European Eating Disorders Review最新文献

Objective: Eating disorders often result in distress, relationship impairment, and emotional, social, and financial burden for family members and other loved ones. However, carer outcomes from eating disorder treatment are under-researched, particularly residential settings. This study aimed to examine carer outcomes from a transdiagnostic residential service for eating disorders, which included therapist-led psychoeducation and peer support for carers.

Method: Measures of carer burden, accommodation and enabling of eating disorder symptoms, psychological distress, and health-related quality of life were completed at pre-treatment and three months' post-treatment by 51 carers (66.7% parents).

Results: Linear mixed effects modelling found significant improvement in carer burden (b = -5.80, p = 0.033), accommodation and enabling of eating disorder symptoms (b = -13.32, p = 0.003), and psychological distress (b = -3.19 p = 0.026), with medium to large effect sizes (d = -0.76-1.32). Averaged across time, women reported significantly greater carer burden than men (b = 12.42, p = 0.011).

Conclusions: Findings support the effectiveness of residential treatment for carers, including improvement in behaviours that are likely to support eating disorder recovery. Future research is needed to determine what elements in residential treatment, the caregiving relationship, and beyond contribute to these positive outcomes.

Trial registration: The study was prospectively registered on the Australian and New Zealand Clinical Trials Registry in November 2021, registration number ACTRN12621001651875.

Objective: Little is known about the longer-term maintenance, remission, or development of binge eating behaviour (BE) following metabolic and bariatric surgery (MBS). This brief report investigated BE prior to and 10 years following MBS and examined mental health and weight outcomes between BE groups (never BE, continued BE, remitted BE, or developed 'de novo' BE).

Method: One hundred and eighty-three participants (76.1% females) with a mean age of 44.8 (± 9.5) years and mean BMI of 42.9 kg/m² (± 5.4) were assessed before and 10 years following MBS (94.0% Roux-n-Y).

Results: At 10 years, 48% had never engaged in BE, 27.9% had remitted, 15.8% had continued BE, and 8.2% reported de novo BE. Individuals who continued BE were younger, reported higher levels of anxiety and depression, and had regained more weight. Individuals who continued or developed de novo BE reported higher levels of post-surgical repetitive eating behaviour and were more likely to regain ≥ 25% of maximum weight lost.

Conclusions: Approximately 25% of the sample reported post-operative BE a decade following MBS, including 8.2% de novo cases. Individuals who engaged in post-operative BE demonstrated significantly worse mental health and weight outcomes, especially those with a lifetime history who continued to engage in BE after 10 years. Findings provide nuance to the existing literature and underscore the value of assessing BE at pre- and post-surgery.

Objective: In the CBT model of anorexia nervosa, emaciation is assumed to occur because individuals over-value their weight and shape. However, current BMI (for adolescents, BMI z-score) may be relevant to psychopathology beyond its relation with weight concern. We explored the relations between BMI/z-BMI and attempts to change one's eating and/or weight (restraint and eating concern) before and after controlling for weight concern among individuals with AN or atypical AN (AAN).

Method: Participants were 1666 female residential patients with AN or AAN. For those below age 21, we examined the relations between z-BMI and EDE-Q Restraint and Eating Concern when Weight Concern was and was not controlled. For adults, we conducted the same analyses using BMI.

Results: BMI and z-BMI were positively related to weight concern, restraint, and eating concern. When controlling for weight concern, the positive relationships between z-BMI and both restraint and eating concern became significant negative relationships. This pattern also emerged among adults, though the negative relationship between BMI and restraint did not reach significance.

Conclusions: In AN-spectrum disorders, (1) BMI/z-BMI was related to weight/eating concerns despite substantial weight loss and (2) when weight concern was controlled, these relationships between BMI/z-BMI and restraint/eating concerns were largely reversed.

Objective: This study aimed to provide a BMI-adjusted meta-analytical calculation of blood leptin levels across different eating disorders (EDs) including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), recovered EDs, and healthy controls (HCs). The goal was to understand BMI-independent leptin alterations and their potential as biomarkers.

Method: PubMed and ClinicalTrials.gov were searched for studies reporting serum leptin in AN, BN, BED, or recovered EDs. A multilevel network meta-analysis using a linear mixed-effects meta-regression model, adjusting for BMI, sex, and assay type, was performed on 146 studies (5048 patients, 3525 controls).

