Pub Date : 2024-02-01DOI: 10.3928/00485713-20240117-02
Sophie Scharner
Avoidant/restrictive food intake disorder (ARFID) is a complex, phenotypically heterogenous, and often severe feeding and eating disorder. Genetic studies suggest that ARFID is highly heritable, and that genes involved in taste perception and neurodevelopmental disorders may confer increased risk for the disorder. Neuroimaging studies are limited but point toward greater activation in reward circuitry among individuals with ARFID who are also overweight or obese, compared to those of normal weight. Endocrine studies have identified maladaptively high satiety-promoting (Peptide YY, cholecystokinin, oxytocin) and low hunger-promoting (ghrelin) hormone levels among individuals with ARFID, which may contribute to disease etiology and/or maintenance. Although research is limited, emerging insights into the pathophysiology of this common and impairing disorder may pave the way for the development of novel biological and pharmacological treatments. [ Psychiatr Ann. 2024;54(2):e47–e50.]
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This cross-sectional study investigated the prevalence of substance use disorders and explored associations between parental substance use disorder history and mental health disorders among psychiatric hospital inpatients in central Morocco. A total of 723 participants were included in the study. Data were collected using a structured questionnaire and medical records, covering psychiatric diagnoses, sociodemographic characteristics, substance use disorders among patients and their parents, as well as the patient's psychiatric history and length of hospital stay. Participants were divided into two groups: those with parental history of substance use disorders (PSUD) and those without. Patients' mean ages were 34.40 years (± 11) and 35.5 years (± 12), respectively. The prevalence of substance use was notably high among participants, with cannabis use being the most prevalent (90.6%). Educational level was associated with PSUD, with participants having no formal education showing a higher likelihood of having parents with SUD (unadjusted odds ratio, UOR = 2.11, 95% CI = 1.1 to 4.03). Polysubstance use was also associated with the PSUD group (UOR = 2.42, 95% CI = 1.73 to 3.40). Regarding psychiatric disorders, one in five patients in the PSUD group had schizophrenia (21.35%), followed by acute psychotic episodes (20.5%), depression (20.29%), and anorexia (8.24%). The study revealed a high overall prevalence of substance use among participants with mental health disorder, highlighting the significance of parental SUD history as a predictor for patients' mental health disorders. This suggests the need for special attention and preventive measures. [ Psychiatr Ann . 2024;54(2):e56–e66.]
这项横断面研究调查了摩洛哥中部地区精神病院住院患者的药物使用障碍患病率，并探讨了父母药物使用障碍史与精神疾病之间的关联。共有 723 人参与了这项研究。研究使用结构化问卷和病历收集数据，内容包括精神病诊断、社会人口特征、患者及其父母的药物使用障碍，以及患者的精神病史和住院时间。参与者分为两组：父母有药物滥用史（PSUD）和无药物滥用史。患者的平均年龄分别为 34.40 岁（± 11）和 35.5 岁（± 12）。参与者使用药物的比例很高，其中使用大麻的比例最高（90.6%）。教育水平与 PSUD 相关，未受过正规教育的参与者的父母患有 SUD 的可能性更高（未调整的几率比，UOR = 2.11，95% CI = 1.1 至 4.03）。使用多种药物也与 PSUD 组相关（UOR = 2.42，95% CI = 1.73 至 3.40）。 在精神疾病方面，PSUD 组每五名患者中就有一名患有精神分裂症（21.35%），其次是急性精神病发作（20.5%）、抑郁症（20.29%）和厌食症（8.24%）。研究显示，在患有精神疾病的参与者中，药物使用的总体流行率很高，这凸显了父母的药物滥用史作为预测患者精神疾病的一个重要因素。这表明有必要给予特别关注并采取预防措施。 [ Psychiatr Ann .
