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Cai H, Chen P, Zhang Q, Lam MI, Si TL, Liu YF, Zheng WY, Su Z, Cheung T, Jackson T, Ungvari GS, Ren Z, Li X, Li XH, Xiang YT. Global prevalence of major depressive disorder in LGBTQ+ samples: A systematic review and meta-analysis of epidemiological studies. J Affect Disord 2024; 360:249-258. [PMID: 38795782 DOI: 10.1016/j.jad.2024.05.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND LGBTQ+ populations have been reported to have higher rates of depression compared with their heterosexual peers. Such data provided us the impetus to conduct a meta-analysis on the worldwide prevalence of major depressive disorder (MDD) in LGBTQ+ populations and moderating factors that contributed to differences in prevalence estimates between studies. METHODS A systematic literature search was performed in major international (PubMed, PsycINFO, Web of Science, EMBASE) and Chinese (Chinese Nation Knowledge Infrastructure (CNKI) and WANFANG) databases from dates of inception to 10 December 2021. RESULTS 48 articles comprising 4,616,903 individuals were included in the meta-analysis. The overall prevalence of MDD was 32.2 % (95%CI: 30.8-33.6 %, I2 = 99.6 %, τ2 = 0.284). MDD prevalence was higher in the LGBTQ+ samples from the United States than other countries, though the difference was not significant in moderator analyses. Moderator analyses indicated point and lifetime prevalence of MDD were significantly higher than estimates based on the past year (Q = 6.270, p = 0.043). Furthermore, studies that relied on convenience sampling had a higher prevalence of MDD than those based on other sampling methods (Q = 8.159, p = 0.017). In meta-regression analyses, mean age (B = 0.03, z = 9.54, p < 0.001) and study quality assessment score (B = 0.24, z = 67.64, p < 0.001) were positively associated with pooled prevalence of MDD while mediation data of year of study (B = -0.08, z = -72.55, p < 0.001) and sample size (B = -1.46, z = -37.83, p < 0.001) were negatively associated with pooled prevalence of MDD in LGBTQ+ samples. CONCLUSIONS MDD is common among in LGBTQ+ individuals. Considering the negative consequences MDD has on daily life and well-being, appropriate prevention and treatment measures should be provided to vulnerable members of these populations. The findings of this meta-analysis could facilitate identifying at-risk subgroups, developing relevant health policy for LGBTQ+ individuals and allocating health resources from an intersectionality perspective.
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Affiliation(s)
- Hong Cai
- Unit of Psychology and Behavior, School of Public Health, Guangxi Medical University, Naning, Guangxi, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mei Ieng Lam
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Kiang Wu Nursing College of Macau, Macau
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Wan-Ying Zheng
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - Todd Jackson
- Department of Psychology, University of Macau, Macau
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia / Graylands Hospital, Perth, Australia
| | - Zhihong Ren
- School of Psychology, Central China Normal University, China
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Menzies RE, Richmond B, Sharpe L, Skeggs A, Liu J, Coutts-Bain D. The 'revolving door' of mental illness: A meta-analysis and systematic review of current versus lifetime rates of psychological disorders. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024; 63:178-196. [PMID: 38197576 DOI: 10.1111/bjc.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES Therapists have long observed a phenomenon referred to as the 'revolving door' of mental health services, in which individuals often develop, seek treatment for, and recover from multiple mental illnesses across their life. However, this has not been systematically examined. If this phenomenon is widespread, one would expect that the number of lifetime disorders would exceed that of current disorders. The aim of this meta-analysis was to test this hypothesis. METHODS A search was conducted of the following databases: MEDLINE, PsycINFO and Web of Science. In total, 38 studies were included in the current review; 27 of these contained sufficient quantitative data to be included in the meta-analysis, addressing the primary research aim. The remaining 11 studies were included in the systematic review only. RESULTS Meta-analyses of the 27 studies indicated that the average number of lifetime disorders was 1.84 times that of current disorders. Previous treatment significantly moderated this relationship, while the clinical nature of the sample did not. Examination of the remaining studies revealed common temporal sequences, indicating disorders which typically develop first or consequently to other disorders. CONCLUSIONS These findings provide support for the revolving door of mental illness, suggesting a need for transdiagnostic treatments and broader conceptualisation of relapse prevention.
