating Screening (QBES) in PCOS patients. METHODS A total of 122 hospitalized women with PCOS aged 16-45 (M = 26; SD = 5.22) took part in the study. Binge eating disorder (BED) was diagnosed according to the DSM-5 diagnostic criteria. QBES was used as a screening tool for BED. RESULTS The point prevalence of BED in PCOS women according to DMS-5 criteria was 51 (42%). At least two positive answers to four QBES items had 100% sensitivity and 91% specificity. Positive answers to even only the first two questions from QBES had 98% sensitivity and 85% specificity. CONCLUSIONS Women with polycystic ovary syndrome are at a very high risk of binge eating behaviors. Screening for eating disorders should be a routine procedure in women with PCOS. The first two questions from QBES are a brief and relatively reliable screening tool that may be used in everyday practice with POSC patients.
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Affiliation(s)
- Katarzyna Suchta
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetric and Gynaecology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Ewa Rudnicka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Andrzej Kokoszka
- II Department of Psychiatry, Medical University of Warsaw, 02-091 Warsaw, Poland
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Pekin C, McHale M, Seymour M, Strodl E, Hopkins G, Mitchell D, Byrne GJ. Psychopathology and eating behaviour in people with type 2 diabetes referred for bariatric surgery. Eat Weight Disord 2022; 27:3627-3635. [PMID: 36495463 PMCID: PMC9803743 DOI: 10.1007/s40519-022-01502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Psychopathology and disordered eating behaviours are putative pre-operative risk factors for suboptimal outcomes post-bariatric surgery. Documented psychopathology prevalence rates vary in bariatric candidate samples. Further, less attention has been paid to vulnerable subgroups such as people with diabetes who might be at an elevated risk. For these reasons, this study aimed to investigate the rates of psychopathology and disordered eating in pre-surgical candidates with type 2 diabetes mellitus (T2DM). METHODS Participants were 401 consecutive patients from a state-wide bariatric surgery service for people with T2DM. Psychopathology was measured using multi-modal assessment including diagnostic interview and battery of validated questionnaires. The mean age of the sample was 51 years with a mean BMI of 46 kg/m2. The majority of the sample was female (60.6%), born in Australia (87%) and 18.2% identified as Aboriginal and/or Torres Strait Islander. RESULTS Rates of current psychopathology in this sample included: major depressive disorder (MDD; 16.75%), generalised anxiety disorder (GAD; 20.25%), insomnia (17.75%) and binge eating disorder (BED; 10.75%). There were no significant differences on measures between people who endorsed Aboriginal and/or Torres Strait Islander status compared to those who did not endorse. The mean total score on the BES was 21.82 ± 10.40 (range 0-39), with 8.2% of participants meeting criteria for severe binge eating. Presence of an eating disorder was not significantly associated with degree of glycemic compensation. Average emotional eating scores were significantly higher in this study, compared to reference samples. Significantly increased binge eating severity and emotional eating severity was revealed for people with T2DM and comorbid MDD, social anxiety and eating disorders. Binge eating severity was associated with GAD, food addiction, substance use disorders, and history of suicide attempt but not emotional eating severity. CONCLUSION Amongst people with T2DM seeking bariatric surgery, MDD, GAD and emotional eating were common. Psychopathology in a sample of people with T2DM seeking bariatric surgery was significantly associated with severity of disordered eating. These findings suggest people with T2DM seeking bariatric surgery may be vulnerable to psychopathology and disordered eating with implications for early identification and intervention. LEVEL OF EVIDENCE Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- C Pekin
- Faculty of Medicine, Academy of Psychiatry, University of Queensland, Brisbane, QLD, Australia.
- Department of Psychology, Royal Brisbane & Women's Hospital and School of Psychology, University of Queensland, Brisbane, QLD, Australia.
