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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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2
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Meule A. On the prevalence of 'food addiction' in persons with bulimia nervosa. Eur Eat Disord Rev 2024; 32:490-492. [PMID: 38200630 DOI: 10.1002/erv.3061] [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: 01/12/2024]
Abstract
A meta-analysis by Praxedes and colleagues published in this journal reports that the prevalence of 'food addiction' as measured with the Yale Food Addiction Scale is lower than 50% in persons with bulimia nervosa and higher in persons with binge eating disorder. However, closely examining the supplementary material of that article reveals that these numbers cannot possibly be correct. Instead, most studies indicate that the prevalence of 'food addiction' is higher than 80% in persons with bulimia nervosa and, thus, higher than in persons with other eating disorders.
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Affiliation(s)
- Adrian Meule
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany
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3
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Lalonde-Bester S, Malik M, Masoumi R, Ng K, Sidhu S, Ghosh M, Vine D. Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review. Adv Nutr 2024; 15:100193. [PMID: 38408541 PMCID: PMC10973592 DOI: 10.1016/j.advnut.2024.100193] [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: 08/15/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder affecting females across the lifespan. Eating disorders (EDs) are psychiatric conditions that may impact the development of PCOS and comorbidities including obesity, metabolic syndrome, and type 2 diabetes. The aim of this scoping review was to determine the prevalence of EDs and disordered eating, and to review the etiology of EDs in PCOS. The review was conducted using search terms addressing PCOS, EDs, and disordered eating in databases, including PubMed, Scopus, PsycINFO, and CINAHL. Structured interviews, self-administered questionnaires, chart review, or self-reported diagnosis were used to identify EDs in 38 studies included in the review. The prevalence of any ED in those with PCOS ranged from 0% to 62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios (ORs) of an elevated ED score compared with controls. In those with PCOS, 30% had a higher OR of bulimia nervosa and binge ED was 3-fold higher compared with controls. Studies were limited on anorexia nervosa and other specified feeding or ED (such as night eating syndrome) and these were not reported to be higher in PCOS. To our knowledge, no studies reported on avoidant/restrictive food intake disorder, rumination disorder, or pica in PCOS. Studies showed strong associations between overweight, body dissatisfaction, and disordered eating in PCOS. The etiologic development of EDs in PCOS remains unclear; however, psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied because of the use of different diagnostic and screening tools. Screening of all individuals with PCOS for EDs is recommended and high-quality studies on the prevalence, pathogenesis of specific EDs, relationship to comorbidities, and effective interventions to treat ED in those with PCOS are needed.
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Affiliation(s)
- Sophie Lalonde-Bester
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mishal Malik
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Reihaneh Masoumi
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Ng
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Simran Sidhu
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Donna Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada.
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4
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Pascoe LA, Mikhail ME, Burt SA, Culbert KM, Klump KL. Shared genetic influences between eating disorders and gastrointestinal disease in a large, population-based sample of adult women and men. Psychol Med 2024; 54:1184-1195. [PMID: 37920985 DOI: 10.1017/s003329172300301x] [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: 11/04/2023]
Abstract
BACKGROUND Some preliminary research suggests higher rates of gastrointestinal disease in individuals with eating disorders (EDs). However, research is limited, and it remains unknown what etiologic factors account for observed associations. This was the first study to examine how EDs and dimensional ED symptoms (e.g. body dissatisfaction, binge eating) are phenotypically and etiologically associated with gastrointestinal disease in a large, population-based twin sample. METHODS Adult female (N = 2980) and male (N = 2903) twins from the Michigan State University Twin Registry reported whether they had a lifetime ED (anorexia nervosa, bulimia nervosa, or binge-eating disorder) and completed a measure of dimensional ED symptoms. We coded the presence/absence of lifetime gastrointestinal disease (e.g. inflammatory bowel disease) based on responses to questions regarding chronic illnesses and medications. We first examined whether twins with gastrointestinal disease had higher rates of EDs and ED symptoms, then used correlated factors twin models to investigate genetic and environmental contributions to the overlap between disorders. RESULTS Twins with gastrointestinal disease had significantly greater dimensional ED symptoms (β = 0.21, p < 0.001) and odds of a lifetime ED (OR 2.90, p = 0.001), regardless of sex. Shared genetic factors fully accounted for the overlap between disorders, with no significant sex differences in etiologic associations. CONCLUSIONS Comorbidity between EDs and gastrointestinal disease may be explained by overlap in genetic influences, potentially including inflammatory genes implicated in both types of disorders. Screening for gastrointestinal disease in people with EDs, and EDs in those with gastrointestinal disease, is warranted.
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Affiliation(s)
- Laura A Pascoe
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kristen M Culbert
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
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5
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Kerr JA, Paine J, Thrower E, Hoq M, Mollica C, Sawyer SM, Azzopardi PS, Pang KC. Prevalence of Eating Disorder Symptoms in Transgender and Gender Diverse Adolescents Presenting for Gender-Affirming Care. J Adolesc Health 2024; 74:850-853. [PMID: 38206224 DOI: 10.1016/j.jadohealth.2023.11.396] [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: 03/15/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To describe the prevalence of eating disorder symptoms among adolescents seeking gender-affirming care. METHODS Cross-sectional study of 660 gender-diverse adolescents who completed the Branched Eating Disorder Test to measure anorexia and bulimia symptoms. RESULTS 23.9% (95% CI 20.7-27.4) reported both anorexia symptoms, namely overvaluation of weight and fear of (or recurrent interference with) weight gain. 0.9% (95% CI 0.3-2.0) reported all bulimia symptoms, namely overvaluation of weight, recurrent binge eating, and recurrent compensatory behaviors (e.g., weekly purging). For all symptoms, prevalence was higher among i) adolescents assigned female at birth compared to those assigned male at birth, and ii) adolescents who felt unsure about their gender identity compared to those who identified as trans or nonbinary. DISCUSSION Clinicians should monitor eating disorder symptoms among adolescents presenting for gender-affirming care, especially among those assigned female at birth or who are unsure about their gender identity.
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Affiliation(s)
- Jessica A Kerr
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; Population Health and Clinical Sciences Themes, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica Paine
- Royal Children's Hospital Department of Adolescent Medicine, Parkville, Victoria, Australia
| | - Emily Thrower
- Royal Children's Hospital Department of Adolescent Medicine, Parkville, Victoria, Australia
| | - Monsurul Hoq
- Population Health and Clinical Sciences Themes, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Mollica
- Royal Children's Hospital Department of Adolescent Medicine, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Population Health and Clinical Sciences Themes, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Peter S Azzopardi
- Population Health and Clinical Sciences Themes, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Adolescent Health and Wellbeing Program, Telethon Kids Institute, Adelaide, South Australia, Australia
| | - Ken C Pang
- Population Health and Clinical Sciences Themes, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital Department of Adolescent Medicine, Parkville, Victoria, Australia.
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6
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Michel EJ, Reich G, Meyer T. Parent-child age gaps in patients with anorexia and bulimia nervosa and their associations with family dysfunction. Neuropsychiatr 2024; 38:32-38. [PMID: 36287385 DOI: 10.1007/s40211-022-00433-0] [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: 07/30/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Family factors are linked to the development of anorexia nervosa (AN) and bulimia nervosa (BN). However, due to a lack of direct comparison, it is still unknown whether the two entities of eating disorders differ with respect to the age gaps between parents and their affected children. METHODS In a cohort of 568 patients from the FamFINED study (FAMily Factors INvolved in Eating Disorders) diagnosed with eating disorders, we assessed the relationships between the parent-child age differences and family dysfunction, as determined by means of the General Family Questionnaire ("Allgemeiner Familienbogen" [FBA]). RESULTS Data showed that the age difference between the mother and the affected child was significantly higher in AN compared to BN patients (29.3 ± 5.3 vs. 28.3 ± 5.1 years, p = 0.017). Logistic regression confirmed that, also in adjusted models, the mother-child age difference significantly differed between the diagnoses of the two eating disorders (exp (B) = 0.918, 95% confidence interval 0.87-0.97, p = 0.004). However, the paternal age difference did not reach a statistical significance in the comparison between the two groups (p = 0.071). CONCLUSIONS The two entities of eating disorders differed significantly with respect to the age difference between the mother and the affected subject. The maternal age difference was higher in anorectic than in bulimic patients from the same study population. Further research is required to identify the psychophysiological mechanisms underlying these age-dependent effects.
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Affiliation(s)
- Emma Josephine Michel
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany
| | - Günter Reich
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany.
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Çiçekoğlu Öztürk P, Taştekin Ouyaba A. Prevalence and related factors of eating disorders in pregnancy: a systematic review and meta-analysis. Arch Gynecol Obstet 2024; 309:397-411. [PMID: 37162562 DOI: 10.1007/s00404-023-07051-3] [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: 01/16/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To reveal the prevalence of eating disorders (EDs) and related factors in pregnancy. METHODS The search was performed in PubMed, EBSCOhost, Web of Science, Scopus, Google Scholar, and Ovid databases search up to April 3, 2022, using the keywords combination of "(eating disorders OR anorexia nervosa OR bulimia nervosa OR binge eating disorder) AND (pregnancy OR pregnant)". Two researchers independently extracted data from the articles using a standard form. We evaluated the quality of the studies according to the Joanna Briggs Institute assessment tools. RESULTS The prevalence of EDs in pregnant women in the 11 studies involving 2,369,520 pregnant women was ranging between 0.5 and 10.6%. The prevalence of EDs in pregnant women was 4.3% (95% confidence interval 2%-9%; I2 = 99.5%). The prevalence of anorexia nervosa and binge eating disorder during pregnancy shows a statistically significant increase compared to pre-pregnancy, and the prevalence of bulimia nervosa during pregnancy decreases. The prevalence of EDs is higher in pregnant women under 30 years of age, secondary school graduates, married, and with normal BMI. Half of the pregnant women with EDs had anxiety and about one-third of pregnant women had depression. Excessive exercise is observed in 0.7% of pregnant women, fasting in 0.3%, laxative or diuretic use in 0.1%, and self-induced vomiting in 0.6%. CONCLUSIONS This study is important as it is the first systematic review and meta-analysis to reveal the global prevalence of EDs in pregnant women and related factors. Continuing routine screening tests to detect EDs during pregnancy may contribute to taking special preventive measures for risk groups and protecting mother-child health. TRIAL REGISTRATION PROSPERO registration number (CRD42022324721), date of registration: 10/05/2022.
