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1.
J Affect Disord ; 285: 77-83, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33636674

RESUMO

BACKGROUND: We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on specific Eating Disorder (ED) and general psychopathology in people with an ED diagnosis during the lockdown period and after the end of the related containment measures. METHODS: People with clinically defined diagnosis and undergoing treatment for an ED completed an online survey, which included adapted questions from standardized psychometric scales. Data relative to three different time periods (before, during and after the end of lockdown) were collected. Psychopathological changes over these periods were investigated and compared through one-way analysis of variance or covariance with repeated measures. RESULTS: Three hundred twelve people completed the survey (57.4% diagnosed with Anorexia Nervosa (AN) or atypical AN, 20.2% with Bulimia Nervosa, 15.4% with Binge Eating Disorder, 7.05% with Other Specified Feeding or Eating Disorders). The severity of both specific and general psychopathology increased during the lockdown and the rise of general symptoms persisted in the following re-opening phase, except for suicide ideation. Almost all of these findings were not affected by ED diagnosis, participants' age and illness duration. LIMITATIONS: The retrospective nature of data collection is the main limitation of the study. CONCLUSIONS: People with EDs showed a COVID-19 emergency-induced worsening of both general and specific psychopathology. The effect on general psychopathology persisted in the re-opening period. These findings suggest a high stress vulnerability of ED individuals with important effects on internalizing symptoms, which are worth of attention by clinicians.

2.
Eat Weight Disord ; 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-33426630

RESUMO

PURPOSE: The COVID-19 pandemic restrictions had negative impact on the psychopathology of people with Eating Disorders (EDs). Factors involved in the vulnerability to stressful events have been under-investigated in this population. We aimed to assess which factors contributed to COVID-19-induced worsening in both general and specific psychopathology. METHODS: Three-hundred and twelve people with a clinically defined diagnosis of an ED and undergoing a specialist ED treatment in different Italian ED services before the spreading of COVID-19 pandemic filled in an online survey. ED specific and general psychopathology changes after COVID-19 quarantine were retrospectively evaluated. Factors related to COVID-19 concerns (financial condition, fear of contagion, perceived social isolation/support, satisfaction in peer, family or sentimental relationships), illness duration and treatment-related variables (type of treatment provided, type of access to care, satisfaction with therapeutic relationships) were included as predicting factors in a structural equational model, which included latent variables consisting of general and ED psychopathology items as outcomes. RESULTS: A perceived low quality of therapeutic relationships, fear of contagion and increased isolation were positively associated with psychopathology worsening. Reduced satisfaction with family and with friends' relationships and reduced perceived social support were associated with ED and general symptoms deterioration, respectively. No significant effect emerged for intimate relationships, illness duration, economic condition and type of treatment. CONCLUSIONS: This study provides a comprehensive evaluation of clinical variables associated with psychopathological changes during the COVID-19 lockdown period highlighting potential risk and resilience factors and, possibly, informing treatment as well as prevention strategies for EDs. LEVEL OF EVIDENCE IV: Evidence obtained from multiple time series analysis such as case studies.

3.
Int J Eat Disord ; 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33205495

RESUMO

OBJECTIVE: Suicidality in eating disorders (EDs) is high, and identification of therapeutically targetable traits associated with past, current, and future suicidality is of considerable clinical importance. We examined overall and ED subtype-specific associations among suicidal ideation, suicide attempts, and general and specific aspects of emotion dysregulation in a large sample of individuals with ED, at presentation for treatment and 1-year follow-up. METHOD: Using registry data from 2,406 patients, scores on the Difficulties in Emotion Dysregulation Scale (DERS) at initial registration were examined as predictors of recent suicidal ideation and self-report lifetime suicide attempts. Associations were examined in the full sample and in each ED subtype. In 406 patients, initial DERS scores were examined as predictors of suicidality at 1-year follow-up. RESULTS: Overall DERS was associated with suicidal ideation and suicide attempts, even when adjusting for ED psychopathology and current depression. Perceived lack of emotion regulation strategies showed unique associations with suicidal ideation and suicide attempts, both in the full sample and in most ED subtypes. Initial DERS was also associated with follow-up suicidal ideation and suicide attempts, although this association did not remain when adjusting for past suicidality. DISCUSSION: Results suggest that emotion dysregulation may be a potential mechanism contributing to suicidality in EDs, beyond the effects of ED psychopathology and current depression. Although the prevalence of suicidality differs across ED subtypes, emotion dysregulation may represent a risk trait for future suicidality that applies transdiagnostically. Results support addressing emotion dysregulation in treatment in order to reduce suicidality.