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Affiliation(s)
| | | | - Louise Sharpe
- The University of Sydney, Sydney, New South Wales, Australia
| | - Amira Skeggs
- The University of Sydney, Sydney, New South Wales, Australia
| | - Janessa Liu
- The University of Sydney, Sydney, New South Wales, Australia
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Epidemiology of eating disorders: population, prevalence, disease burden and quality of life informing public policy in Australia-a rapid review. J Eat Disord 2023; 11:23. [PMID: 36793104 PMCID: PMC9933292 DOI: 10.1186/s40337-023-00738-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Understanding of the epidemiology and health burden of eating disorders has progressed significantly in the last 2 decades. It was considered one of seven key areas to inform the Australian Government commissioned National Eating Disorder Research and Translation Strategy 2021-2031, as emerging research had highlighted a rise in eating disorder prevalence and worsening burden-of-illness. The aim of this review was to better understand the global epidemiology and impact of eating disorders to inform policy decision-making. METHODS Using a systematic Rapid Review methodology, ScienceDirect, PubMed and Medline (Ovid) were searched for peer-reviewed studies published between 2009 and 2021. Clear inclusion criteria were developed in consultation with experts in the field. Purposive sampling of literature was conducted, which predominately focused on higher-level evidence (meta-analyses, systematic reviews, and large epidemiological studies), synthesised, and narratively analysed. RESULTS 135 studies were deemed eligible for inclusion in this review (N = 1324). Prevalence estimates varied. Global Lifetime prevalence of any eating disorder ranged from 0.74 to 2.2% in males, and 2.58-8.4% in females. Australian 3-month point-prevalence of broadly defined disorders was around 16% in females. Eating disorders appeared more prevalent in young people and adolescents, particularly females (in Australia: eating disorders ~ 22.2%; disordered eating ~ 25.7%). Limited evidence was found on sex, sexuality and gender diverse (LGBTQI +) individuals, particularly males, who had a six-fold increase in prevalence compared to the general male population, with increased illness impact. Similarly, limited evidence on First Australian's (Aboriginal and Torres Strait Islander) suggests prevalence rates similar to non-Indigenous Australians. No prevalence studies were identified specifically assessing culturally and linguistically diverse populations. Global disease burden of any eating disorder was 43.4 age-standardised disability-adjusted-life-years per 100,000; increasing by 9.4% between 2007 and 2017. Australian's total economic cost was estimated at $84 billion from years-of-life lost due to disability and death, and annual lost earnings ~ $1.646 billion." CONCLUSIONS There is no doubt that eating disorder prevalence and impact are on the rise, particularly in at-risk and understudied populations. Much of the evidence came from female-only samples, and Western, high-income countries which more readily have access to specialised services. Future research should examine more representative samples. There is an urgent need for more refined epidemiological methods to better understand these complex illnesses over time, to guide health policy and development-of-care.
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4
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O'Flynn JL, Nowicki GP, Laveway K, Gordon AR, Rodgers RF. Toward inclusivity: A systematic review of the conceptualization of sexual minority status and associated eating disorder outcomes across two decades. Int J Eat Disord 2023; 56:350-365. [PMID: 36321787 DOI: 10.1002/eat.23830] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Sexual minority (SM) groups (e.g., those who identify as lesbian, gay, bisexual, questioning, queer, asexual, or those who feel their sexual orientation identity cannot be captured with existing terminology [LGBQA+] and those who report same-sex or same-gender attraction and/or behavior) are at elevated risk for eating disorder (ED) symptoms and behaviors. However, the ways in which this risk varies across SM is less clear, and findings are not fully convergent. Evolution in the definition and assessment of SM status may contribute to this divergence. The aim of this study was to systematically review how sexual orientation and SM status have been assessed in the ED literature and how this may relate to patterns of associations between SM status and ED symptoms. METHODS A systematic review of the literature focused on ED symptoms and behaviors and SM groups was conducted, yielding 182 studies. RESULTS Five categories were created reflecting SM status assessment: identity only (n = 105), attraction only (n = 8), behavior only (n = 4), combinations of identity, behavior, or attraction (n = 58), and articles with unclear or insufficient information about SM status assessment (n = 7). SM status operationalizations varied across studies, with more inclusive assessments in more recent work. Findings revealed persistent conflicting patterns of disordered eating symptomatology for some SM groups. In addition, decisions to selectively combine SM participants in some studies, most often to increase power, decreased the specificity of their results in relation to differential risk and protective factors within specific LGBQA+ groups. DISCUSSION Findings highlight the importance of inclusive assessments of sexual orientation in the ED literature and research focused on underrepresented groups with intersecting identities. Identifying modifiable targets for intervention is a critical next step. PUBLIC SIGNIFICANCE Sexual minority (SM) groups have been identified as presenting elevated risk for eating disorder symptoms and behaviors. Our findings suggest that the level of risk is variable across SM groups and points to the need for multi-dimensional assessments of SM status, and increased focus on the function of disordered eating behaviors and different profiles that might emerge related to efforts to modify physical appearance or to regulate emotion.
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Affiliation(s)
- Jennifer L O'Flynn
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Genevieve P Nowicki
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Katherine Laveway
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, Massachusetts, USA.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
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5
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Goldblatt AEA, Bankoff SM, Katz-Wise SL, Pantalone DW. A heavy burden: Associations between sexual minority status, mental health, and BMI in women. J Clin Psychol 2022; 78:2180-2196. [PMID: 35881947 DOI: 10.1002/jclp.23423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 05/20/2022] [Accepted: 07/10/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Sexual minority women (SMW) are at increased risk of elevated body mass index (BMI) compared to heterosexual women, increasing their vulnerability to chronic diseases. Nonmonosexual SMW appear to be at additional risk for elevated BMI, likely due to unique sexual minority stressors. METHODS A total of 437 SMW and heterosexual women completed a cross-sectional, online survey including self-report measures of sexual orientation dimensions, weight, psychological distress, and eating behaviors. We investigated relations among these variables to better understand disparities in self-reported BMI based on sexual orientation and sexual orientation discordance (SOD). RESULTS SMW self-reported more psychological distress, more binge eating, and higher BMIs than their heterosexual peers, with nonmonosexual groups of SMW often reporting the highest values. SOD was positively associated with psychological distress. CONCLUSIONS SMW-particularly nonmonosexual SMW-are at increased risk for psychological distress, binge eating, and elevated BMI relative to heterosexual peers. Future research should further elucidate mechanisms for these disparities.
