Athletes with Eating Disorders: Analysis of Their Clinical Characteristics, Psychopathology and Response to Treatment.

Eating disorders (ED) have frequently been described among athletes. However, their specific features and therapy responses are lacking in the literature. The aims of this article were to compare clinical, psychopathological and personality traits between ED patients who were professional athletes (ED-A) with those who were not (ED-NA) and to explore differences in response to treatment. The sample comprised n = 104 patients with ED (n = 52 ED-A and n = 52 matched ED-NA) diagnosed according to DSM-5 criteria. Evaluation consisted of a semi-structured face-to-face clinical interview conducted by expert clinicians and a psychometric battery. Treatment outcome was evaluated when the treatment program ended. ED-A patients showed less body dissatisfaction and psychological distress. No differences were found in treatment outcome among the groups. Within the ED-A group, those participants who performed individual sport activities and aesthetic sports presented higher eating psychopathology, more general psychopathology, differential personality traits and poor therapy outcome. Individual and aesthetic sports presented more severity and worse prognosis. Although usual treatment for ED might be similarly effective in ED-A and ED-NA, it might be important to develop preventive and early detection programs involving sports physicians and psychologists, coaches and family throughout the entire athletic career and afterwards.

Online multidisciplinary treatment of binge eating disorder in people with high weight: a case series study.

BACKGROUND: Binge eating disorder (BED) is the most frequent eating behavior among the general population (Guerdjikova in Med Clin 103:669-680, 2019). Many studies on interventions and BED treatments have been carried out in the United States and Europe, few have been reported in Latin American populations. People with this disorder not only have physical consequences of it but also social and psychological ones, therefore a multidisciplinary treatment approach is a good option to treat this condition. OBJECTIVE: To evaluate the feasibility of a multidisciplinary online intervention (i.e., psychological, nutritional, and physical activity) in patients with BED. METHOD: The design was a case series study of two clinical treatment groups, with pre-test and post-test psychometric measures along with two follow-ups (at 2 and 6 months). Fifteen people diagnosed with BED (2 men and 13 women), with a mean age of 34.93 years (SD=11.91) and a mean initial BMI of 42, participated in this study. The treatment was carried out over the span of 28 sessions, each one being two hours per week consisting of 1 hour of group therapy and 1 hour of individual therapy. There were four evaluations: pre, post and two follow-ups. RESULTS: Five patients did not complete the treatment (30%). The comparisons were made through the non-parametric Friedman test, finding a statistically significant decrease in binge eating symptoms (x2=15.57; p=.001), anxiety symptoms (x2=15.96; p=.001) and depression (x2=15.03; p=.002). There was an improvement in clarity (x2=11.60; p=.010) and emotional regulation (x2=7.75; p=.050), only in women. The patients reduced their body weight, and improved their eating and exercise habits by introducing fruits and vegetables and including 20-30 minutes of physical activity into their daily routine. Regarding the Objective Clinical Change Index, in terms of the objective clinical change, a positive change was observed in all the variables addressed. CONCLUSIONS: The data presented allowed us to conclude that the online multidisciplinary intervention was effective in the treatment of BED. Trial registration Retrospectively registered.

Comparing the Personality Traits of Patients with an Eating Disorder versus a Dual Diagnosis.