4.
BMC Psychiatry ; 20(1): 432, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887554

RESUMO

An amendment to this paper has been published and can be accessed via the original article.

5.
An. psicol ; 36(2): 254-261, mayo 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192062

RESUMO

The existence of early maladaptive schemas (EMS) is the core concept of Schema Therapy (ST). Several studies have demonstrated that EMSs are involved in many psychiatric disorders. The Young Schema Questionnaire is a self-report measure developed to assess the 18 EMSs and has long form (YSQ-L) and short form (YSQ-S) versions. It is currently in its third version (YSQ-S3). To the best of our knowledge, this is the first study that aims to validate the YSQ-S3 according to the new proposed organization of EMSs into four domains. A non clinical sample of 1372 Italian population was involved in this research. Confirmatory Factor Analysis (CFA) was conducted to examine the latent structure of the YSQ-S3, including both first- and second-order structures. Cronbach's alpha and intra-class correlation coefficients were calculated to evaluate internal consistency and test-retest reliability. Correlations between the YSQ-S3 and anxiety and mood symptoms were calculated to measure construct validity. Cronbach's alpha of almost all EMSs were higher than 0.7, which indicated good internal reliability, and test-retest reliability was excellent. CFA supports the new proposed organization of EMSs into four domains. Regarding concurrent validity, each schema in the YSQ-S3 was highly correlated with anxiety and mood symptoms. The new four-domains model of the YSQ-S3 has demonstrated that it can be a useful and valid tool for clinicians and researchers in the self-report measurement of EMSs


La existencia de esquemas maladaptativos tempranos (EMTs) es el concepto central de Schema Therapy (ST). Varios estudios han demostrado que los EMS están involucrados en muchos trastornos psiquiátricos. El Young Schema Questionnaire es una medida de autoinforme desarrollada para evaluar los 18 EMTs y tiene versiones de forma larga (YSQ-L) y forma corta (YSQ-S). Actualmente se encuentra en su tercera versión (YSQ-S3). Hasta donde tenemos conocimiento, este es el primer estudio que tiene como objetivo validar la versión italiana del YSQ-S3 de acuerdo con la nueva organización propuesta de EMTs en cuatro dominios. Una muestra no clínica de 1372 estudiantes italianos participó en esta investigación. El análisis factorial confirmatorio (CFA) se realizó para examinar la estructura latente del YSQ-S3, incluidas las estructuras de primer y segundo orden. Se calcularon la omega coeficiente de McDonald y la correlación interclase para evaluar la consistencia interna y la fiabilidad test-retest. Las correlaciones entre el YSQ-S3 y la ansiedad y los síntomas del estado de ánimo se calcularon para medir la validez de constructo. El omega de McDonald de casi todos los EMTs fue superior a 0.7, lo que indicó una buena confiabilidad interna, y la confiabilidad test-retest fue excelente. CFA apoya la nueva organización propuesta de EMS en cuatro dominios. Con respecto a la validez concurrente, cada esquema en el YSQ-S3 estaba altamente correlacionado con la ansiedad y los síntomas del estado de ánimo. El nuevo modelo de cuatro dominios del YSQ-S3 ha demostrado que puede ser una herramienta útil y válida para los médicos e investigadores en la medición del autoinforme de los EMTs