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Affiliation(s)
- Pınar Çiçekoğlu Öztürk
- Department of Psychiatric Nursing, Fethiye Faculty of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Ayşe Taştekin Ouyaba
- Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, Afyon, Turkey
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8
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Lawson ML, Hisle-Gorman E, Susi A, Dorr M, Nylund CM, Chokshi B. Impact of the COVID-19 pandemic on care for anorexia and bulimia nervosa in US military-connected adolescents and young adults. Int J Eat Disord 2024; 57:376-387. [PMID: 38069451 DOI: 10.1002/eat.24105] [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: 07/17/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 02/10/2024]
Abstract
OBJECTIVE This study examined the impact of the COVID-19 pandemic on healthcare engagement for anorexia nervosa (AN) and bulimia nervosa (BN) in a large, geographically diverse population. METHOD This repeated monthly, cross-sectional study queried Military Health System records of individuals aged 10-21 before and during the pandemic (February 2019-January 2022). ICD-10 codes identified encounters for AN and BN. Monthly rates of care were modeled as the number of unique individuals with an ICD-10-identified eating disorder-related encounter per month divided by the enrolled population. Poisson regression analysis evaluated rates of care stratified by eating disorder, clinical setting, and sex. RESULTS In a population of 1.76 million adolescents and young adults, 1629 individuals with AN or BN received care during the pre-pandemic period; 3256 received care during the pandemic. The monthly rate of care for females with AN during the pandemic increased in inpatient settings (adjusted relative risk [aRR]: 1.31 [1.16-1.49]) and outpatient settings (aRR: 1.42 [1.37-1.47]); monthly care rates in males with AN increased in the outpatient setting (aRR: 1.46 [1.28-1.67]). Females with BN had increased engagement in outpatient settings (aRR: 1.09 [1.03-1.16]); BN care for males showed no significant monthly changes during the pandemic period in either healthcare setting. DISCUSSION With increased rates of AN and BN disorder-related care during the pandemic, screening for eating disorder symptomatology may allow for timely diagnosis and intervention in periods of heightened stress. Pandemic-related increases in healthcare engagement may strain limited resources, emphasizing a need to expand accessibility of clinical expertise. PUBLIC SIGNIFICANCE This study indicates that monthly rates of healthcare engagement during the COVID-19 pandemic for AN and BN varied based on clinical setting and sex in an adolescent and young adult population. The increased number of individuals seeking eating disorder-related care, especially outpatient care, attributed to heightened stressors necessitates accessible professionals with eating disorder clinical expertise.
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Affiliation(s)
- Michelle L Lawson
- Department of Pediatrics, Division of Adolescent Medicine, Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas, USA
| | - Elizabeth Hisle-Gorman
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Madeline Dorr
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA
| | - Cade M Nylund
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Binny Chokshi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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9
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Nielsen S, Vilmar JW. Educational attainment in eating disorders: What can we learn from visualising data. Eur Eat Disord Rev 2024; 32:3-12. [PMID: 37501224 DOI: 10.1002/erv.3015] [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: 05/05/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Educational attainment is an understudied outcome in eating disorders (ED). We compared the educational attainment of individuals with and without ED. METHODS This study is a nationwide, register-based, observational epidemiological study using record linkage. The studied cohorts were (1) all persons treated psychiatrically for ED from 1970 to 2014, and (2) a control population matched for sex, age, and place of residence. The International Standard Classification of Education 2011 was used to classify educational attainment. We employed ineqord, a series of graphical and analytical tools that are appropriate for comparing the distributions of ordinal data (Jenkins, 2020). RESULTS Females with ED attained higher educational levels than males with ED. Males with ED had lower average educational levels than controls. On average, female controls attained higher educational levels than patients with ED in the eating disorders not otherwise specified or overeating groups. Females with anorexia nervosa, differed from matched controls: While their median was the same, too many participants were in the lower and higher levels of educational attainment. Females with bulimia nervosa had higher educational levels than matched controls on average. CONCLUSIONS Educational attainment differs between individuals with and without out ED for all ED diagnoses and in both sexes.
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Affiliation(s)
- Søren Nielsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Janne Walløe Vilmar
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Roskilde, Denmark
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10
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Soullane S, Israël M, Steiger H, Chadi N, Low N, Dewar R, Ayoub A, Auger N. Association of hospitalization for suicide attempts in adolescent girls with subsequent hospitalization for eating disorders. Int J Eat Disord 2023; 56:2223-2231. [PMID: 37646466 DOI: 10.1002/eat.24052] [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: 04/28/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To determine the association between adolescent hospitalization for suicide attempts and the subsequent risk of eating disorder hospitalization. METHOD This was a cohort study of 162,398 adolescent girls in Quebec, Canada, including 7741 with suicide attempts before 20 years of age, matched to 154,657 adolescents with no attempt between 1989 and 2019. The main exposure measure was suicide attempt hospitalization. The main outcome measure was hospitalization for an eating disorder up to 31 years later, including anorexia nervosa, bulimia nervosa, and other eating disorders. We used adjusted Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between adolescent suicide attempts and eating disorder hospitalization. RESULTS Adolescent girls admitted for a suicide attempt had 5.55 times the risk of eating disorder hospitalization over time (95% CI 3.74-8.23), compared with matched controls. Suicide attempt was associated with anorexia nervosa (HR 3.57, 95% CI 1.78-7.17) and bulimia nervosa and other eating disorders (HR 8.55, 95% CI 5.48-13.32). Associations were pronounced in girls with repeated suicide attempts. Girls who attempted suicide through self-poisoning had an elevated risk of anorexia nervosa, whereas girls who used violent methods such as cutting or piercing had a greater risk of bulimia nervosa and other eating disorders. Suicide attempt was strongly associated with eating disorder hospitalization in the year following the attempt, but associations persisted throughout follow-up. DISCUSSION Suicide attempt admission is associated with the long-term risk of eating disorder hospitalization in adolescent girls. PUBLIC SIGNIFICANCE This study of adolescent girls suggests that suicide attempt admission is associated with the long-term risk of hospitalization for eating disorders. The risk is greatest in the year after the attempt, but persists over time. Adolescents who present with a suicide attempt may benefit from screening for eating disorders and long-term follow-up to help prevent the exacerbation or development of eating disorders.
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Affiliation(s)
- Safiya Soullane
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Mimi Israël
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Howard Steiger
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Nicholas Chadi
- Department of Pediatrics, Sainte-Justine University Hospital Centre, Montreal, Quebec, Canada
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Ron Dewar
- Cancer Care Program, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
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11
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Mushtaq T, Ashraf S, Hameed H, Irfan A, Shahid M, Kanwal R, Aslam MA, Shahid H, Koh-E-Noor, Shazly GA, Khan MA, Jardan YAB. Prevalence of Eating Disorders and Their Association with Social Media Addiction among Youths. Nutrients 2023; 15:4687. [PMID: 37960340 PMCID: PMC10647586 DOI: 10.3390/nu15214687] [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: 09/13/2023] [Revised: 10/01/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Eating disorders and excessive attachment to social media are a matter of great concern among youths. This study assessed the prevalence of eating disorders and their association with social media addiction among youths. A descriptive cross-sectional study was conducted on 350 participants aged 14-25 years. Two pre-validated tools were used, i.e., the Eating Attitude Test and the Social Networking Addiction Scale. SPSS was used to analyze the data. Out of the 350 students, 42% had probable eating disorders, and 41.7% had social media addictions. The findings revealed that the chances of having eating disorders were significantly higher among youths who lived in separate places, smoked, and had a family history of eating disorders (p ≤ 0.05). Furthermore, the dieting domain displayed notably higher scores for youths living separately (p ≤ 0.05) and smokers (p ≤ 0.01). Moreover, the scores for bulimia and food preoccupation were significantly higher among participants who were married (p = 0.038), were smokers (p = 0.027), and had a family history of eating disorders (p = 0.001). Higher scores in the oral control domain were reported by females (p ≤ 0.05) and severely obese youths (p ≤ 0.01). Moreover, social media addiction was significantly higher among students aged 18-21 (p ≤ 0.01). Spearman's correlation revealed that social media addiction has a weak positive relationship with eating disorders (r = 0.133, p ≤ 0.01), particularly bulimia and food preoccupation (r = 0.173, p ≤ 0.001). This reflects the need to address the harmful consequences of social media addiction that might raise the likelihood of developing eating disorders, particularly bulimia nervosa.
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Affiliation(s)
- Tehreem Mushtaq
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Seemab Ashraf
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Huma Hameed
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Ali Irfan
- Department of Chemistry, Government College University Faisalabad, Faisalabad 38000, Pakistan;
| | - Maria Shahid
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Rabbia Kanwal
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Muhammad Arslan Aslam
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Hijab Shahid
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Koh-E-Noor
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
| | - Gamal A. Shazly
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mahtab Ahmad Khan
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Lahore 54000, Pakistan
- Institute of Clinical and Experimental Pharmacology and Toxicology, University of Lubeck, 23566 Lubeck, Germany
| | - Yousef A. Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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12
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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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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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Van Dyne A, Washington N, Villodas M, Cronan T. Racial/ethnic differences in anorexia and bulimia diagnoses among U.S. college students. Eat Behav 2023; 50:101779. [PMID: 37418803 DOI: 10.1016/j.eatbeh.2023.101779] [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: 04/02/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
This study examined the prevalence of anorexia nervosa (AN) and bulimia nervosa (BN) diagnoses among college students from different racial/ethnic backgrounds. Utilizing archival data from the American College Health Association - National College Health Assessment II-C (ACHA-NCHA II-C), information from 426,425 college students collected between 2015 and 2019 was examined. Binary logistic regression analyses were conducted to determine the prevalence of AN and BN diagnoses among various racial and ethnic groups. The highest odds of AN diagnosis were observed among American Indian, Alaska Native, or Native Hawaiian (AI/AN/NH) students, with odds ranging from 2.143 (compared to White students) to 3.744 (compared to Black students). White students had higher odds of AN than Black (OR = 1.748), Hispanic/Latino (OR = 1.706), and Asian (OR = 1.531) students. Biracial/Multiracial students had significantly higher odds of AN than Black (OR = 1.653), Hispanic/Latino (OR = 1.616), and Asian (OR = 1.449) students. In terms of BN diagnoses, AI/AN/NH students had the highest odds compared to all other groups, ranging from 2.149 (compared to White students) to 2.899 (compared to Hispanic/Latino students). White students had higher odds of BN than Black (OR = 1.271) and Hispanic/Latino (OR = 1.350) students. Biracial/Multiracial students also had significantly higher odds of BN than Black (OR = 1.388) and Hispanic/Latino (OR = 1.474) students. Asian students had higher odds of BN than Black (OR = 1.252) and Hispanic/Latino (OR = 1.329) students. These findings demonstrate complex patterns of AN and BN diagnoses among different racial/ethnic groups. These results highlight the need for culturally sensitive prevention and treatment plans on college campuses.
