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Pike KM, So M, Hilbert A, Maekawa H, Shimanouchi T, Wilfley D, Dohm FA, Fairburn CG, Weissman RS. Risk factors for anorexia nervosa and bulimia nervosa in Japan and compared to a U.S. sample. Int J Eat Disord 2021; 54:155-167. [PMID: 33355934 DOI: 10.1002/eat.23442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study provides the first systematic investigation of environmental exposure to putative psychosocial risk factors for eating disorders in individuals with AN and BN in Japan. It also provides a comparison of risk factors for the development of AN and BN in Japan versus the United States. METHOD Participants in Japan were 96 women with a current DSM-IV AN or BN primary diagnosis (AN, n = 60; BN, n = 36) and 57 women with no current psychiatric diagnosis (NC group). Participants in the United States were 137 women with a current DSM-IV AN or BN primary diagnosis (AN-U.S., n = 71; BN-U.S., n = 66). A standardized semi-structured interview retrospectively assessed exposure to risk factors prior to first symptom onset, which were analyzed using General Linear Model analyses. RESULTS Perfectionism and negative affectivity, family relationship issues, and, to a lesser degree, parental psychopathology predicted the emergence of AN and BN in Japan. Physical and sexual abuse and family eating and weight concerns were not significant risk factors in Japan. Compared to their respective diagnostic U.S. groups, the Japanese AN group reported higher levels of individual mental health factors and lower levels of family dieting and family overweight, and the Japanese BN group reported higher levels on individual mental health factors, lower exposure to problems with their parents, and lower exposure to family weight and eating concerns. DISCUSSION These country-specific data from Japan contribute to an increasingly nuanced and global understanding of risk factors for eating disorders.
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Affiliation(s)
- Kathleen M Pike
- Department of Psychiatry, Columbia University, New York, New York, USA.,Department of Epidemiology, Columbia University, New York, New York, USA.,Department of Health Policy and Management, Columbia University, New York, New York, USA
| | - Mirai So
- Department of NeuroPsychiatry, Tokyo Dental College, Tokyo, Japan
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Hiroko Maekawa
- Faculty of Humanities, Kanazawa Gakuin University, Kanazawa City, Japan
| | - Tomoko Shimanouchi
- Department of Psychiatry, St. Marianna University School of Medicine, Kawasaki City, Japan
| | - Denise Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Department of Psychological & Brain Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Faith-Anne Dohm
- Department of Psychological and Educational Consultation, Fairfield University, Fairfield, Connecticut, USA
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Nakai Y, Nin K, Noma S, Hamagaki S, Takagi R, Teramukai S, Wonderlich SA. Clinical presentation and outcome of avoidant/restrictive food intake disorder in a Japanese sample. Eat Behav 2017; 24:49-53. [PMID: 28013169 DOI: 10.1016/j.eatbeh.2016.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/13/2016] [Accepted: 12/19/2016] [Indexed: 11/30/2022]
Abstract
We conducted a study of the clinical presentation and outcome in patients with avoidant/restrictive food intake disorder (ARFID), aged 15-40years, and compared this group to an anorexia nervosa (AN) group in a Japanese sample. A retrospective chart review was completed on 245 patients with feeding and eating disorders (FEDs), analyzing prevalence, clinical presentation, psychopathological properties, and outcomes. Using the DSM-5 criteria, 27 (11.0%) out of the 245 patients with a FED met the criteria for ARFID at entry. All patients with ARFID were women. In terms of eating disorder symptoms, all patients with ARFID had restrictive eating related to emotional problems and/or gastrointestinal symptoms. However, none of the ARFID patients reported food avoidance related to sensory characteristics or functional dysphagia. Additionally, none of them exhibited binge eating or purging behaviors, and none of them reported excessive exercise. The ARFID group had a significantly shorter duration of illness, lower rates of admission history, and less severe psychopathology than the AN group. The ARFID group reported significantly better outcome results than the AN group. These results suggest that patients with ARFID in this study were clinically distinct from those with AN and somewhat different from pediatric patients with ARFID in previous studies.