{"title":"Epidemiological Association of Parental Substance Use History and Mental Health Disorders in Central Morocco","authors":"Abdelmounaim Baslam, Hajar Azraida, Aboufatima Rachida, Samia Boussaa, Abderrahman Chait","doi":"10.3928/00485713-20231204-01","DOIUrl":"https://doi.org/10.3928/00485713-20231204-01","url":null,"abstract":"This cross-sectional study investigated the prevalence of substance use disorders and explored associations between parental substance use disorder history and mental health disorders among psychiatric hospital inpatients in central Morocco. A total of 723 participants were included in the study. Data were collected using a structured questionnaire and medical records, covering psychiatric diagnoses, sociodemographic characteristics, substance use disorders among patients and their parents, as well as the patient's psychiatric history and length of hospital stay.\u0000 Participants were divided into two groups: those with parental history of substance use disorders (PSUD) and those without. Patients' mean ages were 34.40 years (± 11) and 35.5 years (± 12), respectively. The prevalence of substance use was notably high among participants, with cannabis use being the most prevalent (90.6%). Educational level was associated with PSUD, with participants having no formal education showing a higher likelihood of having parents with SUD (unadjusted odds ratio, UOR = 2.11, 95% CI = 1.1 to 4.03). Polysubstance use was also associated with the PSUD group (UOR = 2.42, 95% CI = 1.73 to 3.40).\u0000 \u0000 Regarding psychiatric disorders, one in five patients in the PSUD group had schizophrenia (21.35%), followed by acute psychotic episodes (20.5%), depression (20.29%), and anorexia (8.24%). The study revealed a high overall prevalence of substance use among participants with mental health disorder, highlighting the significance of parental SUD history as a predictor for patients' mental health disorders. This suggests the need for special attention and preventive measures.\u0000 \u0000 [\u0000 Psychiatr Ann\u0000 . 2024;54(2):e56–e66.]\u0000 \u0000","PeriodicalId":506992,"journal":{"name":"Psychiatric Annals","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139817605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.3928/00485713-20240119-02
Andrew A. Nierenberg
{"title":"Thinking About the System (or Lack Thereof) of Psychiatric Care","authors":"Andrew A. Nierenberg","doi":"10.3928/00485713-20240119-02","DOIUrl":"https://doi.org/10.3928/00485713-20240119-02","url":null,"abstract":"","PeriodicalId":506992,"journal":{"name":"Psychiatric Annals","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139884863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This cross-sectional study investigated the prevalence of substance use disorders and explored associations between parental substance use disorder history and mental health disorders among psychiatric hospital inpatients in central Morocco. A total of 723 participants were included in the study. Data were collected using a structured questionnaire and medical records, covering psychiatric diagnoses, sociodemographic characteristics, substance use disorders among patients and their parents, as well as the patient's psychiatric history and length of hospital stay. Participants were divided into two groups: those with parental history of substance use disorders (PSUD) and those without. Patients' mean ages were 34.40 years (± 11) and 35.5 years (± 12), respectively. The prevalence of substance use was notably high among participants, with cannabis use being the most prevalent (90.6%). Educational level was associated with PSUD, with participants having no formal education showing a higher likelihood of having parents with SUD (unadjusted odds ratio, UOR = 2.11, 95% CI = 1.1 to 4.03). Polysubstance use was also associated with the PSUD group (UOR = 2.42, 95% CI = 1.73 to 3.40). Regarding psychiatric disorders, one in five patients in the PSUD group had schizophrenia (21.35%), followed by acute psychotic episodes (20.5%), depression (20.29%), and anorexia (8.24%). The study revealed a high overall prevalence of substance use among participants with mental health disorder, highlighting the significance of parental SUD history as a predictor for patients' mental health disorders. This suggests the need for special attention and preventive measures. [ Psychiatr Ann . 2024;54(2):e56–e66.]
这项横断面研究调查了摩洛哥中部地区精神病院住院患者的药物使用障碍患病率，并探讨了父母药物使用障碍史与精神疾病之间的关联。共有 723 人参与了这项研究。研究使用结构化问卷和病历收集数据，内容包括精神病诊断、社会人口特征、患者及其父母的药物使用障碍，以及患者的精神病史和住院时间。参与者分为两组：父母有药物滥用史（PSUD）和无药物滥用史。患者的平均年龄分别为 34.40 岁（± 11）和 35.5 岁（± 12）。参与者使用药物的比例很高，其中使用大麻的比例最高（90.6%）。教育水平与 PSUD 相关，未受过正规教育的参与者的父母患有 SUD 的可能性更高（未调整的几率比，UOR = 2.11，95% CI = 1.1 至 4.03）。使用多种药物也与 PSUD 组相关（UOR = 2.42，95% CI = 1.73 至 3.40）。 在精神疾病方面，PSUD 组每五名患者中就有一名患有精神分裂症（21.35%），其次是急性精神病发作（20.5%）、抑郁症（20.29%）和厌食症（8.24%）。研究显示，在患有精神疾病的参与者中，药物使用的总体流行率很高，这凸显了父母的药物滥用史作为预测患者精神疾病的一个重要因素。这表明有必要给予特别关注并采取预防措施。 [ Psychiatr Ann .