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Inquéritos e Questionários/normas , Modelos Psicológicos , Autorrelato/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Psicometria/métodos , Psicoterapia , Autorrelato/normas , Estudantes/psicologia , Psicometria/estatística & dados numéricos
6.
BMC Psychiatry ; 20(1): 411, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32819315

RESUMO

BACKGROUND: Bullous pemphigoid (BP) is an autoimmune blistering skin disease that takes a profound physical and mental toll on those affected. The aim of the study was to investigate the bidirectional association between BP and all bullous disorders (ABD) with a broad array of psychiatric disorders, exploring the influence of prescribed medications. METHODS: This nationwide, register-based cohort study encompassed 6,470,450 individuals born in Denmark and alive from 1994 to 2016. The hazard ratios (HRs) of a subsequent psychiatric disorder in patients with BP/ABD and the reverse exposure and outcome were evaluated. RESULTS: Several psychiatric disorders were associated with increased risk of subsequent BP (4.18-fold for intellectual disorders, 2.32-fold for substance use disorders, 2.01-fold for schizophrenia and personality disorders, 1.92-1.85-1.49-fold increased risk for organic disorders, neurotic and mood disorders), independent of psychiatric medications. The association between BP and subsequent psychiatric disorders was not significant after adjusting for BP medications, except for organic disorders (HR 1.27, CI 1.04-1.54). Similar results emerged with ABD. CONCLUSION: Psychiatric disorders increase the risk of a subsequent diagnosis of BP/ABD independent of medications, whereas medications used for the treatment of BP/ABD appear to account for the subsequent onset of psychiatric disorders. Clinically, an integrated approach attending to both dermatological and psychiatric symptoms is recommended, and dermatologists should remain vigilant for early symptoms of psychiatric disorders to decrease mental health comorbidity.

7.
Eat Weight Disord ; 2020 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-32666375

RESUMO

BACKGROUND: Orthorexia nervosa (ON) has gained increasing interest in the last 2 decades. Although a consensus on the diagnostic boundaries of ON has not yet been reached, there is some evidence for an overlap with eating disorders, obsessive-compulsive disorder, and psychotic disorder. Most of the knowledge about ON has emerged from studies of non-clinical and at-risk populations and is focused on differential diagnosis; therefore, further clinical studies are needed to better outline the ON phenomenon in a real-life setting. OBJECTIVE: This case series aims at describing clinical cases that developed symptoms suggestive of ON after being diagnosed with a prior psychiatric disorder and then discussing them in light of possible clinical pathways. METHODS: Four women consecutively admitted to an outpatient unit for the treatment of eating disorders were diagnosed with ON through a clinical interview, according to Dunn and Bratman's criteria and self-administered questionnaire assessment (ORTO-15), and were considered to be eligible for this case series study. Psychiatric anamnestic data were collected retrospectively. RESULTS: The anamnesis revealed that all patients were previously diagnosed with a psychiatric disorder (i.e. obsessive-compulsive disorder, bulimia nervosa, illness anxiety disorder, and psychotic disorder) before developing ON. CONCLUSION: Past literature focused on differential diagnosis between ON and other psychiatric disorders. This is the first description of clinical cases in a real-life setting that started with different psychiatric disorders and later developed symptoms suggestive of ON. These cases have generated a new research question on the possibility that different psychiatric disorders may associate with a later onset of ON. LEVEL OF EVIDENCE: Level V, descriptive study.

