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Zagami M, Klepper E, Wienecke E, Andrzejewski M, Sikder A, Ahmed A, Robinson H. A review of psychocutaneous disorders from a psychotherapeutic perspective—Toolkit for the dermatologist. SKIN HEALTH AND DISEASE 2023. [PMID: 37538328 PMCID: PMC10395638 DOI: 10.1002/ski2.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction The study of psychocutaneous disorders requires a multidisciplinary approach. It is of paramount importance that dermatologists understand the psychiatric premise for these disorders. Mental health professionals can also benefit from a better understanding of the dermatologic manifestations of psychiatric disorders they may encounter in their practice. Aim The aim of this study is to elevate the level of understanding regarding psychotherapeutic treatment of psychocutaneous disorders. Methods We performed a literature review using the major databases. Four researchers reviewed English, full text, peer-reviewed articles that were published after 2000 using our specific search terms and inclusion/exclusion criteria. Results The majority of psychocutaneous disorders seem to be clustered among three DSM-5 disorders: depressive disorders, anxiety disorders, and obsessive-compulsive related disorders. Conclusions Better recognition of the underlying psychiatric comorbidities may lead to improved patient outcomes.
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Affiliation(s)
- Mary Zagami
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Edward Klepper
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Eric Wienecke
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | | | - Ahmed Sikder
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Ali Ahmed
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
| | - Howard Robinson
- Robinson & Max Dermatology PA Lutherville‐ Timonium Maryland USA
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Naser AY, Dahmash EZ, Alqahtani JS, Alsairafi ZK, Alsaleh FM, Alwafi H. Trends in Hospital Admissions for Mental, Behavioural and Neurodevelopmental Disorders in England and Wales between 1999 and 2019: An Ecological Study. Healthcare (Basel) 2022; 10:healthcare10112191. [PMID: 36360532 PMCID: PMC9690103 DOI: 10.3390/healthcare10112191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives: To investigate the trends in hospital admissions for mental, behavioural and neurodevelopmental disorders (MBNDs) in England and Wales. Methods: This is an ecological study using the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data was collected for the period between April 1999 and March 2019. Results: The most common type of hospital admission was for mental and behavioural disorders due to psychoactive substance use, which accounted for 26.6%. The admission rate among males increased by 8.1% [from 479.59 (95% CI 476.90−482.27) in 1999 to 518.30 (95% CI 515.71−520.90) in 2019 per 1000 persons; p < 0.001]. The admission rate among females increased by 0.3% [from 451.45 (95% CI 448.91−453.99) in 1999 to 452.77 (95% CI 450.37−455.17) in 2019 per 1000 persons; p = 0.547]. The 15−59 years’ age group accounted for 65.1% of the entire number of such hospital admissions, followed by the 75 years and above age group, with 19.0%. Conclusion: We observed an obvious variation in MBNDs influenced by age and gender. Observational studies are needed to identify other factors associated with increased hospital admission rates related to MBNDs, specifically among the young population (aged 15−59 years) and males.
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Affiliation(s)
- Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Eman Zmaily Dahmash
- School of Life Science, Pharmacy, and Chemistry, Faculty of Health, Science, Social Care & Education, Kingston University, Surrey KT1 2EE, UK
| | - Jaber S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia
| | - Zahra K. Alsairafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli 13060, Kuwait
| | - Fatemah M. Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli 13060, Kuwait
- Correspondence:
| | - Hassan Alwafi
- Faculty of Medicine, Umm Al-Qura University, Mecca 21955, Saudi Arabia
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da Luz Neto LM, Pinto TCC, Sougey EB, Dionisio WÁDS, Dos Santos AV, Ximenes RCC. Risk of eating disorders, changes in salivary cortisol concentrations and nutritional status of adolescents. Eat Weight Disord 2022; 27:2415-2423. [PMID: 35226345 DOI: 10.1007/s40519-022-01382-x] [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: 11/02/2021] [Accepted: 02/15/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The imposition of the thin body as an ideal of beauty and the changes that occur in adolescence lead to a constant concern with adolescents' body weight, putting them at risk for eating disorders. Thus, the study sought to investigate associations between eating disorders and salivary cortisol concentrations, nutritional status and depressive symptoms in female adolescents with bulimia. METHODS A cross-sectional study was carried out with 1435 adolescents aged 10-19 years. The Bulimic Investigatory Test of Edinburgh (BITE) and Body Shape Questionnaire (BSQ) questionnaires were used. A follow-up study was conducted from a random selection of female adolescents diagnosed with Bulimia Development and Well-Being Assessment-(DAWBA) to assess associations with salivary cortisol concentrations and nutritional status. RESULTS The prevalence of body dissatisfaction among adolescents with symptoms of bulimia was 37%. There was a significant difference between salivary cortisol and bulimia (Risk Group = 0.33 ± 0.20 μg/100 ml, Diagnostic Group = 0.44 ± 0.21 μg/100 ml p = 0.040), and correlation positive between the risk of bulimia with symptoms of depression (0.355 p = 0.002) and with Body Mass Index (0.259 p = 0.028). High concentrations of salivary cortisol in bulimic adolescents may be associated with hyperactivity of the hypothalamic-pituitary-adrenal axis and depressive symptoms. CONCLUSIONS Nutritional status indicators cannot be used alone for the diagnosis of bulimia, since cortisol levels seem to be a reliable parameter in the identification of bulimia, provided they are used with other diagnostic criteria. LEVEL III Evidence obtained from cross-sectional study.