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Pub Date : 2024-02-01DOI: 10.3928/00485713-20240110-01
P. E. Kambanis, Lilian P. Palmer, Lazaro Zayas
Differential diagnosis between avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa may be challenging due to shared clinical features. Diagnostic criteria for ARFID prohibit disturbance of one's body shape/weight. In contrast to body image disturbance, body image dissatisfaction is normative and ubiquitous and may characterize those with ARFID. Distinguishing between body image disturbance and dissatisfaction is critical to derive accurate diagnoses. We compare these constructs, highlighting that body image dissatisfaction rises to the level of clinically significant body image disturbance when it results in: (1) behavioral symptoms, such as persistent behavior that interferes with weight gain; and/or (2) eating disorder cognitions, such as a distorted perception of one's shape/weight or overvaluation of shape/weight. We illustrate the application of this definition via a brief case example and conclude by providing recommendations to aid providers in differential diagnosis between ARFID and its most similar eating disorder, anorexia nervosa. [ Psychiatr Ann . 2024;54(2):e37–e41.]
由于具有共同的临床特征，对回避型/限制型食物摄入障碍（ARFID）和神经性厌食症进行鉴别诊断可能具有挑战性。ARFID的诊断标准禁止对自己的体形/体重进行干扰。与体像障碍相反，体像不满意是正常的、普遍存在的，可能是 ARFID 患者的特征。区分体像困扰和体像不满意对于得出准确的诊断结果至关重要。我们对这两个概念进行了比较，强调当身体形象不满意导致：（1）行为症状，如妨碍体重增加的持续行为；和/或（2）进食障碍认知，如对自身体形/体重的扭曲感知或对体形/体重的高估时，身体形象不满意就上升到了具有临床意义的身体形象障碍的水平。我们通过一个简短的病例说明了这一定义的应用，最后提出了一些建议，以帮助医疗服务提供者对 ARFID 及其最相似的饮食失调症（神经性厌食症）进行鉴别诊断。 [ Psychiatr Ann .
{"title":"Differential Diagnosis Between Avoidant/Restrictive Food Intake Disorder and Anorexia Nervosa","authors":"P. E. Kambanis, Lilian P. Palmer, Lazaro Zayas","doi":"10.3928/00485713-20240110-01","DOIUrl":"https://doi.org/10.3928/00485713-20240110-01","url":null,"abstract":"\u0000 Differential diagnosis between avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa may be challenging due to shared clinical features. Diagnostic criteria for ARFID prohibit disturbance of one's body shape/weight. In contrast to body image disturbance, body image dissatisfaction is normative and ubiquitous and may characterize those with ARFID. Distinguishing between body image disturbance and dissatisfaction is critical to derive accurate diagnoses. We compare these constructs, highlighting that body image dissatisfaction rises to the level of clinically significant body image disturbance when it results in: (1) behavioral symptoms, such as persistent behavior that interferes with weight gain; and/or (2) eating disorder cognitions, such as a distorted perception of one's shape/weight or overvaluation of shape/weight. We illustrate the application of this definition via a brief case example and conclude by providing recommendations to aid providers in differential diagnosis between ARFID and its most similar eating disorder, anorexia nervosa.\u0000 \u0000 [\u0000 Psychiatr Ann\u0000 . 2024;54(2):e37–e41.]\u0000 \u0000","PeriodicalId":506992,"journal":{"name":"Psychiatric Annals","volume":"27 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139814433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.3928/00485713-20240119-02
Andrew A. Nierenberg
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Pub Date : 2024-02-01DOI: 10.3928/00485713-20240119-01
Copeland G. Winten, E. Strodl, Lynda J. Ross
Given that research into the treatment of avoidant/restrictive food intake disorder (ARFID) is in its early phases, there is a paucity of evidence-based guidelines directing best practices. However, there is still a need for clinicians to access summations of literature to guide clinical decision-making. Early data on the treatment of ARFID highlight the importance of a multidisciplinary team that can provide medical, pharmacologic, nutritional, and psychological care. While medical treatment is often informed by care guidelines for other eating disorders, pharmacological management often focuses on ARFID's psychiatric comorbidities. The psychological treatments with the strongest current evidence for ARFID include family-based therapy for young children, and cognitive-behavioral therapy for older children, adolescents, and adults. [ Psychiatr Ann. 2024;54(2):e51–e55.]
