Abstract
Night eating syndrome (NES) is currently classified as an Other Specified Feeding or Eating Disorder (OSFED) under the Diagnostic Statistical Manual−5 (DSM-5). This systematic review aims to consolidate the studies that describe the sociodemographic, clinical and psychological features of NES in a population of patients with eating disorders (ED), obesity, or those undergoing bariatric surgery, and were published after the publication of the DSM-5. A further aim was to compare, where possible, NES with BED on the aforementioned variables. Lastly, we aimed to appraise the quality of the studies being included in the review. We conducted a systematic search on three databases (MEDLINE, PubMed and Embase) which resulted in the selection of 22 studies for the review. We included the articles that studied patients with NES and their sociodemographic, clinical and psychological features in a clinical (i.e., ED, obese or bariatric surgery) population, through a quantitative study design. Articles were excluded if the NES patients included in the study had a comorbid psychological disorder, and/or the sample was collected from a university/non-clinical population, and/or the study design was qualitative, and/or NES features were compared with any other disorder, except BED. Our study found that no conclusions about the link between any sociodemographic feature (such as, age, gender, income, etc.) and an NES diagnosis could be made. Further, NES patients presented with elevated ED pathology (including emotional eating and loss of control eating) and higher occurrence of depressive symptoms than controls. Contrary to the literature suggesting that NES and Binge Eating Disorder (BED; an ED subtype which is also comorbid with obesity) patients often report overlapping features, questioning the validity of NES as an ED diagnosis, we found that BED can be differentiated from NES by the higher occurrence of emotional eating, body related concerns and abnormal eating episodes. The review also suggested an overlap between NES and Sleep-Related Eating Disorder. We recommend that it is essential to study NES as an independent disorder to further develop its diagnostic criteria and treatment options, thereby, increasing the quality of life of the patients suffering from this syndrome.
Highlights
The switch from the 4th edition of the Diagnostic Statistical Manual (DSM-IV-TR; American Psychiatric Association, 2000) to the 5th edition (DSM-5; American Psychiatric Association, 2013) saw significant changes to the diagnoses of eating disorders (ED)
In DSM IV-TR (American Psychiatric Association, 2000), Night Eating Syndrome (NES) was present under the category of Eating Disorder Not Otherwise Specified (EDNOS) but has been characterized as an OSFED, after EDNOS was dropped as a category of EDs in the Diagnostic Statistical Manual−5 (DSM-5) (∗Roer et al, 2014; use of ∗ denotes that the cited paper was selected for data extraction in this systematic review)
Depression, anxiety: No significant difference between groups BDI-IA: NEB > non-NEB Sleep duration: No significant difference between groups; NEB group had greater within group sleep duration variability
Summary
The switch from the 4th edition of the Diagnostic Statistical Manual (DSM-IV-TR; American Psychiatric Association, 2000) to the 5th edition (DSM-5; American Psychiatric Association, 2013) saw significant changes to the diagnoses of eating disorders (ED). Allison et al.’s (2010) efforts to improve the criteria for diagnosing NES, led to a fruitful change in the way symptoms of NES are described in the DSM-5 (American Psychiatric Association, 2013) Their proposed criteria includes: (A) evening hyperphagia, defined as the consumption of 25% or more of total daily caloric intake after the evening meal, and/or two nocturnal ingestions on average per week; (B) awareness of one’s eating behaviors and ingestions; (C) three of the following: (i) morning anorexia, (ii) the desire to eat between dinner and sleep, (iii) sleep onset insomnia, (iv) the belief that one needs to eat in order to fall asleep, (v) depressed or lowering of mood in the evening and night time; (D) distress or impaired functioning; (E) a period of 3 months or more under these conditions; and (F) these conditions are not secondary to any medical condition
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