Emotional overeating affected nine in ten female students during the COVID-19 university closure: A cross-sectional study in France

OBJECTIVES

To estimate the proportion of female university students reporting overeating (EO) in response to emotions during the COVID-19 university closures, and to investigate social and psychological factors associated with this response to stress.

DESIGN

Online survey gathered sociodemographic data, alcohol/drugs use disorders, boredom proneness and impulsivity using validated questionnaires, and EO using the Emotional Overeating Questionnaire (EOQ) assessing eating in response to six emotions (anxiety, sadness, loneliness, anger, fatigue, happiness), whose structure remains to be determined.

PARTICIPANTS

Sample of 302 female students from Rennes University, France.

MAIN OUTCOME MEASURE

Frequencies of emotional overeating.

ANALYSIS

The frequency of emotional overeating was expressed for each emotion as percentages. Exploratory Factor analyses (EFA) were used to determine EOQ structure and provide an index of all EOQ items used for further analysis. Linear regression models were used to explore relationships between EO and others covariates.

RESULTS

Nine in ten participants reported intermittent EO in the last 28 days, mostly during 6 to 12 days, in response to Anxiety (75.5%), Sadness (64.5%), Happiness (59.9%), Loneliness (57.9%), Tiredness (51.7%), and to a lesser extent to Anger (31.1%). EFA evidenced a one-factor latent variable reflecting "Distress-Induced Overeating" positively correlated with internal boredom proneness, tobacco use, attentional impulsivity, inability to resist emotional cues, and loss of control over food intake, and negatively with age and well-being. EO was unrelated to body mass index or substance abuse.

CONCLUSION AND IMPLICATIONS

Nine in ten female students reported emotional overeating during the COVID-19 university closure. This response to stress was related to eating tendencies typical of young women, but also to personality/behavioral patterns such as boredom and impulsivity proneness. Better understanding of the mechanisms underlying EO in response to stress and lack of external/social stimulation would improve preventive interventions.

Subjective feeling of control during fNIRS-based neurofeedback targeting the DL-PFC is related to neural activation determined with short-channel correction

Neurofeedback (NF) training is a promising preventive and therapeutic approach for brain and behavioral impairments, the dorsolateral prefrontal cortex (DL-PFC) being a relevant region of interest. Functional near-infrared spectroscopy (NIRS) has recently been applied in NF training. However, this approach is highly sensitive to extra-cerebral vascularization, which could bias measurements of cortical activity. Here, we examined the feasibility of a NF training targeting the DL-PFC and its specificity by assessing the impact of physiological confounds on NF success via short-channel offline correction under different signal filtering conditions. We also explored whether the individual mental strategies affect the NF success. Thirty volunteers participated in a single 15-trial NF session in which they had to increase the oxy-hemoglobin (HbO2) level of their bilateral DL-PFC. We found that 0.01-0.09 Hz band-pass filtering was more suited than the 0.01-0.2 Hz band-pass filter to highlight brain activation restricted to the NF channels in the DL-PFC. Retaining the 10 out of 15 best trials, we found that 18 participants (60%) managed to control their DL-PFC. This number dropped to 13 (43%) with short-channel correction. Half of the participants reported a positive subjective feeling of control, and the "cheering" strategy appeared to be more effective in men (p<0.05). Our results showed successful DL-PFC fNIRS-NF in a single session and highlighted the value of accounting for extra cortical signals, which can profoundly affect the success and specificity of NF training.

Interactions between emotions and eating behaviors: Main issues, neuroimaging contributions, and innovative preventive or corrective strategies

Emotional eating is commonly defined as the tendency to (over)eat in response to emotion. Insofar as it involves the (over)consumption of high-calorie palatable foods, emotional eating is a maladaptive behavior that can lead to eating disorders, and ultimately to metabolic disorders and obesity. Emotional eating is associated with eating disorder subtypes and with abnormalities in emotion processing at a behavioral level. However, not enough is known about the neural pathways involved in both emotion processing and food intake. In this review, we provide an overview of recent neuroimaging studies, highlighting the brain correlates between emotions and eating behavior that may be involved in emotional eating. Interaction between neural and neuro-endocrine pathways (HPA axis) may be involved. In addition to behavioral interventions, there is a need for a holistic approach encompassing both neural and physiological levels to prevent emotional eating. Based on recent imaging, this review indicates that more attention should be paid to prefrontal areas, the insular and orbitofrontal cortices, and reward pathways, in addition to regions that play a major role in both the cognitive control of emotions and eating behavior. Identifying these brain regions could allow for neuromodulation interventions, including neurofeedback training, which deserves further investigation.

Assessment of risk factors of treatment discontinuation among patients on paliperidone palmitate and risperidone microspheres in france, germany and belgium – a retrospective database study

Introduction

Long-acting antipsychotics (e.g. 1-monthly (PP1M) / 3-monthly (PP3M) injection forms of paliperidone palmitate) have been developed to improve treatment continuation in schizophrenia patients.

Objectives

To assess risk factors of treatment discontinuation in patients on paliperidone palmitate and risperidone microsphere. Additionally, treatment continuation between patients with PP1M and PP3M was compared.

Methods

The IQVIA Longitudinal Prescription databases were used. Risk factors of treatment discontinuation were identified by a multilevel survival regression using Cox proportional hazards model. Kaplan Meier analyses were performed by identified significant risk factors.

