Does food use disorder exist? Item response theory analyses of a food use disorder adapted from the DSM-5 substance use disorder criteria in a treatment seeking clinical sample.

BACKGROUND: Increased consumption of food that are high in energy and sugar have been pointed as a major factor in the obesity epidemic. Impaired control of food intake and the concept of food addiction has been developed as a potential contributor. Our objective was to evaluate the dimensionality and psychometric validity of diagnostic criteria for food addiction adapted from the 11 DSM-5 substance use disorder (SUD) criteria (i.e.: Food Use Disorder (FUD) criteria), and to evaluate the influence of age, gender, and body mass index (BMI). METHODS: Cross-sectional observational study including 508 participants (56.1% male; mean age 42.2) from outpatient treatment clinics for obesity or addiction disorders at time of admission. FUD diagnostic criteria were analyzed using confirmatory factor and 2-parameter item response theory analyses. Differential Item and Test Functioning analyses were performed across age, gender, and BMI. RESULTS: We demonstrated the one-factor dimensionality of the criteria set. The criterion "craving" presented the strongest factor loading and discrimination parameter and the second-lowest difficulty. We found some significant uniform differential item functioning for body mass index. We found some differential test functioning for gender and BMI. CONCLUSIONS: This study reports, for the first time, the validity of a potential Food Use Disorder (derived from the 11 DSM-5 SUD criteria adapted to food) in a sample of treatment seeking adults. This has great implications both at the clinical level and in terms of public health policy in the context of the global obesity epidemic.

Brazilian HIV-infected population: assessment of the needs of endodontic treatment in the post-highly active antiretroviral therapy era.

INTRODUCTION: The effects of highly active antiretroviral therapy (HAART) on the prevalence of endodontic diseases in HIV-infected individuals have not been reported. METHODS: The purpose of this study was to determine and compare sex, age, need for root canal treatment, CD4 and CD8 lymphocyte counts, HIV viral load, and antiretroviral therapy in 222 HIV-infected individuals who were monitored at an HIV Reference Center in Brazil. RESULTS: One hundred sixty-six patients comprised the studied population; the rate of the need for endodontic treatment was 14.5%. There was a positive correlation between the CD4 + T-cells count (< 500 cell/ mm(3)) and the need for endodontic treatment, but there was no statistical difference between the need for endodontic treatment and the HIV viral load or the CD4+/CD8+ ratio in T-cell counts. Of the population that needed endodontic treatment, 79.2% was taking the HAART regimen, and the majority of the studied population was female. CONCLUSION: We found that those HIV-infected individuals needing endodontic treatment had a lower CD4 + T-cell count, which probably correlated with a lower adherence to the HAART regimen.