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Affiliation(s)
- Angelina Van Dyne
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Nicole Washington
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Miguel Villodas
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Terry Cronan
- Department of Psychology, San Diego State University, San Diego, CA, USA
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15
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Leth-Møller KB, Hebebrand J, Strandberg-Larsen K, Baker JL, Jensen BW. Childhood body mass index and the subsequent risk of anorexia nervosa and bulimia nervosa among women: A large Danish population-based study. Int J Eat Disord 2023; 56:1614-1622. [PMID: 37194360 DOI: 10.1002/eat.23986] [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: 12/15/2022] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Evidence linking childhood body mass index (BMI) with subsequent eating disorders is equivocal. Potential explanations include different study populations and size, and that anorexia nervosa (AN) and bulimia nervosa (BN) should be studied separately. We examined whether birthweight and childhood BMI were associated with subsequent risk of AN and BN in girls. METHOD We included 68,793 girls from the Copenhagen School Health Records Register born between 1960 and 1996 with information on birthweight and measured weights and heights obtained from school health examinations at ages 6-15 years. Diagnoses of AN and BN were retrieved from Danish nationwide patient registers. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS We identified 355 cases of AN (median age: 19.0) and 273 cases of BN (median age: 21.8). Higher childhood BMI was linearly associated with decreasing risk of AN and increasing risk of BN at all childhood ages. At age 6, the HR for AN was 0.85 (95% CI: 0.74-0.97) per BMI z-score and the HR for BN was 1.78 (95% CI: 1.50-2.11) per BMI z-score. Birthweight >3.75 kg was associated with increased risk of BN compared to a birthweight of 3.26-3.75 kg. CONCLUSION Higher BMI in girls at ages 6-15 years was associated with decreasing risk of AN and increasing risk of BN. Premorbid BMI could be relevant for the etiology of AN and BN, and in identifying high risk individuals. PUBLIC SIGNIFICANCE Eating disorders are associated with elevated mortality, especially AN. Using a cohort of Copenhagen school children, we linked information on BMI at ages 6-15 years for 68,793 girls with nationwide patient registers. Low childhood BMI was associated with increased risk of AN, whereas high childhood BMI was associated with increased risk of BN. These findings may assist clinicians in identifying individuals at high-risk of these diseases.
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Affiliation(s)
- Katja Biering Leth-Møller
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Jennifer Lyn Baker
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Britt Wang Jensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
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16
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Yamamiya Y, Desjardins CD, Stice E. Sequencing of symptom emergence in anorexia nervosa, bulimia nervosa, binge eating disorder, and purging disorder in adolescent girls and relations of prodromal symptoms to future onset of these eating disorders. Psychol Med 2023; 53:4657-4665. [PMID: 37698515 DOI: 10.1017/s0033291722001568] [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: 11/06/2022]
Abstract
BACKGROUND To advance knowledge regarding the etiology of eating disorders, we characterized the sequencing of eating disorder symptom emergence for adolescent girls who subsequently developed anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) for community-recruited adolescents and tested whether prodromal symptoms increased risk for future onset of each eating disorder. METHODS Data collected from adolescent girls (N = 496; M age = 13.02, s.d.= 0.73) who completed a diagnostic interview annually over an 8-year period were used to address these aims. RESULTS For all four eating disorders, compensatory weight-control behaviors were the first behavioral symptom to emerge and weight/shape overvaluation was the first cognitive symptom to emerge. Moreover, lower-than-expected BMI predicted future AN onset, binge eating and all cognitive symptoms predicted future BN onset, weight/shape overvaluation predicted future BED onset, and compensatory behavior and all cognitive symptoms predicted future PD onset. These predictive effects were small-to-large in magnitude. Collectively, prodromal symptoms predicted an eating disorder onset with 83-87% accuracy. CONCLUSIONS Results suggest that compensatory weight-control behaviors and weight/shape overvaluation typically emerge before other prodromal symptoms in all eating disorders during adolescence. Moreover, different prodromal symptoms seem to predict future onset of different eating disorders. Screening adolescent girls for these prodromal symptoms and implementing indicated prevention programs designed to reduce these symptoms may prove effective in preventing future onset of eating disorders.
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Affiliation(s)
| | | | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, US
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17
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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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Franzago M, Orecchini E, Porreca A, Mondanelli G, Orabona C, Dalla Ragione L, Di Nicola M, Stuppia L, Vitacolonna E, Beccari T, Ceccarini MR. SLC6A4 DNA Methylation Levels and Serum Kynurenine/Tryptophan Ratio in Eating Disorders: A Possible Link with Psychopathological Traits? Nutrients 2023; 15:nu15020406. [PMID: 36678277 PMCID: PMC9866524 DOI: 10.3390/nu15020406] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Background: The incidence of eating disorders (EDs), serious mental and physical conditions characterized by a disturbance in eating or eating-related behaviors, has increased steadily. The present study aims to develop insights into the pathophysiology of EDs, spanning over biochemical, epigenetic, psychopathological, and clinical data. In particular, we focused our attention on the relationship between (i) DNA methylation profiles at promoter-associated CpG sites of the SCL6A4 gene, (ii) serum kynurenine/tryptophan levels and ratio (Kyn/Trp), and (iii) psychopathological traits in a cohort of ED patients. Among these, 45 patients were affected by restricting anorexia nervosa (AN0), 21 by purging AN (AN1), 21 by bulimia (BN), 31 by binge eating disorders (BED), 23 by unspecified feeding or eating disorders (UFED), and finally 14 by other specified eating disorders (OSFED) were compared to 34 healthy controls (CTRs). Results: Kyn level was higher in BED, UFED, and OSFED compared to CTRs (p ≤ 0.001). On the other hand, AN0, AN1, and BN patients showed significatively lower Kyn levels compared to the other three ED groups but were closed to CTRs. Trp was significantly higher in AN0, AN1, and BN in comparison to other ED groups. Moreover, AN1 and BN showed more relevant Trp levels than CTRs (p <0.001). BED patients showed a lower Trp as compared with CTRs (p ≤ 0.001). In addition, Kyn/Trp ratio was lower in the AN1 subtype but higher in BED, UFED, and OSFED patients than in CTRs (p ≤ 0.001). SCL6A4 DNA methylation level at CpG5 was lower in AN0 compared to BED (p = 0.021), and the CpG6 methylation was also significantly lower in AN0 in comparison to CTRs (p = 0.025). The mean methylation levels of the six CpGs analyzed were lower only in the AN0 subgroup compared to CTRs (p = 0.008). Relevant psychological trait EDI-3 subscales were correlated with biochemical and epigenetic data. Conclusions: These findings underline the complexity of psychological and pathophysiological components of EDs.
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Affiliation(s)
- Marica Franzago
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy
- Center for Advanced Studies and Technology, “G. d’Annunzio” University, 66100 Chieti, Italy
| | - Elena Orecchini
- Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Annamaria Porreca
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy
| | - Giada Mondanelli
- Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Ciriana Orabona
- Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Laura Dalla Ragione
- Food Science and Human Nutrition Unit, University Campus Biomedico of Rome, 00128 Rome, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy
| | - Liborio Stuppia
- Center for Advanced Studies and Technology, “G. d’Annunzio” University, 66100 Chieti, Italy
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy
- Center for Advanced Studies and Technology, “G. d’Annunzio” University, 66100 Chieti, Italy
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy
| | - Maria Rachele Ceccarini
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy
- Correspondence: ; Tel.: +39-075-585-7905
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19
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Zhang R, Kuja-Halkola R, Birgegård A, Larsson H, Lichtenstein P, Bulik CM, Bergen SE. Association of family history of schizophrenia and clinical outcomes in individuals with eating disorders. Psychol Med 2023; 53:371-378. [PMID: 33926592 PMCID: PMC9899560 DOI: 10.1017/s0033291721001574] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Familial co-aggregation studies of eating disorders (EDs) and schizophrenia reveal shared genetic and environment factors, yet their etiological and clinical relationship remains unclear. We evaluate the influence of schizophrenia family history on clinical outcomes of EDs. METHODS We conducted a cohort evaluation of the association between family history of schizophrenia and ED clinical features, psychiatric comorbidities, and somatic and mental health burden in individuals born in Sweden 1977-2003 with anorexia nervosa (AN) or other EDs (OED: bulimia nervosa, binge-eating disorder, and ED not otherwise specified). RESULTS Of 12 424 individuals with AN and 20 716 individuals with OED, 599 (4.8%) and 1118 (5.4%), respectively, had a family history of schizophrenia (in up to third-degree relatives). Among individuals with AN, schizophrenia in first-degree relatives was significantly associated with increased comorbid attention-deficit/hyperactivity disorder (ADHD) [HR(95% CI) 2.26 (1.27-3.99)], substance abuse disorder (SUD) [HR (95% CI) 1.93 (1.25-2.98)], and anxiety disorders [HR (95% CI) 1.47 (1.08-2.01)], but higher lowest illness-associated body mass index (BMI) [1.14 kg/m2, 95% CI (0.19-2.10)]. Schizophrenia in any relative (up to third-degree) in AN was significantly associated with higher somatic and mental health burden, but lower ED psychopathology scores [-0.29, 95% CI (-0.54 to -0.04)]. Schizophrenia in first-degree relatives in individuals with OED was significantly associated with increased comorbid ADHD, obsessive-compulsive disorder, SUD, anxiety disorders, somatic and mental health burden, and suicide attempts. CONCLUSIONS We observed different patterns of ED-related outcomes, psychiatric comorbidity, and illness burden in individuals with EDs with and without family histories of schizophrenia and provide new insights into the diverse manifestations of EDs.
