Exploring health-related quality of life in eating disorders by a cross-sectional study and a comprehensive review.

BACKGROUND: People with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness' severity and its effects on cognitive performance. We aimed to analyze health-related quality of life (HRQoL) in subgroups of eating disorder (ED) patients by using the brief version of WHOQoL questionnaire (WHOQoL-BREF) before treatment administration. Moreover, in order to compare our findings with other published data, we carried out a comprehensive review of the literature on HRQoL in ED patients. METHODS: Our review was carried out by means of an accurate data mining of PsychInfo and Medline databases and other available sources. In our cross-sectional study, eighty female ED patients (26 with bulimia nervosa, 33 with anorexia nervosa, 7 with binge eating disorder and 14 with ED not otherwise specified) completed the WHOQoL-BREF. HRQoL scores were compared among ED subgroups and clinical information (presence of previous contacts, length of illness, psychiatric comorbidity) was considered in the analysis. RESULTS: Our review shows that with few exceptions ED patients have a poorer HRQoL than the healthy population of control and sometimes the mental component of HRQoL is the most involved dimension. Moreover, there are no differences in the HRQoL among ED groups, even if AN patients in some studies have a lower HRQoL scores. Furthermore, BED patients have a poorer HRQoL than obese patients who do not have binge episodes. Finally, all treatments were positively correlated with an improvement on general and specific QoL dimensions. In our sample, ED subgroups differed only for Psychological Health HRQoL scores (F = 4.072, df = 3; p = 0.01). No differences were found between inpatients and outpatients, treatment naïve and previously treated patients and patients with or without psychiatric comorbidity. Moreover, HRQoL scores were not correlated to length of illness within each ED subgroup. CONCLUSIONS: The analysis of the literature adds some relevant information on HRQoL in ED and may address the future research toward the exploration of specific questions. One of these may be the prominent role of Psychological Health domain in HRQoL, since our study confirms that this component is able to differentiate eating disorders.

Assessing burnout among neonatologists.

OBJECTIVES: To measure burnout in a cohort of neonatologists and to explore its association with several psychological and biographic factors. MATERIALS AND METHODS: A total of 110 neonatologists filled in a personal questionnaire composed of four parts: (a) biographic data, (b) personal beliefs, (c) attitudes toward clinical decisions and (d) a validated tool (the Link Burnout Questionnaire [LBQ]) to assess their burnout. The LBQ categorizes burnout into four subscales: psycho-physical exhaustion, relationship deterioration, sense of professional failure and disillusion. Scores of each subscale range from 6 (minimum) to 36 (maximum). Burnout values were matched with the data of the personal questionnaire. RESULTS: Most neonatologists (60%-65%) were in the "at risk" range for burnout. High burnout was experienced by 30% of the neonatologists. Having no children is associated with low rates of burnout; work experience of less than 5 years, believing that living with a physical disability is unworthy and having recurrent death ideation are associated with high rates of burnout. The attitude to resuscitating a 24-week baby is inversely correlated with the disillusion rate. CONCLUSION: In our cohort, burnout exceeds the alarm threshold in one-third of cases. Some of the risk factors we examined were correlated with burnout and should be considered in future prevention programs.