Nasogastric Tube Feeding in Anorexia Nervosa: A Propensity Score-Matched Analysis on Clinical Efficacy and Treatment Satisfaction.

The choice of a refeeding strategy is essential in the inpatient treatment of Anorexia Nervosa (AN). Oral nutrition is usually the first choice, but enteral nutrition through the use of a Nasogastric Tube (NGT) often becomes necessary in hospitalized patients. The literature provides mixed results on the efficacy of this method in weight gain, and there is a scarcity of studies researching its psychological correlates. This study aims to analyze the effectiveness of oral versus enteral refeeding strategies in inpatients with AN, focusing on Body Mass Index (BMI) increase and treatment satisfaction, alongside assessing personality traits. We analyzed data from 241 inpatients, comparing a group of treated vs. non-treated individuals, balancing confounding factors using propensity score matching, and applied regression analysis to matched groups. The findings indicate that enteral therapy significantly enhances BMI without impacting treatment satisfaction, accounting for the therapeutic alliance. Personality traits showed no significant differences between patients undergoing oral or enteral refeeding. The study highlights the clinical efficacy of enteral feeding in weight gain, supporting its use in severe AN cases when oral refeeding is inadequate without adversely affecting patient satisfaction or being influenced by personality traits.

Role of parental educational level as psychosocial factor in a sample of inpatients with anorexia nervosa and bulimia nervosa.

Introduction: Evidence on parental educational level (PEL) as a risk factor for Eating Disorders (EDs) is mixed, and no study has assessed its role in relation to the compliance and outcomes of treatments in EDs. Further, no study differentiated from the educational level of mothers and fathers, nor considered the possible mediation of perfectionism in fostering EDs. Methods: A clinical sample of 242 first-ever admitted inpatients with EDs provided information on PEL and completed the following questionnaires: the Eating Disorder Examination Questionnaire (EDE-Q) and the Frost Multidimensional Perfectionism Scale (F-MPS). Clinicians also provided information on the Hamilton Rating Scale for Anxiety (HAM-A) and the Hamilton Rating Scale for Depression (HAM-D) for each participant. Results: Individuals with high PEL (whether mothers, fathers, or both parents) showed significantly higher scores on depressive symptoms and lower on parental criticism, were younger, had an earlier age of onset, had fewer years of illness, more were students and employed, and fewer had offspring. Individuals with fathers or both parents with high educational levels suffered more from Anorexia Nervosa rather than Bulimia Nervosa, had a longer length of stay during the current hospitalization, had less dietary restraint, and had higher personal standards. Individuals with mothers with high educational levels showed a lower rate of previous substance or alcohol addiction. Personal standards partially mediated the relationship between higher PEL and lower dietary restraint. Discussion: PEL emerged to be a twofold psychosocial risk factor, being associated with higher depressive symptoms and a longer length of stay, but also with a shorter duration of illness and better scholar and working involvement. Higher PEL was related to higher personal standards but not to global perfectionism. Patterns of eating psychopathology emerged based on the high PEL of mothers or fathers.

Inpatient treatments for adults with anorexia nervosa: a systematic review of literature.

PURPOSE: Anorexia nervosa (AN) is a mental disorder for which hospitalization is frequently needed in case of severe medical and psychiatric consequences. We aim to describe the state-of-the-art inpatient treatment of AN in real-world reports. METHODS: A systematic review of the literature on the major medical databases, spanning from January 2011 to October 2023, was performed, using the keywords: "inpatient", "hospitalization" and "anorexia nervosa". Studies on pediatric populations and inpatients in residential facilities were excluded. RESULTS: Twenty-seven studies (3501 subjects) were included, and nine themes related to the primary challenges faced in hospitalization settings were selected. About 81.48% of the studies detailed the clinical team, 51.85% cited the use of a psychotherapeutic model, 25.93% addressed motivation, 100% specified the treatment setting, 66.67% detailed nutrition and refeeding, 22.22% cited pharmacological therapy, 40.74% described admission or discharge criteria and 14.81% follow-up, and 51.85% used tests for assessment of the AN or psychopathology. Despite the factors defined by international guidelines, the data were not homogeneous and not adequately defined on admission/discharge criteria, pharmacological therapy, and motivation, while more comprehensive details were available for treatment settings, refeeding protocols, and psychometric assessments. CONCLUSION: Though the heterogeneity among the included studies was considered, the existence of sparse criteria, objectives, and treatment modalities emerged, outlining a sometimes ambiguous report of hospitalization practices. Future studies must aim for a more comprehensive description of treatment approaches. This will enable uniform depictions of inpatient treatment, facilitating comparisons across different studies and establishing guidelines more grounded in scientific evidence. LEVEL OF EVIDENCE: Level I, systematic review.