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Affiliation(s)
- Ruyue Zhang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sarah E. Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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20
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Abstract
PURPOSE OF REVIEW Public policy efforts for prevention of and intervention upon eating disorders is severely limited in the United States due to the paucity of population-based data. This review article summarizes findings regarding eating disorders based on the National Epidemiological Studies on Alcohol and Related Conditions, Third Wave. The studies reviewed provide the most recent epidemiological indicators of anorexia nervosa, bulimia nervosa, and binge-eating disorder (BED) in the United States and demonstrate the utility of population-based data for validating the generalizability of findings from clinical samples. RECENT FINDINGS Anorexia nervosa, bulimia nervosa, and BED are widely distributed across sociodemographic characteristics, with substantially elevated risks for a variety of serious psychiatric, medical, and functional impairments, including heighted suicidality over the lifespan. Sexual minorities and individuals with adverse childhood experiences may be particularly vulnerable. Yet, many adults with eating disorders do not seek help, particularly professional help. National Epidemiological Studies on Alcohol and Related Conditions, Third Wave studies also validated some important clinical observations (e.g., overvaluation of shape/weight and physical inactivity in BED, more severe anorexia nervosa with onset prior to 14 years old). SUMMARY More rigorous population-based studies are needed to further advocate for appropriate resources and policies for eating disorders in the United States.
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Affiliation(s)
- Tomoko Udo
- Department of Health Policy, Management and Behavior
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Albany, New York
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
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21
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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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Kolar DR, Mebarak M. An update on the epidemiology of eating disorders in Latin America: current findings and future challenges. Curr Opin Psychiatry 2022; 35:385-389. [PMID: 35855501 DOI: 10.1097/yco.0000000000000813] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW We systematically reviewed the recent literature on the epidemiology of eating disorders in Latin America. RECENT FINDINGS Most screened articles only investigated risk for eating disorders or disordered eating behaviors. Four studies reported prevalence for eating disorders. One study reported age-standardized prevalence ranging from 0.04% [95% confidence interval, CI (0.03, 0.06)] to 0.09% [95% CI (0.07, 0.13)] for anorexia nervosa and from 0.13% [95% CI (0.08, 0.17)] to 0.27% [95% CI (0.18, 0.37)] for bulimia nervosa. Three additional studies conducted in Brazil identified a general eating disorder point-prevalence of 0.40% in children aged 6--14 years and a point-prevalence of 0.7 % [95% CI (0.34, 1.55)] for bulimia nervosa, 1.4% [95% CI (0.81, 2.43)] for binge-eating disorder and 6.2% [95% CI (3.10, 5.27)] for recurrent binge eating. SUMMARY Since 2020, only few studies were published on the epidemiology of full-threshold eating disorders in Latin America. Prevalence was in a comparable range to previous findings. No studies regarding new DSM-5 eating disorder diagnoses were identified, and studies investigating the impact of the COVID-19 pandemic on prevalence or incidence of eating disorders in these countries are needed.
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Affiliation(s)
- David R Kolar
- Department of Psychology, University of Regensburg, Regensburg, Germany
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Birgegård A, Forsén Mantilla E, Dinkler L, Hedlund E, Savva A, Larsson H, Bulik CM. Validity of eating disorder diagnoses in the Swedish national patient register. J Psychiatr Res 2022; 150:227-230. [PMID: 35398665 DOI: 10.1016/j.jpsychires.2022.03.064] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/10/2022] [Accepted: 03/31/2022] [Indexed: 11/18/2022]
Abstract
The Swedish National Patient Register (NPR) includes population-level longitudinal data, and determining the validity of NPR diagnoses is critical to undergirding the research and policy recommendations they inform. Sweden also has the integrated "Riksät" and "Stepwise" National Quality Registers (QR), with data from specialized eating disorder (ED) treatment based on structured, valid assessment methods. To validate NPR ED diagnoses, we compared ICD-10-based anorexia nervosa (AN), bulimia nervosa (BN), and unspecified ED in NPR to DSM-IV-based AN, BN, and ED not otherwise specified category (EDNOS) in QR. Patients' first diagnoses registered in QR between February 2008 and August 2013 were compared with NPR diagnoses entered within ±1 month (N = 2074). QR registration includes the semi-structured DSM-IV-based Structured ED Interview. Each ED diagnosis was analyzed separately for degree of match using several indices: overall agreement, sensitivity, positive predictive value, specificity, negative predictive value, area under the curve, and Cohen's kappa. Results showed moderate to excellent agreement depending on estimate (e.g. positive predictive values AN: 0.747; BN:.836; EDNOS: 0.761), except for a somewhat low sensitivity for BN, and EDNOS agreement was overall the lowest. Case prevalence in the NPR and QR was highly similar for AN, and within five percentage points for BN and EDNOS. Generalizability is hampered by limited age range and diagnostic resolution as well as few males. Available data precluded study of presence/absence of ED, and complementary approaches are considered for future research. We conclude that NPR ED diagnoses have acceptable validity and are appropriate for use in research.
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Affiliation(s)
- Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden.
| | - Emma Forsén Mantilla
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden
| | - Lisa Dinkler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden
| | - Elin Hedlund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden
| | - Androula Savva
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels Väg 12A, 171 77, Stockholm, Sweden
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Abstract
BACKGROUND Eating disorders (ED) have increasingly become a global topic of concern for public health. A better understanding of ED incidence is a basic requirement for improving its management. However, the temporal trend of ED incidence in China is still unknown. METHODS The incidence rates of ED from 1990 to 2017 were collected from the Global Burden of Disease Study 2017 database according to the following: subtype, i.e. anorexia nervosa (AN) and bulimia nervosa (BN); sex; and age group. The average annual percent changes and relative risks were calculated using joinpoint regression and the age-period-cohort model, respectively. RESULTS From 1990 to 2017, age-standardized incidence rates of ED continued to increase in males and females, and this variation trend was observed in AN and BN. Joinpoint regression analysis showed that the incidence rates increased in all age groups. Adolescents had the highest risk of developing ED, followed by young adults. Age effects were the most influential risk factor for ED incidence. Period effects showed that the risk of developing ED continuously increased with increasing time periods in BN, but not in ED and AN. Concerning the cohort effects, people born after the 1990s presented a higher risk of ED, though they presented a lower risk of BN as compared to the whole cohort. CONCLUSIONS ED incidence rates continue to increase in China, particularly among adolescents and young adults. Further etiological studies are needed to explain these increases and to facilitate the early identification of high-risk individuals.
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Affiliation(s)
- Jiayuan Wu
- School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Department of Clinical Research, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Zhixiong Lin
- Department of Psychiatry, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Zhou Liu
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang524001, Guangdong, China
| | - Hairong He
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Ling Bai
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
| | - Jun Lyu
- School of Public Health, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, Guangdong, China
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Abstract
PURPOSE OF REVIEW To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality. RECENT FINDINGS Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk. SUMMARY Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.
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Affiliation(s)
- Annelies E. van Eeden
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | | | - Hans W. Hoek
- Parnassia Psychiatric Institute, The Hague, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
- Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
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26
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Stice E, Desjardins CD, Rohde P, Shaw H. Sequencing of symptom emergence in anorexia nervosa, bulimia nervosa, binge eating disorder, and purging disorder and relations of prodromal symptoms to future onset of these disorders. J Abnorm Psychol 2021; 130:377-387. [PMID: 34180702 PMCID: PMC8244173 DOI: 10.1037/abn0000666] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 11/08/2022]
Abstract
The objective of this study was to characterize the temporal sequencing of symptom emergence for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD), as well as to test whether prodromal symptoms increase risk for future onset of each type of eating disorder and compare the predictive effects to those of established risk factors. Data from four prevention trials that targeted high-risk young women with body image concerns (N = 1,952; Mage = 19.7, SD = 5.7) and collected annual diagnostic interview data over 3-year follow-up were combined to address these aims. Regarding behavioral symptoms, compensatory weight control behaviors typically emerged first for AN, BN, and PD, whereas binge eating typically emerged first for BED. Regarding cognitive symptoms, for AN, weight/shape overvaluation typically emerged first, whereas for BN, BED, and PD, overvaluation typically emerged simultaneously with feeling fat and fear of weight gain. Binge eating, compensatory behaviors, weight/shape overvaluation, fear of weight gain, and feeling fat predicted BN, BED, and PD onset, whereas weight/shape overvaluation, fear of weight gain, and lower than expected body mass index predicted AN onset. Predictive effects of prodromal symptoms were similar in magnitude to those of established risk factors: Collectively, prodromal symptoms and risk factors predicted onset of specific eating disorders with 67-83% accuracy. Results suggest that compensatory weight control behaviors and cognitive symptoms are likely to emerge before binge eating in the various eating disorders and that offering indicated prevention programs to youth with prodromal symptoms may be an effective way to prevent eating disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University
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Yao S, Larsson H, Norring C, Birgegård A, Lichtenstein P, DʼOnofrio BM, Almqvist C, Thornton LM, Bulik CM, Kuja-Halkola R. Genetic and environmental contributions to diagnostic fluctuation in anorexia nervosa and bulimia nervosa. Psychol Med 2021; 51:62-69. [PMID: 31658910 PMCID: PMC7856409 DOI: 10.1017/s0033291719002976] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/12/2019] [Accepted: 09/26/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Anorexia nervosa and bulimia nervosa are two severe eating disorders associated with high premature mortality, suicidal risk and serious medical complications. Transition between anorexia nervosa and bulimia nervosa over the illness course and familial co-aggregation of the two eating disorders imply aetiological overlap. However, genetic and environmental liabilities to the overlap are poorly understood. Quantitative genetic research using clinical diagnosis is needed. METHODS We acquired a clinical diagnosis of anorexia nervosa (prevalence = 0.90%) and bulimia nervosa (prevalence = 0.48%) in a large population-based sample (N = 782 938) of randomly selected full-sisters and maternal half-sisters born in Sweden between 1970 and 2005. Structural equation modelling was applied to quantify heritability of clinically diagnosed anorexia nervosa and bulimia nervosa and the contributions of genetic and environmental effects on their overlap. RESULTS The heritability of clinically diagnosed anorexia nervosa and bulimia nervosa was estimated at 43% [95% confidence interval (CI) (36-50%)] and 41% (31-52%), respectively, in the study population, with the remaining variance explained by variance in unique environmental effects. We found statistically significant genetic [0.66, 95% CI (0.49-0.82)] and unique environmental correlations [0.55 (0.43-0.66)] between the two clinically diagnosed eating disorders; and their overlap was about equally explained by genetic and unique environmental effects [co-heritability 47% (35-58%)]. CONCLUSIONS Our study supports shared mechanisms for anorexia nervosa and bulimia nervosa and extends the literature from self-reported behavioural measures to clinical diagnosis. The findings encourage future molecular genetic research on both eating disorders and emphasize clinical vigilance for symptom fluctuation between them.