Results: Significant differences in leptin levels were found across EDs. AN patients exhibited the lowest leptin levels, while BED patients had the highest. BN and recovered AN patients had leptin levels similar to AN, significantly lower than HCs. BMI, sex, and assay type were significant covariates. The model accounted for heterogeneity due to diagnostic criteria, assay types, and study-level differences.

Conclusions: Leptin levels in EDs are significantly altered beyond BMI effects, suggesting disease-specific factors. These findings support leptin's potential as a biomarker for ED staging and prognosis. Further research is needed to explore leptin's role in ED pathogenesis and trajectory, to identify subpopulations and improve clinical interventions.

Background: In recent years, social networks (SNs) have increasingly become a core activity adolescent's daily life. Their impact on mental health is an actual worldwide concern. This massive usage of social network has been suggested to increase the risk of depressive and anxiety disorders, as well as alterations in sleep quality and quantity. In particular, it has been suggested that it could increase concerns about body image and thereby encourage eating disorders. Aiming at further investigating these relations, this study examined, for the first time, the links between the clinical profile of adolescents with anorexia nervosa and SNs use patterns.

Methods: The sample included 131 adolescent girls with anorexia nervosa who completed an online survey assessing their SNs practices in terms of duration, intensity and function of SNs use, misuse and addictive tendencies, as well as the number of online peers. Clinical characteristics such as eating behaviours, body image perception, depression, anxiety and sleep quality were also assessed.

Results: showed that adolescents with anorexia nervosa spend more than 3 h per day on SNs. Those spending 5 h per day or more preferred a passive use, with limited connection with peers and greater clinical difficulties. In addition, high problematic use of SNs significantly aggravated eating behaviour, dysmorphophobia, depressive symptoms and sleep impairment. The activities performed on SNs were not significantly associated with variations in clinical characteristics.

Conclusion: Presents findings suggests that a profile of social networking marked by a problematic, prolonged and passive use, is associated with more severe symptomatology in adolescent girls with anorexia nervosa. These first data could inspire professionals to encourage a SNs use favouring care and recovery, thereby supporting adolescents with an eating disorder but also their relatives.

Objective: Eating disorders (EDs) and non-suicidal self-injury (NSSI) are both phenomena with onset in adolescence. Their co-occurrence is associated with higher symptom severity and an elevated risk of suicide. In this meta-analysis, we examine the lifetime prevalence of NSSI in youth with EDs.

Methods: We searched PsycInfo, PubMed and previously published systematic reviews for studies reporting on lifetime NSSI prevalence among children and adolescents (19 years or younger) with an ED (anorexia nervosa, bulimia nervosa, binge eating or other specified feeding and EDs) published until June 2024. A generalized linear mixed model meta-analysis was performed to estimate the pooled prevalence. Meta-regressions and multivariate meta-analyses were conducted to estimate separate prevalence rates based on ED diagnosis and care frame (e.g., inpatient vs. outpatient), respectively.

Results: Fifteen studies comprising 3311 children and adolescents were included. Pooled lifetime NSSI prevalence across all ED diagnoses was 34.2% [CI: 27.5%-41.7%]. Heterogeneity was large (I² = 93.8%). Lifetime NSSI prevalence rates were significantly higher for participants with bulimia nervosa (53.6%) and those with anorexia nervosa binge-eating/purging type (51.9%) than for participants with anorexia nervosa restrictive type (15.8%).

Discussion: The small number of studies and the large heterogeneity limit the conclusiveness of this meta-analysis. Results suggest an even higher prevalence of lifetime NSSI in adolescents with an ED than in adults with an ED. The results support previous findings indicating higher prevalence rates of NSSI for EDs associated with binge eating and purging behaviours than for restrictive EDs.

Objective: Inflexible thinking among individuals with anorexia nervosa (AN) was proposed to reflect difficulties in set-shifting. However, studies assessing set-shifting in AN often find mixed results, especially in adolescent samples. It has been proposed that affective states and exposure to disorder-salient stimuli may modulate executive functions in AN. The current study examined the influence of induced negative emotion on the ability to shift toward or away from a food categorisation task among adolescents with AN.