Cognitive Impulsivity in Anorexia Nervosa in Correlation with Eating and Obsessive Symptoms: A Comparison with Healthy Controls.

Impulsivity in eating disorders (ED) has been historically focused on bingeing-purging symptoms, evidencing lower levels in restricting subtypes. In the recent literature, obsessive-compulsive disorder (OCD) has been described as characterized by high cognitive impulsivity. This specific impulsivity factor has been rarely studied in anorexia nervosa (AN). In this study, 53 inpatients with anorexia nervosa and 59 healthy controls completed the following questionnaires: the Barratt Impulsiveness Scale (BIS-11), the Obsessive-Compulsive Inventory (OCI), the Eating Disorders Inventory-2 (EDI-2), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). AN individuals showed significantly increased levels of cognitive instability but no difference in global score and other subscales of impulsivity compared to the healthy controls. Among AN individuals, cognitive instability emerged as being associated with the global score and obsession subscale of the OCI. It was also significantly associated with interoceptive awareness and impulse regulation. Cognitive instability was the main predictor of obsessive thoughts and behaviors in AN. Our study supports the hypothesis of AN as being characterized by high cognitive instability and adds the result that the cognitive domain of impulsivity may be associated with the presence of obsessive symptoms, specifically obsessive thoughts.

Perfectionism in anorexia nervosa: Associations with clinical picture and personality traits.

Although many researchers addressed the topics, no consistent data are currently available regarding the relationship between perfectionism and personality traits in anorexia nervosa (AN). The present study aimed to assess differences between high- and low-perfectionism groups of patients with AN and to identify which variables show the strongest association with perfectionism. A group of inpatients with AN (n = 193) was recruited and completed a battery of self-report questionnaires regarding eating-related and general psychopathology, perfectionism, and personality. On the basis of perfectionism scores, patients were divided into high- and low-perfectionism groups. High-perfectionist patients displayed higher eating-related and general psychopathology; higher depressive, cyclothymic, irritable and anxious temperament, and lower self-directedness, cooperativeness and self-esteem. Perfectionism was associated with the drive for thinness, cooperativeness, self-esteem and anxious temperament. On the basis of the two personality traits most strongly correlated with perfectionism (i.e., cooperativeness and anxious temperament), patients could be correctly assigned to the high- or low-perfectionism group by an algorithm. The study suggests that perfectionism in AN is related to eating psychopathology, especially of restrictive type, and personality features such as cooperativeness and anxious temperament. These findings confirm the important role of perfectionism in AN, not only concerning eating behaviour but personality as well.

The Nepean Belief Scale (NBS) as a tool to investigate the intensity of beliefs in anorexia nervosa: psychometric properties of the Italian version.

