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Wiss DA, LaFata EM, Tomiyama AJ. A novel weight suppression score associates with distinct eating disorder and ultra-processed food symptoms compared to the traditional weight suppression measure among adults seeking outpatient nutrition counseling. J Eat Disord 2024; 12:75. [PMID: 38853271 PMCID: PMC11162565 DOI: 10.1186/s40337-024-01029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/23/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Weight suppression has been defined as diet-induced weight loss, traditionally operationalized as the difference between one's highest and current weight. This concept has been studied in the context of eating disorders, but its value in predicting treatment outcomes has been inconsistent, which may be partially attributed to its calculation. METHOD The current study operationalizes a novel weight suppression score, reflecting the midpoint between the lowest and highest adult weights among adults (N = 287, ages 21-75, 73.9% women) seeking outpatient treatment for disordered eating. This report compared the traditional weight suppression calculation to the novel weight suppression score in a simulated dataset to model their differential distributions. Next, we analyzed shared and distinct clinical correlates of traditional weight suppression versus the novel weight suppression score using clinical intake data. RESULTS The novel weight suppression score was significantly associated with meeting criteria for both eating disorders and ultra-processed food addiction and was more sensitive to detecting clinically relevant eating disorder symptomatology. However, the novel weight suppression score (vs. traditional weight suppression) was associated with fewer ultra-processed food addiction symptoms. CONCLUSION The novel weight suppression score may be particularly relevant for those with eating disorders and ultra-processed food addiction, with more relevance to individual eating disorder compared to ultra-processed food addiction symptoms. Consideration of the novel weight suppression score in future research on eating behaviors should extend beyond just those with diagnosed eating disorders.
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Affiliation(s)
- David A Wiss
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Young Drive South, Los Angeles, CA, 90095, USA.
| | - Erica M LaFata
- Drexel University Center for Weight Eating and Lifestyle Science, 3201 Chestnut Street, Philadelphia, PA, 19104, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Los Angeles, CA, 90095, USA
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2
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Lewis YD, Bergner L, Steinberg H, Bentley J, Himmerich H. Pharmacological Studies in Eating Disorders: A Historical Review. Nutrients 2024; 16:594. [PMID: 38474723 PMCID: PMC11154472 DOI: 10.3390/nu16050594] [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: 12/28/2023] [Revised: 02/11/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Eating disorders (EDs) are serious mental health conditions characterised by impaired eating behaviours and nutrition as well as disturbed body image, entailing considerable mortality and morbidity. Psychopharmacological medication is an important component in the treatment of EDs. In this review, we performed a historic analysis of pharmacotherapeutic research in EDs based on the scientific studies included in the recently published World Federation of Societies for Biological Psychiatry (WFSBP) guidelines for ED treatment. This analysis focuses on early approaches and trends in the methods of clinical pharmacological research in EDs, for example, the sample sizes of randomised controlled trials (RCTs). We found the development of psychopharmacological treatments for EDs followed advancements in psychiatric pharmacotherapy. However, the application of RCTs to the study of pharmacotherapy for EDs may be an impediment as limited participant numbers and inadequate research funding impede generalisability and statistical power. Moreover, current medication usage often deviates from guideline recommendations. In conclusion, the RCT model may not effectively capture the complexities of ED treatment, and funding limitations hinder research activity. Novel genetically/biologically based treatments are warranted. A more comprehensive understanding of EDs and individualised approaches should guide research and drug development for improved treatment outcomes.
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Affiliation(s)
- Yael D. Lewis
- Hadarim Eating Disorders Unit, Shalvata Mental Health Centre, Hod Hasharon 4534708, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Lukas Bergner
- Forschungsstelle für die Geschichte der Psychiatrie, Klinik und Poliklinik Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, 04103 Leipzig, Germany; (L.B.); (H.S.)
| | - Holger Steinberg
- Forschungsstelle für die Geschichte der Psychiatrie, Klinik und Poliklinik Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, 04103 Leipzig, Germany; (L.B.); (H.S.)
| | - Jessica Bentley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (J.B.); (H.H.)
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK; (J.B.); (H.H.)
- South London and Maudsley NHS Foundation Trust, London BR3 3BX, UK
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3
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Fan S, Guo W, Xiao D, Guan M, Liao T, Peng S, Feng A, Wang Z, Yin H, Li M, Chen J, Xiong W. Microbiota-gut-brain axis drives overeating disorders. Cell Metab 2023; 35:2011-2027.e7. [PMID: 37794596 DOI: 10.1016/j.cmet.2023.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/10/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
Overeating disorders (ODs), usually stemming from dieting history and stress, remain a pervasive issue in contemporary society, with the pathological mechanisms largely unresolved. Here, we show that alterations in intestinal microbiota are responsible for the excessive intake of palatable foods in OD mice and patients with bulimia nervosa (BN). Stress combined with a history of dieting causes significant changes in the microbiota and the intestinal metabolism, which disinhibit the vagus nerve terminals in the gut and thereby lead to a subsequent hyperactivation of the gut-brain axis passing through the vagus, the solitary tract nucleus, and the paraventricular nucleus of the thalamus. The transplantation of a probiotic Faecalibacterium prausnitzii or dietary supplement of key metabolites restores the activity of the gut-to-brain pathway and thereby alleviates the OD symptoms. Thus, our study delineates how the microbiota-gut-brain axis mediates energy balance, unveils the underlying pathogenesis of the OD, and provides potential therapeutic strategies.
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Affiliation(s)
- Sijia Fan
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Weiwei Guo
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Dan Xiao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Mengyuan Guan
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Tiepeng Liao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China; Anhui Province Key Laboratory of Biomedical Imaging and Intelligent Processing, Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230088, China
| | - Sufang Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Airong Feng
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Ziyi Wang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Hao Yin
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China
| | - Min Li
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230026, China.
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Wei Xiong
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Hefei National Research Center for Physical Sciences at the Microscale, University of Science and Technology of China, Hefei 230001, China; Anhui Province Key Laboratory of Biomedical Imaging and Intelligent Processing, Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230088, China; Anhui Province Key Laboratory of Biomedical Aging Research, Hefei 230026, China.
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4
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Feng B, Harms J, Chen E, Gao P, Xu P, He Y. Current Discoveries and Future Implications of Eating Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6325. [PMID: 37510558 PMCID: PMC10379623 DOI: 10.3390/ijerph20146325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/20/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
Eating disorders (EDs) are characterized by severe disturbances in eating behaviors and can sometimes be fatal. Eating disorders are also associated with distressing thoughts and emotions. They can be severe conditions affecting physical, psychological, and social functions. Preoccupation with food, body weight, and shape may also play an important role in the regulation of eating disorders. Common eating disorders have three major types: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). In some cases, EDs can have serious consequences for an individual's physical and mental health. These disorders often develop during adolescence or early adulthood and affect both males and females, although they are more commonly diagnosed in young adult females. Treatment for EDs typically involves a combination of therapy, nutrition counseling, and medical care. In this narrative review, the authors summarized what is known of EDs and discussed the future directions that may be worth exploring in this emerging area.
