Is Food Addiction a Specific Feature of Individuals Seeking Dietary Treatment from Nutritionists?

Objective: Food addiction (FA) is a condition characterized by excessive and dysregulated consumption of high-energy food, and impulsivity. The diagnostic and nosological framework of FA is still controversial. Therefore, this study aimed at exploring the prevalence of FA in patients seeking help from nutritionists for weight loss, along with its relationship with eating habits, in a pool of 842 participants of both sexes. Method: Eating habits and FA were assessed by, respectively, a self-administered questionnaire and the Yale Food Addiction Scale (YFAS). Statistical analysis included Chi-square for categorical variables, independent t tests to investigate continuous variables and an univariate logistic regression analysis to determine potential risk factors for FA. The relationship between FA diagnosis and potential risk factors was assessed through a stepwise logistic regression model, controlling for age, sex, and body mass index (BMI) classes. Results: Our results indicate that a prevalence of FA in our sample was 15.3%, with no difference between women and men. A higher prevalence was recorded in overweight subjects or obese. According to the YFAS criteria, women were more likely to report a persistent desire and withdrawal than men. Patients with FA compared with those without it, reported a greater number of attempts to lose weight, to self-dieting, a different mealtime repertoire, and to nibble continuously throughout the day. Moreover, the amount of carbohydrates ingested in the same meal seems to represent an eating habit significantly associated with FA. Conclusions: Taken together, our findings show how patients seeking help from nutritionists may display some peculiar features of FA. In spite of its diagnostic controversies, it is evident that FA may play a role in obesity and may also be a feature of some psychopathological conditions. Therefore, it should be more deeply investigated and possibly specifically targeted with tailored therapeutic interventions.

Acute Stress Response Profiles in Health Workers Facing SARS-CoV-2.

OBJECTIVE: The study is an explorative investigation aimed to assess the differences in acute stress response patterns of health workers facing coronavirus disease 2019 (COVID-19) during Italy's first lockdown. METHODS: A cross-sectional investigation using convenience sampling method was conducted in Italy during April 2020. Eight hundred fifty-eight health workers participated in the research filling out self-report measures including Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), and Impact of Event Scale-Revised (IES-R). RESULTS: Moderate/severe depression was found in 28.9% (95% CI, 25.8-32.04), moderate/severe anxiety in 55.4% (95% CI, 51.9-58.8), insomnia in 15% (95% CI, 12.5-17.5), and distress in 52.5% (95% CI, 48.5%-56.6) of participants. The 3% of health workers reported frequent suicidal thoughts. Female sex, working for >15 h/week in a COVID-19 unit, and living apart from family were associated with a significantly higher risk of distress, anxiety, insomnia, depression, and functional impairment. Four profiles were identified on the basis of psychopathological measures: Profile_0 included 44% (N = 270); Profile_1, 25.6% (N = 157); Profile_2, 19.1% (N = 117); and Profile_3, 11.3% (N = 69) of participants. Results showed a significant effect for Profiles X IES-R (η2 = 0.079; f = 0.29), indicating that in all profiles, except for Profile_0, avoidance scale is lower than hyperarousal and intrusion symptoms scales of the IES-R. This characteristic could be a probable index of the control exerted by the responders to not fly away from their job. CONCLUSION: The identification of specific profiles could help psychiatrists and emergency psychologists to build specific interventions in terms of both primary and secondary prevention to face future waves of the COVID-19 outbreak.

Anagrus breviphragma Soyka Short Distance Search Stimuli.

Anagrus breviphragma Soyka (Hymenoptera: Mymaridae) successfully parasitises eggs of Cicadella viridis (L.) (Homoptera: Cicadellidae), embedded in vegetal tissues, suggesting the idea of possible chemical and physical cues, revealing the eggs presence. In this research, three treatments were considered in order to establish which types of cue are involved: eggs extracted from leaf, used as a control, eggs extracted from leaf and cleaned in water and ethanol, used to evaluate the presence of chemicals soluble in polar solvents, and eggs extracted from leaf and covered with Parafilm (M), used to avoid physical stimuli due to the bump on the leaf surface. The results show that eggs covered with Parafilm present a higher number of parasitised eggs and a lower probing starting time with respect to eggs washed with polar solvents or eggs extracted and untreated, both when the treatments were singly tested or when offered in sequence, independently of the treatment position. These results suggest that the exploited stimuli are not physical due to the bump but chemicals that can spread in the Parafilm, circulating the signal on the whole surface, and that the stimuli that elicit probing and oviposition are not subjected to learning.