BACKGROUND: People with anorexia nervosa (AN) show a peculiar impairment of insight regarding their condition, often manifesting a denial of extreme emaciation and sometimes hiding or underreporting socially undesirable abnormal eating patterns. Sometimes the intensity of the beliefs held by patients with AN reach a delusional intensity. OBJECTIVES: In this study, the Italian version of the Nepean Belief Scale was applied to a sample of patients diagnosed with AN to investigate the intensity of their beliefs and convictions and its clinical correlates. METHODS: The Nepean Belief Scale (NBS) was translated and adapted to Italian and applied to a sample of patients diagnosed with AN based on the Structured Clinical Interview for DSM-5 (SCID-5). RESULTS: The Italian version of the 5-item NBS showed excellent reliability. Convergent validity was proved by negative association with levels of insight measured with the Schedule for the Assessment of Insight in Eating Disorders. Beliefs of delusional intensity were reported by 10% of participants. Those with a greater intensity of beliefs, either overvalued or delusional ideas, were more likely to report poorer general cognitive performances on the Montreal Cognitive Assessment. No association was observed between NBS score and age, body mass index, symptoms of eating disorders, body dissatisfaction, or levels of depression. Fear of weight gain and control seeking were the most often reported themes at the NBS. CONCLUSIONS: The Italian version of the NBS is a reasonably reliable, valid, and usable tool for the multidimensional assessment of insight in AN. Level of evidence Level III, Evidence obtained from well-designed cohort or case-control analytic studies.

Exploring Caloric Restriction in Inpatients with Eating Disorders: Cross-Sectional and Longitudinal Associations with Body Dissatisfaction, Body Avoidance, Clinical Factors, and Psychopathology.

Reduction in food intake is an important feature of eating disorders (EDs). However, whereas self-reported cognitive control over food (i.e., dietary restraint) is commonly assessed, we are not aware of any study evaluating the actual reduction in caloric intake (i.e., caloric restriction, CR) and its relationships with psychopathological, clinical, and anamnestic factors in individuals with EDs. In this study, we quantified caloric intake, CR, and weight suppression in 225 ED inpatients and explored significant relationships with self-reported eating symptoms, body dissatisfaction, body avoidance, personality, and affective symptoms. For underweight inpatients (n = 192), baseline predictors of caloric intake and restriction at discharge were assessed through a data-driven approach. CR at admission was significantly related to eating symptomatology, state anxiety, and body image. In regression models, CR, higher BMI, binge-purging symptoms, and the interaction between weight suppression and CR were significantly related to body dissatisfaction. The best psychopathological predictors of caloric intake and restriction at discharge for underweight inpatients were perfectionistic concern over mistakes and state anxiety. These results suggest that caloric restriction is associated to relevant ED features and warrant for a multidimensional assessment of ED psychopathology.

What's New in Research during the Current Epidemic Wave of Eating Disorders?

The COVID-19 pandemic has caused physical health concerns and has significantly impacted mental health [...].

Pathways to eating disorder care: A European multicenter study.

BACKGROUND: The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). METHODS: Eleven ED services located in seven European countries recruited patients with an ED. Clinicians administered an adapted version of the World Health Organization "Encounter Form," a standardized tool to assess the pathways to care. The unadjusted overall time needed to access the ED unit was described using the Kaplan-Meier curve. RESULTS: Four-hundred-nine patients were recruited. The median time between the onset of the current ED episode and the access to a specialized ED care was 2 years. Most of the participants did not directly access the specialist ED unit: primary "points of access" to care were mental health professionals and general practitioners. The involvement of different health professionals in the pathway, seeking help for general psychiatric symptoms, and lack of support from family members were associated with delayed access to ED units. CONCLUSIONS: Educational programs aiming to promote early diagnosis and treatment for EDs should pay particular attention to general practitioners, in addition to mental health professionals, and family members to increase awareness of these illnesses and of their treatment initiation process.

Increased General, Eating, and Body-Related Psychopathology in Inpatients in a Specialized Eating Disorders Unit after the Beginning of the COVID-19 Pandemic: A Retrospective Comparison with the Pre-Pandemic Period.