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Affiliation(s)
| | - Kazuko Nin
- School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Shun'ichi Noma
- Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Japan
| | | | | | - Satoshi Teramukai
- Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Stephen A Wonderlich
- Department of Clinical Neuroscience, University of North Dakota, School of Medicine and Health Sciences, Fargo, ND, USA
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Hilker I, Sánchez I, Steward T, Jiménez-Murcia S, Granero R, Gearhardt AN, Rodríguez-Muñoz RC, Dieguez C, Crujeiras AB, Tolosa-Sola I, Casanueva FF, Menchón JM, Fernández-Aranda F. Food Addiction in Bulimia Nervosa: Clinical Correlates and Association with Response to a Brief Psychoeducational Intervention. EUROPEAN EATING DISORDERS REVIEW 2016; 24:482-488. [DOI: 10.1002/erv.2473] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/01/2016] [Accepted: 08/08/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Ines Hilker
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Department of Child and Adolescent Psychiatry and Psychology; Hospital Clínic of Barcelona; Barcelona Spain
| | - Isabel Sánchez
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Trevor Steward
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
- Department of Psychobiology and Methodology; University Autònoma of Barcelona; Spain
| | | | | | - Carlos Dieguez
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
- Department of Physiology, CIMUS; University of Santiago de Compostela-Instituto de Investigación Sanitaria; Santiago de Compostela Spain
| | - Ana B. Crujeiras
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
- Laboratory of Molecular and Cellular Endocrinology, Research Area; Complejo Hospitalario Universitario de Santiago de Compostela; A Coruña Spain
| | - Iris Tolosa-Sola
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Felipe F. Casanueva
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
- Laboratory of Molecular and Cellular Endocrinology, Research Area; Complejo Hospitalario Universitario de Santiago de Compostela; A Coruña Spain
| | - José M. Menchón
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
- Ciber Salud Mental (CIBERSAM); Instituto Salud Carlos III; Barcelona Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERObn); Instituto Salud Carlos III; Barcelona Spain
- Department of Clinical Sciences, School of Medicine; University of Barcelona; Spain
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Abstract
Objective To evaluate some risk factors for cardiovascular diseases in feeding and eating disorders, the degree of lipid abnormalities was investigated in a large Japanese cohort of different groups of feeding and eating disorders, according to the Japan Atherosclerosis Society Guidelines for the Prevention of Atherosclerotic Cardiovascular Diseases 2012 (JAS Guidelines 2012). Methods Participants in the current study included 732 women divided into four groups of feeding and eating disorders: anorexia nervosa, restricting type (AN-R); anorexia nervosa, binge-eating/purging type; bulimia nervosa (BN); and binge-eating disorder (BED). We measured the serum levels of total cholesterol, high-density-lipoprotein (HDL) cholesterol, and triglyceride in these participants. Low-density-lipoprotein (LDL) cholesterol and non-HDL cholesterol levels were also calculated. Results The concentrations of LDL cholesterol and non-HDL cholesterol were widely distributed in all groups. When the LDL cholesterol risk was defined as ≥120 mg/dL and the non-HDL cholesterol risk as ≥150 mg/dL, according to the JAS Guidelines 2012, the proportion of LDL cholesterol risk ranged from 29.6% (BN) to 38.6% (AN-R), and the proportion of non-HDL cholesterol risk ranged from 17.8% (BN) to 30.1% (BED). Conclusion The present findings suggest the existence of LDL cholesterol risk and non-HDL cholesterol risk in all groups of eating disorders. Given the chronicity of this condition, the development of elevated concentrations of LDL cholesterol and non-HDL cholesterol at an early age may increase the risk of cardiovascular diseases.
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Nakai Y, Fujita M, Nin K, Noma S, Teramukai S. Relationship between duration of illness and cardiac autonomic nervous activity in anorexia nervosa. Biopsychosoc Med 2015; 9:12. [PMID: 25908939 PMCID: PMC4407323 DOI: 10.1186/s13030-015-0032-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 01/16/2015] [Indexed: 12/04/2022] Open
Abstract
Background The mortality rate associated with anorexia nervosa (AN) is high, and death is mainly attributable to cardiac events. A wide range of autonomic nervous system disturbances may be mechanisms underlying the increased cardiovascular mortality and sudden death of patients with AN. Heart rate variability (HRV) has been proven to be a reliable noninvasive method for quantitative assessment of sympathetic and parasympathetic regulation of heart rate (HR). The longer the duration of illness of AN patients, the higher the mortality rate. However, there have been few reports on the relationship between the duration of illness and HRV in AN. Hence, the aims of this study were to compare the cardiac autonomic nervous activity (CANA) of female patients with AN and age-matched female controls and to evaluate the relationship between the duration of illness and the CANA of the AN patients. Methods We studied 14 female patients with AN and 22 age-matched healthy women. Beat-to-beat heart rate variability, recorded in a supine position, was investigated using power spectral analysis. Result Mean heart rate was positively correlated with normalized high-frequency (HF: 0.15 to 0.40 Hz) power and negatively correlated with the low-frequency (LF: 0.04 to 0.15 Hz)/HF power (LF/HF) ratio of the controls. On the other hand, duration of illness was negatively correlated with normalized HF power and positively correlated with the LF/HF ratio of the AN patients. Conclusions These results suggest that, given that the LF/HF ratio is an estimate of cardiac sympathovagal balance, anorectic patients with a long illness duration display lower vagal tone (parasympathetic withdrawal) and high sympathetic tone.
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Affiliation(s)
- Yoshikatsu Nakai
- Kyoto Institute of Health Sciences, Miyako Bldg. 502, Karasuma Oike Agaru Higashigawa, Nakagyo-ku, Kyoto 604-0845 Japan
| | - Masatoshi Fujita
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuko Nin
- Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shun'ichi Noma
- Department of Psychiatry, School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
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