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Affiliation(s)
- Bing Feng
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Jerney Harms
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
- Biology Department, Centenary College of Louisiana, Shreveport, LA 71104, USA
| | - Emily Chen
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Peiyu Gao
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
| | - Pingwen Xu
- The Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Yanlin He
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA
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5
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de Moraes CEF, Donnelly B, Appolinario JC, Hay P. Obtaining long-term recovery: advances in optimizing treatment outcomes in patients with binge-eating disorder. Expert Rev Neurother 2023; 23:1097-1111. [PMID: 37916419 DOI: 10.1080/14737175.2023.2273392] [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: 05/30/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Binge-eating disorder (BED) is a complex and disabling eating disorder (ED) associated with considerable burden and impairments in quality of life and physical/mental health. It has been recognized as a formal ED category since 2013, however BED is still underdetected and undertreated. AREAS COVERED This review summarizes the advances in the understanding of the pathophysiology of BED as well as the evidence on the efficacy of the existing treatments. The authors searched Scopus, PubMed, ClinicalTrials.Gov, and ANZCTR with terms including 'assessment' OR 'treatment' OR 'diagnosis' OR 'mechanisms' AND 'binge eating' OR 'binge-eating disorder' for manuscripts published between January 2013 and April 2023. EXPERT OPINION Most of the trials on treatments of BED have been in people of high weight with weight loss as an outcome. Nevertheless, less is known about the treatment of this condition in people with body mass index (BMI) within the normal range where weight stabilization may be a more appropriate goal. Moreover, there is a need for an enhanced appreciation of the role of combination treatment to improve overall outcomes. Also, there are important opportunities for future research in understanding the mechanisms of action and effectiveness of BED treatments.
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Affiliation(s)
- Carlos Eduardo Ferreira de Moraes
- Obesity and Eating Disorders Group (GOTA), Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Brooke Donnelly
- Clinical Psychology Unit, School of Psychology, University of Sydney, Camperdown, Australia
| | - Jose Carlos Appolinario
- Obesity and Eating Disorders Group (GOTA), Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
- Mental Health Services, South West Sydney Local Health District (SWSLHD), Campbelltown, Australia
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6
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Anderson S, Gopi-Firth S. Eating disorders and the role of the dental team. Br Dent J 2023; 234:445-449. [PMID: 36964374 DOI: 10.1038/s41415-023-5619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 03/26/2023]
Abstract
Although primarily classified as psychiatric disorders, eating disorders have a complex aetiology and presentation, with comorbidities spanning multiple disciplines, including dental complications. In some cases, general dental practitioners may be the first health professional to become aware that someone is struggling with an eating disorder. The dental team is in an ideal position to sensitively explore the presentation and signpost the patient to appropriate services while offering support and/or remedial management for dental complications of the eating disorder. Anyone from any background, gender or ethnicity may develop an eating disorder, of which the main diagnoses are anorexia nervosa, bulimia nervosa and binge eating disorder. Some of the frequently seen oral manifestations of these disorders include generalised dental erosion, caries, self-inflicted palatal or oropharyngeal trauma, atrophic mucosa, bilateral parotid gland enlargement, xerostomia and periodontal disease. The dentist's role is pivotal in recognising the possible implications of some of these findings, approaching the patient sensitively, and communicating empathetically to engage them in treatment, reducing the risk of further erosion and improving oral health and hygiene. The dental team may be able to signpost the patient to their general practitioner for onward referral or to a local eating disorder support network.
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Affiliation(s)
- Stephen Anderson
- Consultant Psychiatrist in Eating Disorders, NHS Greater Glasgow and Clyde, UK.
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7
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Barakat S, Maguire S. Accessibility of Psychological Treatments for Bulimia Nervosa: A Review of Efficacy and Engagement in Online Self-Help Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010119. [PMID: 36612445 PMCID: PMC9819826 DOI: 10.3390/ijerph20010119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/30/2023]
Abstract
Bulimia nervosa is an eating disorder characterised by marked impairment to one's physical health and social functioning, as well as high rates of chronicity and comorbidity. This literature review aims to summarise existing academic research related to the symptom profile of BN, the costs and burden imposed by the illness, barriers to the receipt of care, and the evidence base for available psychological treatments. As a consequence of well-documented difficulties in accessing evidence-based treatments for eating disorders, efforts have been made towards developing innovative, diverse channels to deliver treatment, with several of these attempting to harness the potential of digital platforms. In response to the increasing number of trials investigating the utility of online treatments, this paper provides a critical review of previous attempts to examine digital interventions in the treatment of eating disorders. The results of a focused literature review are presented, including a detailed synthesis of a knowledgeable selection of high-quality articles with the aim of providing an update on the current state of research in the field. The results of the review highlight the potential for online self-help treatments to produce moderately sized reductions in core behavioural and cognitive symptoms of eating disorders. However, concern is raised regarding the methodological limitations of previous research in the field, as well as the high rates of dropout and poor adherence reported across most studies. The review suggests directions for future research, including the need to replicate previous findings using rigorous study design and methodology, as well as further investigation regarding the utility of clinician support and interactive digital features as potential mechanisms for offsetting low rates of engagement with online treatments.
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Affiliation(s)
- Sarah Barakat
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Camperdown 2050, Australia
- School of Psychology, University of Sydney, Camperdown 2050, Australia
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, University of Sydney, Sydney Local Health District, Camperdown 2050, Australia
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8
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Enouy S, Desrochers JE, Bossom IRL, Tabri N. A p-curve analysis of the emotional Stroop effect among women with eating disorders. Int J Eat Disord 2022; 55:1459-1483. [PMID: 36124885 DOI: 10.1002/eat.23807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A recent meta-review of attentional bias research in eating disorders suggests that meta-analyses and systematic reviews include many low-quality and underpowered studies (Stott et al., 2021). As such, we examined whether published research examining the link between attentional bias, using the emotional Stroop task, and eating disorders among women with eating disorders has evidential value (ruling out selective reporting of a statistically significant effect) using a p-curve analysis. A p-curve analysis plots statisticall significant p-values onto a curve from .01 to .05 to examine its distribution. We hypothesized that the p-curve would be flat, indicating no true effect. METHOD The hypothesis, database search strategy, and data analytic approach were pre-registered. The inclusion criteria were reports that compared control and eating disorder groups, reported inferential statistics, and that used body shape/weight or general threat target words. RESULTS Fifty published reports were included in the p-curve analyses. Unexpectedly, the half and full p-curves were significantly right-skewed, indicating evidential value. However, the results were not robust to the exclusion of the seven lowest p-values and on average, reports were underpowered. There were also 18 reports with null results (they had a p-value greater than .05), which precluded their inclusion in the p-curve analyses. DISCUSSION The findings suggest that most of the evidence from research examining attentional biases using the emotional Stroop task among women with an eating disorder or with elevated eating disorder symptoms is underpowered and so should be interpreted with considerable caution. PUBLIC SIGNIFICANCE Concerns have been raised about the low quality of research examining attentional biases among women with eating disorders using the emotional Stroop task. In the current research, we observed that the evidential value of primary research reporting differences between women with and without eating disorders was equivocal and had low statistical power. These results can guide researchers towards conducting more rigorous research on attentional biases among people with eating disorders.
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Affiliation(s)
- Sarah Enouy
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
| | - Jessica E Desrochers
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
| | - Isabella R L Bossom
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada.,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, Ontario, Canada
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9
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Skin signs in eating disorders: a literature review. Eat Weight Disord 2022; 27:867-879. [PMID: 34142354 DOI: 10.1007/s40519-021-01241-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To summarize and describe the available knowledge on dermatological manifestation of eating disorders: anorexia nervosa, bulimia nervosa, binge eating disorder and eating disorder not otherwise specified, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders IV-TR and 5th edition. METHODS We searched in PubMed, Scopus and Web of Science databases from January 1, 1980 through May 1, 2020 for papers in English language on the skin manifestation of eating disorders. Results were screened using the PRISMA tool. RESULTS The study yielded 207 results. According with PRISMA guidelines, 26 papers were included in the review. More than 73% of screened papers (19/26) were case reports. Cross-sectional studies represented the 19.2% of screened papers (5/26). Each eligible study has been screened and analyzed. CONCLUSION Huge heterogeneity of skin signs of eating disorders were identified. The number of controlled studies available is very limited, and most papers of interest are case reports or narrative review articles. Larger, more methodologically rigorous studies to evaluate the presence of dermatological issue in eating disorder patients are needed. LEVEL OF EVIDENCE Level IV. Evidence obtained from multiple time series analysis such as case studies.