| | - M McHale
- Department of Psychology, Royal Brisbane & Women's Hospital and School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - M Seymour
- Faculty of Medicine, Department of Endocrinology and Diabetes, Royal Brisbane & Women's Hospital, University of Queensland, Brisbane, QLD, Australia
| | - E Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - G Hopkins
- Division of Surgery Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - D Mitchell
- Division of Surgery Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - G J Byrne
- Faculty of Medicine, Academy of Psychiatry, University of Queensland, Brisbane, QLD, Australia
- Mental Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
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Wons O, Lampe E, Patarinski AG, Schaumberg K, Butryn M, Juarascio A. Perceived influence of wearable fitness trackers on eating disorder symptoms in a clinical transdiagnostic binge eating and restrictive eating sample. Eat Weight Disord 2022; 27:3367-3377. [PMID: 36006603 PMCID: PMC9403232 DOI: 10.1007/s40519-022-01466-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/31/2022] [Indexed: 01/06/2023] Open
Abstract
Wearable fitness trackers are an increasingly popular tool for measuring physical activity (PA) due their accuracy and momentary data collection abilities. Despite the benefits of using wearable fitness trackers, there is limited research in the eating disorder (ED) field using wearable fitness trackers to measure PA in the context of EDs. Wearable fitness trackers are often underused in ED research because there is limited knowledge about whether wearable fitness trackers negatively or positively impact PA engagement and ED symptoms in individuals with EDs. The current study aimed to assess the perceived impact wearable fitness trackers have on PA engagement and ED symptoms over a 12-week CBT treatment for 30 individuals with binge eating and restrictive eating that presented to treatment engaging or not engaging in maladaptive exercise. Participants in the maladaptive exercise group (n = 17) and non-maladaptive exercise group (n = 13) wore a fitness tracker for 12 weeks and completed questionnaires assessing participants' perceptions of the fitness trackers' influence on ED symptoms and PA engagement throughout treatment. Results demonstrated a small percentage of individuals perceived the fitness tracker influenced ED behaviors or PA engagement, and there were mixed results on whether participants positively or negatively perceived the fitness tracker influenced them to engage in ED behaviors or PA engagement. Although preliminary, these results demonstrate the need to continue using objective measurements of PA via wearable fitness trackers to further our understanding of the positive and negative effects of fitness trackers on clinical ED samples.Level of Evidence: Level 1, randomized controlled trial.
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Affiliation(s)
- Olivia Wons
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Elizabeth Lampe
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Anna Gabrielle Patarinski
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI, 53719, USA
| | - Meghan Butryn
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Adrienne Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
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Presseller EK, Lampe EW, Nunez N, Juarascio AS. Latent profiles of dietary restraint among individuals with binge-spectrum eating disorders: Associations with eating disorder symptom severity. Int J Eat Disord 2022; 55:1843-1852. [PMID: 36161726 PMCID: PMC9742196 DOI: 10.1002/eat.23816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/15/2022] [Accepted: 09/08/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The relationship of dietary restraint in increasing risk for binge eating among individuals with binge-spectrum eating disorders (B-EDs) is well established. However, previous research has not yet identified whether these individuals exhibit heterogeneous profiles of dietary restraint and whether these profiles are associated with differences in eating pathology. METHODS Individuals with B-EDs (N = 290) completed the Eating Disorder Examination. Latent profile analysis was conducted on dietary restraint frequency data, including restriction of overall amount of food consumed, avoidance of eating, desire for an empty stomach, food avoidance, and dietary rules. Identified latent profiles were compared on binge eating frequency, compensatory behaviors frequency, and ED pathology using the three-step procedure. RESULTS A four-class model of dietary restraint best fit the data. Classes significantly differed in frequency of compensatory behaviors (F[3, 286] = 31.01, p < .001), EDE Eating Concern (F[3, 286] = 14.36, p < .001), EDE Shape Concern (F[3, 286] = 7.06, p < .001), EDE Weight Concern (F[3, 286] = 6.83, p < .001), and ED Pathology (F[3, 286] = 12.86, p < .001), but did not differ in frequency of objective (F[3, 286] = 2.45, p = .06) or subjective binge episodes (F[3, 286] = 1.87, p = .14). DISCUSSION Individuals with B-EDs exhibit distinct profiles of dietary restraint, which are associated with frequency of compensatory behaviors and severity of ED pathology. PUBLIC SIGNIFICANCE STATEMENT Individuals with binge-spectrum eating disorders have different patterns of restrictive eating symptoms. These profiles of restrictive eating behaviors are associated with differences in severity of compensatory behaviors and cognitive eating disorder symptoms, like shape and weight dissatisfaction. Understanding the relationships between profiles of restrictive eating behaviors and other eating disorder symptoms may allow for personalization of treatment and improvements in treatment efficacy.