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Affiliation(s)
- Alison E A Goldblatt
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Sarah M Bankoff
- Behavioral Medicine Service, VA Boston Healthcare System, Boston, Massachusetts, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sabra L Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David W Pantalone
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA.,The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
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6
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Shepherd BF, Brochu PM, Rodriguez-Seijas C. A critical examination of disparities in eating disorder symptoms by sexual orientation among US adults in the NESARC-III. Int J Eat Disord 2022; 55:790-800. [PMID: 35467039 DOI: 10.1002/eat.23717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Sexual minoritized persons evidence higher prevalence of eating disorders than heterosexual persons, yet it is unclear which specific symptoms drive these disparities. Empirical evidence also documents the importance of considering subclinical eating disorder presentations, as well as potential differentiation in expression of eating disorder symptoms based on gender. The current study complements that of Kamody et al. (2020), who examined sexual orientation-based disparities in eating disorder diagnoses using a nationally representative sample of the US adult population. METHOD Using the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we compared the prevalence of eating disorder symptoms across sexual minority status separately for men and women. RESULTS Sexual minoritized men were more likely than heterosexual men to report body mass index (BMI) < 18.5 kg/m2 (odds ratio [OR] = 1.76), thus, being screened into questions about restrictive eating. Sexual minoritized women were more likely than heterosexual women to endorse ever engaging in a binge-eating episode (OR = 2.25) and engaging in weekly binge eating for at least 3 months (OR = 1.58), thus, being screened into follow-up questions about binge eating. Sexual minoritized men were more likely than heterosexual men to fear gaining weight even when at their lowest weight (OR = 4.35) and experience a loss of control when overeating (OR = 3.13). DISCUSSION Sexual orientation-based disparities in eating disorder symptom endorsement were nuanced when stratifying the entire sample by gender. Findings expand previous research on disparities in clinical/diagnosed eating disorders, highlighting the importance of assessing symptomology beyond diagnosis, as well as the intersectional influence of sexual orientation and gender, in both research and practice.
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Affiliation(s)
- Benjamin F Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Paula M Brochu
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, Florida, USA
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7
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Ancheta AJ, Caceres BA, Zollweg SS, Heron KE, Veldhuis CB, VanKim NA, Hughes TL. Examining the associations of sexual minority stressors and past-year depression with overeating and binge eating in a diverse community sample of sexual minority women. Eat Behav 2021; 43:101547. [PMID: 34412003 PMCID: PMC8629849 DOI: 10.1016/j.eatbeh.2021.101547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 07/16/2021] [Accepted: 07/31/2021] [Indexed: 02/01/2023]
Abstract
Sexual minority stressors (e.g., stigma consciousness, internalized homophobia, discrimination) are posited to contribute to higher prevalence of overeating and binge eating among sexual minority women (SMW) relative to heterosexual women. Few studies have examined psychosocial mediators of the associations of minority stressors with overeating and binge eating in SMW. Using data from a diverse, community-based sample of SMW, we examined these associations, including the potential mediating effects of past-year depression. We also conducted exploratory analyses to determine if the associations of sexual minority stressors with overeating and binge eating differed by sexual identity or by race and ethnicity. The sample included 607 SMW (38.2% White, 37.1% African American, 24.7% Latina) with a mean age of 39.7 years. Approximately 17% and 9% of SMW reported overeating and binge eating, respectively, in the past 3 months. Greater stigma consciousness was associated with higher odds of overeating (AOR 1.31, 95% CI = 1.03-1.66). We found no significant associations between minority stressors and binge eating. Past-year depression did not mediate associations between minority stressors and overeating or binge eating. Although we found no sexual identity differences, stigma consciousness among Latina SMW was associated with higher odds of overeating relative to White SMW (AOR 1.95, 95% CI = 1.21-3.12) and African American SMW (AOR 1.99, 95% CI = 1.19-3.31). Findings highlight the importance of screening SMW for stigma consciousness as a correlate of overeating and considering racial and ethnic differences in overeating and binge eating in this population.
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Affiliation(s)
- April J Ancheta
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Billy A Caceres
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Sarah S Zollweg
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Kristin E Heron
- Department of Psychology, Old Dominion University, Virginia Consortium Program in Clinical Psychology, 250 Mills Godwin Building, Norfolk, VA 23529, United States of America.
| | - Cindy B Veldhuis
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
| | - Nicole A VanKim
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences University of Massachusetts Amherst, 406 Arnold House, Amherst, MA 01003, United States of America.
| | - Tonda L Hughes
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032, United States of America.
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Pertuz-Cortes C, Navarro-Jiménez E, Laborde-Cárdenas C, Gómez-Méndez P, Lasprilla-Fawcett S. Implementation of clinical practice guidelines for the timely detection and diagnosis of eating disorders in adolescents and adults in the outpatient and priority department of a public psychiatric hospital in Colombia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 49:102-108. [PMID: 32446416 DOI: 10.1016/j.rcp.2018.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 02/18/2018] [Accepted: 05/28/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To implement clinical practice guidelines (CPGs) for the timely detection and diagnosis of eating disorders in adolescents and adults in the priority outpatient department of a public psychiatric hospital in Barranquilla, Colombia. Barriers to access to the implemented guidelines were identified. METHODS For the identification of evidence-based CPGs to be implemented, systematic searches were carried out in international databases of development agencies or compilers of clinical practice guidelines, and in databases that contained scientific literature on issues related to eating disorders. CONCLUSIONS The two guidelines shortlisted for the final selection by consensus of a multidisciplinary team at the hospital were the "Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders" and the "Guía de práctica clínica sobre trastornos de la conducta alimentaria de Catalunya", the latter being finally chosen by consensus. There are not yet CPGs implemented for health professionals in the priority outpatient department of Colombian hospitals for eating disorders.