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Affiliation(s)
- Laércio Marques da Luz Neto
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil
| | - Tiago Coimbra Costa Pinto
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil
| | - Everton Botelho Sougey
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil
| | - Weslley Álex da Silva Dionisio
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil.
| | - Alisson Vinicius Dos Santos
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil
| | - Rosana Christine Cavalcanti Ximenes
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco (UFPE), Av. da Engenharia, 186-298 - Cidade Universitária, Recife, Pernambuco, 50740-600, Brazil
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Abstract
The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.
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Johnston O, Startup H, Lavender A, Godfrey E, Schmidt U. Therapeutic writing as an intervention for symptoms of bulimia nervosa: effects and mechanism of change. Int J Eat Disord 2010; 43:405-19. [PMID: 19544556 DOI: 10.1002/eat.20714] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study explored the effects on bulimic symptomatology of a writing task intended to reduce emotional avoidance. METHOD Eighty individuals reporting symptoms of bulimia completed, by e-mail, a therapeutic or control writing task. Participants completed questionnaires on bulimic symptoms, mood, and potential moderating and mediating factors, and were followed up after 4 and 8 weeks. Writing content was explored using a word count package and qualitative framework analysis. RESULTS Bulimic symptoms decreased in both groups, although in both groups the number of participants who improved was approximately equal to the number who did not improve. Symptom decreases were associated with increases in perceived mood regulation abilities, and decreases in negative beliefs about emotions. Participants preferred internet delivery to face to face discussion. DISCUSSION For individuals experiencing symptoms of bulimia, the effects of therapeutic writing did not differ significantly from effects of a control writing task.
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Affiliation(s)
- Olwyn Johnston
- Department of Psychology, Institute of Psychiatry, King's College London, United Kingdom.
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Hepworth N, Paxton SJ. Pathways to help-seeking in bulimia nervosa and binge eating problems: a concept mapping approach. Int J Eat Disord 2007; 40:493-504. [PMID: 17573682 DOI: 10.1002/eat.20402] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To conduct an in-depth study, using concept mapping, of three factors related to help-seeking for bulimia nervosa and binge eating: problem recognition, barriers to help-seeking, and prompts to help-seeking. METHOD Semistructured interviews were conducted to elicit information about help-seeking with 63 women (18-62 years) with past or present bulimic behaviors. RESULTS Using Leximancer software, factors identified as associated with problem recognition were Changes in Behavior, Interference with Life Roles, Comments about Changes and Psychological Problems. Salient barriers to help-seeking were Fear of Stigma, Low Mental Health Literacy/Perception of Need, Shame, Fear of Change and Cost. Prompts to help-seeking were increased Symptom Severity, Psychological Distress, Interference with Life Roles, Health Problems, and Desire to Get Better. CONCLUSION Results highlighted the need for awareness campaigns to reduce both self and perceived stigma by others towards bulimic behaviors, and the need to enhance awareness of available interventions for people ready to engage in treatment, to increase help-seeking.
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Affiliation(s)
- Natasha Hepworth
- School of Psychological Science, La Trobe University, Melbourne, Australia
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Levine D, Mishna F. A self psychological and relational approach to group therapy for university students with bulimia. Int J Group Psychother 2007; 57:167-85. [PMID: 17419669 DOI: 10.1521/ijgp.2007.57.2.167] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Bulimia is a complex disorder that can significantly interfere with psychosocial functioning. It is a particularly significant problem among adolescents and young women in college and university settings. The preponderance of literature on group therapeutic approaches for this disorder is from a cognitive-behavioral perspective. In this paper, we present a psychodynamic group therapy approach for female university students, informed specifically by self psychological and relational frameworks. Through clinical illustrations, we demonstrate how the group provides selfobject experiences, including mirroring, idealizing, twinship, and adversarial experiences, and how the group becomes the arena through which group members can experience, express, and understand emotions. The interpersonal context of the group uniquely provides opportunities for members to examine their bulimic symptoms in relation to interactions that take place outside of or within the group.