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10
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Shobeiri P, Kalantari A, Teixeira AL, Rezaei N. Shedding light on biological sex differences and microbiota-gut-brain axis: a comprehensive review of its roles in neuropsychiatric disorders. Biol Sex Differ 2022; 13:12. [PMID: 35337376 PMCID: PMC8949832 DOI: 10.1186/s13293-022-00422-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/14/2022] [Indexed: 12/15/2022] Open
Abstract
Women and men are suggested to have differences in vulnerability to neuropsychiatric disorders, including major depressive disorder (MDD), generalized anxiety disorder (GAD), schizophrenia, eating disorders, including anorexia nervosa, and bulimia nervosa, neurodevelopmental disorders, such as autism spectrum disorder (ASD), and neurodegenerative disorders including Alzheimer’s disease, Parkinson’s disease. Genetic factors and sex hormones are apparently the main mediators of these differences. Recent evidence uncovers that reciprocal interactions between sex-related features (e.g., sex hormones and sex differences in the brain) and gut microbiota could play a role in the development of neuropsychiatric disorders via influencing the gut–brain axis. It is increasingly evident that sex–microbiota–brain interactions take part in the occurrence of neurologic and psychiatric disorders. Accordingly, integrating the existing evidence might help to enlighten the fundamental roles of these interactions in the pathogenesis of neuropsychiatric disorders. In addition, an increased understanding of the biological sex differences on the microbiota–brain may lead to advances in the treatment of neuropsychiatric disorders and increase the potential for precision medicine. This review discusses the effects of sex differences on the brain and gut microbiota and the putative underlying mechanisms of action. Additionally, we discuss the consequences of interactions between sex differences and gut microbiota on the emergence of particular neuropsychiatric disorders. The human microbiome is a unique set of organisms affecting health via the gut–brain axis. Neuropsychiatric disorders, eating disorders, neurodevelopmental disorders, and neurodegenerative disorders are regulated by the microbiota–gut–brain axis in a sex-specific manner. Understanding the role of the microbiota–gut–brain axis and its sex differences in various diseases can lead to better therapeutic methods.
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Affiliation(s)
- Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran
| | - Amirali Kalantari
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, 14194, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Antônio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nima Rezaei
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran. .,Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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11
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Psychophysical chemosensory dysfunction in eating disorders: a qualitative systematic review. Eat Weight Disord 2022; 27:429-447. [PMID: 33876410 DOI: 10.1007/s40519-021-01189-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/02/2021] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Patients with chemosensory dysfunction experience significant quality of life disruptions, including reduced enjoyment of eating. While chemosensory dysfunction has been associated with eating disorders, the relationship is poorly understood. This systematic review aims to characterize psychophysical gustation and olfaction in patients with eating disorders. METHODS Systematic review of investigations assessing psychophysical chemosensory function in patients with organic eating disorders. RESULTS 26 studies were included. Five studies assessed both chemosenses, while 12 and 9 assessed exclusively gustation or olfaction, respectively. In total, 779 patients were included [72.4% anorexia nervosa (AN), 26.7% bulimia nervosa (BN), 0.8% combined AN/BN]. Patients with eating disorders experienced rates of hypogeusia up to 87% in AN and 84.6% in BN. There was evidence for alterations in psychophysical olfaction, but orientation of trends were less clear. Chemosensory dysfunction was more evident in AN patients. Treatment correlated with improved chemosensory function. CONCLUSIONS Despite heterogeneity in study methodology and results, this review demonstrates that patients with eating disorders experience some degree of chemosensory dysfunction, particularly in gustation. This symptomatology overlaps with those experienced by patients with other causes of chemosensory impairment. These findings suggest potential broad psychosocial, dietary, and mental health implications in patient populations experiencing chemosensory dysfunction. LEVEL OF EVIDENCE Level II.
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12
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Kotsanos N, Marks LAM, Arapostathis KN, Kubota K. Disabilities, Neuropsychiatric Disorders, and Syndromes in Childhood and Adolescence. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Johansson AK, Mjanger Øvretvedt T, Reinholtsen KK, Johansson A. Eating Disorders: An Analysis of Self-Induced Vomiting, Binge Eating, and Oral Hygiene Behavior. Int J Clin Pract 2022; 2022:6210372. [PMID: 35685564 PMCID: PMC9159179 DOI: 10.1155/2022/6210372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/11/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Self-induced vomiting (SIV) is often present in patients with eating disorders (ED) and potentially damaging for oral health. Related behaviors, such as binge eating and oral hygiene habits, may equally increase the risk for dental damage. This study aimed to investigate behaviors and habits in patients with ED and SIV in relation to oral health. METHODS All patients enlisting for treatment in an ED clinic for 1 year were offered to take part in the study. Fifty-four of 65 patients were accepted to participate, and a questionnaire included questions on dietary and oral hygiene habits was included. A subgroup consisting of only those 17 ED patients who reported SIV during the previous six months comprised the sample for this study and received additional questions related to other compensatory behaviors and oral hygiene habits in relation to oral health. RESULTS Binge eating before SIV was common (14/17 patients). Time point for SIV after binge eating and the procedures performed after vomiting varied. Tooth brushing after vomiting was common (7/17). Food and drinks during binge eating included mainly items rich in calories (sugar/fat) or acid. All 17 patients believed that vomiting could damage their teeth, but only one of them had informed the dentist about having an ED. A number of oral symptoms were reported. Ten patients considered their oral health to be good/fairly good, while the remaining seven patients reported their oral health as not so good/bad/very bad. Information on how ED could affect their teeth was commonly received from the media. CONCLUSIONS The dental team should be made aware of the likely detrimental effects of binge eating and vomiting on oral health in patients with eating disorders. The team should also be aware of the cyclical nature of the disease and the similarities and diversities that exist within this group of ED patients. Since ED patients hide their disease from the dental team, this stresses the importance of open and trustful communication between patients and health workers. An organized collaboration between ED clinics and dental professionals is suggested as well as a development of avenues for information about ED and oral health.
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Affiliation(s)
- Ann-Katrin Johansson
- Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tonje Mjanger Øvretvedt
- Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Karen Knudsen Reinholtsen
- Department of Clinical Dentistry-Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Anders Johansson
- Department of Clinical Dentistry-Prosthodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
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Li Z, Halls D, Byford S, Tchanturia K. Autistic characteristics in eating disorders: Treatment adaptations and impact on clinical outcomes. EUROPEAN EATING DISORDERS REVIEW 2021; 30:671-690. [PMID: 34850503 DOI: 10.1002/erv.2875] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Autistic people with eating disorders (EDs) may have special needs that are not met in standard ED treatment, raising the need for treatment adaptations to accommodate co-existing autism spectrum condition (ASC). Little is currently known about the nature of existing treatment options or adaptations for this population. We conducted a pre-registered systematic review to: (1) identify research articles describing existing interventions for patients with ED and comorbid ASC, and to critically review evidence of their clinical effectiveness and cost-effectiveness (Review 1); (2) review the impact of ASC comorbidity on ED clinical outcomes (Review 2). METHOD Peer-reviewed studies published until the end of December 2020 were identified through a systematic search of the electronic databases: Medline, Embase, PsycINFO, Web of Science, CINAHL, Scopus and Cochrane Library. RESULTS Only one clinical pathway of treatment adaptations (the 'PEACE' pathway) was identified in Review 1 with early evidence of cost-savings and favourable treatment outcomes. ASC characteristics were shown in Review 2 to have no direct impact on physical outcomes or ED symptoms, but could be associated with higher rates of comorbidities and greater use of intensive ED treatment. Additionally, patients with ASC characteristics may benefit more from individual sessions, rather than group sessions. CONCLUSIONS Any new treatments or treatment adaptations may not directly impact on ED symptoms, but may be better able to support the complex needs of the ASC population, thus reducing subsequent need for intensive treatment. Future research is warranted to explore evidence of clinical and cost-effectiveness of interventions for this population.