Increased Classroom Consumption of Home-Provided Fruits and Vegetables for Normal and Overweight Children: Results of the Food Dudes Program in Italy.

OBJECTIVE: To increase classroom consumption of home-provided fruits (F) and vegetables (V) in obese, overweight, and normal weight children. DESIGN: Consumption evaluated within and across the baseline phase and the end of the intervention and maintenance phases. SETTING: Three Italian primary schools. PARTICIPANTS: The study involved 672 children (321 male and 329 female) aged 5-11 years. Body mass index measures were available for 461 children. INTERVENTION: Intervention schools received the Food Dudes (FD) program: 16 days of repeated taste exposure (40 g of F and 40 g of V), video modeling, and rewards-based techniques. The comparison school was only repeatedly exposed to FV. MAIN OUTCOME MEASURE: Grams of FV brought from home and eaten. ANALYSIS: Chi-square, independent t test, repeated-measures ANOVA, and generalized estimating equation model. RESULTS: Intervention schools show a significant increase in home-provided F (P < .001) and V (P < .001) consumption both in overweight and non-overweight children. Approximately half of children in the intervention schools ate at least 1 portion of FV at the end of the intervention and maintenance phases. CONCLUSIONS AND IMPLICATIONS: The increase in home-provided FV intake was similar in overweight and non-overweight children in the FD intervention schools compared with the comparison school. The effect of the FD program was higher at the end of the intervention phase than the end of the maintenance phase.

SUICIDALITY in the perinatal period: comparison of two self-report instruments. Results from PND-ReScU.

The aim of this study was to assess suicidality in a non-clinical sample during the perinatal period and to report suicidality rates in women with major or minor depressive episode (MmD), assessed with the SCID, during the perinatal period. Women (1,066) were recruited at the third month of pregnancy and followed until the 12th month postpartum (N = 500). Suicidality was assessed with the MOODS-SR and with item 10 of the EPDS at different time-points during the perinatal period. The period prevalence of suicidality was 6.9% (95% CI: 6.0-7.8) during pregnancy and 4.3% (95% CI: 3.4-5.2) during postpartum, assessed with the MOODS-SR, and was 12.0% (95% CI: 10.8-13.2) during pregnancy and 8.6% (95% CI: 7.4-9.8) during the postpartum period, assessed with the EPDS. The prevalence of suicidality in women who had MmD during pregnancy was 26.4% and 34.1%, assessed with the MOODS-SR and the EPDS, respectively, while it was 18.4% (MOODS-SR) and 30.6% (EPDS) during the postpartum period. Clinicians should assess suicidality in women presenting with MmD during the whole perinatal period. Furthermore, suicidality should be assessed in women with a previous history of psychiatric disorder that reported a lifetime suicidal ideation.

From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the perinatal depression-research & screening unit study.

OBJECTIVE: Perinatal depression is a particular challenge to clinicians, and its prevalence estimates are difficult to compare across studies. Furthermore, to our knowledge, there are no studies that systematically assessed the incidence of perinatal depression. The aim of this study is to estimate the prevalence, incidence, recurrence, and new onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, minor and major depression (mMD) in an unselected population of women recruited at the third month of pregnancy and followed up until the 12th month postpartum. METHOD: One thousand sixty-six pregnant women were recruited. Minor and major depression was assessed in a naturalistic, longitudinal study. The Edinburgh Postnatal Depression Scale and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders were administered at different time points during pregnancy and in the postpartum period. RESULTS: The period prevalence of mMD was 12.4% in pregnancy and 9.6% in the postpartum period. The cumulative incidence of mMD in pregnancy and in the postpartum period was 2.2% and 6.8%, respectively. Thirty-two (7.3%) women had their first episode in the perinatal period: 1.6% had a new onset of depression during pregnancy, 5.7% in the postpartum period. CONCLUSIONS: Our postpartum prevalence figures, which are lower than those reported in the literature, may reflect treatment during the study, suggesting that casting a multiprofessional network around women in need of support may be potentially useful for reducing the effects of this disorder on the mother and the newborn child. Furthermore, our results indicate that women with a history of depression have a 2-fold risk of developing mMD in the perinatal period.

Beyond "postpartum depressions": specific anxiety diagnoses during pregnancy predict different outcomes: results from PND-ReScU.