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Affiliation(s)
- Emily K. Presseller
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA
| | - Elizabeth W. Lampe
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA
| | - Nicole Nunez
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA
| | - Adrienne S. Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA
- Center for Weight, Eating, and Lifestyle Sciences, Drexel University, Philadelphia, PA
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Chew KK, Temples HS. Adolescent Eating Disorders: Early Identification and Management in Primary Care. J Pediatr Health Care 2022; 36:618-627. [PMID: 37855407 DOI: 10.1016/j.pedhc.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 11/24/2022]
Abstract
Eating disorders are complex, potentially life-threatening conditions characterized by disruptive eating behaviors that significantly impact physical and psychosocial functioning. The adolescent population is at an increased risk of developing eating disorders because of developmental changes affecting their perception. Eating disorders are associated with devastating medical complications and high mortality rates if left untreated. As the prevalence of eating disorders among adolescents continues to increase, it is important that clinicians are knowledgeable about early signs of disordered eating and facilitate timely evaluation and care coordination. Newly released clinical guidelines from the American Academy of Pediatrics are reviewed for early identification and management of eating disorders in children and adolescents. The epidemiology, risk factors, and medical complications for common eating disorders in primary care such as anorexia nervosa, bulimia nervosa, and binge eating disorder, are presented. An approach to screening for eating disorders, clinical assessment, and treatment options are outlined.
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Abstract
PURPOSE OF REVIEW Eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders) affect young people worldwide. This narrative review summarizes key studies conducted on the prevalence of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) eating disorders among young people in 2013-22. RECENT FINDINGS In Western settings, a substantial proportion of young people have reported an eating disorder. Overall, 5.5--17.9% of young women and 0.6-2.4% of young men have experienced a DSM-5 eating disorder by early adulthood. Lifetime DSM-5 anorexia nervosa was reported by 0.8-6.3% of women and 0.1-0.3% of men, bulimia nervosa by 0.8-2.6% of women and 0.1-0.2% of men, binge eating disorder by 0.6-6.1% of women and 0.3-0.7% of men, other specified feeding or eating disorders by 0.6-11.5% of women and 0.2-0.3% of men, and unspecified feeding or eating disorders 0.2-4.7% of women and 0-1.6% of men. Gender and sexual minorities were at particularly high risk. Emerging studies from Eastern Europe, Asia, and Latin America show similar high prevalences. During the COVID-19 pandemic, the incidence of eating disorders has still increased. SUMMARY Eating disorders are a global health concern among young people. Improved detection, management, and prevention methods are urgently needed.
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Affiliation(s)
- Yasmina Silén
- Department of Public Health, University of Helsinki, Finland
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Bodell LP, Egbert AH, Anaya C, Wildes JE. Associations between emotion reactivity and eating disorder symptoms in a transdiagnostic treatment-seeking sample. Int J Eat Disord 2022; 55:1390-1396. [PMID: 36086863 DOI: 10.1002/eat.23808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Individuals with eating disorders (EDs) demonstrate difficulties with emotion regulation, and these difficulties have been associated with severity and maintenance of ED symptoms. Although emotion reactivity (i.e., the strength and duration of emotional experiences) is distinct from emotion regulation, few studies have examined emotion reactivity in the context of EDs. The purpose of the current study was to examine longitudinal associations between emotion reactivity and ED symptoms and impairment in individuals with EDs. METHOD Individuals seeking outpatient ED treatment (N = 265) completed questionnaires assessing ED symptoms and severity, emotion reactivity, and emotion regulation difficulties at treatment intake and bi-monthly during treatment. RESULTS Individuals with anorexia nervosa or binge eating or purging presentations had higher emotion reactivity scores than a non-ED comparison group. Controlling for age, diagnosis, and emotion regulation difficulties, emotion reactivity was positively associated with ED severity, ED-related impairment, and loss of control eating severity. Moreover, emotion reactivity, but not emotion regulation difficulties, was associated with change in ED symptoms during treatment. DISCUSSION Findings support that emotion reactivity may differ based on ED presentations and may be an important correlate of ED symptom severity. PUBLIC SIGNIFICANCE Emotion reactivity refers to the strength and duration of an emotional experience. This study found that higher emotion reactivity was related to greater eating disorder symptom severity and eating disorder-related impairment. It may be beneficial to consider the role of emotion reactivity in conceptualizations of eating disorders, particularly those characterized by binge eating or purging.