8.
Eur Eat Disord Rev ; 28(5): 580-586, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32419220

RESUMO

OBJECTIVE: This study aims to test a model where low self-monitoring (a sub-function of first-person domain of metacognition) and high negative urgency lead to a worsening of binge severity through the mediation of emotional dysregulation in patients with binge eating disorder (BED). METHOD: Forty non-BED-obese and 46 BED-obese patients completed a battery of tests assessing metacognition and psychopathology. To test our hypothesized model, a structural equation model (SEM) using maximum likelihood estimation was conducted. RESULTS: BED-obese patients had significantly higher scores in BES, UPPS-P Negative urgency, and DERS total score, and lower MSAS self-monitoring than non-BED-obese, while no differences emerged in the MSAS others-monitoring subscale. The structural model demonstrated very good fit indexes (χ2 = 1.377, df = 2; p = .502, CMIN/DF = 0.688, CFI = 1.000, RMSEA = 0.000, TLI = 1.047) and all paths were significant in the predicted directions. CONCLUSIONS: These preliminary findings show that, low self-monitoring and high negative urgency lead BED-obese patients to express the worsening of binge severity through the mediation of emotional dysregulation. This knowledge may be helpful in the clinical practice to develop a tailor-made treatment. Accordingly, an approach through Metacognitive Interpersonal Therapy could be attempted in BED-obese patients with these characteristics. Highlights Patients with BED exhibited low self-monitoring and high negative urgency. Binge severity was mediated by high level of emotional dysregulation. Metacognitive Interpersonal Therapy may be useful for BED patients.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Comportamento Impulsivo , Metacognição/fisiologia , Adolescente , Adulto , Idoso , Regulação Emocional/fisiologia , Feminino , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Obesidade/psicologia , Índice de Gravidade de Doença , Adulto Jovem
9.
Eat Weight Disord ; 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32356145

RESUMO

PURPOSE: Binge eating disorder (BED) has a considerable clinical relevance by virtue of its high numerous psychiatric and medical comorbidities; among the latter, the most frequent is obesity. Available treatments for BED have shown frequent relapse of binges or weight regain in the long term. The new combination of naltrexone and bupropion sustained release (NB) has proved to be effective for weight loss among obese patients. As NB acts on hypothalamic and reward circuits, that seem involved in the pathogenesis and maintenance of BED symptoms, this study aims to evaluate the efficacy of NB in improving pathological eating behavior and losing weight in BED patients. METHODS: In this preliminary study, 23 obese-BED patients and a control group of 20 obese non-BED patients (respectively, Groups 1 and 2) who had previously undergone at least 5 unsuccessful weight-loss programs were treated with NB in addition to modified life style. Evaluation at t0 and after 16 weeks of treatment (t1) included anthropometric measurement, eating behavior assessment and psychopathological questionnaires (EDE-Q, BES, YFAS, BDI and STAI). RESULTS: A significant and similar weight loss (ΔBMI% ≈ 8%) was evident for both groups. Pathological eating behavior (i.e., binge, grazing, emotional eating, craving for carbohydrates, and post-dinner eating), BES score and YFAS severity significantly improved, especially among BED. NB was well tolerated and drop-out rate was low. CONCLUSION: Treatment with NB, in addition to a reduced-calorie diet and increased physical activity, seems an effective and well-tolerated option for improving pathological eating behavior and losing weight in obese-BED patients. LEVEL OF EVIDENCE: Level III case-control study.

10.
Eat Weight Disord ; 25(5): 1183-1189, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302882

RESUMO

PURPOSE: The present study examined the predictive value of early maladaptive schema (EMS) domains on the diagnosis of binge eating disorder (BED). METHODS: Seventy obese patients seeking treatment for weight loss were recruited and allocated to either group 1 (obese) or group 2 (BED-obese) according to clinical diagnosis. Both groups underwent psychometric assessment for EMS (according to the latest four-factor model), eating and general psychopathologies. Logistic regression analysis was performed on significant variables and BED diagnosis. RESULTS: In addition to showing higher values on all clinical variables, BED-obese patients exhibited significantly higher scores for all four schema domains. Regression analysis revealed a 12-fold increase in risk of BED with 'Impaired Autonomy and Performance'. Depression did not account for a higher risk. CONCLUSIONS: Impaired Autonomy and Performance is associated with BED in a sample of obese patients. Schema therapy should be considered a potential psychotherapy strategy in the treatment of BED. LEVEL OF EVIDENCE: Level III, case-control study.