OBJECTIVE: Literature underlines that the Edinburgh Postnatal Depression Scale (EPDS) is the most common measure to assess postpartum depression (PPD) worldwide and suggests that the rate of false positives is high. Furthermore, the EPDS does not distinguish between depression and anxiety. This study describes different definitions of PPD and whether pregnancy anxiety disorders are risk factors for different PPDs at both 1month and 1year postpartum. METHOD: 1066 women were recruited during pregnancy and followed until the 12th month postpartum (N=500). Women were administered the SCID and completed the PDPI-R during pregnancy. During the postpartum women who had an EPDS score of 13 or more were administered the SCID to distinguish minor or major depressive episodes (mMD) from false positives. RESULTS: 41.5% and 44.9% of the PPD assessed with the EPDS were false positives at the 1st month and during the 1st year postpartum respectively. The difference observed in prevalence rates estimated with EPDS and SCID was statistically significant both at the 1st month and during the 1st year postpartum. Overall the effect of anxiety diagnoses in predicting PPD was stronger at the 1st month than during the 1st year postpartum. The role of panic disorder is associated both with probable depression (ES=0.82) and with mMD (ES=0.87) at the 1st month postpartum, and predicted mMD during the 1st year postpartum (ES=0.71). OCD predicted false positives at the 1st month postpartum (ES=0.89). CONCLUSION: An antenatal screening of specific anxiety diagnoses could be extremely useful for the prevention of possible postpartum distress outcomes.

Sensitivity to change and predictive validity of the MOODS-SR questionnaire, last-month version.

BACKGROUND: Instruments that are intended to measure change over time need to emphasize sensitivity to change as a central property. The aims of this report are to test whether the MOODS-SR, a measure of mood spectrum symptomatology, is sensitive to changes during acute and continuation treatment of depression and whether residual mood spectrum symptoms predict relapse in the subsequent 6 months. METHODS: The study sample includes 316 patients with nonpsychotic depression participating in the protocol 'Depression: the search for treatment-relevant phenotypes'. Patients were initially randomized to selective serotonin reuptake inhibitors or interpersonal psychotherapy and then treated for 9 months using an algorithm-based protocol. Measures of mood symptomatology included the self-report version of the structured clinical interview for mood spectrum (MOODS-SR), the Quick Inventory for Depressive Symptomatology and the Hamilton Rating Scale for Depression. RESULTS: Repeated-measures ANOVA indicates that during the acute phase MOODS scores decrease significantly from baseline to weeks 6 and 12. This decrease was significantly different (p < 0.001) between those who remitted and those who did not remit on the depressive, the rhythmicity component and the total score. Nonrelapsing subjects had stable scores across the continuation phase, while among relapsing subjects, a significant increase was found in the depressive component (p < 0.001), the rhythmicity component (p = 0.024) and the total score (p < 0.001), at 2 months, followed by a decrease from 2 to 6 months. Scores on the depressive component at the entry into continuation predicted relapse in the subsequent 6 months. CONCLUSIONS: Our findings suggest that the MOODS-SR is sensitive to change in depression status and may help the clinician to detect symptoms and signs not considered by established symptom severity scales.

Axis I and II disorders and quality of life in bariatric surgery candidates.

OBJECTIVE: This study examined the prevalence of Axis I and II psychopathology and its relationship with quality of life in candidates for bariatric surgery. METHOD: Consecutive obese subjects (N = 282) with a body mass index (BMI) of 30 kg/m(2) or more received a thorough psychiatric assessment including the Structured Clinical Interviews for DSM-IV Axis I and II Disorders; the Hamilton Rating Scale for Depression; the Bulimic Investigatory Test, Edinburgh; and the short-form Quality of Life Enjoyment and Satisfaction Questionnaire. Subjects were recruited between November 2001 and March 2006. RESULTS: The overall prevalence of lifetime Axis I disorders in the sample was 37.6%. Mood disorders were the most common diagnoses (22.0%). Anxiety disorders and eating disorders were found in 18.1% and 12.8% of the sample, respectively. Alcohol or substance use disorders were uncommon. The percentage of subjects meeting criteria for at least 1 lifetime Axis I disorder did not vary by BMI class or gender. The prevalence of current Axis I disorders was 20.9% (N = 59). Fifty-five subjects (19.5%) met criteria for at least 1 Axis II disorder. Cluster C disorders, including avoidant, dependent, and obsessive-compulsive personality disorders, comprised virtually all the disorders in the sample (N = 53, 18.8%). Quality of life was poor, unrelated with gender or BMI, and significantly more impaired in individuals with comorbid Axis I and II disorders compared with those without disorders (p = .035). CONCLUSION: About one fifth of the sample presented with a current Axis I disorder, and the same percentage had a personality disorder. Although obesity surgery is not contraindicated based on psychiatric disorders, adequate preoperative treatment should be provided to individuals in need of psychiatric support to improve the postoperative outcome and reduce the risk of complications.