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Affiliation(s)
- Lindsay P Bodell
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Amy H Egbert
- The Miriam Hospital/Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Carolina Anaya
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
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Breithaupt L, Kahn DL, Slattery M, Plessow F, Mancuso C, Izquierdo A, Dreier MJ, Becker K, Franko DL, Thomas JJ, Holsen L, Lawson EA, Misra M, Eddy KT. Eighteen-month Course and Outcome of Adolescent Restrictive Eating Disorders: Persistence, Crossover, and Recovery. J Clin Child Adolesc Psychol 2022; 51:715-725. [PMID: 35476589 PMCID: PMC9444807 DOI: 10.1080/15374416.2022.2034634] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE In adults, low-weight restrictive eating disorders, including anorexia nervosa (AN), are marked by chronicity and diagnostic crossover from restricting to binge-eating/purging. Less is known about the naturalistic course of these eating disorders in adolescents, particularly atypical AN (atyp-AN) and avoidant/restrictive food intake disorder (ARFID). To inform nosology of low-weight restrictive eating disorders in adolescents, we examined outcomes including persistence, crossover, and recovery in an 18-month observational study. METHOD We assessed 82 women (ages 10-23 years) with low-weight eating disorders including AN (n = 40; 29 restricting, 11 binge-eating/purging), atyp-AN (n = 26; 19 restricting, seven binge-eating/purging), and ARFID (n = 16) at baseline, nine months (9 M; 75% retention), and 18 months (18 M; 73% retention) via semi-structured interviews. First-order Markov modeling was used to determine diagnostic persistence, crossover, and recovery occurring at 9 M or 18 M. RESULTS Among all diagnoses, the likelihood of remaining stable within a given diagnosis was greater than that of transitioning, with the greatest probability among ARFID (0.84) and AN-R (0.62). Persistence of BP and atypical presentations at follow-up periods was less stable (AN-BP probability 0.40; atyp-AN-R probability 0.48; atyp-AN-BP probability, 0.50). Crossover from binge-eating/purging to restricting occurred 72% of the time; crossover from restricting to binge-eating/purging occurred 23% of the time. The likelihood of stable recovery (e.g., recovery at both 9 M and 18 M) was between 0.00 and 0.36. CONCLUSION Across groups, intake diagnosis persisted in about two-thirds, and recovery was infrequent, underscoring the urgent need for innovative treatment approaches to these illnesses. Frequent crossover between AN and atyp-AN supports continuity between typical and atypical presentations, whereas no crossover to ARFID supports its distinction.
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Affiliation(s)
- Lauren Breithaupt
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Danielle L. Kahn
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Franziska Plessow
- Harvard Medical School, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | - Alyssa Izquierdo
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Melissa J. Dreier
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Kendra Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Jennifer J. Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Laura Holsen
- Harvard Medical School, Boston, MA, USA
- Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA, USA
| | - Elizabeth A. Lawson
- Harvard Medical School, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Madhusmita Misra
- Harvard Medical School, Boston, MA, USA
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
- Division of Pediatric Endocrinology, Massachusetts General Hospital, Boston, MA, USA
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Abstract
Binge eating is characterised by the ingestion of large quantities of food in a short time. Cases in the literature deal exclusively with gastric perforation in people with a history of anorexia nervosa, binge eating disorder or bulimia nervosa.We report the case of a young woman with no previous diagnosis of mental illness and a history of only two binge-eating episodes that occurred a few years earlier. She died suddenly during a binge-eating episode from stomach rupture resulting from a single perforation of the stomach with leakage of food material within the abdominal cavity. There was no sign of gastric necrosis or peritonitis. The deceased died quickly.Our case, which appears unique in the literature, shows that there is a risk of death even in people with no diagnosis of eating disorders and a history of only few and isolated binge-eating episodes. Physicians should carefully investigate a patient's history to assess any risks.