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Affiliation(s)
- Zhuo Li
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Daniel Halls
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Sarah Byford
- King's Health Economics, Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kate Tchanturia
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.,Psychological Medicine Clinical Academic Group, National Eating Disorders Service, South London and Maudsley NHS Trust, London, UK.,Department of Psychology, Ilia State University, Tbilisi, Georgia
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Abstract
Eating disorders such as anorexia nervosa, female athlete triad, bulimia nervosa, obesity, and binge eating initially emerge during adolescence. These disorders are present primarily in females, but males may also present with these conditions. Dentistry has a pivotal role in the management of patients with such diet-related disorders. Because dentists examine their patients at frequent intervals and may be the health care professionals with whom patients feel more comfortable discussing eating disorders, dentists must have knowledge of the etiology, diagnostic criteria, systemic effects, and intraoral manifestations of eating disorders. In addition, the dental professional may be the first health care provider to identify the condition and refer the patient appropriately to medical colleagues for subsequent treatment. This chapter provides dentists with current and relevant information to recognize, diagnose, and integrate dental treatment for their adolescent patients who may exhibit manifestations of an eating disorder.
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16
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Chen JY, Singh S, Lowe MR. The food restriction wars: Proposed resolution of a primary battle. Physiol Behav 2021; 240:113530. [PMID: 34273346 DOI: 10.1016/j.physbeh.2021.113530] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 06/27/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022]
Abstract
Research regarding the definition and consequences of dieting has generated controversy for years. This controversy has spilled over into the public domain, especially as eating disorders and obesity have become more prevalent. One of the earliest and longest-lasting controversies involves the restrained eating framework, which was originally developed by Herman and Polivy and also strongly influenced the development of the cognitive-behavioral model of bulimia nervosa. An alternative framework for understanding the role of dieting in nonclinical and clinical groups, called the Three-Factor Model of Dieting, took a sharply different approach to defining, and understanding the impact of, dieting. This paper provides a brief historical review of the development of these divergent perspectives and updates the Three Factor Model's critical distinction between restraining eating to prevent over-consumption and dieting to lose weight. We suggest that three historical trends impacted the development of Restraint Theory in ways that unfairly impugned dieting for weight control: the emergence of the new eating disorders of bulimia nervosa and binge eating disorder, a population-based increase in loss of control eating and a population-based increase in obesity. This update is aimed in part at encouraging new research to reconcile ongoing, unresolved issues between Herman and Polivy's restrained eating model and the Three-Factor model of Dieting model. Such research might also contribute to the public's understanding of the pros and cons of dieting and to new approaches to treating eating disorders and obesity.
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Affiliation(s)
- Joanna Y Chen
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA 19104, United States
| | - Simar Singh
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA 19104, United States
| | - Michael R Lowe
- Department of Psychology, Drexel University, 3141 Chestnut Street, Suite 119, Philadelphia, PA 19104, United States.
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Bergner L, Himmerich H, Kirkby KC, Steinberg H. Descriptions of Disordered Eating in German Psychiatric Textbooks, 1803-2017. Front Psychiatry 2021; 11:504157. [PMID: 33519534 PMCID: PMC7840701 DOI: 10.3389/fpsyt.2020.504157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/25/2020] [Indexed: 12/13/2022] Open
Abstract
The most common eating disorders (EDs) according to DSM-5 are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). These disorders have received increasing attention in psychiatry due to rising prevalence and high morbidity and mortality. The diagnostic category "anorexia nervosa," introduced by Ernest-Charles Lasègue and William Gull in 1873, first appears a century later in a German textbook of psychiatry, authored by Gerd Huber in 1974. However, disordered eating behavior has been described and discussed in German psychiatric textbooks throughout the past 200 years. We reviewed content regarding eating disorder diagnoses but also descriptions of disordered eating behavior in general. As material, we carefully selected eighteen German-language textbooks of psychiatry across the period 1803-2017. Previously, in German psychiatry, disordered eating behaviors were seen as symptoms of depressive disorders, bipolar disorder or schizophrenia, or as manifestations of historical diagnoses no longer used by the majority of psychiatrists such as neurasthenia, hypochondria and hysteria. Interestingly, 19th and early 20th century psychiatrists like Kraepelin, Bumke, Hoff, Bleuler, and Jaspers reported symptom clusters such as food refusal and vomiting under these outdated diagnostic categories, whereas nowadays they are listed as core criteria for specific eating disorder subtypes. A wide range of medical conditions such as endocrinopathies, intestinal or brain lesions were also cited as causes of abnormal food intake and body weight. An additional consideration in the delayed adoption of eating disorder diagnoses in German psychiatry is that people with EDs are commonly treated in the specialty discipline of psychosomatic medicine, introduced in Germany after World War II, rather than in psychiatry. Viewed from today's perspective, the classification of disorders associated with disordered eating is continuously evolving. Major depressive disorder, schizophrenia and physical diseases have been enduringly associated with abnormal eating behavior and are listed as important differential diagnoses of EDs in DSM-5. Moreover, there are overlaps regarding the neurobiological basis and psychological and psychopharmacological therapies applied to all of these disorders.
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Affiliation(s)
- Lukas Bergner
- Archiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Leipzig, Germany
| | - Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Kenneth C. Kirkby
- Department of Psychiatry, University of Tasmania, Hobart, TAS, Australia
| | - Holger Steinberg
- Archiv für Leipziger Psychiatriegeschichte, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Medizinische Fakultät der Universität Leipzig, Leipzig, Germany
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18
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Hagan KE, Walsh BT. State of the Art: The Therapeutic Approaches to Bulimia Nervosa. Clin Ther 2020; 43:40-49. [PMID: 33358256 DOI: 10.1016/j.clinthera.2020.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Bulimia nervosa (BN) is an eating disorder characterized by binge eating, inappropriate compensatory behaviors, and body image concerns in persons at or above a healthy weight. BN is a serious disorder with medical sequelae and marked psychosocial impairment. To reduce and eliminate symptoms of BN, psychological and pharmacologic treatments for BN have been developed. We review the current state-of-the-art treatments for BN. METHODS We conducted a narrative review of the BN treatment literature to synthesize the current evidence base, provide recommendations, and propose future directions for BN treatment research. FINDINGS Currently, the first-line, state-of-the-art treatment for adults with BN is cognitive-behavioral therapy (CBT). Interpersonal therapy is a second-line evidence-based treatment for adults with BN, and dialectical behavior therapy and integrative cognitive-affective therapy are also promising. For BN in adolescents, family-based treatment for BN or CBT are evidence-based approaches. Pharmacotherapy is best considered adjunctive to psychotherapy in adults with BN but may be helpful, depending on the type of psychotherapy and whether psychotherapy is ineffective or unavailable. Fluoxetine 60 mg/d is the medication of choice for adults with BN. Little is known with respect to pharmacologic treatment of BN in adolescents, although fluoxetine 60 mg/d holds promise. IMPLICATIONS Despite decades of treatment-development research in BN, there is room for improvement because nearly 60% of those with BN do not achieve remission with specialty treatment and strikingly few randomized controlled trials for BN in adolescents exist. Moreover, the field should address issues related to treatment dissemination, access, and cost.
