Parental eating disorders symptoms in different clinical diagnoses / Síntomas parentales de trastornos de la conducta alimentaria en distintos diagnósticos clínicos

BACKGROUND: The influence of parents can be an important variable in the development of eating disorders (EDs). However, few studies exist which simultaneously assess parents and their children, especially in different clinical groups. METHODS: Our study examines the differences in ED symptoms as measured on the Eating Disorder Inventory (EDI), in parents and their children as patients with anorexia nervosa (AN), bulimia nervosa (BN), unspecified eating disorder (UED) and a control group (CG). RESULTS: The mothers in the clinical group scored higher in ineffectiveness, interoceptive awareness, maturity fears, social insecurity and impulse regulation than the mothers in the control group. The patients' fathers scored higher on impulse regulation than those in the control group. In addition, the fathers of patients in the BN group scored higher than the fathers of patients in the UED group in body dissatisfaction. They also scored higher in impulse regulation than the fathers of patients with AN. Ineffectiveness and impulse regulation were the variables in which patients' scores were most similar to their parents. CONCLUSIONS: These results show the presence of ED psychological variables in both parents, not just mothers. Prevention and intervention activities for eating disorders must be designed to also give an active role to the father

ANTECEDENTES: la influencia parental puede ser un importante factor en el desarrollo de los trastornos de la conducta alimentaria (TCA). Sin embargo, existen muy pocos estudios que evalúen de forma simultánea a ambos progenitores (padre y madre), así como a sus hijos y, de forma específica, que comparen grupos con diferentes diagnósticos clínicos. MÉTODO: este estudio analiza diferencias en síntomas de TCA medidos mediante el Eating Disorder Inventory 2 (EDI-2), tanto en padres como madres y sus respectivos hijos. Éstos se dividieron en: pacientes con diagnóstico de anorexia nerviosa (AN), bulimia nerviosa (BN), trastorno de la conducta alimentaria no especificado (TCANE) y grupo control (GC). RESULTADOS: las madres de los grupos clínicos puntuaron más alto en ineficacia, consciencia introceptiva, miedo a la madurez, inseguridad social e impulsividad en comparación con las madres del grupo control. Ineficacia e impulsividad fueron las variables con mayor coincidencia entre pacientes y sus progenitores. CONCLUSIONES: estos resultados ponen de manifiesto la presencia de variables de funcionamiento psicológico que podrían estar asociadas con TCA también en padres de pacientes. De esta forma, las actividades de intervención en estos pacientes deberían diseñarse para otorgar un papel activo no solo a las madres sino también a sus padres

A computerized version of the Patient Health Questionnaire-4 as an ultra-brief screening tool to detect emotional disorders in primary care.

BACKGROUND: The Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report consisting of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). The aim of the present study is to determine the psychometric properties of a computerized version of the PHQ-4 used to detect emotional disorders (anxiety and depression) in the primary care setting. METHOD: A total of 1052 patients with suspected anxiety, depression, or somatic symptoms were recruited from 28 primary care centres participating in the PsicAP trial and completed the full version of the computerized PHQ. In addition, 178 of these patients also underwent in clinical interviews as a gold standard. RESULTS: Confirmatory factor analyses showed very good fit indices for a two-factor solution. This model was structurally invariant among the various age and gender groups and internal consistency was acceptable (PHQ-4; α = .83, PHQ-2; α = .86, and GAD-2; α = .76). The best cut-off points to obtain high sensitivity values was 3, on both the PHQ-2 (major depressive disorder) and the GAD-2 (generalized anxiety disorder). The criterion validity (sensitivity and specificity) for the PHQ-2 were .90 and .61 and for the GAD-2, .88 and 0.61. LIMITATIONS: The study was not designed as a prevalence study. Therefore, does not contain information on patients whose general practitioners do not consider them to suffer emotional disorders. CONCLUSION: This is the first study to provide evidence for the reliability and validity of a computerized version of the PHQ-4. This computerized tool can be used to detect depression and anxiety in a primary care setting.

Analysis of the familiar psychopathology as a therapeutic tool / Análisis de la psicopatología familiar como herramienta terapéutica

The objective of this study is to find out the degree of psychopathology which patients with an eating disorder present (ED) and to which degree this is accompanied by the presence of psychopathology in mothers and fathers of patients. Three groups of patients with Anorexia Nervosa (AN), Bulimia Nervosa (BN), and eating disorders not otherwise specified (EDNOS) and a control group were selected. Each group had 30 participants (and mothers and fathers). A socio-demographic questionnaire and the SCL-90-R were applied. This scale measured nine dimensions of psychopathology in patients, mothers and fathers. An ANOVA of partially repeated measures with two factors was applied to each dimension of SCL- 90-R. Multiple comparisons between groups within each of the repeated measures were carried out with Sidak test. Patients in three clinical groups obtained significant differences in all psychopathological variables compared with the control group, except in phobic anxiety. These clinical results were accompanied by some degree of psychopathology in mothers but not fathers. The presence of high levels of psychopathology in the three groups of patients and mothers has therapeutic implications that indicate the need for psychological intervention in patients and their mothers (AU)

El objetivo de este estudio es averiguar el grado de psicopatología que presentan los pacientes con un Trastorno de la Conducta Alimentaria (TCA) y en qué grado está acompañado por la presencia de psicopatología en madres y padres de los pacientes. Se seleccionaron tres grupos de 30 pacientes cada uno con Anorexia Nerviosa, Bulimia Nerviosa y TCA No especificado y un grupo control (y sus madres y padres). Se aplicó un cuestionario socio-demográfico y la escala SCL-90-R que mide nueve dimensiones de psicopatología de pacientes, madres y padres, en los cuatro grupos. El análisis de datos se realizó con una ANOVA de dos factores con medidas parcialmente repetidas en cada subescala de la SCL-90-R. Las comparaciones múltiples entre los grupos dentro de cada medida repetida se realizaron con la prueba de Sidak. Los pacientes de los tres grupos clínicos obtuvieron diferencias significativas en todas las variables psicopatológicas frente al grupo control, menos en ansiedad fóbica. Este cuadro clínico fue acompañado por cierto grado de psicopatología de las madres pero no de los padres. La presencia de altos niveles de psicopatología en los tres grupos de pacientes y en las madres tiene implicaciones terapéuticas que marcan la necesidad de la intervención psicológica en las pacientes y en sus madres (AU)