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Affiliation(s)
| | | | | | - Pedro Gómez-Méndez
- Facultad de Ciencias de la Salud, Universidad del Norte, Barranquilla, Colombia
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9
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Milano W, Ambrosio P, Carizzone F, De Biasio V, Foggia G, Capasso A. Gender Dysphoria, Eating Disorders and Body Image: An Overview. Endocr Metab Immune Disord Drug Targets 2020; 20:518-524. [DOI: 10.2174/1871530319666191015193120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/13/2019] [Accepted: 09/25/2019] [Indexed: 11/22/2022]
Abstract
Background::
Gender dysphoria is a clinical condition in which a state of inner suffering,
stress and anxiety is detected when biological sex and a person's gender identity do not coincide.
People who identify themselves as transgender people are more vulnerable and may have higher rates
of dissatisfaction with their bodies which are often associated with a disorderly diet in an attempt to
change the bodily characteristics of the genus of birth and, conversely, to accentuate the characteristics
of the desired sexual identity.
Aim::
The purpose of this work is to examine the association between dissatisfaction with one's own
body and eating and weight disorders in people with gender dysphoria.
Results::
Gender dysphoria and eating disorders are characterized by a serious discomfort to the body
and the body suffers in both conditions. The results of our study suggest that rates of pathological
eating behaviors and symptoms related to a disordered diet are high in patients with gender dysphoria
and that standard screening for these symptoms must be considered in both populations at the time of
evaluation and during the course of the treatment.
Conclusions::
In light of this evidence, clinicians should always investigate issues related to sexuality
and gender identity in patients with eating disorders, to develop more effective prevention measures
and better strategies for therapeutic intervention..
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Affiliation(s)
- Walter Milano
- U.O.S.D. Eating Disorder Unit ASL Napoli 2 Nord Napoli, Italy
| | - Paola Ambrosio
- U.O.S.D. Eating Disorder Unit ASL Napoli 2 Nord Napoli, Italy
| | | | | | | | - Anna Capasso
- Department of Pharmacy, University of Salerno, (84084) Fisciano (Salerno), Italy
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10
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Shaw H, Rohde P, Desjardins CD, Stice E. Sexual orientation correlates with baseline characteristics but shows no moderating effects of dissonance-based eating disorder prevention programs for women. Body Image 2020; 32:94-102. [PMID: 31841780 PMCID: PMC8765481 DOI: 10.1016/j.bodyim.2019.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 11/17/2022]
Abstract
This study provided the first test of whether sexual orientation (categorized as heterosexual vs. sexual minority) is associated with baseline eating disorder risk factors and symptoms, moderated the intervention effects of variants of the dissonance-based Body Project, or moderated the relation of baseline risk factors to future change in eating disorder symptoms. A total of 680 women with body image concerns were randomized to clinician-or peer-led Body Project groups, the eBody Project, or educational video control and completed assessment of eating disorder risk factors and symptoms at pretest, posttest, and at six-, 12-, 24-, and 36-month follow-up. Results indicated that sexual minority women had significantly higher negative affect and impaired psychosocial functioning at baseline, but did not differ on other eating disorder risk factors or symptoms. We found no evidence that sexual orientation moderates the effects of the Body Project on risk factor or symptom change over follow-up or the relation of baseline risk factors to future change in eating disorder symptoms. Overall, sexual minority and heterosexual women differ on two, less specific eating disorder-related risk factors at baseline, but did not differ in response to different versions of the Body Project or the relations of risk factors to future symptom change.
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Affiliation(s)
| | - Paul Rohde
- Oregon Research Institute, United States
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11
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Kamody RC, Grilo CM, Udo T. Disparities in DSM-5 defined eating disorders by sexual orientation among U.S. adults. Int J Eat Disord 2020; 53:278-287. [PMID: 31670848 DOI: 10.1002/eat.23193] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The increased occurrence of disordered eating behaviors among sexual minorities is well established; however, few studies have examined disparities in eating disorder diagnoses among this population. This study sought to examine lifetime prevalence estimates of DSM-5 defined EDs, including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) as a function of sexual orientation. We then compared prevalence of EDs based on experiences with perceived discrimination. METHOD A nationally representative sample of U.S. adults (N = 35,995) participating in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III completed structured diagnostic interviews. RESULTS Prevalence rates were significantly higher among sexual minorities than heterosexual respondents for all EDs: AN = 1.71% (SE = 0.50) versus 0.77% (SE = 0.07), BN = 1.25% (SE = 0.37) versus 0.24% (SE = 0.03), BED = 2.17% (SE = 0.52) versus 0.81% (SE = 0.05). Odds of lifetime diagnosis were significantly greater among sexual minorities for AN (adjusted odds ratio [AOR] = 1.93), BN (AOR = 3.69), and BED (AOR = 2.32), after adjusting for sociodemographic variables. Sexual minorities reporting experiences with perceived discrimination had significantly higher prevalence of AN than those not endorsing perceived discrimination: 3.78% (SE = 1.43) versus 0.82% (SE = 0.33); AOR = 5.06. There were no significant differences in prevalence of BN or BED by perceived discrimination. DISCUSSION Findings indicate that sexual minorities are disproportionately affected by EDs. Further research is needed to better understand mechanisms contributing to these disparities and heightened risk for EDs.