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Affiliation(s)
- Kelsey E Hagan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA.
| | - B Timothy Walsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
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19
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[Cutaneous disorders caused by physical damage mimicking rheumatic diseases]. Z Rheumatol 2020; 79:1025-1032. [PMID: 32410116 DOI: 10.1007/s00393-020-00814-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The skin is the primary interface between the body and the environment. It is exposed to a variety of external physical factors to which it must respond in a dynamic manner. In the following review such cutaneous reactions to physical damage are discussed under the aspects of rheumatological differential diagnoses. In particular, circumscribed hyperpigmentation and hyperkeratosis, reactive patterns to cold, with or without humidity, and lightning are presented. Most of these disorders do not need extensive laboratory investigations or imaging techniques. Knowledge of such cutaneous disease symptoms due to physical damage prevents overdiagnostics and possible overtreatment.
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20
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Reexamining the restraint pathway as a conditional process among adolescent girls: When does dieting link body dissatisfaction to bulimia? Dev Psychopathol 2020; 32:1031-1043. [PMID: 31658908 DOI: 10.1017/s0954579419001287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The mediational sequence from body dissatisfaction through dieting to bulimia-often referred to as the "restraint pathway"-has been validated in numerous samples of adolescent girls, but the prevalence rate of bulimic pathology pales in comparison to rates of body dissatisfaction and dieting in this risk group. This discrepancy indicates that the restraint pathway may only apply to adolescent girls possessing certain characteristics or experiencing certain circumstances. Accordingly, the current study examined the moderating roles of thin-ideal internalization, interoceptive deficits, and age by using self-report data from a community sample of 353 middle school (n = 115), high school (n = 112), and college girls (n = 126). We found that (a) body-dissatisfied girls who reported high, versus low, thin-ideal internalization engaged in greater dietary restraint; (b) only dieters who reported high interoceptive deficits and were of college age expressed bulimic symptoms; and (c) the mediating effect pertained only to college girls with high interoceptive deficits, but was strongest for those who reported high, versus low, thin-ideal internalization. These results suggest that the restraint pathway's precision may be fine-tuned through greater sensitivity to potentiating factors and developmental context. Theoretical, empirical, and practical implications are discussed.
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21
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Ayton A, Ibrahim A. The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research. Nutr Rev 2020; 78:579-596. [PMID: 31846028 PMCID: PMC7682725 DOI: 10.1093/nutrit/nuz089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.
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Affiliation(s)
- Agnes Ayton
- University of Oxford, Oxford, United Kingdom
| | - Ali Ibrahim
- South London and Maudsley NHS Foundation Trust, Snowsfields Adolescent Unit, Mapother House, Maudsley Hospital, London
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22
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Al-Qahtani AM, Al-Harbi LM. Prevalence and Risk Factors of Disordered Eating Attitudes and Behaviors Among High-school Girls in Al-Madinah City, Saudi Arabia. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666191009095502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives::
To determine the prevalence of disordered eating attitudes and behaviors
among high-school girls in Al-Madinah City, Saudi Arabia.
Methods::
A cross-sectional descriptive study was conducted in Al-Madinah city in 2014-15. A multi-
stage random sampling technique was adopted to include female students of government secondary
schools. The Eating Attitudes Test (EAT-26) and socio-economical questionnaires were used in the
study for assessing the prevalence of disordered eating. All data were entered and analyzed using
SPSS version 20.
Results::
Overweight and obesity were reported among 11.2% and 5.6% of them, respectively,
whereas 31.3% of the participants were underweight. The overall prevalence of disordered eating
attitudes among female students was 42.5%. This rate was significantly higher among younger
(≤16 years old) and those of the first scholastic level than others. The rate of disordered eating
attitude was reported at a higher rate among obese students (59.1%) than underweight (41.5%) and
normal students (42.4%). The commonest reported disordered eating behavior was self-reported
binge eating behaviour (25.2%), followed by self-induced vomiting (8.7%) and the use of laxatives/
diuretics to control weight (6.1%).
Conclusion::
The findings show a high prevalence of disordered eating attitude among high school
female students in Al-Madinah city. Younger girls and those of the first scholastic level showed
higher disordered eating attitude.
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Affiliation(s)
- Awad M. Al-Qahtani
- Department of Family and Community Medicine, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Lamees M. Al-Harbi
- Family Medicine, Post-graduate Studies of Family Medicine Program in Al-Madinah, Ministry of Health, Al-Madinah, Saudi Arabia
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Abstract
RésuméDe nombreuses études récentes montrent que la boulimie est une perturbation fréquente des conduites alimentaires de l’adulte dont la prévalence dans la population féminine avoisinerait 10 %. Il reste cependant difficile d’être plus précis, car les critères diagnostiques, les instruments d’évaluation et les populations varient beaucoup entre eux.A titre d’exemple, la définition du DSM III ne retient pas la présence des vomissements comme critére obligatoire, contrairement à d’autres.Les auteurs présentent également les premiers résultats d’une enquête effectuée auprès de l’ensemble des étudiants de l’Université de Genève. A partir de 4200 des 12000 questionnaires qui ont été retournés, la representativité selon le sexe et l’âge a été obtenue en sélectionnant un groupe de 3102 questionnaires valides, soit 25.7 % du total. Au moment de l’étude, 20.5 % des femmes et 8.6 % des hommes utilisaient l’un des moyens de contrôle du poids, régime inclus, et 2.6 % des femmes et 0.5 % des hommes recouraient aux vomissements. Concernant la boulimie, si ce travail ne permet pas de conclusions définitives, il permet néanmoins d’approcher un groupe à risque boulimique avoisinant 4 à 6 % des femmes et 0.5 à 0.8 % des hommes. Ces résultats ainsi que les ratios F/H et les âges de début sont superposables aux valeurs des études de référence. Les rapports que la boulimie entretient avec la dépression, les conduites toxicomaniaques ou d’alcoolisation, voire les troubles paniques, phobiques et obsessifs-compulsifs devraient être mieux étudiés afin d’éviter les erreurs de diagnostic. La recherche d’un poids idéal est une caractéristique de ce syndrome. Un traitement visant à modifier la représentation de ce paramétre constituerait un des éléments utiles d’une thérapie cognitive et informative.
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Peters C, Butterfield P, Swassing CS, McKay G. Assessment and Treatment of Anorexia Nervosa and Bulimia in School Age Children. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.1984.12085093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Murnen SK, Smolak L. The Cash effect: Shaping the research conversation on body image and eating disorders. Body Image 2019; 31:288-293. [PMID: 30665749 DOI: 10.1016/j.bodyim.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/02/2019] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
Cash and Deagle (1997) examined the associations between body image disturbance (BID) and the eating disorders (EDs) of anorexia nervosa (AN) and bulimia nervosa (BN) in a meta-analytic review. They found almost twice as many studies employing perceptual measures of body size evaluation compared to cognitive-evaluative measures of body dissatisfaction, even though effect sizes were larger for studies with cognitive-evaluative measurement. We examined 109 "influential" (i.e., well-cited) studies that cited the Cash and Deagle meta-analysis. We found a slight, continued emphasis on research using body size evaluation measures that implied a biological correlate for perceptual differences (especially for those with AN). We found proportionally more studies using cognitive-evaluative measures than was true in 1997, and more variability in the types of measures used. In these studies researchers emphasized the role of sociocultural factors in the link between BID and EDs. Theory and research that integrate a variety of factors to conceptualize the association between BID and EDs are still needed.
