Abstract
PurposeThe co-occurrence of obesity, eating and mood disorders has been frequently reported in clinical and epidemiological settings. This study aimed to explore the prevalence of night-eating obese patients referred for bariatric surgery and to identify associated psychopathology and psychiatric comorbidity.MethodsThe sample was composed of 121 obese patients consecutively enrolled between November 2010 and May 2012 during psychiatric evaluations for bariatric intervention. Clinical features and psychiatric diagnoses were collected. Night-eating was investigated through the administration of the Night-eating Questionnaires (NEQ) and was defined as the presence of self-reported evening hyperphagia and/or nocturnal ingestions. Binge-eating and purging behaviors and general psychopathology were respectively assessed using the Bulimic Investigatory Test, Edinburgh and the Symptom Checklist-90-Revised.ResultsNight-eating was reported by twenty subjects (16.5%). Patients with night-eating behavior were significantly more frequently diagnosed with bipolar spectrum disorders and with comorbid eating and mood disorders in comparison with other patients. Night-eating patients showed significantly more binging/purging behaviors and greater severity of somatization, obsessive–compulsive symptoms, phobic anxiety, psychoticism and sleep disorders. Patients with bipolar disorder type 1 or 2 scored significantly higher than those without mood disorders at NEQ total score, mood/sleep and nocturnal ingestions subscales, but also scored significantly higher than other patients with mood disorders at the latter subscale.ConclusionPatients with evening hyperphagia and/or nocturnal ingestions should be carefully evaluated to detect possible bipolar spectrum disorders and other eating disorders. Prompt management of these conditions should be provided before bariatric interventions.Level of evidenceV, cross-sectional descriptive study.
Highlights
Night-eating syndrome was first described by Stunkard et al [1] in a small sample of morbidly obese patients
There are limited published data about psychopathology related to night-eating
We observed a strong relationship between bipolar spectrum disorders and night-eating behavior (NEB)
Summary
Night-eating syndrome was first described by Stunkard et al [1] in a small sample of morbidly obese patients. In this early description, it was depicted as an eating disorder. Night-eating syndrome was included in the 5th edition of the Diagnostic and Statistical Manual of Mental. Disorders (DSM-5) [4] among “other specified feeding or eating disorders”, giving way to its possible recognition as an independent diagnostic category. Frequency and duration criteria were not specified Despite this progress, night-eating is still poorly described and under-investigated. The high prevalence of obesity/overweight in patients with night-eating seems to confirm this association [9]. Night-eating shows important, but yet to be elucidated, relationships with various psychiatric disorders, often found in comorbidity, such as mood, eating, anxiety, sleep and substance use disorders [10,11,12]
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