Methods: The study included 47 adolescents with AN and 41 healthy adolescents who performed a modified task-switching paradigm.

Results: No indication of general set-shifting difficulties among adolescents with AN was found. Nevertheless, the results showed that when negative emotion was induced, adolescents with AN shifted from a non-food categorisation task to a food categorisation task with greater efficiency compared to a neutral emotion condition. Emotion and switch type did not influence set-shifting abilities among healthy adolescents.

Conclusion: The findings indicate automatic and more efficient switching towards preoccupation with food among adolescents with AN while experiencing negative emotion. The results emphasise the important role played by situational factors in modulating cognitive abilities in individuals with AN.

Objective: The present study examined whether patients with binge/purge and restricting anorexia nervosa (AN-BP and AN-R), bulimia nervosa (BN), binge eating disorder (BED), avoidant/restrictive food intake disorder (ARFID), and other specified feeding and eating disorder (OSFED) differ in generalised anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and depression symptom patterns and overall comorbid symptom severity at admission. We also assessed between-group differences in the patterns of change and overall comorbid symptom severity change from admission to discharge from routine eating disorder (ED) treatment at higher levels of care (HLOC).

Method: The initial sample included 3730 adults routinely assessed for GAD, depression, and OCD at admission and discharge from treatment.

Results and conclusions: ED diagnostic groups exhibited somewhat different symptom patterns (e.g., AN-R and ARFID were more prone to GAD and OCD than depression symptoms; BED exhibited the opposite pattern) and overall symptom severity at admission (i.e., AN-BP and OSFED had the highest overall comorbid symptom severity; BED had the lowest). Although the overall symptom improvement was significantly greater in ARFID and BED than in AN-BP, AN-R, and OSFED, ED patients collectively and within each diagnostic group improved significantly in GAD, OCD, and depression symptoms following routine ED treatment at HLOC.

Objective: Machine learning (ML) techniques have shown promise for enhancing prediction of clinical outcomes; however, its application to predicting binge eating has been scarcely explored. We applied ML techniques to predict binge eating onset (vs. continued absence) and persistence (vs. remission) over time.

Method: Data were used from a larger prospective study of 1106 participants who were assessed on a range of putative risk, maintaining, and protective factors at baseline and 8 months follow-up. Nine ML models for classification were developed and compared against a generalised linear model (GLM) for predicting onset (n = 334) and persistence (n = 623) outcomes using 39 self-reported baseline variables as predictors.

Results: All models performed poorly at predicting onset (AUC = 0.49-0.61) and persistence (AUC = 0.50-0.59) outcomes, with ML models demonstrating comparable performance to the GLM.

Conclusion: We suspect that poor ML performance may have been a result of the limited set of self-reported baseline predictors used to generate prediction models. Improved predictive accuracy and optimisation of ML models in future research may require consideration of a larger, more disparate set of predictors that also incorporate various data types, such as neuroimaging, physiological, or smartphone sensor data.

Objective: This study aimed to compare treatment outcomes associated with three severity indicators-DSM-5 for anorexia nervosa (AN) and bulimia nervosa (BN), ICD-11 for AN, and drive for thinness (DT) for AN and BN-within a treatment-seeking population.

Method: A total of 628 female participants diagnosed with either AN (n = 266; mean age = 26.71) or BN (n = 362; mean age = 29.49) were recruited from an ED unit. Upon admission, participants were classified based on DSM-5 (AN and BN) and ICD-11 severity categories. They underwent CBT-E comprehensive manualised programs, according to ED subtype, and were categorised into 'full remission', 'partial remission', 'non-remission' or 'drop-out' based on DSM-5 diagnostic criteria at discharge.

Results: Significant associations were found only for ICD-11 AN severity groups (p = 0.03, Cramer's V = 0.18), with 'dangerously low BMI' associated with poorer outcomes than 'significantly low BMI'. No other significant relationships were found with DSM-5 or DT severity groups.

Conclusion: This study reveals the limitation of using a single severity indicator and emphasises the necessity of a comprehensive assessment to capture the complexities of AN and BN. Future research should also evaluate the validity of these severity measures across various factors, including biological correlates and psychopathology.