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Affiliation(s)
- Rebecca C Kamody
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Carlos M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Tomoko Udo
- Department of Health Policy, Management, and Behavior, School of Public Health, University of Albany, State University of New York, Albany, New York
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12
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Tran A, Kaplan JA, Austin SB, Davison K, Lopez G, Agénor M. “It’s all outward appearance-based attractions”: A qualitative study of body image among a sample of young gay and bisexual men. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2020. [DOI: 10.1080/19359705.2019.1706683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alvin Tran
- Department of Health Administration and Policy, University of New Haven, West Haven, Connecticut, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Justin A. Kaplan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Kirsten Davison
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Gilberto Lopez
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Madina Agénor
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Parker LL, Harriger JA. Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature. J Eat Disord 2020; 8:51. [PMID: 33088566 PMCID: PMC7566158 DOI: 10.1186/s40337-020-00327-y] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND According to past research, lesbian, gay, bisexual, and transgender (LGBT) individuals experience a higher prevalence of psychopathology, which is attributable to the increased stress (i.e., stigma and prejudice) that they experience, as detailed by the minority stress model (MSM). MAIN This current literature review examined the empirical literature regarding the rates and types of, and risk factors for eating disorders and disordered eating behaviors in LGBT adults and adolescents, in addition to each individual subgroup (i.e., lesbians, gay males, bisexuals, transgender and gender-nonconforming individuals). CONCLUSION LGBT adults and adolescents experience greater incidence of eating disorders and disordered eating behaviors than their heterosexual and cisgender counterparts. Additionally, gay, bisexual, and transgender adults and adolescents were all at increased risk for eating disorders and disordered eating behaviors. Mixed results were found for lesbian adults and adolescents. Results are discussed within the framework of the MSM.
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Affiliation(s)
- Lacie L Parker
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Suite 106, Loma Linda, CA 92350 USA
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Nagata JM, Capriotti MR, Murray SB, Compte EJ, Griffiths S, Bibbins-Domingo K, Obedin-Maliver J, Flentje A, Lubensky M, Lunn MR. Community norms for the Eating Disorder Examination Questionnaire among cisgender gay men. EUROPEAN EATING DISORDERS REVIEW 2020; 28:92-101. [PMID: 31793119 PMCID: PMC7275693 DOI: 10.1002/erv.2708] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/07/2019] [Accepted: 09/15/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Prior norms of the Eating Disorders Examination Questionnaire (EDE-Q) among men have not considered sexual orientation. This study's objective was to assess EDE-Q community norms among cisgender gay men. METHOD Participants were 978 self-identified cisgender gay men from The PRIDE Study recruited in 2018. RESULTS We present mean scores and standard deviations for the EDE-Q among cisgender gay men ages 18-82. Among cisgender gay men, 4.0% scored in the clinically significant range on the global score, 5.7% on the restraint, 2.1% on the eating concern, 10.5% on the weight concern, and 21.4% on the shape concern subscales of the EDE-Q. The global score as well as weight and shape concerns in a young adult subsample (18-26 years) from The PRIDE Study were higher than previously reported norms in young men (Lavender, 2010). Participants reported any occurrence (≥1/28 days) of dietary restraint (19.8%), objective binge episodes (10.9%), excessive exercise (10.1%), laxative misuse (1.1%), and self-induced vomiting (0.6%). Binge eating, excessive exercise, and self-induced vomiting in The PRIDE Study subsample were lower than previously reported in young men. DISCUSSION We provide EDE-Q norms among cisgender gay men, which should aid clinicians and researchers to interpret the EDE-Q scores of cisgender gay men.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Matthew R. Capriotti
- Department of Psychology, San José State University, San Jose, CA
- Department of Medicine, University of California, San Francisco, San Francisco, CA
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA
| | - Stuart B. Murray
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Emilio J Compte
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
- School of Human and Behavioral Sciences, Favaloro University, Buenos Aires, Argentina
- DBT-Eating Disorders Team, Fundación Foro, Buenos Aires, Argentina
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Kirsten Bibbins-Domingo
- Department of Medicine, University of California, San Francisco, San Francisco, CA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA
| | - Micah Lubensky
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Mitchell R. Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA
- Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Bell K, Rieger E, Hirsch JK. Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model. Front Psychol 2019; 9:2692. [PMID: 30671007 PMCID: PMC6331421 DOI: 10.3389/fpsyg.2018.02692] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 12/14/2018] [Indexed: 11/13/2022] Open
Abstract
In this study we sought to compare eating disorder attitudes and behaviors, and proneness to an eating disorder (“ED proneness”), between gay men, lesbian women, and transgender and gender non-conforming (TGNC) adults. A further aim was to identify and compare risk and protective factors, and examine a mediational model based on the interpersonal theory of eating disorders (IPT-ED), whereby the association between interpersonal factors and ED proneness would be mediated by psychological constructs pertaining to the self and negative affect. Data was obtained from a larger national study of health risk and protective factors among sexual minority and gender diverse populations. The sample included 97 gay men, 82 lesbian women, and 138 TGNC adults. Participants completed the National College Health Assessment, Eating Disorders Screen for Primary Care, Patient Health Questionnaire Depression scale, Generalized Anxiety Disorder 7 scale, Self-Compassion Scale-Short Form, Negative Social Exchange subscale of the Multidimensional Health Profile, Interpersonal Needs Questionnaire, and Perceived Stigma Scale. There was a significant difference between groups in ED proneness, with lesbian women (66.7%) having a significantly higher percentage than gay men (47.6%). There was also a significant difference between groups in weight-based self-worth, with the lowest percentage in gay men (63%) and the highest percentage in lesbian women (82%), as well as dissatisfaction with eating patterns, with the highest percentage in TGNC adults (69.8%) and the lowest percentage in gay men (47.7%). There was a low percentage of inappropriate compensatory behaviors, with no significant difference between groups. Logistic regression analyses showed that the predictor variables of ED proneness were depression, perceived stigma, and self-compassion in gay men; depression in lesbian women; and self-compassion in the TGNC adults. Mediation analyses showed that thwarted belongingness (i.e., an unmet to belong) and perceived stigma had an indirect association with ED proneness that was mediated by self-compassion and depression (for perceived stigma alone) in gay men, depression in lesbian women, and self-compassion in TGNC adults. The interpersonal theory of eating disorders therefore extends to sexual minority and gender diverse populations; however, the results suggest a broadening of theoretical models and intervention programs to include the role of stigma and self-compassion.