11.
Eat Weight Disord ; 25(2): 373-377, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30382543

RESUMO

PURPOSE: Research has demonstrated impaired executive functioning among Binge Eating Disorder (BED) patients that could be influenced by age and weight. We aim to compare decision-making, set-shifting and central coherence between BED-obese patients (BED-Ob), non-BED-obese patients (non-BED-Ob), and normal-weight healthy controls (NW-HC) without the influence of these variables. METHODS: Overall, 35 BED-Ob, 32 non-BED-Ob and 26 NW-HC participants completed the Iowa Gambling Task, the Trail Making Test and the Rey-Osterrieth Complex Figure Test. RESULTS: BED-Ob patients showed higher cognitive impairment compared to NW-HC on decision-making, set-shifting, visual attention and memory. CONCLUSIONS: BED-Ob patients have an impaired cognitive profile on decision-making, set-shifting, visual attention and memory but not impaired central coherence. As all groups were aged-matched and no significant differences between BED-Ob and non-BED-Ob participants were evident, our results demonstrate that this impairment is independent from weight/age, pointing out that it is BED itself to account for inefficiencies in cognitive functioning. LEVEL OF EVIDENCE: Level III, case-control study.

12.
J Clin Psychol ; 76(3): 539-548, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31733127

RESUMO

OBJECTIVE: The present study aimed to (a) assess and compare personological traits and early maladaptive schemas (EMSs) of obese women with and without binge eating disorder (BED) and (b) identify the variables associated with the binge severity. METHOD: One hundred women (55 BED-obese and 45 non-BED-obese) completed psychopathological and personological self-report questionnaires. A forward stepwise linear regression analysis was performed to assess variables associated with binge eating severity. RESULTS: Not only psychopathological but also personological differences were evident between BED and non-BED-obese women. BED severity was significantly associated with depressivity, emotional deprivation, and defectiveness. CONCLUSIONS: Our preliminary findings suggest that BED patients exhibit some EMSs that could be linked to the construct of emotional neglect and specific personological traits closely related to depressive dimensions, emotional lability, and impulsivity. In particular, binge severity is associated with the pervasiveness of depressogenic cognitive schemas, as well as those of emotional deprivation and defectiveness.

13.
Nutrients ; 11(9)2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31450770

RESUMO

Alterations of the immune system are known in eating disorders (EDs), however the importance of cytokine balance in this context has not been clarified. We compared cytokines and growth factors at opposite ends of BMI ranges, in 90 patients classified in relation to BMI, depressive and EDs comorbidities. Serum concentrations of interleukin (IL)-1α, IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) were determined by a biochip analyzer (Randox Labs). Differences were calculated through ANOVA. Possible predictors of higher cytokine levels were evaluated through regression analysis. IL-1α, IL-10, EGF, and IFN-γ were altered individuals with anorexia nervosa (AN) and binge eating disorder (BED). Night-eating was associated with IL-8 and EGF levels, IL-10 concentrations with post-dinner eating and negatively with sweet-eating, long fasting with higher IFN-γ levels. IL-2 increase was not linked to EDs, but to the interaction of depression and BMI. Altogether, for the first time, IL-1α, IL-10, EGF, and IFN-γ were shown to differ between AN and HCs, and between AN and individuals with obesity with or without BED. Only IL-2 was influenced by depression. Dysfunctional eating behaviors predicted abnormal concentrations of IL-10, EGF, IL-8 and IFN-γ.


Assuntos
Índice de Massa Corporal , Encéfalo/metabolismo , Citocinas/sangue , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Ganho de Peso , Perda de Peso , Adolescente , Adulto , Anorexia Nervosa/sangue , Anorexia Nervosa/imunologia , Anorexia Nervosa/fisiopatologia , Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/sangue , Transtorno da Compulsão Alimentar/imunologia , Transtorno da Compulsão Alimentar/fisiopatologia , Transtorno da Compulsão Alimentar/psicologia , Biomarcadores/sangue , Encéfalo/imunologia , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Citocinas/imunologia , Transtornos da Alimentação e da Ingestão de Alimentos/imunologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Comer Noturno/sangue , Síndrome do Comer Noturno/imunologia , Síndrome do Comer Noturno/fisiopatologia , Síndrome do Comer Noturno/psicologia , Fatores de Tempo , Adulto Jovem
14.
Eur Eat Disord Rev ; 27(3): 274-282, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30848056