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Affiliation(s)
- Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Claes Norring
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Andreas Birgegård
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Stockholm, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian M. DʼOnofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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28
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Mitchison D, Mond J, Bussey K, Griffiths S, Trompeter N, Lonergan A, Pike KM, Murray SB, Hay P. DSM-5 full syndrome, other specified, and unspecified eating disorders in Australian adolescents: prevalence and clinical significance. Psychol Med 2020; 50:981-990. [PMID: 31043181 DOI: 10.1017/s0033291719000898] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [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: 02/05/2023]
Abstract
BACKGROUND Little information is available on the prevalence of Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 eating disorders in adolescence, and eating disorders remain unique in the DSM for not systematically including a criterion for clinical significance. This study aimed to provide the first prevalence report of the full suite of DSM-5 eating disorders in adolescence, and to examine the impact of applying a criterion for clinical significance. METHODS In total, 5191 (participation rate: 70%) Australian adolescents completed a survey measuring 1-month prevalence of eating disorder symptoms for all criterial, 'other specified' and unspecified eating disorders, as well as health-related quality of life and psychological distress. RESULTS The point prevalence of any eating disorder was 22.2% (12.8% in boys, 32.9% in girls), and 'other specified' disorders (11.2%) were more common than full criterial disorders (6.2%). Probable bulimia nervosa and binge eating disorder, but not anorexia nervosa (AN), were more likely to be experienced by older adolescents. Most disorders were associated with an increased odds for being at a higher weight. The prevalence of eating disorders was reduced by 40% (to 13.6%) when a criterion for clinical significance was applied. CONCLUSIONS Eating disorders, particularly 'other specified' syndromes, are common in adolescence, and are experienced across age, weight, socioeconomic and migrant status. The merit of adding a criterion for clinical significance to the eating disorders, similar to other DSM-5 disorders, warrants consideration. At the least, screening tools should measure distress and impairment associated with eating disorder symptoms in order to capture adolescents in greatest need for intervention.
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Affiliation(s)
- Deborah Mitchison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Jonathan Mond
- Centre for Rural Health, University of Tasmania, Launceston, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Kay Bussey
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Scott Griffiths
- School for Psychological Sciences, University of Melbourne, Sydney, Australia
| | - Nora Trompeter
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Alexandra Lonergan
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Kathleen M Pike
- Departments of Psychiatry and Epidemiology, Columbia University, New York, USA
| | - Stuart B Murray
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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29
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Herle M, Stavola BD, Hübel C, Abdulkadir M, Ferreira DS, Loos RJF, Bryant-Waugh R, Bulik CM, Micali N. A longitudinal study of eating behaviours in childhood and later eating disorder behaviours and diagnoses. Br J Psychiatry 2020; 216:113-119. [PMID: 31378207 PMCID: PMC7000294 DOI: 10.1192/bjp.2019.174] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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: 11/23/2022]
Abstract
BACKGROUND Eating behaviours in childhood are considered as risk factors for eating disorder behaviours and diagnoses in adolescence. However, few longitudinal studies have examined this association. AIMS We investigated associations between childhood eating behaviours during the first ten years of life and eating disorder behaviours (binge eating, purging, fasting and excessive exercise) and diagnoses (anorexia nervosa, binge eating disorder, purging disorder and bulimia nervosa) at 16 years. METHOD Data on 4760 participants from the Avon Longitudinal Study of Parents and Children were included. Longitudinal trajectories of parent-rated childhood eating behaviours (8 time points, 1.3-9 years) were derived by latent class growth analyses. Eating disorder diagnoses were derived from self-reported, parent-reported and objectively measured anthropometric data at age 16 years. We estimated associations between childhood eating behaviours and eating disorder behaviours and diagnoses, using multivariable logistic regression models. RESULTS Childhood overeating was associated with increased risk of adolescent binge eating (risk difference, 7%; 95% CI 2 to 12) and binge eating disorder (risk difference, 1%; 95% CI 0.2 to 3). Persistent undereating was associated with higher anorexia nervosa risk in adolescent girls only (risk difference, 6%; 95% CI, 0 to 12). Persistent fussy eating was associated with greater anorexia nervosa risk (risk difference, 2%; 95% CI 0 to 4). CONCLUSIONS Our results suggest continuities of eating behaviours into eating disorders from early life to adolescence. It remains to be determined whether childhood eating behaviours are an early manifestation of a specific phenotype or whether the mechanisms underlying this continuity are more complex. Findings have the potential to inform preventative strategies for eating disorders.
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Affiliation(s)
- Moritz Herle
- Research Associate, Great Ormond Street Institute of Child Health, University College London, UK
| | - Bianca De Stavola
- Professor of Medical Statistics, Great Ormond Street Institute of Child Health, University College London, UK
| | - Christopher Hübel
- PhD Student, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London; UK National Institute for Health Research Biomedical Research Centre, South London and Maudsley Hospital, UK; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Mohamed Abdulkadir
- PhD Student, Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
| | - Diana Santos Ferreira
- Senior Research Associate, Medical Research Council Integrative Epidemiology Unit, University of Bristol; and Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Ruth J F Loos
- Professor, The Charles Bronfman Institute for Personalized Medicine, The Mindich Child Health and Development Institute, Icahn Mount Sinai School of Medicine, New York, USA
| | - Rachel Bryant-Waugh
- Consultant Clinical Psychologist, Great Ormond Street Institute of Child Health, University College London, UK
| | - Cynthia M Bulik
- Professor of Eating Disorders, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Department of Psychiatry, University of North Carolina at Chapel Hill; and Department of Nutrition, University of North Carolina at Chapel Hill, USA
| | - Nadia Micali
- Senior Lecturer and Honorary Consultant Psychiatrist, Great Ormond Street Institute of Child Health, University College London, UK; Department of Psychiatry, Faculty of Medicine, University of Geneva; and Child and Adolescent Psychiatry Division, Department of Child and Adolescent Health, Geneva University Hospital, Switzerland
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Kuipers GS, van der Ark LA, Bekker MHJ. [Attachment, mentalization and autonomy in anorexia nervosa and bulimia nervosa]. Tijdschr Psychiatr 2020; 62:148-156. [PMID: 32141522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Attachment insecurity and difficulty with mentalization are common in patients with eating disorders and might be related to their symptoms and lack of autonomy.<br/> AIM: To investigate the role of attachment and mentalization in the course of anorexia nervosa (AN) and bulimia nervosa (BN).<br/> METHOD: Patients with AN and BN were assessed at the start of treatment, and after 1 year and 1.5 years concerning attachment security and mentalization in relation to eating disorder and co-morbid symptoms and autonomy. The results at the start of treatment were compared to those of controls without an eating disorder.<br/> RESULTS: Attachment insecurity and low level of mentalization were more prevalent in patients than in controls, and associated with borderline personality disorder and/or self-injurious behaviour. Attachment security increased after 1 year of treatment. Recovery from eating disorder after 1 year was related to higher level of mentalization and improvement of autonomy. Low pre-treatment level of mentalization predicted persistence of eating disorder until 1.5 years of follow-up.<br/> CONCLUSION: Good mentalization is associated with recovery from eating disorder. More research on the effect of mentalization based treatment for patients with eating disorders, with or without borderline personality disorder, is recommended.
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Schaumberg K, Zerwas S, Goodman E, Yilmaz Z, Bulik CM, Micali N. Anxiety disorder symptoms at age 10 predict eating disorder symptoms and diagnoses in adolescence. J Child Psychol Psychiatry 2019; 60:686-696. [PMID: 30353925 PMCID: PMC6482103 DOI: 10.1111/jcpp.12984] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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] [Accepted: 08/23/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cross-sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent-reported anxiety in mid-childhood (age 10) and child-reported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population-based sample. METHODS Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14. RESULTS Parent-reported anxiety symptoms at age 10 yielded 5 factors: obsessive-compulsive disorder (OCD) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 (OR = 1.11, p = .007), whereas Factor 4 predicted diagnoses of anorexia nervosa (OR = 1.10, p = .01) and disordered eating by age 16 (OR = 1.08, p = .001). CONCLUSIONS Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescent-onset ED symptoms and ED diagnoses.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Erica Goodman
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
- Department of Psychology, University of North Dakota, United States
| | - Zeynep Yilmaz
- Department of Psychiatry, 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 Institute, Stockholm, Sweden
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States
- Institute of Child Health, University College London, United Kingdom
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32
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Abstract
PURPOSE OF REVIEW The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments. RECENT FINDINGS Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.
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Affiliation(s)
- Bethany A Nightingale
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
| | - Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.
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Schaumberg K, Jangmo A, Thornton LM, Birgegård A, Almqvist C, Norring C, Larsson H, Bulik CM. Patterns of diagnostic transition in eating disorders: a longitudinal population study in Sweden. Psychol Med 2019; 49:819-827. [PMID: 29911514 PMCID: PMC6788452 DOI: 10.1017/s0033291718001472] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 12/31/2022]
Abstract
BACKGROUND Transition across eating disorder diagnoses is common, reflecting instability of specific eating disorder presentations. Previous studies have examined temporal stability of diagnoses in adult treatment-seeking samples but have not uniformly captured initial presentation for treatment. The current study examines transitions across eating disorder diagnostic categories in a large, treatment-seeking sample of individuals born in Sweden and compares these transitions across two birth cohorts and from initial diagnosis. METHODS Data from Swedish eating disorders quality registers were extracted in 2013, including 9622 individuals who were seen at least twice from 1999 to 2013. Patterns of remission were examined in the entire sample and subsequently compared across initial diagnoses. An older (born prior to 1990) and younger birth cohort were also identified, and analyses compared these cohorts on patterns of diagnostic transition. RESULTS Although diagnostic instability was common, transition between threshold eating disorder diagnoses was infrequent. For all diagnoses, transition to remission was likely to occur following a diagnosis state that matched initial diagnosis, or through a subthreshold diagnostic state. Individuals in the younger cohort were more likely to transition to a state of remission than those in the older cohort. CONCLUSIONS Results indicate more temporal continuity in eating disorder presentations than suggested by previous research and highlight the importance of early detection and intervention in achieving remission.