Results

25,361 patients (France: 9,720; Germany: 14,461; Belgium: 1,180) were included. Over a one-year follow-up period, a significant higher treatment continuation was observed for patients newly initiated on paliperidone palmitate (46.2%) than those initiated on risperidone microspheres (14.6%). Additionally, a significantly higher treatment continuation was found for ‘stable’ PP3M patients (81.8%) than ‘stable’ PP1M patients (62.9%). Patients were more likely to discontinue when drugs prescribed by GP only (HR = 1.68, p < 0.001 vs. psychiatrist only) or being females (HR = 1.07, p < 0.001), whereas discontinuation rate decreased with age (31-50 years: HR = 0.95, p = 0.006 and > 50 years: HR = 0.91, p < 0.001 vs. 18-30 years).

Conclusions

Paliperidone palmitate was associated with a significantly higher treatment continuation than risperidone microspheres. Treatment continuation is likely to be improved by targeting young patients (18-30 years), empowering GPs with mental health knowledge and managing patients by a collaborative primary care-mental health model. Further research is needed to understand why females have more treatment discontinuation.

Disclosure

Rui Cai, Flore Decuypere and Pierre Chevalier are IQVIA employees and served as paid consultants to Janssen during the conduct of this study. Antonie Wimmer, Pascal Guillon, Stefan Pype, Annabelle Godet, Valeria Timtschenko are Janssen employees.

Do Food Odors Differently Influence Cerebral Activity Depending on Weight Status? An Electroencephalography Study of Implicit Olfactory Priming Effects on the Processing of Food Pictures

Attentional automatic processes and cerebral activity may differ between individuals with different weight statuses in the presence of food stimuli (e.g. odors, pictures). In the present study, we used an implicit olfactory priming paradigm to test the influence of non-attentively perceived food odors on the cerebral activity underlying the processing of food pictures, in normal-weight, overweight, and obese adults. A pear odor and a pound cake odor were used as primes, respectively priming sweet low-energy-density foods and high-energy-density foods. Event-related potentials were recorded while the participants passively watched pictures of sweet low and high-energy-density foods, under the two priming conditions plus an odorless control condition. The amplitude and latency of several peaks were measured (P100, N100, P200, N400). As a major result, we found that weight status influences the cerebral activity underlying the processing of food cues outside of consciousness, as early as the first detectable P100 peak.

Current intakes of trans-palmitoleic (trans-C16:1 n-7) and trans-vaccenic (trans-C18:1 n-7) acids in France are exclusively ensured by ruminant milk and ruminant meat: A market basket investigation

High circulating levels of trans-palmitoleic acid (TPA) are associated with a lower risk of type 2 diabetes in humans. Thus, the origin of circulating TPA matters. Direct intakes of TPA are ensured by dairy products, and perhaps by partially hydrogenated oils (PHOs). Indirect intakes of TPA rely on dietary trans-vaccenic acid (TVA), which occurs in ruminant-derived foods and PHOs. As it is usually assumed that PHOs are not used any longer, we analyzed here a wide range of foods currently available at retail in France. We report that TPA and TVA (1) do occur in ruminant milk and meat, dairy products and in foreign PHOs, (2) do occur in dairy fat-containing foods and (3) do not occur in dairy fat-free foods. Together, our findings demonstrate that ruminant fats are the only contributors to circulating levels of TPA in humans.

Analyse coût-efficacité du palmitate de palipéridone par rapport aux autres antipsychotiques indiqués dans le traitement de la schizophrénie en France

Objectif

Évaluer l’efficience du palmitate de palipéridone (PP) par rapport aux antipsychotiques les plus communément utilisés en France.

Méthodes

Un modèle médico-économique a été développé afin de simuler la progression d’une cohorte de patients atteints de schizophrénie à travers quatre états de santé (« Stable-traité », « Stable-non-traité », « En-rechute », « Décédé »). PP a été comparé à rispéridone injectable à libération prolongée (ILP), aripiprazole ILP, olanzapine ILP, halopéridol décanoate et olanzapine orale (OO). Les coûts, les années de vie pondérées par la qualité de vie (« Quality-adjusted-life-year » ; QALY) et le nombre de rechutes ont été estimés sur cinq ans selon une perspective tous payeurs. Supposés stabilisés suite à une décompensation clinique, les patients initiaient un antipsychotique et passaient en phase de prévention de la rechute en cas de succès après trois mois. Ils/elles pouvaient arrêter leur traitement après une rechute, un manque de tolérance ou par choix, et passer sur la ligne de traitement suivante jusqu’à la troisième ligne (c.-à.-d. clozapine). Afin de prendre en compte l’observance, les probabilités de rechute en phase de prévention ont été calculées à partir de taux d’hospitalisation sur des données françaises en vie réelle. Les données de tolérance et d’utilité ont été dérivées d’études internationales, et les coûts de sources françaises. La robustesse des résultats a été testée via des analyses de sensibilité.

Résultats

À 5 ans, PP est le moins coûteux des ILP et est associé à un surcoût de 249 € par rapport à OO. Rispéridone ILP et PP sont associés aux plus grands nombres de QALY. PP domine tous les autres ILP en termes de rechute évitée hormis olanzapine ILP.

Conclusion

PP est le moins coûteux des antipsychotiques ILP en France. OO est l’antipsychotique le moins coûteux, mais est associée à un nombre plus faible de QALY gagnées et de rechutes évitées comparé aux antipsychotiques ILP.

Peptidergic nerves in the ureter

Vasoactive intestinal peptide (VIP) and substance P were demonstrated in the pig ureter by immunohistochemical techniques. Nerves containing these materials were related mainly to the smooth muscle layer in the normal and obstructed ureter. In isolated ureteral segments, VIP caused relaxation at doses exceeding 0.18 micrograms/ml, with no significant difference seen in the effect on normal and obstructed ureter. Vasoactive intestinal polypeptide may play a role in the regulation of ureteral smooth muscle tone.