Impact of parenthood on eating pathology in young adults.

OBJECTIVE: Few studies investigated parenthood as a predictor of eating pathology in young adulthood. We studied the association between parenthood, in the first year after becoming a parent and beyond, and eating pathology. Furthermore, we examined whether moving in together with a partner affected this association. METHOD: This study used data of four measurement waves from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2229) from preadolescence into young adulthood. The Eating Disorder Diagnostic Scale (EDDS), a measure to assess eating pathology, was assessed at ages 22, 26, and 29. Risk for eating disorder was assessed at age 19. Pregnant participants were excluded. RESULTS: Parenthood was not associated with an increase of eating pathology in the first year after becoming a parent and beyond. Instead, parents were more likely to report being free from eating pathology symptoms compared to childless individuals (OR 2.07, 95% CI: 1.11-3.84). Among those who reported experiencing at least one eating problem, parenthood was not associated with the number of eating problems. Moving in together with a partner did not alter the association between parenthood and eating problems and neither did this association differ between males and females. DISCUSSION: Parenthood in young adulthood was associated with a decreased risk of having eating pathology. PUBLIC SIGNIFICANCE STATEMENT: In this longitudinal study among young adults, parenthood was not associated with the development of eating pathology.

Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

BACKGROUND: Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. METHOD: A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. RESULTS: The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. CONCLUSIONS: The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

[A study of the connection between coercive measures used in a closed acute psychiatric ward and the socio-demographic and clinical characteristics of the patients involved]. / Dwang- en drangmaatregelen binnen een gesloten acute psychiatrische opnameafdeling; relatie met socio-demografische en klinische kenmerken.

BACKGROUND: Admission at a closed acute psychiatric ward is a severe and possibly life changing experience for a patient. Sometimes admission is accompanied by coercive measures. Despite the impact that these measures may have on the patient, very little research has been published concerning this patient population. AIM: To obtain insight into the connection between the socio-demographic characteristics of patients admitted to a closed acute psychiatric ward and the coercive measures to which they were subjected. METHOD: For a year a database was compiled to give us information about the socio-demographic and clinical characteristics of patients admitted to a closed acute psychiatric ward in The Hague in the Netherlands. This record enables us to analyse the relation between these characteristics and coercive measures. RESULTS: The majority of patients admitted were male, single, childless and were unemployed or not in education but were receiving some form of welfare payment. 33% of admissions were in fact re-admissions. 20% of the admissions/re-admissions were secluded during the admission procedure - for the following reasons: symptoms of a psychotic disorder, a manic episode and/or aggression. Secluded patients were younger and had more serious psychiatric problems; they functioned less well and had been in hospital longer than patients who had not been secluded upon admission. During the admission procedure 14% of patients received emergency medication. CONCLUSION: These results have given us more insight into the connection between the use of coercive measures in psychiatry and the socio-demographic characteristics and clinical characteristics of the patients involved. This information could serve as reference material for future research.

Perceptions of quality of life and disability in homeless persons with schizophrenia and persons with schizophrenia living in non-institutional housing.

BACKGROUND: Homelessness is common in persons with schizophrenia. It is unclear how housing conditions and homelessness affect their quality of life and their disability. AIMS: To explore the self-perceived quality of life and disability of homeless persons with schizophrenia and of those of persons with schizophrenia living in non-institutional housing. METHODS: Seventy-six not-homeless and 50 homeless persons with schizophrenia were assessed using the World Health Organization's Quality of Life - short version (WHOQOL-Bref) and Disability Assessment Schedule (WHODAS-II). Univariate comparisons of the two groups were made for sociodemographic variables, clinical characteristics, perceived quality of life and disability. A regression model was used to adjust for potential confounding factors between quality of life, disability and housing. RESULTS: After controlling for age, gender, marital status and age of first hospital admission, homeless persons had more positive scores for the quality of life domain 'health', for the disability domain 'getting along with people' and for the total disability score than persons in non-institutional housing. CONCLUSION: Contrary to our expectations, the persons in non-institutional housing reported a lower quality of life and more disability than the homeless people. Future research should clarify whether non-institutional housing in and of itself can improve the well-being of people with schizophrenia.