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Affiliation(s)
- Sarah K Murnen
- Kenyon College, Samuel Mather Hall, Psychology Department Ohio, Gambier, OH, 43022, United States.
| | - Linda Smolak
- Kenyon College, Samuel Mather Hall, Psychology Department Ohio, Gambier, OH, 43022, United States
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26
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Piers AD, Espel-Huynh HM, Lowe MR. The independent and interacting effects of weight suppression and admission body mass index on treatment weight change in patients with anorexia nervosa or bulimia nervosa. Int J Eat Disord 2019; 52:1301-1309. [PMID: 31392766 DOI: 10.1002/eat.23149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Weight suppression (WS) and body mass index (BMI) have predicted weight change in individuals with eating disorders, but the interaction between these variables is understudied. Furthermore, WS is usually measured as absolute WS-the numeric difference between current weight and highest past weight-overlooking the potentially important influence of how much a person weighed at their highest historical weight. METHOD The current study investigated the independent and interacting effects of BMI and two measures of WS at admission on residential treatment weight change. WS measures included absolute WS and the relative WS index, the percentage of total body weight lost from highest past weight. Participants were women with anorexia nervosa (n = 357) or bulimia nervosa (n = 293) who provided complete data, 87% of the eligible treatment sample. RESULTS In both diagnostic subsamples, BMI, absolute WS, and the relative WS index all significantly predicted weight change. The interaction between BMI and WS predicted weight change, but only when the relative WS index was used. DISCUSSION Results highlight the potential importance of considering an individual's weight and weight history when predicting their treatment weight change and support the importance of utilizing both methods of calculating WS in future research.
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Affiliation(s)
- Amani D Piers
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania
| | | | - Michael R Lowe
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania.,Research Department, The Renfrew Center for Eating Disorders, Philadelphia, Pennsylvania
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Abstract
There are few systematic studies of treatment of bulimia nervosa (BN) in adolescents. Although family-based treatment has demonstrated preliminary evidence to support involvement of caregivers in treatment, there is significant opportunity for improvement in mitigating binge-eating and purging symptoms among adolescents afflicted with BN. When caregivers are unable to participate in treatment, there is evidence that BN-specific cognitive behavioral therapy approaches are helpful for some adolescents. Further research is needed to determine for whom, and under what conditions certain types of family involvement might be most effective in adolescent treatment of BN.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA; The University of Chicago, Chicago, IL, USA.
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Södersten P, Brodin U, Zandian M, Bergh CEK. Verifying Feighner's Hypothesis; Anorexia Nervosa Is Not a Psychiatric Disorder. Front Psychol 2019; 10:2110. [PMID: 31607977 PMCID: PMC6756277 DOI: 10.3389/fpsyg.2019.02110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/30/2019] [Indexed: 12/17/2022] Open
Abstract
Mental causation takes explanatory priority over evolutionary biology in most accounts of eating disorders. The evolutionary threat of starvation has produced a brain that assists us in the search for food and mental change emerges as a consequence. The major mental causation hypothesis: anxiety causes eating disorders, has been extensively tested and falsified. The subsidiary hypothesis: anxiety and eating disorders are caused by the same genotype, generates inconsistent results because the phenotypes are not traits, but vary along dimensions. Challenging the mental causation hypothesis in Feighner et al. (1972) noted that anorexic patients are physically hyperactive, hoarding for food, and they are rewarded for maintaining a low body weight. In 1996, Feighner's hypothesis was formalized, relating the patients' behavioral phenotype to the brain mechanisms of reward and attention (Bergh and Södersten, 1996), and in 2002, the hypothesis was clinically verified by training patients how to eat normally, thus improving outcomes (Bergh et al., 2002). Seventeen years later we provide evidence supporting Feighner's hypothesis by demonstrating that in 2012, 20 out of 37 patients who were referred by a psychiatrist, had a psychiatric diagnosis that differed from the diagnosis indicated by the SCID-I. Out of the 174 patients who were admitted in 2012, most through self-referral, there was significant disagreement between the outcomes of the SCID-I interview and the patient's subjective experience of a psychiatric problem in 110 of the cases. In addition, 358 anorexic patients treated to remission scored high on the Comprehensive Psychopathological Rating Scale, but an item response analysis indicated one (unknown) underlying dimension, rather than the three dimensions the scale can dissociate in patients with psychiatric disorders. These results indicate that psychiatric diagnoses, which are reliable and valid in patients with psychiatric disorders, are less well suited for patients with anorexia. The results are in accord with the hypothesis of the present Research Topic, that eating disorders are not always caused by disturbed psychological processes, and support the alternative, clinically relevant hypothesis that the behavioral phenotype of the patients should be addressed directly.
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Affiliation(s)
- Per Södersten
- Karolinska Institutet, Mandometer Clinics, Huddinge, Sweden
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Mehler PS, O'Melia A, Brown C, Gibson D, Hollis J, Westmoreland P. Medical complications of bulimia nervosa. Br J Hosp Med (Lond) 2019; 78:672-677. [PMID: 29240508 DOI: 10.12968/hmed.2017.78.12.672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Bulimia nervosa is a psychiatric disorder with many different medical sequelae. This article reviews the principal medical complications associated with bulimia nervosa, and emphasizes the importance of a timely approach to diagnosis and management.
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Affiliation(s)
- Philip S Mehler
- Founder and Executive Medical Director ACUTE at Denver Health, Chief Medical Officer, Eating Recovery Center of Denver, Denver, CO 80204, USA
| | - Anne O'Melia
- Psychiatrist, Eating Recovery Center of Denver, Denver, CO, USA
| | - Carrie Brown
- Hospitalist, Denver Health and Hospital Authority, Denver, CO, USA
| | - Dennis Gibson
- Hospitalist, Denver Health and Hospital Authority, Denver, CO, USA
| | - Jeff Hollis
- Hospitalist, Denver Health and Hospital Authority, Denver, CO, USA
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Himmerich H, Hotopf M, Shetty H, Schmidt U, Treasure J, Hayes RD, Stewart R, Chang CK. Psychiatric comorbidity as a risk factor for the mortality of people with bulimia nervosa. Soc Psychiatry Psychiatr Epidemiol 2019; 54:813-821. [PMID: 30756148 DOI: 10.1007/s00127-019-01667-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/04/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bulimia nervosa (BN) is associated with increased mortality. Frequent comorbidities of BN include substance use disorders, affective disorders and personality disorders (PD). These comorbidities may add an additional risk for mortality. METHODS We investigated the influence of these psychiatric comorbidities on all-cause mortality with demographic and socioeconomic factors considered as confounders over an observation period from January 2007 to March 2016 for 1501 people with BN using anonymised health records data from the South London and Maudsley NHS Foundation Trust (SLaM), retrieved through its Clinical Records Interactive Search (CRIS) data resource. Mortality was ascertained through monthly linkages to the nationwide tracing system administered by the Office for National Statistics (ONS). We used Cox proportional hazards regression to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Multivariable analyses were also performed to estimate effects when controlling for confounding of age, sex, ethnicity, borough, marital status and deprivation score. RESULTS A total of 18 patients with BN died during the observation period. The standardised mortality ratio (SMR) for our study cohort (against the population of England and Wales in 2012 as a standard) was 2.52 (95% CI 1.49-3.97). Cox regressions revealed significant associations of mortality with older age and male gender. Comorbid PD (HR: 3.36; 95% CI 1.05-10.73) was significantly associated with all-cause mortality, even after controlling for demographic and socioeconomic covariates. CONCLUSIONS These results highlight increased mortality in patients with BN and the importance of recognising and treating PDs in patients with BN.
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Affiliation(s)
- Hubertus Himmerich
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Hitesh Shetty
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Ulrike Schmidt
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Janet Treasure
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard D Hayes
- Department of Psychological Medicine, King's College London, London, UK
| | - Robert Stewart
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Chin-Kuo Chang
- Department of Psychological Medicine, King's College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
- Department of Health and Welfare, University of Taipei, No. 101, Sec. 2, Jhongcheng Rd, Shilin District, Taipei, 111, Taiwan.