The study of the effects of the COVID-19 pandemic on individuals who attended mental health services is needed to identify the specific vulnerabilities associated to this challenging period. Despite several analyses reporting the worsening of eating disorders symptomatology after the beginning of the pandemic, characterizations of adult inpatients with eating disorders are still lacking. We conducted a retrospective analysis to assess whether adult individuals who underwent hospitalization in a specialized eating disorders unit in the two years after the beginning of the COVID-19 pandemic differed in clinical presentation, psychopathological measures, and treatment outcomes from inpatients hospitalized in the two years before. In the comparison between the two groups, the individuals who began treatment after the start of the pandemic presented with more physical hyperactivity and more severe psychopathological scores in most of the areas investigated, with differences in eating symptoms still evident at discharge. Notably, body-related symptoms (i.e., body shape concerns, body checking, body avoidance) were associated with the pandemic, and also for inpatients with extreme anorexia nervosa. This retrospective analysis does not allow us to separate the impact of COVID-19 from other potentially relevant co-occurring factors; however, these findings help in understanding how the pandemic could have affected individuals that needed specialized intensive treatment.

Diagnostic Concordance between Research and Clinical-Based Assessments of Psychiatric Comorbidity in Anorexia Nervosa.

The literature has reported poor concordance in the assessment of psychiatric conditions, and inhomogeneity in the prevalence of psychiatric comorbidities in Anorexia Nervosa (AN). We aimed to investigate concordance level between clinicians' and researchers' diagnoses of psychiatric comorbidity in AN and differences in eating and general psychopathology between patients with and without psychiatric comorbidity assessed by clinicians versus researchers. A clinical psychiatrist interviewed 122 patients with AN; then a researcher administered the Structured and Clinical Interview for DSM-5 (SCID-5). Participants completed the Eating Disorder Examination Questionnaire (EDE-Q), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). The agreement between clinicians and researchers was poor for all diagnoses but obsessive-compulsive disorder and substance use disorder. Patients with comorbid disorders diagnosed by researchers reported more severe eating and general psychopathology than those without SCID-comorbidity. The differences between patients with and without comorbidities assessed by a clinician were smaller. Two approaches to psychiatry comorbidity assessment emerged: SCID-5 diagnoses yield a precise and rigorous assessment, while clinicians tend to consider some symptoms as secondary to the eating disorder rather than as part of another psychiatric condition, seeing the clinical picture as a whole. Overall, the study highlights the importance of carefully assessing comorbidity in AN.

Shame, Guilt, and Self-Consciousness in Anorexia Nervosa.

BACKGROUND: the role of self-conscious emotions (SCE) such as shame and guilt in eating disorders (ED) has been systematically studied only in recent years, but it is still debated. This study aims to investigate the role of SCE in anorexia nervosa (AN), evaluating the role of self-consciousness. METHODS: fifty-five individuals with AN and seventy-four healthy controls (HC) were enrolled and completed a battery of tests evaluating the proneness to feel shame and guilt, as well as comparing self-consciousness, eating, and general psychopathology. RESULTS: individuals with AN showed a higher proneness to shame. Shame was correlated with body dissatisfaction and drive for thinness, which are core symptoms in AN, after controlling for scores of depression and anxiety. Proneness to guilt seemed to be less correlated with eating and body symptomatology, but it appeared to have a negative correlation with binge-purging symptoms. Furthermore, proneness to shame was independent of guilt or self-consciousness and the two groups did not differ regarding public and private self-consciousness. CONCLUSIONS: shame is an important and independent factor in AN. Future research may offer progress in the development of shame-focused therapies.

Research in eating disorders: the misunderstanding of supposing serious mental illnesses as a niche specialty.