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Affiliation(s)
- Kathryn Bell
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - Elizabeth Rieger
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - Jameson K Hirsch
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States
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Coniglio KA, Becker KR, Tabri N, Keshishian AC, Miller JD, Eddy KT, Thomas JJ. Factorial integrity and validation of the Eating Pathology Symptoms Inventory (EPSI). Eat Behav 2018; 31:1-7. [PMID: 30025234 DOI: 10.1016/j.eatbeh.2018.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 11/30/2022]
Abstract
The Eating Pathology Symptoms Inventory (EPSI) is a 45-item self-report measure of eating pathology designed to be sensitive in assessing symptoms among diverse populations of individuals with disordered eating. The current study represents the first external validation of the EPSI as well as the first to examine the factor structure in an outpatient eating disorder clinic sample. We conducted an exploratory factor analysis in three separate samples: an outpatient clinic sample (n = 284), a college sample (n = 296), and a community sample (n = 341) and compared the observed factor structures to the original 8-factor solution proposed by Forbush et al. (2013). We also investigated whether the subscales correlated with the Eating Disorder Examination Questionnaire (EDE-Q) and a clinical impairment measure among the outpatient clinic sample. Results suggested between 7 and 8 factors for each of the three samples. Our findings largely replicated those of the original EPSI development study, excepting some deviations in the Muscle Building, Cognitive Restraint, and Excessive Exercise subscales. However, confirmatory factor analysis and exploratory structural equation modeling produced poor model fit, which may be related to the item heterogeneity within many of the subscales. Finally, eating disorder attitudes and behaviors assessed by the EPSI were significantly correlated with the EDE-Q and with clinical impairment. Overall, our results highlight both strengths and limitations of the EPSI. Findings provide preliminary support for the use of the EPSI among research with diverse populations, and present several avenues for future research for enhancing clinical utility.
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Affiliation(s)
- Kathryn A Coniglio
- Department of Psychology, Rutgers, The State University of New Jersey, United States of America.
| | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America.
| | - Nassim Tabri
- Department of Psychology, Carleton University, Canada
| | - Ani C Keshishian
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, United States of America
| | - Joshua D Miller
- Department of Psychology, University of Georgia, United States of America
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America
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Meneguzzo P, Collantoni E, Gallicchio D, Busetto P, Solmi M, Santonastaso P, Favaro A. Eating disorders symptoms in sexual minority women: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2018; 26:275-292. [DOI: 10.1002/erv.2601] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Paolo Meneguzzo
- Department of Neurosciences; University of Padova; Padova Italy
| | | | | | - Paolo Busetto
- Department of Neurosciences; University of Padova; Padova Italy
| | - Marco Solmi
- Department of Neurosciences; University of Padova; Padova Italy
| | | | - Angela Favaro
- Department of Neurosciences; University of Padova; Padova Italy
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18
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Kask J, Ramklint M, Kolia N, Panagiotakos D, Ekbom A, Ekselius L, Papadopoulos FC. Anorexia nervosa in males: excess mortality and psychiatric co-morbidity in 609 Swedish in-patients. Psychol Med 2017; 47:1489-1499. [PMID: 28162109 DOI: 10.1017/s0033291717000034] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is a psychiatric disorder with high mortality. METHOD A retrospective register study of 609 males who received hospitalized care for AN in Sweden between 1973 and 2010 was performed. The standardized mortality ratios (SMRs) and Cox regression-derived hazard ratios (HRs) were calculated as measures of mortality. The incidence rate ratios (IRRs) were calculated to compare the mortality rates in patients with AN and controls both with and without psychiatric diagnoses. RESULTS The SMR for all causes of death was 4.1 [95% confidence interval (CI) 3.1-5.3]. For those patients with psychiatric co-morbidities, the SMR for all causes of death was 9.1 (95% CI 6.6-12.2), and for those without psychiatric co-morbidity, the SMR was 1.6 (95% CI 0.9-2.7). For the group of patients with alcohol use disorder, the SMR for natural causes of death was 11.5 (95% CI 5.0-22.7), and that for unnatural causes was 35.5 (95% CI 17.7-63.5). The HRs confirmed the increased mortality for AN patients with psychiatric co-morbidities, even after adjusting for confounders. The IRRs revealed no significant difference in mortality patterns between the AN patients with psychiatric co-morbidity and the controls with psychiatric diagnoses, with the exceptions of alcohol use disorder and neurotic, stress-related and somatoform disorders, which seemed to confer a negative synergistic effect on mortality. CONCLUSION Mortality in male AN patients was significantly elevated compared with the general population among only the patients with psychiatric co-morbidities. Specifically, the presence of alcohol and other substance use disorders was associated with more profound excess mortality.