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Affiliation(s)
- Andrea Cioffi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
| | - Stefania De Simone
- Department of Clinical and Experimental Medicine, University of Foggia, Italy
| | - Luigi Cipolloni
- Department of Clinical and Experimental Medicine, University of Foggia, Italy
| | - Benedetta Baldari
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Italy
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Lampe EW, Wons O, Taylor LC, Juarascio AS, Manasse SM. Associations between fear of weight gain and exercise in binge-spectrum eating disorders. Eat Weight Disord 2022; 27:2121-2128. [PMID: 35064918 PMCID: PMC9288521 DOI: 10.1007/s40519-022-01361-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/06/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Maladaptive exercise (i.e., exercise that is either driven or compensatory) is thought to momentarily down-regulate elevated fear of weight gain (FOWG). However, little research has examined associations between FOWG and exercise, and no research has measured FOWG at a momentary level or considered exercise type (i.e., maladaptive vs. adaptive). Thus, we examined both within- and between-subject associations between FOWG and exercise among individuals with trans-diagnostic binge eating. METHODS We recruited treatment-seeking adults (N = 58, 82.9% female) to complete a 7-14-day ecological momentary assessment protocol which assessed levels of FOWG and exercise engagement and type. Mixed models and generalized estimating equations assessed within-subject associations, and linear regression assessed between-subject associations. RESULTS There was no main effect of FOWG on exercise engagement at the next survey. However, unexpectedly, exercise type moderated this relationship such that the relationship between FOWG and exercise was strongest for episodes of adaptive exercise. Overall exercise frequency accounted for 10.4% of the variance in FOWG and exercise type explained an additional 1.7% of the variance in FOWG. CONCLUSION The findings of the current study indicate that momentary levels of FOWG are associated with subsequent adaptive exercise episodes, while higher overall levels of maladaptive exercise were associated with higher levels of FOWG. Future treatments should place a greater emphasis on reducing the frequency of maladaptive exercise by providing strategies for reducing FOWG. LEVEL OF EVIDENCE Level IV: Evidence obtained from multiple time series analysis such as case studies.
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Affiliation(s)
- Elizabeth W Lampe
- Department of Psychology, Drexel University, Philadelphia, PA, USA.
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
| | - Olivia Wons
- Department of Psychology, Drexel University, Philadelphia, PA, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Lauren C Taylor
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Adrienne S Juarascio
- Department of Psychology, Drexel University, Philadelphia, PA, USA
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
| | - Stephanie M Manasse
- Center for Weight Eating and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
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43
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Ritholz M, Salvia M, Craigen KLE, Quatromoni P. What helps and what hinders primary care treatment for women with type 2 diabetes and binge eating disorder? A qualitative study. Diabet Med 2022; 39:e14887. [PMID: 35593036 DOI: 10.1111/dme.14887] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/17/2022] [Indexed: 12/01/2022]
Abstract
AIM Although binge-eating disorder (BED) is a common comorbidity of type 2 diabetes, little is known about the treatment experiences for persons with both conditions. Our aim was to explore perceptions of Primary Care Providers' (PCPs') treatment among adult women with both diagnoses. METHODS In this qualitative descriptive study, we conducted semi-structured interviews with a sample of 21 women (90% non-Hispanic white; mean age 49 ± 14.8 years, mean body mass index [BMI] 43.8 ± 8.4; 48% had type 2 diabetes, mean HbA1c 68 mmol/mol, 8.4%) who had previously participated in a secondary care specialized eating disorder treatment programme. Interviews were audio-recorded, transcribed and analysed using thematic analysis and NVivo 12. RESULTS Participants described PCPs' helpful and unhelpful attitudes and behaviours during type 2 diabetes and BED treatment experiences. Helpful treatment was experienced when PCPs demonstrated a person-centred approach by providing adequate diabetes education, individualized care and non-judgmental attitudes from which participants reported increased understanding of diabetes and BED, improved diabetes self-care and fewer negative self-perceptions. Unhelpful treatment occurred when PCPs did not provide sufficient diabetes education and manifested deficient understanding of BED characterized by simplistic advice or judgmental attitudes, from which participants reported having limited knowledge and understanding of diabetes and BED, low self-efficacy, diminished trust and feelings of guilt, shame and failure. CONCLUSIONS We propose a preliminary pathways treatment model derived from our findings, which utilizes integrated type 2 diabetes and BED education and person-centred collaboration. This preliminary model needs to be tested in quantitative research with a larger sample.