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31
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Madea B, Doberentz E. Commentary on: Di Luca A, Ricci E, Grassi VM, Arena V, Oliva A. An exceptional case of acute respiratory failure caused by intrathoracic gastric perforation secondary to overeating. J Forensic Sci 2019;64(1):292–4. J Forensic Sci 2019; 64:965-966. [DOI: 10.1111/1556-4029.14059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Burkhard Madea
- Institute of Forensic Medicine of the University of Bonn Stiftsplatz 12 D‐53111 Bonn Germany
| | - Elke Doberentz
- Institute of Forensic Medicine of the University of Bonn Stiftsplatz 12 D‐53111 Bonn Germany
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Latzer Y, Stein D. Introduction: Novel perspectives on the psychology and psychotherapy of eating disorders. J Clin Psychol 2019; 75:1369-1379. [PMID: 30995356 DOI: 10.1002/jclp.22786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of this introduction to this issue is to review and summarize significant new psychological perspectives and psychotherapeutic interventions in the treatment of eating disorder (EDs). In this issue, five novel therapeutic strategies for the treatment of EDs are presented. These include a combination of psychodynamic psychotherapy and neuropsychology, two recent modifications of cognitive behavioral therapy (the MANTRA, and the conceptualization of change in patients with ED in terms of sense of agency), a specific group movement therapy, and an innovative rehabilitation treatment. In addition, one article offers an historic review of the development of psychotherapy of EDs, and two articles highlight specific considerations related to the treatment of EDs: compulsory treatment, and culturally sensitive treatment.
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Affiliation(s)
- Yael Latzer
- Faculty of Social welfare and Health Science, Haifa University, Haifa, Israel.,Eating Disorders Institution, Rambam Medical Center, Haifa, Israel
| | - Daniel Stein
- Medical School, Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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33
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Gay L, Satori N. [Eating disorders]. REVUE DE L'INFIRMIÈRE 2019; 68:16-18. [PMID: 30910110 DOI: 10.1016/j.revinf.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Anorexia and bulimia are part of eating disorders which are defined in the diagnostic and statistical manual as mental health disorders. Screening tools exist and there are different types of treatment which are generally multi-disciplinary. The nurse, as well as the family or immediate circle, are essential players in the care. Specialist units and the development of research are improving the understanding, treatment and support of these complex disorders.
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Affiliation(s)
- Laura Gay
- Unité spécialisée dans les troubles du comportement alimentaire (TCA), service du Pr Gorwood centre hospitalier Sainte-Anne, 1, rue Cabanis, 75674 Paris, France.
| | - Nadine Satori
- Unité spécialisée dans les troubles du comportement alimentaire (TCA), service du Pr Gorwood centre hospitalier Sainte-Anne, 1, rue Cabanis, 75674 Paris, France
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34
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Werneke U. Conference proceedings of the 4th Masterclass Psychiatry: Transcultural Psychiatry - Diagnostics and Treatment, Luleå, Sweden, 22-23 February 2018 (Region Norrbotten in collaboration with the Maudsley Hospital and Tavistock Clinic London). Nord J Psychiatry 2018:1-33. [PMID: 30547691 DOI: 10.1080/08039488.2018.1481525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 05/23/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND According to estimates from the European Commission, Europe has experienced the greatest mass movement of people since the Second World War. More than one million refugees and migrants have arrived in the European Union in the past few years. Mental health and primary care professionals are more likely than ever to meet patients from different cultures and backgrounds. AIMS To equip mental health and primary care professionals with transcultural skills to deal with patients from unfamiliar backgrounds. METHOD Lectures and case discussions to explore the latest advances in the diagnosis and treatment of serious mental health problems in a transcultural context. RESULTS Lectures covered transcultural aspects of mental health problems, treatment in different cultural and ethnic contexts, and assessment of risk factors for self-harm and harm in migrant populations. CONCLUSIONS Clinicians require a sound grounding in transcultural skills to confidently and empathically deal with patients from unfamiliar backgrounds.
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Affiliation(s)
- Ursula Werneke
- a Department of Clinical Sciences, Division of Psychiatry, Sunderby Research Unit , Umeå University , Umeå , Sweden
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35
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Murray SB, Strober M, Craske MG, Griffiths S, Levinson CA, Strigo IA. Fear as a translational mechanism in the psychopathology of anorexia nervosa. Neurosci Biobehav Rev 2018; 95:383-395. [DOI: 10.1016/j.neubiorev.2018.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/11/2018] [Accepted: 10/22/2018] [Indexed: 12/30/2022]
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Abstract
BACKGROUND Unlike the majority of 'culture-bound syndromes', eating disorders are one of the few mental disorders initially conceptualized as 'culture-bound' to North America/Europe. Social norms vary massively within cultures-class, ethnicity and gender. Over time there have been substantial changes in body shape preferences. AIM To describe some key areas in the transcultural aspects of eating disorders (ED) and body image disturbance (BID). METHOD This lecture describes a different and complementary manner of understanding eating disorders, specifically anorexia nervosa (AN), from a cultural, social and psychoanalytic perspective. RESULTS Social norms vary massively within cultures, social strata, ethnicity and gender. Social norms also vary over time leading to substantial changes in body shape preferences and the epidemiology of eating disorders. CONCLUSIONS Understanding eating disorders requires integration of psychological factors into a cultural and epidemiological context.
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37
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Keel PK, Haedt-Matt AA, Hildebrandt B, Bodell LP, Wolfe BE, Jimerson DC. Satiation deficits and binge eating: Probing differences between bulimia nervosa and purging disorder using an ad lib test meal. Appetite 2018; 127:119-125. [PMID: 29654850 DOI: 10.1016/j.appet.2018.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 04/02/2018] [Accepted: 04/10/2018] [Indexed: 01/28/2023]
Abstract
Purging disorder (PD) has been included as a named condition within the DSM-5 category of Other Specified Feeding or Eating Disorder and differs from bulimia nervosa (BN) in the absence of binge-eating episodes. The current study evaluated satiation through behavioral and self-report measures to understand how this construct may explain distinct symptom presentations for bulimia nervosa (BN) and purging disorder (PD). Women (N = 119) were recruited from the community if they met DSM-5 criteria for BN (n = 57), PD (n = 31), or were free of eating pathology (n = 31 controls). Participants completed structured clinical interviews and questionnaires and an ad lib test meal during which they provided reports of subjective states. Significant group differences were found on self-reported symptoms, ad lib test meal intake, and subjective responses to food intake between individuals with eating disorders and controls and between BN and PD. Further, ad lib intake was associated with self-reported frequency and size of binge episodes. In a multivariable model, the amount of food consumed during binges as reported during clinical interviews predicted amount of food consumed during the ad lib test meal, controlling for other binge-related variables. Satiation deficits distinguish BN from PD and appear to be specifically linked to the size of binge episodes. Future work should expand exploration of physiological bases of these differences to contribute to novel interventions.
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Affiliation(s)
- Pamela K Keel
- Department of Psychology, Florida State University, United States.
| | | | - Britny Hildebrandt
- Department of Psychiatry, Western Psychiatric Institute and Clinics, United States
| | | | - Barbara E Wolfe
- College of Nursing, University of Rhode Island, United States
| | - David C Jimerson
- Department of Psychiatry, Beth Israel Deaconess Medical Center, United States
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38
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Golden BR, Buzcek T, Robbins SB. Parameters of Bulimia: Examining the Compulsive Eating Scale. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1080/07481756.1986.12022827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Beth R. Golden
- Beth R. Golden is a doctoral graduate student and Steven B. Robbins is an assistant professor, both in the Psychology Department, Virginia Commonwealth University, Richmond
| | - Teresa Buzcek
- Teresa Buzcek is a psychologist in private practice in Richmond
| | - Steven B. Robbins
- Beth R. Golden is a doctoral graduate student and Steven B. Robbins is an assistant professor, both in the Psychology Department, Virginia Commonwealth University, Richmond
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39
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Probst M, Kürsa K, Van Damme T, Diedens J, Vanderlinden J. Changes in eating disorder characteristics over the years. EUROPEAN EATING DISORDERS REVIEW 2018; 26:417-421. [PMID: 29774627 DOI: 10.1002/erv.2603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/11/2018] [Accepted: 04/12/2018] [Indexed: 11/07/2022]
Abstract
Since 1980, the diagnostic criteria of patients with eating disorders (ED) have changed over the years. Are these changes also expressed in the clinical features of the ED patients? A cross-sectional sample was drawn consisting of 100 consecutive female patients' files diagnosed with anorexia nervosa (AN) and bulimia nervosa (BN) and bulimia nervosa and admitted at an inpatient unit from the first of January 1990, 2000, and 2010, respectively. Several reliable and well-validated questionnaires (Eating Disorder Inventory, Body Attitude Test, Symptom Checklist, and the Beck Depression Inventory) were administered and scores were compared. The ratio AN/BN remained the same (65/35). No differences were found between the three cohorts except for depression, which increased over the years. This pattern is the same for the subsamples of anorexia nervosa and bulimia nervosa. Specific characteristics of eating disorder pathology did not change across time.