PURPOSE: Eating disorders (EDs) are mental illnesses with severe consequences and high mortality rates. Notwithstanding, EDs are considered a niche specialty making it often difficult for researchers to publish in high-impact journals. Subsequently, research on EDs receives less funding than other fields of psychiatry potentially slowing treatment progress. This study aimed to compare research vitality between EDs and schizophrenia focusing on: number and type of publications; top-cited articles; geographical distribution of top-ten publishing countries; journal distribution of scientific production as measured by bibliometric analysis; funded research and collaborations. METHODS: We used the Scopus database, then we adopted the Bibliometrix R-package software with the web interface app Biblioshiny. We included in the analyses 1,916 papers on EDs and 6491 on schizophrenia. RESULTS: The ED field published three times less than schizophrenia in top-ranking journals - with letters and notes particularly lacking-notwithstanding a comparable number of papers published per author. Only 50% of top-cited articles focused on EDs and a smaller pool of journals available for ED research (i.e., Zones 1 and 2 according to Bradford's law) emerged; journals publishing on EDs showed an overall lower rank compared to the schizophrenia field. Schizophrenia research was more geographically distributed and more funded; in contrast, a comparable collaboration index was found between the fields. CONCLUSION: These data show that research on EDs is currently marginalized and top-rank journals are seldom achievable by researchers in EDs. Such difficulties in research dissemination entail potentially serious repercussions on clinical advancements. LEVEL OF EVIDENCE: Level V: opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Sulcal characteristics patterns and gyrification gradient at different stages of Anorexia Nervosa: A structural MRI evaluation.

Previous research evidenced alterations of different cortical parameters in patients with acute Anorexia Nervosa (AN), but no study to date investigated the morphology of individual sulci and their relationship with other structural indices. Our study aims at exploring the depth and width of 16 major cortical sulci in AN at different stages of the disorder and their relationships with the gyrification gradient. Two samples were included in the study. The first involved 38 patients with acute AN, 20 who fully recovered from AN, and 38 healthy women (HW); the second included 16 patients with AN and 16 HW. Sulcal width and depth were estimated for 16 sulci and outlined with a factorial analysis. An anterior-posterior gradient of gyrification was also extracted. Compared to HW, patients with acute AN displayed higher width and depth values in specific cortical sulci, and an altered gyrification gradient in areas encompassing the Central Sulcus, and Parieto-Temporal and Frontal Lobe regions. Sulcal width negatively correlated with gyrification gradient in areas where these values are altered in AN patients. Our results suggest the presence of alterations in sulcal morphology with a pattern similar to the gyrification gradient one and which seems to be related with malnutrition.

Comparison between inpatients with anorexia nervosa with and without major depressive disorder: Clinical characteristics and outcome.

Anorexia Nervosa (AN) and Major Depressive Disorder (MDD) are frequent comorbid conditions. It is unclear how MDD affects intensive emergency treatment and outcome. Eighty-seven AN inpatients were analyzed, twenty-two suffered also from MDD. Individuals with AN and MDD at admission had no remarkable differences in psychopathology, but a full diagnosis of MDD - and not just the presence of depressive symptoms - was associated with longer length of stay and worse clinical outcome (weight restoration, increase of caloric intake). Health care policies might consider that MDD comorbidity, regardless of AN clinical severity, affects the efficacy and timing of acute treatments.

Psychoform and somatoform dissociation in anorexia nervosa: A systematic review.

Dissociation is a debilitating condition often present as comorbidity in patients with eating disorders, but to date only sparse findings are available on this topic. Additionally, very little data exist on the classification of dissociation, namely, psychoform and somatoform, in anorexia nervosa (AN). This review aimed to provide an updated view on the literature about dissociation in AN, with a focus on AN subtypes (i.e., restricter and binge-purging) as well as dissociation type (i.e., psychoform and somatoform), when available. We screened 304 studies, and after title and abstract selection and full-text reading, 29 of them were included in this review. Most of the studies investigated psychoform dissociation, whereas just four publications considered somatoform dissociation. Dissociation resulted to be present in AN more than in healthy controls and in individuals with other psychiatric disorders, and it was related mostly to the binge-purging subtype of AN. Moreover, dissociation was linked to traumatic events, self-harm and negative treatment outcomes, especially in patients affected by the binge-purging subtype of AN. However, results on these matters are scarce and partially discordant. The methodological assessment we performed revealed an overall fair quality of the included studies, although several flaws emerged as well. The present review reported on one hand the relevance of dissociation in AN, but on the other hand the need to stimulate the scientific debate on (a) a deeper investigation of somatoform dissociation in AN and (b) the relationship between dissociation and both clinical severity and treatment response/resistance in AN.