{"title":"Multidisciplinary Treatment of Avoidant/Restrictive Food Intake Disorder","authors":"Copeland G. Winten, E. Strodl, Lynda J. Ross","doi":"10.3928/00485713-20240119-01","DOIUrl":"https://doi.org/10.3928/00485713-20240119-01","url":null,"abstract":"\u0000 Given that research into the treatment of avoidant/restrictive food intake disorder (ARFID) is in its early phases, there is a paucity of evidence-based guidelines directing best practices. However, there is still a need for clinicians to access summations of literature to guide clinical decision-making. Early data on the treatment of ARFID highlight the importance of a multidisciplinary team that can provide medical, pharmacologic, nutritional, and psychological care. While medical treatment is often informed by care guidelines for other eating disorders, pharmacological management often focuses on ARFID's psychiatric comorbidities. The psychological treatments with the strongest current evidence for ARFID include family-based therapy for young children, and cognitive-behavioral therapy for older children, adolescents, and adults.\u0000 \u0000 [\u0000 Psychiatr Ann.\u0000 2024;54(2):e51–e55.]\u0000 \u0000","PeriodicalId":506992,"journal":{"name":"Psychiatric Annals","volume":"123 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139832468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.3928/00485713-20240117-02
Sophie Scharner
Avoidant/restrictive food intake disorder (ARFID) is a complex, phenotypically heterogenous, and often severe feeding and eating disorder. Genetic studies suggest that ARFID is highly heritable, and that genes involved in taste perception and neurodevelopmental disorders may confer increased risk for the disorder. Neuroimaging studies are limited but point toward greater activation in reward circuitry among individuals with ARFID who are also overweight or obese, compared to those of normal weight. Endocrine studies have identified maladaptively high satiety-promoting (Peptide YY, cholecystokinin, oxytocin) and low hunger-promoting (ghrelin) hormone levels among individuals with ARFID, which may contribute to disease etiology and/or maintenance. Although research is limited, emerging insights into the pathophysiology of this common and impairing disorder may pave the way for the development of novel biological and pharmacological treatments. [ Psychiatr Ann. 2024;54(2):e47–e50.]
{"title":"Neurobiology of Avoidant/Restrictive Food Intake Disorder","authors":"Sophie Scharner","doi":"10.3928/00485713-20240117-02","DOIUrl":"https://doi.org/10.3928/00485713-20240117-02","url":null,"abstract":"\u0000 Avoidant/restrictive food intake disorder (ARFID) is a complex, phenotypically heterogenous, and often severe feeding and eating disorder. Genetic studies suggest that ARFID is highly heritable, and that genes involved in taste perception and neurodevelopmental disorders may confer increased risk for the disorder. Neuroimaging studies are limited but point toward greater activation in reward circuitry among individuals with ARFID who are also overweight or obese, compared to those of normal weight. Endocrine studies have identified maladaptively high satiety-promoting (Peptide YY, cholecystokinin, oxytocin) and low hunger-promoting (ghrelin) hormone levels among individuals with ARFID, which may contribute to disease etiology and/or maintenance. Although research is limited, emerging insights into the pathophysiology of this common and impairing disorder may pave the way for the development of novel biological and pharmacological treatments.\u0000 \u0000 [\u0000 Psychiatr Ann.\u0000 2024;54(2):e47–e50.]\u0000 \u0000","PeriodicalId":506992,"journal":{"name":"Psychiatric Annals","volume":"49 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139876812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.3928/00485713-20240117-01
Ashley Dunford, Jennifer J. Thomas
Avoidant/restrictive food intake disorder (ARFID) is a relatively new category within DSM-5 feeding and eating disorders, which expands beyond developmentally normative picky eating. Given its recent introduction to the diagnostic nomenclature, research on the epidemiology of ARFID is in its infancy. Prevalence estimates for ARFID vary considerably by methodology, setting, and population, but growing evidence suggests that ARFID is just as common as other more well-known eating disorders, affecting approximately 0.3% to 15.5% of children and 0.3% to 4.1% of adults. Despite common misconceptions, ARFID impacts a wide range of individuals across ages and genders, and both medical and psychiatric comorbidities are common. Limited research has investigated prognosis, but existing longitudinal studies highlight the persistence of the disorder and the possibility of diagnostic crossover to other eating disorders. [ Psychiatr Ann . 2024;54(2):e42–e46.]