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Affiliation(s)
- Michel Probst
- Department of Rehabilitation Sciences, KU Leuven, Belgium.,Eating Disorder Unit, UPC-KU Leuven, Belgium
| | - Kärt Kürsa
- Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Belgium
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40
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41
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Affiliation(s)
- M B King
- Academic Department of Psychiatry, Royal Free Hospital School of Medicine, London
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42
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Dakanalis A, Colmegna F, Zanetti MA, Di Giacomo E, Riva G, Clerici M. Evaluation of the DSM-5 Severity Specifier for Bulimia Nervosa in Treatment-Seeking Youth. Child Psychiatry Hum Dev 2018; 49:137-145. [PMID: 28510006 DOI: 10.1007/s10578-017-0735-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A new severity specifier for bulimia nervosa (BN), based on the frequency of inappropriate weight compensatory behaviours (e.g., laxative misuse, self-induced vomiting, fasting, diuretic misuse, and excessive exercise), has been added to the most recent (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a means of addressing variability and heterogeneity in the severity of the disorder. While existing research provides support for the DSM-5 severity specifier for BN in adult patients, evidence for its validity and clinical utility in youth is currently lacking. To address this gap, data from 272 treatment-seeking adolescents with DSM-5 BN (94.2% female, M age = 15.3 years, SD 1.7) were analysed to examine whether these patients, sub-grouped based on the DSM-5 severity definitions, would show meaningful differences in a broad range of clinical variables and demographic and physical characteristics. Analyses revealed that participants categorized with mild, moderate, severe, and extreme severity of BN significantly differed from each other in 15 variables regarding eating disorder pathological features and putative maintenance factors (i.e., core low self-esteem, perfectionism, social appearance anxiety, body surveillance, and mood intolerance), health-related quality of life and comorbid psychiatric (i.e., affective and anxiety) disorders (large effect sizes). Between-group differences in demographics, body mass index, or age-of-BN onset were not observed. Collectively, our findings provide support for the utility of the frequency of inappropriate weight compensatory behaviours as a severity indicator for BN and suggest that age-at-onset of BN is probably more disorder- than severity-dependent. Implications for future research are outlined.
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Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy. .,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | | | | | - Ester Di Giacomo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University, Milan, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900, Monza, Italy.,Department of Mental Health, San Gerardo Hospital, Monza, Italy
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Abstract
“Evidence-based medicine builds upon, rather than disparages or neglects, the evidence gained from good clinical skills and sound clinical experience.” (Sackett, 1995: p. 840)
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Abstract
French historian and literary critic René Girard (1923-2015), most widely known for the concepts of mimetic desire and scapegoating, also engaged in the discussion of the surge of eating disorders in his 1996 essay Eating Disorders and Mimetic Desire. This article explores Girard's ideas on the mimetic nature and origin of eating disorders from a clinical psychiatric perspective and contextualizes them within the field of eating disorders research as well as in relation to broader psychological, sociological and anthropological models of social comparison and non-consumption. Three main themes in Girard's thinking on the topic of eating disorders are identified and explored: the 'end of prohibitions' as a driving force in the emergence of eating disorders, eating disorders as a phenomenon specific to modernity, and the significance of 'conspicuous non-consumption' in the emergence of eating disorders.
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45
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46
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The enigma of male eating disorders: A critical review and synthesis. Clin Psychol Rev 2017; 57:1-11. [DOI: 10.1016/j.cpr.2017.08.001] [Citation(s) in RCA: 338] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/20/2017] [Accepted: 08/01/2017] [Indexed: 01/05/2023]
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Abstract
INTRODUCTION Anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) are the primary eating disorders (EDs). The only psychopharmacological treatment options for EDs with approval in some countries include fluoxetine for BN and lisdexamfetamine for BED. Given the high comorbidity and genetic correlations with other psychiatric disorders, it seems possible that novel medications for these conditions might also be effective in EDs. Areas covered: The current scientific literature has increased our understanding of how medication could be beneficial for patients with EDs on a molecular, functional and behavioral level. On the basis of theoretical considerations about neurotransmitters, hormones and neural circuits, possible drug targets for the treatment of EDs may include signal molecules and receptors of the self-regulatory system such as serotonin, norepinephrine and glutamate, the hedonic system including opioids, cannabinoids and dopamine and the hypothalamic homeostatic system including histamine, ghrelin, leptin, insulin, and glucagon-like peptide-1. Expert commentary: The latest research points to an involvement of both the immune and the metabolic systems in the pathophysiology of EDs and highlights the importance of the microbiome. Therefore, the next few years may unveil drug targets for EDs not just inside and outside of the brain, but possibly even outside of the human body.
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Affiliation(s)
- Hubertus Himmerich
- a Department of Psychological Medicine , King's College London , London , UK
| | - Janet Treasure
- a Department of Psychological Medicine , King's College London , London , UK
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48
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Abstract
In 1977, I fell in love at first sight, and since then eating disorders have been a central part of my life. As I step down after 25 years as editor of Eating Disorders: The Journal of Treatment and Prevention, I am also saying goodbye to the eating disorders field and moving on to retirement and other areas of interest. In this Last Word article, I will write about my history with the journal and the field and use this forum to thank a few of the people I've known along the way.
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Agras WS, Fitzsimmons-Craft EE, Wilfley DE. Evolution of cognitive-behavioral therapy for eating disorders. Behav Res Ther 2017; 88:26-36. [PMID: 28110674 DOI: 10.1016/j.brat.2016.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 01/20/2023]
Abstract
The evolution of cognitive-behavioral therapy (CBT) for the treatment of bulimic disorders is described in this review. The impacts of successive attempts to enhance CBT such as the addition of exposure and response prevention; the development of enhanced CBT; and broadening the treatment from bulimia nervosa to binge eating disorder are considered. In addition to developing advanced forms of CBT, shortening treatment to guided self-help was the first step in broadening access to treatment. The use of technology such as computer-based therapy and more recently the Internet, promises further broadening of access to self-help and to therapist guided treatment. Controlled studies in this area are reviewed, and the balance of risks and benefits that accompany the use of technology and lessened therapist input are considered. Looking into the future, more sophisticated forms of treatment delivered as mobile applications ("apps") may lead to more personalized and efficacious treatments for bulimic disorders, thus enhancing the delivery of treatments for eating disorders.
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Affiliation(s)
- W Stewart Agras
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA.
| | - Ellen E Fitzsimmons-Craft
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO 63110, USA.
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50
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Dakanalis A, Riva G, Gaudio S, Clerici M. Cognitive-behavioral or psychodynamic therapy for people with bulimia nervosa. Eat Weight Disord 2017; 22:555-556. [PMID: 28674751 DOI: 10.1007/s40519-017-0412-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 06/18/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Antonios Dakanalis
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy. .,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, IRCSS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900, Monza, Italy
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