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Affiliation(s)
- Marilyn Ritholz
- Joslin Diabetes Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Margaret Salvia
- Boston University, Boston, Massachusetts, USA
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Paula Quatromoni
- Boston University, Boston, Massachusetts, USA
- Walden Behavioral Care, Waltham, Massachusetts, USA
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Flatt RE, Thornton LM, Smith T, Mitchell H, Argue S, Baucom BRW, Deboeck PR, Adamo C, Kilshaw RE, Shi Q, Tregarthen J, Butner JE, Bulik CM. Retention, engagement, and binge-eating outcomes: Evaluating feasibility of the Binge-Eating Genetics Initiative study. Int J Eat Disord 2022; 55:1031-1041. [PMID: 35502471 PMCID: PMC9357123 DOI: 10.1002/eat.23726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Using preliminary data from the Binge-Eating Genetics Initiative (BEGIN), we evaluated the feasibility of delivering an eating disorder digital app, Recovery Record, through smartphone and wearable technology for individuals with binge-type eating disorders. METHODS Participants (n = 170; 96% female) between 18 and 45 years old with lived experience of binge-eating disorder or bulimia nervosa and current binge-eating episodes were recruited through the Recovery Record app. They were randomized into a Watch (first-generation Apple Watch + iPhone) or iPhone group; they engaged with the app over 30 days and completed baseline and endpoint surveys. Retention, engagement, and associations between severity of illness and engagement were evaluated. RESULTS Significantly more participants in the Watch group completed the study (p = .045); this group had greater engagement than the iPhone group (p's < .05; pseudo-R2 McFadden effect size = .01-.34). Overall, binge-eating episodes, reported for the previous 28 days, were significantly reduced from baseline (mean = 12.3) to endpoint (mean = 6.4): most participants in the Watch (60%) and iPhone (66%) groups reported reduced binge-eating episodes from baseline to endpoint. There were no significant group differences across measures of binge eating. In the Watch group, participants with fewer episodes of binge eating at baseline were more engaged (p's < .05; pseudo-R2 McFadden = .01-.02). Engagement did not significantly predict binge eating at endpoint nor change in binge-eating episodes from baseline to endpoint for both the Watch and iPhone groups. DISCUSSION Using wearable technology alongside iPhones to deliver an eating disorder app may improve study completion and app engagement compared with using iPhones alone.
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Affiliation(s)
- Rachael E. Flatt
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Psychology and NeuroscienceUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Tosha Smith
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hannah Mitchell
- Department of PsychologyEast Tennessee State UniversityJohnson CityTennesseeUSA
| | | | | | | | - Colin Adamo
- Department of PsychologyUniversity of UtahSalt Lake CityUtahUSA
| | | | - Qinxin Shi
- Department of PsychologyUniversity of UtahSalt Lake CityUtahUSA
| | | | | | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
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do Rosário Caldas N, Braulio VB, Brasil MAA, Furtado VCS, de Carvalho DP, Cotrik EM, Dantas JR, Zajdenverg L. Binge eating disorder, frequency of depression, and systemic inflammatory state in individuals with obesity - A cross sectional study. Arch Endocrinol Metab 2022; 66:489-497. [PMID: 35758834 PMCID: PMC10697643 DOI: 10.20945/2359-3997000000489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 03/07/2022] [Indexed: 06/15/2023]
Abstract
Introduction Binge eating disorder (BED) is the most prevalent eating disorder in individuals with obesity. Its association with factors that control hunger and satiety has not yet been elucidated. We evaluated whether levels of inflammatory markers, frequency of psychiatric comorbidities, and appetite-related hormones levels differ between individuals with obesity with and without BED. Subjects and methods The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 - Clinician Version (SCID-5-CV), Binge Eating Scale, and Hospital Anxiety and Depression Scale were evaluated in 39 individuals with obesity. Plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), leptin, ghrelin, and glucagon-like peptide-1 (GLP-1) were measured. Results Individuals of the BED group exhibited significantly higher percentages of altered eating patterns (hyperphagia, bingeing, post-dinner eating, feeling "stuffed", and emotional eating), higher depressive symptom scores and levels of leptin, CRP, and TNF-α, compared to those from the non-BED group. Logistic regression showed that BED was independently associated with depressive symptoms and CRP levels. Conclusion Individuals with obesity and BED showed greater psychiatric comorbidity, worse eating patterns and worse inflammatory profile than those without BED. BED should be assessed as an indicator of clinical severity in patients with obesity.