The role of prenatal and perinatal factors in eating disorders: a systematic review.

Numerous studies showed that factors influencing fetal development and neonatal period could lead to lasting alterations in the brain of the offspring, in turn increasing the risk for eating disorders (EDs). This work aims to systematically and critically review the literature on the association of prenatal and perinatal factors with the onset of EDs in the offspring, updating previous findings and focusing on anorexia nervosa (AN) and bulimia nervosa (BN). A systematic literature search was performed on Pubmed, PsycINFO, and Scopus. The drafting of this systematic review was conducted following the PRISMA statement criteria and the methodological quality of each study was assessed by the MMAT 2018. A total of 37 studies were included in this review. The factors that showed a more robust association with AN were higher maternal age, preeclampsia and eclampsia, multiparity, hypoxic complications, prematurity, or being born preterm (< 32 weeks) and small for gestational age or lower birth size. BN was only associated with maternal stress during pregnancy. Many methodological flaws emerged in the considered studies, so further research is needed to clarify these inconsistencies. Altogether, data are suggestive of an association between prenatal and perinatal factors and the onset of EDs in the offspring. Nevertheless, given the methodological quality of the available literature, firm conclusions cannot be drawn and whether this vulnerability is specific to EDs or mental disorders remains to be defined. Also, a strong need for longitudinal and well-designed studies on this topic emerged.

Body shape in inpatients with severe anorexia nervosa.

BACKGROUND: Anorexia nervosa (AN) is a severe mental disorder. Body shape disturbances are key in the development and maintenance of AN. Only few data are available on inpatients with life-threatening AN. Therefore, we aimed to investigate if body shape difficulties-with a focus on both body checking and avoidance-could improve during hospitalization in both subtypes of AN and to ascertain eventual associations between body shape concerns upon admission and clinical outcome. METHODS: Upon hospital admission and end of treatment (EOT), 139 inpatients with AN completed Body Shape Questionnaire (BSQ), Body Checking Questionnaire (BCQ), and Body Image Avoidance Questionnaire (BIAQ) in addition to measures of eating and general psychopathology. RESULTS: Patients with severe AN reported improved BSQ and BIAQ scores at EOT while BCQ did not significantly change. Diagnostic subtypes differed only in baseline BSQ scores and had an impact on the improvement in BSQ at EOT. Baseline BCQ was associated with patients' clinical improvement at EOT, even after controlling for age, duration of illness, Body Mass Index, depression, and anxiety scores. CONCLUSIONS: Data on body shape concerns and their trajectory during hospitalization for severe AN are lacking; our findings provide support to the effectiveness of hospitalization in improving body shape concerns and body avoidance, but not body checking. Also, baseline body shape concerns (especially body checking) impacted on clinical improvement. Future research is needed to identify treatments that could further improve the therapeutic approach to severe patients of AN in the acute setting.

Affective temperaments and eating psychopathology in anorexia nervosa: Which role for anxious and depressive traits?

BACKGROUND: Anorexia nervosa (AN) is a severe mental illness. Personality traits and comorbidity with affective and anxiety disorders are key-aspects of its pathogenesis but little attention has been paid so far to affective temperaments in AN. Also, childhood anxiety is proposed to impact on AN clinical severity. Therefore, we aimed to investigate if affective temperaments could be related to AN eating psychopathology also clarifying if those with low versus high scores on depressive and anxious temperaments could differ in AN clinical current and lifetime severity. METHODS: One-hundred and forty-seven inpatients with AN were consecutively recruited. All participants completed: Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire, Eating Disorder Examination Questionnaire, State Trait Anxiety Inventory, Beck Depression Inventory. Clinical data were collected upon admission. RESULTS: Regression models showed that all affective temperaments were associated with eating psychopathology (eating restraint and eating, shape, and weight concerns); however, when controlling for confounders, only the anxious temperament remained significant. Also, those patients with higher scores on depressive and anxious temperaments reported higher current and lowest lifetime body mass index (BMI). LIMITATIONS: Only inpatients were recruited; self-report assessments were used and follow-up data are lacking. CONCLUSIONS: Results from this study support the association between affective (anxious in particular) temperament traits and the presence of altered eating psychopathology in AN. Also, higher traits of depressive and anxious temperaments reported higher current and lowest lifetime BMI. Should these findings be confirmed, the assessment of the anxious temperament could fruitfully inform prevention and treatment interventions for AN.