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Affiliation(s)
- Katherine Schaumberg
- Department of Psychiatry,University of North Carolina at Chapel Hill,Chapel Hill, NC,USA
| | - Andreas Jangmo
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - Laura M Thornton
- Department of Psychiatry,University of North Carolina at Chapel Hill,Chapel Hill, NC,USA
| | - Andreas Birgegård
- Department of Clinical Neuroscience,Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council,Stockholm,Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - Claes Norring
- Department of Clinical Neuroscience,Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council,Stockholm,Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - Cynthia M Bulik
- Department of Psychiatry,University of North Carolina at Chapel Hill,Chapel Hill, NC,USA
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Glazer KB, Sonneville KR, Micali N, Swanson SA, Crosby R, Horton NJ, Eddy KT, Field AE. The Course of Eating Disorders Involving Bingeing and Purging Among Adolescent Girls: Prevalence, Stability, and Transitions. J Adolesc Health 2019; 64:165-171. [PMID: 30509766 PMCID: PMC10535941 DOI: 10.1016/j.jadohealth.2018.09.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [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: 05/08/2018] [Revised: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE To quantify eating disorder (ED) stability and diagnostic transition among a community-based sample of adolescents and young adult females in the United States. METHODS Using 11 prospective assessments from 9,031 U.S. females ages 9-15 years at baseline of the Growing Up Today Study, we classified cases of the following EDs involving bingeing and purging: bulimia nervosa (BN), binge ED, purging disorder (PD), and subthreshold variants defined by less frequent (monthly vs. weekly) bingeing and purging behaviors. We measured number of years symptomatic and probability of maintaining symptoms, crossing to another diagnosis, or resolving symptoms across consecutive surveys. RESULTS Study lifetime disorder prevalence was 2.1% for BN and roughly 6% each for binge ED and PD. Most cases reported symptoms during only one survey year. Twenty-six percent of cases crossed between diagnoses during follow-up. Among participants meeting full threshold diagnostic criteria, transition from BN was most prevalent, crossing most frequently from BN to PD (12.9% of BN cases). Within each disorder phenotype, 20%-40% of cases moved between subthreshold and full threshold criteria across consecutive surveys. CONCLUSIONS Diagnostic crossover is not rare among adolescent and young adult females with an ED. Transition patterns from BN to PD add support for considering these classifications in the same diagnostic category of disorders that involve purging. The prevalence of crossover between monthly and weekly symptom frequency suggests that a continuum or staging approach may increase utility of ED classification for prognostic and therapeutic intervention.
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Affiliation(s)
- Kimberly B Glazer
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
| | | | - Nadia Micali
- Child and Adolescent Psychiatry Division, University of Geneva, DEA, HUG, Geneva, Switzerland; Institute of Child Health, University College London, London, United Kingdom
| | - Sonja A Swanson
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ross Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Nicholas J Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, Massachusetts
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island; Department of Pediatrics, Warren Alpert Medical School, Providence, Rhode Island
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Udo T, Grilo CM. Prevalence and Correlates of DSM-5-Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults. Biol Psychiatry 2018; 84:345-354. [PMID: 29859631 PMCID: PMC6097933 DOI: 10.1016/j.biopsych.2018.03.014] [Citation(s) in RCA: 406] [Impact Index Per Article: 67.7] [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: 12/07/2017] [Revised: 03/20/2018] [Accepted: 03/31/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Few population-based data on the prevalence of eating disorders exist, and such data are especially needed because of changes to diagnoses in the DSM-5. This study aimed to provide lifetime and 12-month prevalence estimates of DSM-5-defined anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. METHODS A national sample of 36,306 U.S. adults completed structured diagnostic interviews (Alcohol Use Disorder and Associated Disabilities Interview Schedule-5). RESULTS Prevalence estimates of lifetime AN, BN, and BED were 0.80% (SE 0.07%), 0.28% (SE 0.03%), and 0.85% (SE 0.05%), respectively. Twelve-month estimates for AN, BN, and BED were 0.05% (SE 0.02%), 0.14% (SE 0.02%), and 0.44% (SE 0.04%). The odds of lifetime and 12-month diagnoses of all three eating disorders were significantly greater for women than for men after adjusting for age, race and/or ethnicity, education, and income. Adjusted odds ratios (AORs) of lifetime AN diagnosis were significantly lower for non-Hispanic black and Hispanic respondents than for white respondents. AORs of lifetime and 12-month BN diagnoses did not differ significantly by race and/or ethnicity. The AOR of lifetime, but not 12-month, BED diagnosis was significantly lower for non-Hispanic black respondents relative to that of non-Hispanic white respondents; AORs of BED for Hispanic and non-Hispanic white respondents did not differ significantly. AN, BN, and BED were characterized by significant differences in age of onset, persistence and duration of episodes, and rates of current obesity and psychosocial impairment. CONCLUSIONS These findings for DSM-5-defined eating disorders, based on the largest national sample of U.S. adults studied to date, indicate some important similarities to and differences from earlier, smaller nationally representative studies.
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Affiliation(s)
- Tomoko Udo
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York, Albany, New York.
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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Williams VF, Stahlman S, Taubman SB. Diagnoses of eating disorders, active component service members, U.S. Armed Forces, 2013-2017. MSMR 2018; 25:18-25. [PMID: 29952209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
During 2013-2017, a total of 1,788 active component service members received incident diagnoses of one of the eating disorders: anorexia nervosa (AN), bulimia nervosa (BN) or "other/unspecified eating disorder" (OUED). The crude overall incidence rate of any eating disorder was 2.7 cases per 10,000 person-years. Of the case-defining diagnoses, OUED and BN accounted for 46.4% and 41.8% of the total incident cases, respectively. The overall incidence rate of any eating disorder among women was more than 11 times that among men. Overall rates were highest among service members in the youngest age groups (29 years or younger). Crude annual incidence rates of total eating disorders increased steadily between 2013 and 2016, after which rates decreased slightly. Results of the current study suggest that service members likely experience eating disorders at rates that are comparable to rates in the general population, and that rates of these disorders are potentially rising among service members. These findings underscore the need for appropriate prevention and treatment efforts in this population.
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Leone A, Martínez-González MÁ, Lahortiga-Ramos F, Molero Santos P, Bertoli S, Battezzati A, Bes-Rastrollo M. Adherence to the Mediterranean dietary pattern and incidence of anorexia and bulimia nervosa in women: The SUN cohort. Nutrition 2018; 54:19-25. [PMID: 29704863 DOI: 10.1016/j.nut.2018.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 11/10/2017] [Revised: 12/15/2017] [Accepted: 02/13/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To our knowledge, no study has yet assessed the association between dietary patterns and incidence of eating disorders. This study aimed to assess the association between adherence to the Mediterranean dietary pattern (MDP) and incident risk of anorexia (AN) and bulimia nervosa (BN). METHODS We conducted a prospective cohort study of 11 800 women from the Seguimiento Universidad de Navarra follow-up project. Participants were classified as having incident AN or BN if they were free of AN or BN at baseline and reported a physician-made diagnosis of AN or BN during the follow-up period. Nutritional status, lifestyle, and behavioral variables were investigated and used as covariates. A validated 136-item food frequency questionnaire and the Trichopoulou score were used to assess adherence to the MDP. RESULTS After a median follow-up time of 9.4 y, 100 new cases of AN and BN were identified. The multivariate hazard ratio of AN and BN for the two upper categories of adherence to the MDP were 0.39 (95% CI: 0.20-0.75) and 0.32 (95% CI: 0.14-0.70; Ptrend = 0.021). Inverse dose-response relationships were found for the consumption of cereals and olive oil and marginally for polyunsaturated fatty acid intake. To address reverse causation, multivariable linear regressions were run using a cross-sectional approach between adherence to the MDP and risk of AN and BN at baseline. No difference in adherence was found between participants with and without eating disorders. CONCLUSIONS Our results suggest a potential inverse association between the MDP and the risk of AN and BN. Additional longitudinal studies and trials are needed.
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Affiliation(s)
- Alessandro Leone
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy.
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; CIBERobn, Instituto de Salud Carlos III, Madrid, Spain; Navarra's Health Research Institute, Pamplona, Spain
| | | | - Patricio Molero Santos
- Department of Psychiatry and Medical Psychology, University Clinic of Navarra, Pamplona, Spain
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status, Department of Food, Environmental and Nutritional Sciences, University of Milan, Milan, Italy
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; CIBERobn, Instituto de Salud Carlos III, Madrid, Spain; Navarra's Health Research Institute, Pamplona, Spain
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Toni G, Berioli MG, Cerquiglini L, Ceccarini G, Grohmann U, Principi N, Esposito S. Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients 2017; 9:E906. [PMID: 28825608 PMCID: PMC5579699 DOI: 10.3390/nu9080906] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/10/2017] [Accepted: 08/17/2017] [Indexed: 12/15/2022] Open
Abstract
Eating problems in adolescents with type 1 diabetes (T1D) can be divided into two groups. The first includes the diagnosed eating disorders (EDs), i.e., diseases specifically identified by defined signs and symptoms for which a degree of severity has been established, such as anorexia nervosa, bulimia nervosa, binge-eating disorder, pica, and rumination. The second is the group of disordered eating symptoms (DES), which include behaviors such as dieting for weight loss, binge eating, self-induced vomiting, excessive exercise, and laxative or diuretic use; these behaviors cannot be categorized as complete diseases, and, although apparently mild, they must be closely evaluated because they can evolve into true EDs. In this review, present knowledge about the clinical relevance of EDs and DES and the possible preventive and therapeutic measures used to reduce their impact on the course of T1D will be discussed. As adolescents with diabetes are at higher risk of eating disturbances and consequently for higher rates of disease complications, care providers should pay attention to clinical warning signs that raise suspicion of disturbed eating to refer these patients early to an expert in nutrition and mental health disorders. To ensure the best care for adolescents with T1D, diabetes teams should be multidisciplinary and include a pediatric diabetologist, a skilled nurse, a dietician, and a psychologist.