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Affiliation(s)
- Nelson do Rosário Caldas
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil,
| | - Valeria Bender Braulio
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
| | - Marco Antônio Alves Brasil
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil
| | | | - Denise Pires de Carvalho
- Universidade Federal do Rio de Janeiro, Instituto de Biofísica Carlos Chagas Filho, Rio de Janeiro, RJ, Brasil
| | - Ervin Michelstaedter Cotrik
- Universidade Federal do Rio de Janeiro, Serviço de Psiquiatria e Psicologia Médica, Rio de Janeiro, RJ, Brasil
| | - Joana Rodrigues Dantas
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
| | - Lenita Zajdenverg
- Universidade Federal do Rio de Janeiro, Serviço de Nutrologia, Rio de Janeiro, RJ, Brasil
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46
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Chua SN, Fitzsimmons-Craft EE, Austin SB, Wilfley DE, Taylor CB. Estimated prevalence of eating disorders in Malaysia based on a diagnostic screen. Int J Eat Disord 2022; 55:763-775. [PMID: 35366018 PMCID: PMC9167751 DOI: 10.1002/eat.23711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 01/28/2023]
Abstract
Eating disorders (EDs) are debilitating health conditions and common across cultures. Recent reports suggest that about 14.0% of university students in Malaysia are at risk for developing an ED, and that prevalence may differ by ethnicity and gender. However, less is known about the prevalence of EDs in nonuniversity populations. OBJECTIVE The current study seeks to (1) estimate the prevalence of EDs and ED risk status among adults in Malaysia using an established diagnostic screen; (2) examine gender and ethnic differences between ED diagnostic/risk status groups; and (3) characterize the clinical profile of individuals who screen positive for an ED. METHOD We administered the Stanford-Washington University Eating Disorder Screen, an online ED screening tool, to adults in Malaysia in September 2020. RESULTS ED risk/diagnostic categories were assigned to 818 participants (ages 18-73 years) of which, 0.8% screened positive for anorexia nervosa, 1.4% for bulimia nervosa, 0.1% for binge-ED, 51.4% for other specified feeding or ED, and 4.8% for avoidant/restrictive food intake disorder. There was gender parity in the high risk and the overall ED categories. The point prevalence of positive eating pathology screening among Malays was significantly higher than Chinese but no different from Indians. DISCUSSION This is the first study to estimate the prevalence of EDs using a diagnostic screen in a population-based sample of Malaysians. It is concerning that over 50% of Malaysians reported symptoms of EDs. This study highlights the need to invest more resources in understanding and managing eating pathology in Malaysia. PUBLIC SIGNIFICANCE This study estimates the prevalence of EDs among adults in Malaysia using an online EDs screen. Over 50% of Malaysians report symptoms of EDs. The study highlights the need for more resources and funding to address this important public health issue through surveillance, prevention, and treatment of EDs in Malaysia.
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Affiliation(s)
- Sook Ning Chua
- Relate Mental Health Malaysia, Kuala Lumpur, Malaysia
- School of Biological Sciences, College of Science, Nanyang Technological University, Singapore, Singapore
| | | | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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Abstract
Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018-2020 is estimated to be 0.6-1.8% in adult women and 0.3-0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging treatment approaches. Psychotherapy is the first-line treatment for BED. Recognition and research on BED has increased since its inclusion into DSM-5; however, continuing efforts are needed to understand underlying mechanisms of BED and to improve prevention and treatment outcomes for this disorder. These efforts should also include screening, identification and implementation of evidence-based interventions in routine clinical practice settings such as primary care and mental health outpatient clinics.
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany.