RESUMO

Two hundred forty six patients with eating disorders (EDs) recruited from eight Italian specialized treatment centres were administered with the World Health Organization "Encounter Form," a standardized schedule that makes it possible to characterize the clinical pathways that patients follow to reach specialized care. The median time from symptoms onset to specialized care was 114 weeks. Primary "points of access to care" were general practitioners (25%), psychiatrists (18%), and clinical nutritionists (17%), followed by various other carers. All patients received specific psychotherapy, whereas only 11% of them were given psychotropic drugs. EDs are characterized by complex care pathways, with low rates of direct access to specialized care. Although the role of general practitioners remains crucial, they tend to follow different clinical routes to refer ED patients. Educational programmes on EDs should be addressed to general practitioners and clinical nutritionists, in order to ease the transition of ED patients to a mental health care setting.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Encaminhamento e Consulta/organização & administração , Especialização , Adulto , Feminino , Humanos , Itália , Masculino
15.
Front Psychol ; 10: 3022, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32038394

RESUMO

Background: Behavioral addiction (BA) is a recent concept in psychiatry. Few studies have investigated the relationship between BA and early maladaptive schemas (EMSs). EMS is the core of Schema Therapy (ST). According to the ST model, psychiatric disorders result from the development of EMSs in response to unmet emotional needs in childhood. Bach et al. (2018) grouped the 18 EMSs into four domains: (1) disconnection and rejection; (2) impaired autonomy and performance; (3) excessive responsibility and standards; and (4) impaired limits. This study aims to assess the possible association of the most frequent BAs with EMSs in a large group of late adolescents and young adults and to evaluate their self-perceived quality of life (QoL). Methods: A battery of psychological tests assessing food addiction (FA), gambling disorder (GD), internet addiction (IA), and QoL was administered to 1,075 late adolescents and young adults (N = 637; 59.3% women). A forward-stepwise logistic regression model was run to identify which variables were associated with BAs. Results: Food addiction was more frequent among women and GD among men, while IA was equally distributed. Regarding the EMSs, participants with FA or IA showed significantly higher scores on all four-schema domains, whereas those with GD exhibited higher scores on impaired autonomy and performance and impaired limits. Besides, average scores of all domains increased with the association of two or more comorbid BAs. Self-perceived QoL was lower for participants with FA and IA, but not for those with GD; the presence of comorbid BAs was associated with lower Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Finally, specific EMS domains and demographic variables were associated with each BA. Conclusion: Late adolescents and young adults with FA or IA have a lower perception of their mental and physical health. The most striking result is that FA appears to be associated with the disconnection and rejection schema domain, IA with all the schema domains (except for impaired autonomy and performance), and GD with impaired autonomy and performance schema domain. In conclusion, our findings suggest that EMS should be systematically assessed during psychotherapy of patients with BAs.