Objectives: This cross-sectional study explored personality traits of individuals receiving treatment in a private clinic for an eating disorder (ED) compared to those receiving treatment for a dual diagnosis (DD; defined as an addiction to illegal drugs and/or alcohol along with a mental illness, in this case an ED). The aims of this study were to: (a) assess the personality profiles and differentiating traits between the ED and DD groups, (b) analyze differences in personality traits of restrictive ED versus bingeing ED profiles, and lastly (c) compare the individuals Temperament and Character Inventory-Revised (TCI-R) results to their personality clusters as per the Diagnostic and Statistical Manual of Mental Disorders - 5th edition (DSM-5). Methods: The TCI-R is a self-report questionnaire consisting of seven scales, each with their own subscales, which provide a fuller understanding of each temperament and character trait evaluated. This questionnaire was given to patients (n = 67) receiving treatment at a private institute specialized in eating disorders in Barcelona, Spain and the surrounding areas, along with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-II (BDI-II), and the Barratt Impulsiveness Scale-11 (BIS-11). These subsequent questionnaires were given as they are often found to be comorbidities of ED. Results: The ED group (n = 41), regarding the TCI-R scales, showed higher scores in harm avoidance (HA), reward dependence (RD), persistence (P), cooperativeness (C) and self-directedness (SD). Whereas, the DD (n = 26) group, showed higher scores in novelty seeking (NS) and self-transcendence (ST). Also, there was a significant positive correlation between the DD group and the extravagance (NS3) subscale of novelty seeking across models. When comparing the two ED groups, the restrictive profile (RP) to the bingeing profile (BP), there were significant negative correlations in the TCI-R subscales of dependence (RD4) and perfectionism (P4) whereas there were positive correlations in the TCI-R subscale of responsibility (SD1). Conclusions: These results support previous studies and help to appraise differences in personality traits between specific groups in a clinical setting.

Substantial Heterogeneity in Progress Toward Reaching the 90-90-90 HIV Target in the WHO European Region.

BACKGROUND: Achieving the UNAIDS 90-90-90 target by 2020 is expected to end the HIV epidemic by 2030. We report on progress in the WHO European Region in meeting this target. METHODS: The European Centre for Disease Prevention and Control (ECDC) sent questionnaires to 55 countries in 2016. We report estimates for 4 stages of the continuum of HIV care (living with HIV, diagnosed, treated, and virally suppressed), corresponding to the Joint United Nations Programme on HIV and AIDS (UNAIDS) target and explore differences by subregion and challenges with reporting data. FINDINGS: Forty-four countries provided data for ≥1 stage, and 29 for all 4 stages. Estimated HIV prevalence was 0.19% (range 0.02%-0.84%, n = 37 countries providing stage 1 data). The proportion diagnosed of people living with HIV ranged from 38% to 98% (n = 37 reporting number of people living with HIV and diagnosed). The proportion on ART of those diagnosed ranged from 27% to 96% (n = 40 reporting numbers diagnosed and treated), and viral suppression rates ranged from 32% to 97% (n = 31 providing numbers treated and virally suppressed). The overall continuum of care estimate for 29 countries with complete data was 81-84-88, which differed by subregion: 84-88-90, 84-69-62, and 57-45-57 for the western, central, and eastern subregions, respectively. Challenges in reporting data included absence of a single data source for all stages, shortage of expertise, and lack of financial and human resources. CONCLUSIONS: There is an urgent need to strengthen HIV testing programs throughout Europe, particularly in the eastern subregion, and to remove constraints hampering access to testing and care. Recent changes to treatment guidelines should help reduce the numbers diagnosed not treated.

The early cognitive development of children at high risk of developing an eating disorder.

Diagnosis of an eating disorder (ED) has been associated with differences in cognition. Recent evidence suggests that differences may be present prior to onset. Children at familial high risk for ED show cognitive differences at ages 8-10 years. Research is required to investigate differences in cognitive development at various time points. This is the first study to investigate cognitive development in children at high risk at 18 months (Griffiths Mental Development Scale; n=982) and 4 years old (Wechsler Preschool and Primary Scale of Intelligence-Revised; n=582), in comparison with children not at risk, using a general population sample, the Avon Longitudinal Study of Parents and Children. Children of women with lifetime anorexia nervosa revealed difficulties in social understanding, visual-motor function, planning and abstract reasoning. Cognitive differences observed here have also been observed in clinical groups. This suggests difficulties may be present prior to onset, potentially affecting risk status for development of ED. Findings contribute to an understanding of aetiology, and design of prevention/intervention strategies.