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Affiliation(s)
- Giada Toni
- Pediatric Clinic, Università degli Studi di Perugia, Piazza Menghini 1, 06129 Perugia, Italy.
| | - Maria Giulia Berioli
- Pediatric Clinic, Università degli Studi di Perugia, Piazza Menghini 1, 06129 Perugia, Italy.
| | - Laura Cerquiglini
- Pediatric Clinic, Università degli Studi di Perugia, Piazza Menghini 1, 06129 Perugia, Italy.
| | - Giulia Ceccarini
- Pediatric Clinic, Università degli Studi di Perugia, Piazza Menghini 1, 06129 Perugia, Italy.
| | - Ursula Grohmann
- Department of Experimental Medicine, Università degli Studi di Perugia, 06129 Perugia, Italy.
| | - Nicola Principi
- Pediatric Highly Intensive Care Unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Susanna Esposito
- Pediatric Clinic, Università degli Studi di Perugia, Piazza Menghini 1, 06129 Perugia, Italy.
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Abstract
BACKGROUND Eating disorders (EDs) have long-term physical and mental impacts on those affected. However, few population-based studies have estimated the prevalence of EDs. We aimed to estimate the lifetime and 12-month prevalence rates of EDs using DSM-IV criteria, and to examine differences against the DSM-5 criteria for anorexia. METHOD A nationally representative sample of 10 038 residents in Switzerland was interviewed, and prevalence rates for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) were assessed using WHO Composite International Diagnostic Interviews (WHO-CIDI). RESULTS The lifetime prevalence rate for any ED was found to be 3.5%. Lifetime prevalence estimates for AN, BN, and/or BED were 1.2%, 2.4%, and 2.4%, respectively, among women and 0.2%, 0.9%, and 0.7%, respectively, among men. Utilizing the DSM-5 criteria, the prevalence of AN in women increased by more than 50%, from 1.2% to 1.9%. Among those meeting the criteria for any ED, only 49.4% of men and 67.9% of women had ever sought professional help about their problems with eating or weight. CONCLUSIONS The higher prevalence of BN we detected relative to other studies should prompt further monitoring for a possible increasing trend. The female v. male ratios, especially for bulimia and BED, are decreasing. Given that more than half of those affected have never consulted any professional about their problems with eating or weight, routine inquiries about eating and weight by clinicians, school teachers/psychologists, and family members may help those who are at risk, especially among men.
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Affiliation(s)
- M Mohler-Kuo
- Epidemiology, Biostatistics, and Prevention Institute,University of Zurich,Zurich,Switzerland
| | - U Schnyder
- Department of Psychiatry and Psychotherapy,University Hospital Zurich,Zurich,Switzerland
| | - P Dermota
- Epidemiology, Biostatistics, and Prevention Institute,University of Zurich,Zurich,Switzerland
| | - W Wei
- Epidemiology, Biostatistics, and Prevention Institute,University of Zurich,Zurich,Switzerland
| | - G Milos
- Department of Psychiatry and Psychotherapy,University Hospital Zurich,Zurich,Switzerland
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40
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Mason TB, Lavender JM, Wonderlich SA, Crosby RD, Joiner TE, Mitchell JE, Crow SJ, Klein MH, Le Grange D, Bardone-Cone AM, Peterson CB. The role of interpersonal personality traits and reassurance seeking in eating disorder symptoms and depressive symptoms among women with bulimia nervosa. Compr Psychiatry 2016; 68:165-71. [PMID: 27234198 PMCID: PMC5293149 DOI: 10.1016/j.comppsych.2016.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/05/2016] [Revised: 04/18/2016] [Accepted: 04/21/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The role of interpersonal factors has been proposed in various models of eating disorder (ED) psychopathology and treatment. We examined the independent and interactive contributions of two interpersonal-focused personality traits (i.e., social avoidance and insecure attachment) and reassurance seeking in relation to global ED psychopathology and depressive symptoms among women with bulimia nervosa (BN). METHOD Participants were 204 adult women with full or subclinical BN who completed a battery of self-report questionnaires. Hierarchical multiple OLS regressions including main effects and interaction terms were used to analyze the data. RESULTS Main effects were found for social avoidance and insecure attachment in association with global ED psychopathology and depressive symptoms. In addition, two-way interactions between social avoidance and reassurance seeking were observed for both global ED psychopathology and depressive symptoms. In general, reassurance seeking strengthened the association between social avoidance and global ED psychopathology and depressive symptoms. CONCLUSION These results demonstrate the importance of reassurance seeking in psychopathology among women with BN who display personality features characterized by social avoidance.
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Affiliation(s)
- Tyler B Mason
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND.
| | - Jason M Lavender
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Stephen A Wonderlich
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Ross D Crosby
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL
| | - James E Mitchell
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND; Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | - Scott J Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN; The Emily Program, St. Paul, MN
| | - Marjorie H Klein
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI
| | - Daniel Le Grange
- Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco, CA
| | - Anna M Bardone-Cone
- Department of Psychology and Neuroscience, University of North Carolina - Chapel Hill, Chapel Hill, NC
| | - Carol B Peterson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN; The Emily Program, St. Paul, MN
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Abstract
The last decade has seen the development of an important literature on the contradictions between neoliberal norms of corporal citizenship and the forms of consumption that market-based food systems promote. This paper seeks to contribute to the literature by exploring the relationship between these contradictions and the increased prevalence of particular eating disorders (binge eating disorder (BED) and bulimia nervosa). Within contemporary neoliberal food systems bingeing is increasingly normalised and consumption temporally disorganised. At the same time, neoliberal public health policy, and the wider 'health' entertainment media it legitimates, focuses on the promotion of 'correct' forms of consumer agency. Individuals who fail to manage consumption 'appropriately' are stigmatised. The growth of bulimia and BED can be related to the contradictory pressures that the food system and regime of corporal governance place on individuals. The paper also seeks to explore how the increased medicalisation and biomedicalisation of eating since the 1980s fits within a broader neoliberal governance strategy. By medicalising key social problems the neoliberal state depoliticises these issues. Medicalisation and biomedicalisation obscure the role of capitalism in generating these problems and encourage a focus on individual dysfunction.
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Affiliation(s)
- Iain Pirie
- Department of Politics, University of Warwick, UK
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Nicholls D, Statham R, Costa S, Micali N, Viner RM. Childhood risk factors for lifetime bulimic or compulsive eating by age 30 years in a British national birth cohort. Appetite 2016; 105:266-73. [PMID: 27263069 DOI: 10.1016/j.appet.2016.05.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 09/03/2015] [Revised: 05/17/2016] [Accepted: 05/28/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine whether previously identified childhood risk factors for bulimia or compulsive eating (BCE) predict self-reported lifetime BCE by age 30 years in a prospective birth cohort. METHOD Using data from the 1970 British Cohort Study at birth, 5, and 10 years, associations between 22 putative childhood risk factors and self-reported lifetime BCE at 30 years were examined, adjusting for sex and socioeconomic status. RESULTS Only female sex (odds ratio (OR): 9.2; 95% confidence interval (CI): 1.9-43.7; p = 0.005), low self-esteem (OR:2.9; 95%CI: 1.1-7.5; p = 0.03) and high maternal education (OR:5.4; 95%CI: 2.0-14.8; p = 0.001) were significantly associated with higher risk of BCE, whereas high SES at 10 years was significantly protective (OR:0.2; 95%CI: 0.1-0.8; p = 0.022) of BCE in fully adjusted multivariable logistic regression analysis. DISCUSSION Our findings do not support a strong role for childhood weight status and eating behaviours in the development of bulimia and compulsive eating pathology, rather suggesting a focus on self esteem may have greater relative importance. Findings in relation to maternal education and SES need further exploration.
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Affiliation(s)
- D Nicholls
- Department of Child and Adolescent Mental Health, Great Ormond Street Hospital, London, WC1N 3JH, UK; UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | - R Statham
- Department of Child and Adolescent Mental Health, Great Ormond Street Hospital, London, WC1N 3JH, UK
| | - S Costa
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - N Micali
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
| | - R M Viner
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK
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Robinson L, Aldridge V, Clark EM, Misra M, Micali N. A systematic review and meta-analysis of the association between eating disorders and bone density. Osteoporos Int 2016; 27:1953-66. [PMID: 26782684 PMCID: PMC7047470 DOI: 10.1007/s00198-015-3468-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [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: 07/01/2015] [Accepted: 12/16/2015] [Indexed: 11/25/2022]
Abstract
This meta-analysis investigates the effect of an eating disorder on bone mineral density in two eating disorder subtypes. Following conflicting findings in previous literature, this study finds that not only anorexia nervosa, but also bulimia nervosa has a detrimental effect on BMD. Key predictors of this relationship are discussed. This systematic review and meta-analysis investigates bone mineral density (BMD) in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) in comparison to healthy controls (HCs). AN has been associated with low BMD and a risk of fractures and mixed results have been obtained for the relationship between BN and BMD. Deciphering the effect these two ED subtypes on BMD will determine the effect of low body weight (a characteristic of AN) versus the effects of periods of restrictive eating and malnutrition which are common to both AN and BN. We conducted a systematic search through the electronic databases MedLine, EMBASE and PsychInfo and the Cochrane Library to investigate and quantify this relationship. We screened 544 articles and included 27 studies in a random-effect meta-analysis and calculated the standardised mean difference (SMD) in BMD between women with a current diagnosis of AN (n = 785) vs HCs (n = 979) and a current diagnosis of BN (n = 187) vs HCs (n = 350). The outcome measures investigated were spinal, hip, femoral neck and whole body BMD measured by DXA or DPA scanning. A meta-regression investigated the effect of factors including age, duration since diagnosis, duration of amenorrhea and BMI on BMD. The mean BMI of participants was 16.65 kg/m(2) (AN), 21.16 kg/m(2) (BN) and 22.06 kg/m(2) (HC). Spine BMD was lowest in AN subjects (SMD, -3.681; 95 % CI, -4.738, -2.625; p < 0.0001), but also lower in BN subjects compared with HCs (SMD, -0.472; 95 % CI, -0.688, -0.255; p < 0.0001). Hip, whole body and femoral neck BMD were reduced to a statistically significant level in AN but not BN groups. The meta-regression was limited by the number of included studies and did not find any significant predictors. This meta-analysis confirms the association between low BMD and AN and presents a strong argument for assessing BMD not only in patients with AN, but also in patients with BN.