16.
Eur Psychiatry ; 48: 58-64, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29331600

RESUMO

BACKGROUND: Considering that specific genetic profiles, psychopathological conditions and neurobiological systems underlie human behaviours, the phenotypic differentiation of obese patients according to eating behaviours should be investigated. The aim of this study was to classify obese patients according to their eating behaviours and to compare these clusters in regard to psychopathology, personality traits, neurocognitive patterns and genetic profiles. METHODS: A total of 201 obese outpatients seeking weight reduction treatment underwent a dietetic visit, psychological and psychiatric assessment and genotyping for SCL6A2 polymorphisms. Eating behaviours were clustered through two-step cluster analysis, and these clusters were subsequently compared. RESULTS: Two groups emerged: cluster 1 contained patients with predominantly prandial hyperphagia, social eating, an increased frequency of the long allele of the 5-HTTLPR and low scores in all tests; and cluster 2 included patients with more emotionally related eating behaviours (emotional eating, grazing, binge eating, night eating, post-dinner eating, craving for carbohydrates), dysfunctional personality traits, neurocognitive impairment, affective disorders and increased frequencies of the short (S) allele and the S/S genotype. CONCLUSIONS: Aside from binge eating, dysfunctional eating behaviours were useful symptoms to identify two different phenotypes of obese patients from a comprehensive set of parameters (genetic, clinical, personality and neuropsychology) in this sample. Grazing and emotional eating were the most important predictors for classifying obese patients, followed by binge eating. This clustering overcomes the idea that 'binging' is the predominant altered eating behaviour, and could help physicians other than psychiatrists to identify whether an obese patient has an eating disorder. Finally, recognising different types of obesity may not only allow a more comprehensive understanding of this illness, but also make it possible to tailor patient-specific treatment pathways.


Assuntos
Cognição , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Obesidade/psicologia , Personalidade , Adulto , Emoções/fisiologia , Comportamento Alimentar/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/genética
17.
Eat Weight Disord ; 22(3): 527-533, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28780748

RESUMO

PURPOSE: Food addiction (FA) refers to a condition characterized by addiction in relation to some high-fat and high-sugar carbohydrate that leads to clinically significant impairment or distress on several areas of functioning. The Yale Food Addiction Scale 2.0 (YFAS 2.0) has been recently updated to measure FA according to the DSM-5 criteria for substance-related and addictive disorders. This study aimed at validating the Italian version of YFAS 2.0. METHODS: A sample of 574 Italian university students was involved in this research. Confirmatory Factor Analysis (CFA) and Kuder-Richardson's alpha for dichotomous data were run to evaluate scale structure and reliability. Correlations between YFAS 2.0 and eating psychopathology, binge eating, sleep, and mood symptoms were evaluated. RESULTS: Analogously to the original version, a single factor structure emerged at the CFA. The alpha coefficient was 0.87. Moreover, sound, from moderate to high, correlations were found with other measures. CONCLUSIONS: The Italian version of the YFAS 2.0 has demonstrated in a sample of university students to be a useful tool to investigate food addictions. Level of evidence Level V, descriptive study.


Assuntos
Bulimia/diagnóstico , Dependência de Alimentos/diagnóstico , Adolescente , Comportamento Alimentar , Feminino , Humanos , Itália , Masculino , Psicometria , Reprodutibilidade dos Testes , Traduções , Adulto Jovem
18.
Eur Eat Disord Rev ; 25(3): 172-178, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28211586

RESUMO

OBJECTIVE: This study aims to evaluate the theory of mind ability in a sample of obese patients with and without binge eating disorder (BED) and to explore the correlations between emotional and clinical assessments. METHODS: Overall, 20 non-BED, 16 under-threshold BED and 22 BED obese patients completed a battery of tests assessing social cognition and eating disorder psychopathology. RESULTS: Binge eating disorder, non-BED and under-threshold-BED obese patients showed similar ability to recognise others' emotions, but BED obese patients exhibited a deficit in recognising their own emotions as demonstrated by more impaired levels of alexithymia and interoceptive awareness and were more depressed. High positive correlations were evident between binging, depression, interoceptive awareness and alexithymia. CONCLUSIONS: Binge eating disorder patients have a comparable ability to understand others' emotions but a more impaired capacity to understand and code their own emotions compared with non-BED obese patients. This impairment is highly correlated with depression. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Cognição , Emoções , Obesidade/psicologia , Percepção Social , Adulto , Transtorno da Compulsão Alimentar/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Teoria da Mente
19.
J Affect Disord ; 208: 424-430, 2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-27846411