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Abstract
OBJECTIVE The aim of this study was to examine, using Mental Health Literacy, acceptability and correlates of acceptability of three treatment interventions for bulimia nervosa; medication, psychological therapy and self-change/lifestyle therapies. METHOD A self-report questionnaire to ascertain correlates of attitudes towards the three interventions was used. Respondents (n = 177) were females aged 18-53 years. RESULTS Psychological therapy was rated the most acceptable treatment to participants as well as the most acceptable to others, and to have most advantages and fewest disadvantages, followed by self-change/lifestyle therapies, and then medication. Social Pressures to be Thin was the most strongly endorsed cause of bulimia, followed by Low Self-Esteem, Eating Behaviour, Relationship and Family Environment, and lastly, Biology. Correlates with acceptability of different treatment approaches were identified. CONCLUSIONS Although no causal link can be assumed from this design, findings suggest that women appear to have a mixed understanding of the different mechanisms that each treatment intervention adopts to treat the causes and symptoms of bulimia, particularly self-change/lifestyle therapies. This may help to explain poor adherence to interventions.
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Affiliation(s)
- Natasha S Hepworth
- School of Psychological Science, La Trobe University, Bundoora, Vic. 3086, Australia
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Grunwald M, Wesemann D. Special Online Consulting for Patients with Eating Disorders and Their Relatives: Analysis of User Characteristics and E-Mail Content. ACTA ACUST UNITED AC 2007; 10:57-63. [PMID: 17305449 DOI: 10.1089/cpb.2006.9992] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In the treatment of chronic diseases, programs that use the internet as a medium are becoming more and more important as a complement to classical intervention techniques. Since 1998, a non-profit information and online consulting service for patients with eating disorders and their friends and relatives (www.ab-server.de) has existed. This was established by members of the Deutsche Forschungsinitiative Essstörungen e.V. (DFE) [German Research Initiative for Eating Disorders] and members of the Clinic of Psychiatry, University of Leipzig, Germany. For the present study, 2,176 e-mail requests from users of the online consultation service were analyzed qualitatively and quantitatively in order to better understand the differences between different types and groups of users. The analysis was related to the social field of the person requesting the consultation, the type of disorder reported, and the content of the e-mail request. Three main user groups could be identified: people who described themselves as having an eating disorder (57.2%), people who were related socially to the affected person (32.4%), and interested persons (9.8%). The consulting service was predominantly used by persons suffering from bulimia nervosa or their families and friends (63.1%). One third (33.3%) of the posted e-mails were related to behavioral patterns in dealing with the illness and the affected person. They were followed by inquiries for information about the disease (18.7%) and by those seeking help in finding specialized clinics/therapists and places in therapies. The increasing use of the online consulting service indicates that there is a substantial need for information and help in persons with eating disorders and in their relatives, who are able to easily contact professionals using this online service. Online consulting has a high potential for complementary care of affected people.
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Affiliation(s)
- Martin Grunwald
- EEG Research Laboratory, Department of Psychiatry, University of Leipzig, Leipzig, Germany.
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Grunwald M, Wesemann D. Individual use of online-consulting for persons affected with eating disorders and their relatives—evaluation of an online consulting service. EUROPEAN EATING DISORDERS REVIEW 2006. [DOI: 10.1002/erv.712] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Affiliation(s)
- Philip S Mehler
- Internal Medicine and Community Health Services, Denver Health, Denver, CO 80204, USA.
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Appolinario JC, Bacaltchuk J. Tratamento farmacológico dos transtornos alimentares. BRAZILIAN JOURNAL OF PSYCHIATRY 2002. [DOI: 10.1590/s1516-44462002000700012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O tratamento dos transtornos alimentares (TA) geralmente exige uma abordagem multidisciplinar em que a farmacoterapia é adjuvante de abordagens psicológicas e nutricionais. Psicotrópicos são indicados para a maioria dos pacientes com TA para tratar as comorbidades e também os sintomas chamados nucleares. Progressos importantes estão ocorrendo nos últimos anos. Este artigo apresenta uma revisão das evidências atuais e perspectivas futuras para o tratamento farmacológico da anorexia nervosa, bulimia nervosa e do transtorno da compulsão alimentar periódica.
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Affiliation(s)
- Jose C Appolinario
- Universidade Federal do Rio de Janeiro; Instituto Estadual de Diabetes e Endocrinologia do Rio de Janeiro, Brasil
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