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Affiliation(s)
- L Robinson
- Institute of Child Health, University College London, Gower Street, London, WC1E 6BT, UK.
| | - V Aldridge
- Institute of Child Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - E M Clark
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - M Misra
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - N Micali
- Institute of Child Health, University College London, Gower Street, London, WC1E 6BT, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
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Guy-Rubin A, Gorwood P. [Not Available]. Rev Prat 2016; 66:e274. [PMID: 27538338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Hammerle F, Huss M, Ernst V, Bürger A. Thinking dimensional: prevalence of DSM-5 early adolescent full syndrome, partial and subthreshold eating disorders in a cross-sectional survey in German schools. BMJ Open 2016; 6:e010843. [PMID: 27150185 PMCID: PMC4861098 DOI: 10.1136/bmjopen-2015-010843] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Investigating for the first time in Germany Diagnostic and Statistical Manual Fifth Edition (DSM-5) prevalences of adolescent full syndrome, Other Specified Feeding or Eating Disorder (OSFED), partial and subthreshold anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). METHOD A national school-based cross-sectional survey with nine schools in Germany was undertaken that was aimed at students from grades 7 and 8. Of the 1775 students who were contacted to participate in the study, 1654 participated (participation rate: 93.2%). The sample consisted of 873 female and 781 male adolescents (mean age=13.4 years). Prevalence rates were established using direct symptom criteria with a structured inventory (SIAB-S) and an additional self-report questionnaire (Eating Disorder Inventory 2 (EDI-2)). RESULTS Prevalences for full syndrome were 0.3% for AN, 0.4% for BN, 0.5% for BED and 3.6% for OSFED-atypical AN, 0% for BN (low frequency/limited duration), 0% for BED (low frequency/limited duration) and 1.9% for purging disorder (PD). Prevalences of partial syndrome were 10.9% for AN (7.1% established with cognitive symptoms only, excluding weight criteria), 0.2% for BN and 2.1% for BED, and of subthreshold syndrome were 0.8% for AN, 0.3% for BN and 0.2% for BED. Cases on EDI-2 scales were much more pronounced with 12.6-21.1% of the participants with significant sex differences. CONCLUSIONS The findings were in accordance with corresponding international studies but were in contrast to other German studies showing much higher prevalence rates. The study provides, for the first time, estimates for DSM-5 prevalences of eating disorders in adolescents for Germany, and evidence in favour of using valid measures for improving prevalence estimates. TRIAL REGISTRATION NUMBER DRKS00005050; Results.
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Affiliation(s)
- Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Verena Ernst
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Arne Bürger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Wuerzburg, Germany
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Smink FRE, van Hoeken D, Donker GA, Susser ES, Oldehinkel AJ, Hoek HW. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa. Psychol Med 2016; 46:1189-1196. [PMID: 26671456 DOI: 10.1017/s003329171500272x] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [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: 12/22/2022]
Abstract
BACKGROUND Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. METHOD A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. RESULTS The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. CONCLUSIONS The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.
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Affiliation(s)
- F R E Smink
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - D van Hoeken
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - G A Donker
- NIVEL Primary Care Database, Sentinel Practices,Utrecht,The Netherlands
| | - E S Susser
- Department of Epidemiology,Columbia University,Mailman School of Public Health,New York,USA
| | - A J Oldehinkel
- Department of Psychiatry,University Medical Center Groningen,University of Groningen,Groningen,The Netherlands
| | - H W Hoek
- Parnassia Psychiatric Institute,The Hague,The Netherlands
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Abstract
Anorexia nervosa and bulimia nervosa are serious psychiatric illnesses related to disordered eating and distorted body images. They both have significant medical complications associated with the weight loss and malnutrition of anorexia nervosa, as well as from the purging behaviors that characterize bulimia nervosa. No body system is spared from the adverse sequelae of these illnesses, especially as anorexia nervosa and bulimia nervosa become more severe and chronic. We review the medical complications that are associated with anorexia nervosa and bulimia nervosa, as well as the treatment for the complications. We also discuss the epidemiology and psychiatric comorbidities of these eating disorders.
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Affiliation(s)
| | - Mori J Krantz
- Cardiology Division, Denver Health Medical Center, Denver, Colo; Department of Medicine, University of Colorado Health Sciences Center, Denver
| | - Philip S Mehler
- Eating Recovery Center of Denver, Denver, Colo; Department of Medicine, University of Colorado Health Sciences Center, Denver; ACUTE at Denver Health, Denver Health Medical Center, Denver, Colo.
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Bernadett M, Szemán-N A. [Prevalence of eating disorders among women with polycystic ovary syndrome]. Psychiatr Hung 2016; 31:136-145. [PMID: 27244869] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Symptomes and complications of PCOS have adverse effect on quality of life among concerned women. Most research findings suggest that PCOS is associated with eating disorders, but there are inconsistent results in connection with their relationship in the published literature. OBJECTIVE The aim of this study was to determine the prevalence of eating disorders among women with PCOS. METHOD Body mass index (BMI), Eating Attitudes Test (EAT) and Eating Behaviour Severity Scale (EBSS) were used to measure eating attitudes and behaviors. Furthermore PCOS symptomes were measured by Ferriman-Gallwey Score, Global Acne Grading Score, Savin Scale and other pcos symptoms were also accessed. A total of 318 women were included in this analysis. The sample consists of a PCOS group (N=95), a control group (N=100) and a hyperandrogen group (N=123). The Prevalence of clinical bulimia nervosa was 5.3%, subclinical anorexia nervosa 1.1% and subclinical bulimia nervosa was 10.5% among PCOS women. 1.6% subclinical bulimia nervosa was detected in the hyperandrogen group. CONCLUSIONS The results of the study indicate that the prevalence of clinical and subclinical bulimia nervosa is increased among women with PCOS compared to healthy women. Eating disorders can have significant negative influence on the outcome of the treatment of PCOS. To sum up, these findings suggest that it should be necessary to pay attention to the screening of eating disorders, and the findings also reveals that psychological treatment of eating disorders among women with PCOS is relevant.
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Affiliation(s)
- Mohácsi Bernadett
- Debreceni Egyetem Egeszsegugyi Kar Szocialis es Tarsadalomtudomanyi Intezet Pszichologiai Tanszek, Debrecen, Hungary, E-mail:
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Szalai TD, Czeglédi E. ATTACHMENT AS A PREDICTOR OF RISK FOR EATING DISORDERS ON A REPRESENTATIVE HUNGARIAN ADULT SAMPLE. Ideggyogy Sz 2015; 68:409-416. [PMID: 26821515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND PURPOSE Many studies confirm the relationship between attachment disturbances and (the severity of) eating disorders, however among them only one Hungarian study can be found. The exact predisposing traits of attachment and the strength of relationship is still uncleared. Our aim was to explore these aspects. METHODS Study was based on a cross-sectional nationally representative survey, called "Hungarostudy 2013" (N = 2000, 46.9% males, mean age 46.9 years, SD = 18.24 years). Measures: Sociodemographic and self-reported anthropometric data (weight and height), short Hungarian version of Relationship Scale Questionnaire, SCOFF questionnaire and short Hungarian version of Beck Depression Inventory. RESULTS The frequency of risk for eating disorders (anorexia or bulimia nervosa) was 3.9% (N = 76) among the respondents (N = 1860). Attachment anxiety was significantly higher in the risk for eating disorders group (t (1888) = -3.939, p < 0.001), and significantly predicted the risk or eating disorders after adjusting for the potential background variables (OR = 1.09, p = 0.040). Detachment was not a significant predictor of risk for eating disorders (OR = 0.98, p = 0.515). Younger age (OR = 0.97, p < 0.001), higher level of depression (OR = 1.09, p < 0.001) and higher body mass index (OR = 1.08, p < 0.001) were also significant cross-sectional predictors of risk for eating disorders. The explained variance of the model was 10.7%. CONCLUSION The study supported, that higher attachment anxiety is associated with the increased risk of eating disorders, with a possible therapeutic relevance. Assessment of attachment's further aspects and creating multivariable models are required for more thorough understanding and optimising of intervention points.
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Fisher M, Bushlow M. Perceptions of family styles by adolescents with eating disorders and their parents. Int J Adolesc Med Health 2015; 27:443-449. [PMID: 25720047 DOI: 10.1515/ijamh-2014-0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 11/22/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE The traditional view has been that there is a great deal of rigidity and enmeshment in the families of adolescents with eating disorders, with poor communication and satisfaction among family members. We used the Family Adaptability and Cohesion Evaluation Scales IV (FACES-IV) to study whether this traditional view remains true or whether family styles among those with eating disorders have changed over time to include a wider range of families. METHODS Forty-four patients (aged 14-18 years; mean, 15.4 years; 38 females and 6 males) being treated for an eating disorder in a Division of Adolescent Medicine completed the FACES-IV questionnaire, along with the Beck Depression Inventory (BDI). Patients were diagnosed with anorexia nervosa (38.6%), eating disorders not otherwise specified (59.5%), and bulimia nervosa (2.3%) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. They had a mean BMI of 19.6 at the time of questionnaire completion, which was an average of 175 days from first visit. Parents (38 mothers and 6 fathers) completed the FACES-IV and the BDI at the same visit without conferring with their children. RESULTS A great majority of patients and parents reported their families as being connected/very connected (93% of patients and 98% of parents) and flexible/very flexible (80% and 93%), with low/very low enmeshment (89% and 89%), moderate/low/very low rigidity (77% and 95%), low/very low chaos (84% and 86%), and moderate/high/very high communication (85% and 50%). Despite these scores, all well within the normal range for families with teenagers, 70% of patients and 64% of parents reported low/very low satisfaction with their families, well below the normal range. Depression scores were moderate/severe for 44% of patients and 14% of parents. Analysis of variance and t-tests showed no differences between FACES-IV scores and age, gender, ethnicity, diagnosis, and time from first visit for patients, whereas patients and parents who were more depressed were each more likely (p<0.05) to report greater dissatisfaction with their families. CONCLUSION A great majority of patients with eating disorders and their parents reported their family styles to be in the healthy range. However, many patients and parents, especially those with depression, expressed dissatisfaction with their families. These data demonstrate that older concepts of the families of adolescents with eating disorders need to be reconsidered.
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