RESUMO

BACKGROUND: Obesity is not a mental disorder, yet DSM-5 recognizes a strong association between obesity and psychiatric syndromes. Disorders within the Bipolar Spectrum (BSD) and Binge Eating Disorder (BED) are the most frequent psychiatric disorders among obese patients. The aim of this research is to investigate the psychopathological differences and the distinctive eating behaviors that accompany these comorbidities in obese patients. METHODS: One hundred and nineteen obese patients (40 males; 79 females) underwent psychological evaluation and psychiatric interview, and a dietitian evaluated their eating habits. Patients were divided into four groups according to comorbidities, and comparisons were run accordingly. RESULTS: Forty-one percent of participants presented BED+BSD comorbidity (Group 1), 21% BED (Group 2) and 8% BSD (Group 3); only 29% obese participants had no comorbidity (Group 4). Female gender was overrepresented among Groups 1 and 2. BSD diagnosis varied according to comorbidities: Type II Bipolar Disorder and Other Specified and Related Bipolar Disorder (OSR BD) were more frequent in Group 1 and Type I Bipolar Disorder in Group 3. A trend of decreasing severity in eating behaviors and psychopathology was evident according to comorbidities (Group 1=Group2>Group3>Group 4). LIMITATIONS: Limitations include the small sample size and the cross-sectional design of the study. CONCLUSIONS: BED and BSD are frequent comorbidities in obesity. Type II Bipolar Disorder and OSR BD are more frequent in the group with double comorbidity. The double comorbidity seems associated to more severe eating behaviors and psychopathology. Distinctive pathological eating behaviors could be considered as warning signals, symptomatic of psychiatric comorbidities in Obesity.


Assuntos
Transtorno da Compulsão Alimentar/complicações , Transtorno Bipolar/complicações , Obesidade/complicações , Adulto , Estudos Transversais , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Índice de Gravidade de Doença
20.
Medicine (Baltimore) ; 94(52): e2098, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26717356

RESUMO

To evaluate whether obese patients with a binge eating disorder (BED) have an altered metabolic and inflammatory profile related to their eating behaviors compared with non-BED obese.A total of 115 White obese patients consecutively recruited underwent biochemical, anthropometrical evaluation, and a 75-g oral glucose tolerance test. Patients answered the Binge Eating Scale and were interviewed by a psychiatrist. The patients were subsequently divided into 2 groups according to diagnosis: non-BED obese (n = 85) and BED obese (n = 30). Structural equation modeling analysis was performed to elucidate the relation between eating behaviors and metabolic and inflammatory profile.BED obese exhibited significantly higher percentages of altered eating behaviors, body mass index (P < 0.001), waist circumference (P < 0.01), fat mass (P < 0.001), and a lower lean mass (P < 0.001) when compared with non-BED obese. Binge eating disorder obese also had a worse metabolic and inflammatory profile, exhibiting significantly lower high-density lipoprotein cholesterol levels (P < 0.05), and higher levels of glycated hemoglobin (P < 0.01), uric acid (P < 0.05), erythrocyte sedimentation rate (P < 0.001), high-sensitive C-reactive protein (P < 0.01), and white blood cell counts (P < 0.01). Higher fasting insulin (P < 0.01) and higher insulin resistance (P < 0.01), assessed by homeostasis model assessment index and visceral adiposity index (P < 0.001), were observed among BED obese. All differences remained significant after adjusting for body mass index. No significant differences in fasting plasma glucose or 2-hour postchallenge plasma glucose were found. Structural equation modeling analysis confirmed the relation between the altered eating behaviors of BED and the metabolic and inflammatory profile.Binge eating disorder obese exhibited an unfavorable metabolic and inflammatory profile, which is related to their characteristic eating habits.


Assuntos
Transtorno da Compulsão Alimentar , Inflamação/sangue , Resistência à Insulina , Obesidade , Adulto , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/metabolismo , Transtorno da Compulsão Alimentar/fisiopatologia , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , HDL-Colesterol/sangue , Feminino , Teste de Tolerância a Glucose/métodos , Humanos , Entrevista Psicológica/métodos , Contagem de Leucócitos/métodos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/metabolismo , Obesidade/psicologia , Estatística como Assunto
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