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Affiliation(s)
- J Kask
- Department of Neuroscience, Psychiatry,University Hospital, Uppsala University,Uppsala,Sweden
| | - M Ramklint
- Department of Neuroscience, Psychiatry,University Hospital, Uppsala University,Uppsala,Sweden
| | - N Kolia
- Department of Nutrition and Dietetics,Harokopio University,Athens,Greece
| | - D Panagiotakos
- Department of Nutrition and Dietetics,Harokopio University,Athens,Greece
| | - A Ekbom
- Unit of Clinical Epidemiology, Department of Medicine,Karolinska Hospital,Karolinska Institute,Stockholm,Sweden
| | - L Ekselius
- Department of Neuroscience, Psychiatry,University Hospital, Uppsala University,Uppsala,Sweden
| | - F C Papadopoulos
- Department of Neuroscience, Psychiatry,University Hospital, Uppsala University,Uppsala,Sweden
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Adaptability of Family Therapy Modalities in the Treatment of Lesbian and Gay Clients with Bulimia Nervosa. CONTEMPORARY FAMILY THERAPY 2017. [DOI: 10.1007/s10591-017-9410-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bankoff SM, Richards LK, Bartlett B, Wolf EJ, Mitchell KS. Examining weight and eating behavior by sexual orientation in a sample of male veterans. Compr Psychiatry 2016; 68:134-9. [PMID: 27234194 PMCID: PMC4884604 DOI: 10.1016/j.comppsych.2016.03.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 03/06/2016] [Accepted: 03/25/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Eating disorders are understudied in men and in sexual minority populations; however, extant evidence suggests that gay men have higher rates of disordered eating than heterosexual men. The present study examined the associations between sexual orientation, body mass index (BMI), disordered eating behaviors, and food addiction in a sample of male veterans. METHOD Participants included 642 male veterans from the Knowledge Networks-GfK Research Panel. They were randomly selected from a larger study based on previously reported trauma exposure; 96% identified as heterosexual. Measures included the Eating Disorder Diagnostic Scale, the Yale Food Addiction Scale, and self-reported height and weight. RESULTS Heterosexual and sexual minority men did not differ significantly in terms of BMI. However, gay and bisexual men (n=24) endorsed significantly greater eating disorder symptoms and food addiction compared to heterosexual men. CONCLUSIONS Our findings that sexual minority male veterans may be more likely to experience eating disorder and food addiction symptoms compared to heterosexual male veterans highlight the importance of prevention, assessment, and treatment efforts targeted to this population.
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Affiliation(s)
- Sarah M. Bankoff
- VA Boston Healthcare System, Boston, MA, USA,Corresponding author at: VA Boston Healthcare System, 150 S. Huntington Ave. (11PC), Boston, MA 02130, USA. Tel.: 857-364-5518
| | - Lauren K. Richards
- Red Sox Foundation and MGH Home Base Program, Department of Psychiatry, Boston, MA, USA,Massachusetts General Hospital, Boston, MA, USA
| | - Brooke Bartlett
- VA Boston Healthcare System, Boston, MA, USA; Women's Health Sciences Division, National Center for PTSD, Boston, MA, USA.
| | - Erika J. Wolf
- VA Boston Healthcare System, Boston, MA, USA,Behavioral Sciences Division, National Center for PTSD, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Karen S. Mitchell
- VA Boston Healthcare System, Boston, MA, USA,Women’s Health Sciences Division, National Center for PTSD, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Brown TA, Keel PK. A randomized controlled trial of a peer co-led dissonance-based eating disorder prevention program for gay men. Behav Res Ther 2015; 74:1-10. [PMID: 26342904 DOI: 10.1016/j.brat.2015.08.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 08/20/2015] [Accepted: 08/24/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Gay males have increased risk for eating disorders compared to heterosexual males, establishing a need to develop and empirically evaluate programs to reduce risk for this population. The present study investigated the acceptability and efficacy of a cognitive dissonance-based (DB) intervention (The PRIDE Body Project(©)) in reducing eating disorder risk factors among gay males in a university-based setting. METHOD Eighty-seven gay males were randomized to either a 2-session DB intervention (n = 47) or a waitlist control condition (n = 40). Participants completed eating disorder risk factor assessments pre-intervention, post-intervention, and at 4-week follow-up, and those receiving the intervention completed post-treatment acceptability measures. RESULTS Acceptability ratings were highly favorable. Regarding efficacy, the DB condition was associated with significantly greater decreases in body dissatisfaction, drive for muscularity, self-objectification, partner-objectification, body-ideal internalization, dietary restraint, and bulimic symptoms compared to waitlist control from pre- to post-intervention. Improvements in the DB group were maintained at 4-week follow-up, with the exception of body-ideal internalization. Body-ideal internalization mediated treatment effects on bulimic symptoms. CONCLUSION Results support the acceptability and efficacy of The PRIDE Body Project(©) and provide support for theoretical models of eating pathology in gay men.