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | | | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
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Qian J, Wu Y, Liu F, Zhu Y, Jin H, Zhang H, Wan Y, Li C, Yu D. An update on the prevalence of eating disorders in the general population: a systematic review and meta-analysis. Eat Weight Disord 2022; 27:415-428. [PMID: 33834377 PMCID: PMC8933366 DOI: 10.1007/s40519-021-01162-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/01/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To update the prevalence of eating disorders in the general population before 2021 and to analyze the distribution characteristics at different times and in different regions and sexes, as well as the diagnostic criteria. METHODS Based on the method from a previous report by the authors, studies were identified from the following databases: PubMed/Medline, PsycINFO, ISI Web of Knowledge, Ovid and the 4 most important Chinese databases. Articles in English and Chinese before 2021 were retrieved. The data retrieved at this time were pooled with the data from a previous report for analyses. RESULTS Thirty-three studies were identified, which included 18 studies supplemented in this retrieval. The pooled lifetime and 12-month prevalence of eating disorders were 0.91% (95% CI, 0.48-1.71) and 0.43% (95% CI, 0.18-0.78), respectively. The pooled lifetime and 12-month prevalence of the subgroup EDs (any), which covers all types of eating disorders, were 1.69% and 0.72%, respectively. The lifetime prevalence of AN, BN and BED was 0.16% (95% CI, 0.06-0.31), 0.63% (95% CI, 0.33-1.02) and 1.53% (95% CI, 1.00-2.17), respectively. The lifetime prevalence of EDs in Western countries was 1.89%, and was high at 2.58% in females. Prevalence studies using DSM-5 criteria were scarce. CONCLUSIONS The prevalence of eating disorders might be underestimated thus far. Not all types of EDs were included in a majority of epidemiological surveys, and the prevalence rates of the new types of EDs were significantly higher. Eating disorders were especially common in Western countries and in females. New diagnostic criteria should be used to comprehensively assess all types of eating disorders. LEVEL OF EVIDENCE 1, systematic review and meta-analysis.
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Affiliation(s)
- Jie Qian
- Shanghai Yangpu District Central Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ying Wu
- Shanghai Tianyou Hospital, Shanghai, China
| | - Fanxiao Liu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yikang Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Jin
- Shanghai Yangpu District Central Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hongmei Zhang
- Shanghai Yangpu District Mental Health Center, Shanghai, China
| | - Yumei Wan
- Shandong Mental Health Center, Jinan, China
| | - Chunbo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dehua Yu
- Shanghai Yangpu District Central Hospital, Tongji University School of Medicine, Shanghai, China.
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Wonderlich JA, Crosby RD, Engel SG, Crow SJ, Peterson CB, Le Grange D, Wonderlich SA, Fischer S. Negative affect and binge eating: Assessing the unique trajectories of negative affect before and after binge-eating episodes across eating disorder diagnostic classifications. Int J Eat Disord 2022; 55:223-230. [PMID: 34877679 PMCID: PMC8861898 DOI: 10.1002/eat.23648] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Ecological momentary assessment (EMA) studies suggest that among individuals who binge eat, emotional states and binge eating are functionally related. However, it is unclear whether the trajectory of negative affect (NA) is the same across diagnostic groups or if specific changes in affect are unique to each diagnostic category. This study examined the moderating effect of diagnosis on the trajectory of negative affect before and after binge eating. METHOD Adults with eating disorder diagnoses (anorexia nervosa [AN] = 118, bulimia nervosa [BN] = 133, binge-eating disorder [BED] = 112) completed an EMA where they reported binge eating and negative affect throughout the day. Generalized estimating equation analyses were used to model the trajectories of NA before and after binge eating. RESULTS For all individuals, the linear trajectory of NA significantly increased before (B = 0.044, p < .001) and decreased following the binge-eating episode (B = -0.054, p < .001). However, diagnosis moderated this trajectory. Specifically, individuals with BN had a greater change in linear trajectories of NA before (B = 2.305, p < .001) and after (B = -4.149, p < .001) binge eating compared to those with BED, but not those with AN. There were no differences in the trajectory of NA between individuals with BED or AN. DISCUSSION These findings suggest that binge-eating episodes in BN may be more strongly associated with NA than in BED, but similar to binge-eating episodes in AN.
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Affiliation(s)
- Joseph A. Wonderlich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Ross D. Crosby
- Sanford Research Center for Biobehavioral Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott G. Engel
- Sanford Research Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Scott J. Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- The Emily Program, Minneapolis, Minnesota, USA
| | - Carol B. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Science, University of California San Francisco, San Francisco, California, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, Illinois, USA
| | - Stephen A. Wonderlich
- Sanford Research Center for Biobehavioral Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Sarah Fischer
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
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50
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Merwin KE, Mackinnon SP, O'Connor RM, Flett GL. Socially prescribed perfectionism predicts next-day binge eating behaviors over 20-days. J Couns Psychol 2021; 69:554-564. [PMID: 34941306 DOI: 10.1037/cou0000600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults (N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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