Traumatic events and post-traumatic symptoms in anorexia nervosa.

Background: Traumatic Events (TEs) are often seen as risk factors not only for the development of eating disorders (EDs) but also for their impact on the severity of clinical presentation and psychiatric comorbidities. Objective: This study aimed to assess the prevalence and time of occurrence of TEs in the two subtypes of anorexia nervosa (AN; restricting [RAN] and binge-purging [BPAN]) and to investigate differences in TEs (number, type, frequency) as well as clusters of post-traumatic symptoms and emotional dysregulation between the two groups. Method: Seventy-seven hospitalized women were recruited and divided into two subgroups according to their AN subtype. Participants completed the following self-reported measures: Eating Disorder Inventory-2 (EDI-2), Life Events Checklist (LEC), Impact of Events Scale-Revised (IES-R) and the Difficulties in Emotion Regulation Scale (DERS). Results: A higher occurrence of TEs was found in patients with BPAN than in those with RAN. In particular, there were significantly more women in the BPAN group than in the RAN group who had been sexually assaulted. Exposure to TEs happened before the onset of illness in most patients, regardless of the AN subtype. Finally, the BPAN group had significantly higher scores in terms of post-traumatic symptoms and emotional dysregulation than RAN patients. Conclusions: Patients with BPAN showed a higher occurrence of TEs, post-traumatic symptom clusters, and emotional dysregulation than those with RAN. These findings are of interest as treatments could benefit from trauma-informed interventions for those affected by AN, and particularly for those with the binge-purging subtype.

Antecedentes: Los Eventos Traumáticos (ETs) con frecuencia se ven como factor de riesgo no solo para el desarrollo de los Trastornos de la conducta alimentaria (EDs por sus siglas en inglés) sino tambien por su impacto en la severidad de la presentación clínica y las comorbilidades psiquiátricas.Objetivo: Este estudio tuvo como objetivo evaluar la prevalencia y tiempo de ocurrencia de los ETs en dos subtipos de anorexia nervosa (AN; restrictiva [RAN por sus siglas en ingles] y purga compulsiva [BPAN por sus siglas en ingles) e investigar las diferencias en los ETs (número, tipo, frecuencia) así como también los grupos de síntomas postraumáticos y desregulación emocional entre los dos tipos. Método: Se reclutaron setenta y siete mujeres hospitalizadas y se dividieron en dos subgrupos de acuerdo al subtipo de AN. Las participantes completaron las siguientes medidas de auto-reporte: El Inventario de Trastornos alimentarios-2 (EDI-2), la Lista de Chequeo de Eventos Vitales (LEC), la Escala Revisada del Impacto de los Eventos (IES-R) y la Escala de Dificultades de la regulación Emocional (DERS).Resultados: Se encontró una mayor ocurrencia de ETs en pacientes con BPAN que en aquellas con RAN. En particular, hubo significativamente más mujeres en el grupo de BPAN que en el grupo de RAN que habían tenido abuso sexual. La exposición a los ETs sucedió antes del inicio de la enfermedad en la mayoría de las pacientes, independientemente del subtipo de AN. Finalmente, el grupo BPAN tenía significativamente puntajes más altos en términos de síntomas postraumáticos y desregulación emocional que las pacientes RAN.Conclusiones: Las pacientes con BPAN mostraron una mayor ocurrencia de ETs, grupos de síntomas postraumáticos, y desregulación emocional que aquellas con RAN. Estos hallazgos son de interés ya que los tratamientos podrían beneficiarse de las intervenciones informadas en trauma para aquellas afectadas por AN y en particular para aquellas con el subtipo purga compulsiva.