Eating Disorders: the Role of Childhood Trauma and the Emotion Dysregulation.

BACKGROUND: The present retrospective case-control study is aimed at evaluating the presence of childhood traumatic factors and the difficulty in regulating emotions, within a sample of patients with eating disorders compared to the group of healthy controls. SUBJECTS AND METHODS: We included 65 people assessed for eating disorders, 40 patients and 25 healthy controls, who were given two tests: the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to investigate the presence of traumatic events and the Difficulties in Emotion Regulation Scale (DERS) to assess the emotional regulation. RESULTS: People with eating disorders showed higher average scores, and therefore greater severity than the control group, in all the domains explored, both considering traumatic experiences and emotional dysregulation. The domain emotional neglect showed the closest correlation with eating disorders (average scoring 15.9 vs 9.9 of healthy controls), followed by emotional abuse (12.2 vs 7.8), physical neglect (8.2 vs 6.6), physical abuse (8.3 vs 6.6) and sexual abuse (7.2 vs 5.6). In the same way, the emotional dysregulation was greater among people with eating disorder than healty controls, concerning every items explored by DERS, as clarity (average scoring 14.8 vs 11.4), awareness (17.1 vs 11.7), goals (16.3 vs 12.9), strategy (22.0 vs 14.7), non acceptance (17.4 vs 12.1) and impulse (16.5 vs 11.4). CONCLUSIONS: Childhood traumatic experiences and emotional dysregulation result significantly higher in people with eating disorders than healthy controls.

Adjunctive Clotiapine for the Management of Delusions in Two Adolescents with Anorexia Nervosa.

Clotiapine is an atypical antipsychotic indicated for the management of a series of acute psychotic disorders. The current literature lacks evidence concerning the tolerability and clinical use of this drug in the management of individuals with anorexia nervosa (AN). In this study, we report two cases of adolescents with AN, treated with clotiapine. The reason for the administration of clotiapine was, for both patients, the manifestation of bizarre delusions concerning food and calories. Patient 1 presented a presyncope after the first dose of clotiapine, and treatment was rapidly discontinued. Patient 2 was treated with clotiapine for 9 months; doses were titrated from 20 mg/day to 70 mg/day, with an improvement in the reported delusions, which also enhanced compliance with psychological and nutritional interventions. EKG, QTc, white blood count, and red blood count were not relevantly influenced by the introduction of clotiapine in either patient. No extrapyramidal effect was documented. These reports stress the need for further studies assessing the tolerability and potential effect of clotiapine in treating adolescents with AN and delusional symptomatology.