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Affiliation(s)
- Tiffany A Brown
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32304, USA.
| | - Pamela K Keel
- Florida State University, Department of Psychology, 1107 W. Call St., Tallahassee, FL 32304, USA.
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Mason TB, Lewis RJ. Minority stress and binge eating among lesbian and bisexual women. JOURNAL OF HOMOSEXUALITY 2015; 62:971-992. [PMID: 25603175 DOI: 10.1080/00918369.2015.1008285] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Previous research demonstrates that lesbian and bisexual (LB) women report more binge eating behaviors compared to heterosexual women although the explanations for this disparity are not well understood. LB women also experience distal (e.g., discrimination) and proximal (e.g., expectations of rejection) minority stressors that are related to negative mental and physical health outcomes. The present study investigated the association between minority stressors and binge eating behaviors in LB women. A sample of 164 LB women completed an online survey that included measures of distal and proximal sexual minority stressors, emotional-focused coping, social isolation, negative affect, and binge eating. The resultant model partially supported both the psychological mediation framework and the affect regulation model. The principal finding was that among LB women, proximal stressors were associated with social isolation and emotion-focused coping, which in turn were associated with negative affect and ultimately binge eating. Overall, the study provides evidence that minority stress is associated with binge eating and may partially explain the disparity in binge eating between LB and heterosexual women.
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Affiliation(s)
- Tyler B Mason
- a Department of Psychology , Old Dominion University , Norfolk , Virginia , USA
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24
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Maloch JK, Bieschke KJ, McAleavey AA, Locke BD. Eating Concerns in College Women Across Sexual Orientation Identities. JOURNAL OF COLLEGE COUNSELING 2013. [DOI: 10.1002/j.2161-1882.2013.00042.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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von Lojewski A, Boyd C, Abraham S, Russell J. Lifetime and recent DSM and ICD psychiatric comorbidity of inpatients engaging in different eating disorder behaviours. Eat Weight Disord 2012; 17:e185-93. [PMID: 23086254 DOI: 10.1007/bf03325346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Previous studies investigating psychiatric comorbidity in eating disorder (ED) patients compared groups according to ED diagnoses. The current paper compared groups according to ED behaviours: self-induced vomiting, objective binge eating, excessive exercising, and to body mass index (BMI, kg/m(2)) for selected psychiatric comorbidity using two systems: Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) and International Classification of Diseases - Tenth Revision (ICD-10) diagnoses. METHOD Two hundred and twenty-six patients admitted for treatment in a specialised Eating Disorders Unit completed the Composite International Diagnostic Interview (CIDI). Lifetime and recent (12 months) psychiatric diagnoses were produced according to DSM-IV and ICD-10. Associations between presence of ED behaviours or BMI and psychiatric comorbidity were investigated. RESULTS Eighty-eight percent of patients had a lifetime history (72% recent history) of at least one comorbid diagnosis (regardless of diagnostic system). Agreement between the systems was high for mood (affective) disorders and moderate for anxiety/somatoform disorders. Significantly more patients who vomit had lifetime and recent mood (affective) disorders (DSM-IV and ICD-10). Significantly more 'vomiters' had recent anxiety disorders (DSM-IV) and neurotic, stress-related and somatoform disorders (ICD-10) including post-traumatic stress disorder (PTSD; DSM-IV and ICD-10). More patients with BMI >17.5 kg/m(2) had lifetime and recent mood (affective) disorders and lifetime PTSD (DSM-IV and ICD-10). The results for 'excessive exercisers' varied and appeared inconsistent. There were no differences in any disorders for objective binge eaters. DISCUSSION Patients who induce vomiting have more psychiatric comorbidity than 'non-vomiters', both lifetime and recent, and may benefit from diagnostic recognition as a separate group, for example 'vomiting' or 'purging' ED, who can then receive specialist treatment for their comorbidity and associated problems.
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Affiliation(s)
- A von Lojewski
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia.
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Calandra C, Russo RG, Luca M. Bupropion versus sertraline in the treatment of depressive patients with binge eating disorder: retrospective cohort study. Psychiatr Q 2012; 83:177-85. [PMID: 21927936 DOI: 10.1007/s11126-011-9192-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study sought to compare Bupropion versus Sertraline in the treatment of depressed patients with Binge Eating Disorder (BED) prescribed off-label. Medical records of outpatients with diagnosis of BED and Depression (DSM-IV-TR criteria) were selected: 15 patients were treated with bupropion 150 mg/per day, and 15 with sertraline 200 mg/per day. During the screening and control visits (2°-6°-14°-24° week), the selected patients were first weighed and then evaluated using the following questionnaires: Binge Eating Disorder-Clinical Interview (BEDCI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory X (STAI-X) and Arizona Sexual Experience Scale (ASEX). Both drugs reduced anxious-depressive symptoms and binge frequency: Bupropion showed a better effectiveness in reducing weight and improving sexual performances; weight loss related to it was proportional to the body mass index. Bupropion may be associated with more weight loss in BED, depressed patients than sertraline.
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Affiliation(s)
- Carmela Calandra
- Department of Medical and Surgery Specialties, Psychiatry Unit of the University Hospital Policlinico-Vittorio Emanuele of Catania, University of Catania, Via S. Sofia 78, 95100, Catania (Sicily), Italy.
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