{"title":"Epidemiology of Avoidant/Restrictive Food Intake Disorder","authors":"Ashley Dunford, Jennifer J. Thomas","doi":"10.3928/00485713-20240117-01","DOIUrl":"https://doi.org/10.3928/00485713-20240117-01","url":null,"abstract":"\u0000 Avoidant/restrictive food intake disorder (ARFID) is a relatively new category within\u0000 DSM-5\u0000 feeding and eating disorders, which expands beyond developmentally normative picky eating. Given its recent introduction to the diagnostic nomenclature, research on the epidemiology of ARFID is in its infancy. Prevalence estimates for ARFID vary considerably by methodology, setting, and population, but growing evidence suggests that ARFID is just as common as other more well-known eating disorders, affecting approximately 0.3% to 15.5% of children and 0.3% to 4.1% of adults. Despite common misconceptions, ARFID impacts a wide range of individuals across ages and genders, and both medical and psychiatric comorbidities are common. Limited research has investigated prognosis, but existing longitudinal studies highlight the persistence of the disorder and the possibility of diagnostic crossover to other eating disorders.\u0000 \u0000 [\u0000 Psychiatr Ann\u0000 . 2024;54(2):e42–e46.]\u0000 \u0000","PeriodicalId":506992,"journal":{"name":"Psychiatric Annals","volume":"20 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139880307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.3928/00485713-20240110-01
P. E. Kambanis, Lilian P. Palmer, Lazaro Zayas
Differential diagnosis between avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa may be challenging due to shared clinical features. Diagnostic criteria for ARFID prohibit disturbance of one's body shape/weight. In contrast to body image disturbance, body image dissatisfaction is normative and ubiquitous and may characterize those with ARFID. Distinguishing between body image disturbance and dissatisfaction is critical to derive accurate diagnoses. We compare these constructs, highlighting that body image dissatisfaction rises to the level of clinically significant body image disturbance when it results in: (1) behavioral symptoms, such as persistent behavior that interferes with weight gain; and/or (2) eating disorder cognitions, such as a distorted perception of one's shape/weight or overvaluation of shape/weight. We illustrate the application of this definition via a brief case example and conclude by providing recommendations to aid providers in differential diagnosis between ARFID and its most similar eating disorder, anorexia nervosa. [ Psychiatr Ann . 2024;54(2):e37–e41.]
由于具有共同的临床特征，对回避型/限制型食物摄入障碍（ARFID）和神经性厌食症进行鉴别诊断可能具有挑战性。ARFID的诊断标准禁止对自己的体形/体重进行干扰。与体像障碍相反，体像不满意是正常的、普遍存在的，可能是 ARFID 患者的特征。区分体像困扰和体像不满意对于得出准确的诊断结果至关重要。我们对这两个概念进行了比较，强调当身体形象不满意导致：（1）行为症状，如妨碍体重增加的持续行为；和/或（2）进食障碍认知，如对自身体形/体重的扭曲感知或对体形/体重的高估时，身体形象不满意就上升到了具有临床意义的身体形象障碍的水平。我们通过一个简短的病例说明了这一定义的应用，最后提出了一些建议，以帮助医疗服务提供者对 ARFID 及其最相似的饮食失调症（神经性厌食症）进行鉴别诊断。 [ Psychiatr Ann .
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