Axis I psychopathology and functional impairment at the third month of pregnancy: Results from the Perinatal Depression-Research and Screening Unit (PND-ReScU) study.

OBJECTIVE: Recent studies indicate that the prevalence and 12-month incidence of mental disorders during pregnancy are similar to those of age-matched nonpregnant women. The aim of this study is to assess the prevalence, sociodemographic correlates, and functional impairment associated with Axis I disorders in women at the third month of pregnancy. METHOD: 1066 women presenting at the Department of Obstetrics and Gynecology of the Azienda Ospedaliera Universitaria Pisana (Pisa, Italy) for the first ultrasound examination between the 12th and the 15th gestational weeks were recruited for participation in the Program "Perinatal Depression-Research and Screening Unit (PND-ReScU)" and were administered the Structured Clinical Interview for DSM-IV Axis I Disorders and the Work and Social Adjustment Scale. Study recruitment began in February 2004 and ended in March 2007. RESULTS: The prevalence of lifetime Axis I disorders at the third month of pregnancy was 50.4%. 255 women (23.9%) had 2 or more lifetime comorbid disorders. 26.3% met criteria for current Axis I disorders. Current comorbidity between depressive and anxiety disorders was found in 47 women (4.4%). CONCLUSION: One in 5 women presented with a current Axis I disorder, and a higher percentage met criteria for a lifetime Axis I disorder. Early detection of psychopathology at the beginning of pregnancy may help to plan an adequate treatment in order to achieve a better postpartum adjustment and to reduce the risk of adverse obstetrical and psychopathological outcome.

Surgery or surveillance for mild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial.

CONTEXT: It is unclear whether patients with asymptomatic primary hyperparathyroidism (PHPT) do better with parathyroidectomy (PTx) as compared with conservative medical management. OBJECTIVE: The aim of the study was to evaluate the beneficial effect of PTx vs. conservative management in patients with mild asymptomatic PHPT. DESIGN: We conducted a prospective, randomized study. SETTING: The study took place at a referral center. PATIENTS: We studied 50 patients who did not meet any guidelines for parathyroid surgery as recommended by the National Institutes of Health Consensus Development Conference on Asymptomatic PHPT. INTERVENTION: Patients were randomly assigned to PTx or no PTx and were evaluated at 6 months and at 1 yr. MAIN OUTCOME MEASURES: We compared changes (percentage of basal) of lumbar spine bone mineral density (BMD) between the two groups at 1 yr. RESULTS: The change in BMD at lumbar spine was greater after PTx (+4.16 +/- 1.13 for PTx vs. -1.12 +/- 0.71 for no PTx; P = 0.0002). The change in BMD at the total hip was also significantly greater in the PTx group (+2.61 +/- 0.71 for PTx vs. -1.88 +/- 0.60 for no PTx; P = 0.0001). There was no difference in BMD after 1 yr between both groups at the one-third radius site. In comparison with those who did not undergo surgery, the PTx subjects, after 1 yr, showed significant differences in four quality of life measures as determined by the 36-item short form health survey scale: bodily pain (P = 0.001), general health (P = 0.008), vitality (P = 0.003), and mental health (P = 0.017). CONCLUSIONS: In patients with mild asymptomatic PHPT, successful PTx is followed by an improvement in BMD and quality of life. Most patients followed without surgery did not show evidence of progression.

The role of affordances in inhibition of return.

Inhibition of return (IOR) is a response delay that occurs when the target is preceded by an irrelevant stimulus (cue) at the same location. IOR can be object based, as well as location based. The aim of the present study was to investigate the role of the pragmatic features of a visually presented object in causing IOR. Two experiments were carried out using different objects as stimuli, for which the graspable part (affordance) was clearly defined. The presentation of a whole object, with the part commonly used to grasp it located below, served as a cue. The presentation of either the graspable or the ungraspable part of the cued or uncued object served as the target. Results showed that responses were slower when the graspable part was shown in the cued location than when the ungraspable part was shown in the same location. The effect was apparently linked to the kind of action necessary to grasp an object.