Clinical Features Of Eating Disorders Research Articles

Potential impact of the COVID-19 pandemic on japanese patients with eating disorders -a cross-sectional study

BackgroundThe COVID-19 pandemic and associated lockdown had a considerable impact on eating disorders (EDs). We evaluated the clinical features of Japanese ED patients before and after the first COVID-19 outbreak-related state of emergency (April 7, 2020).MethodsWe studied 148 patients who were divided into two groups based on when they arrived at our clinic: before (Before group: n = 86) or after (After group: n = 62) the start of the first state of emergency. All patients completed the Japanese versions of the Eating Disorder Inventory (EDI) and Parental Bonding Instrument (PBI).ResultsThe After group was substantially younger than the Before group (p = .0187). Regardless of the ED type, patients who developed an ED during the first state of emergency tended to be significantly younger than those who developed one before. Differences in EDI characteristics were observed between the two groups. The PBI care subscale was notably higher (p = .0177) in the After group. The PBI maternal care subscale was the only statistically significant factor associated with age (β = -0.35, p < .0001).ConclusionsHome confinement associated with the COVID-19 pandemic and the ensuing increase in parent-child closeness may have influenced the decreased age of ED patients at their initial consultation. Treatment interventions should consider the differences in the clinical features of EDs.

Расстройства приема пищи у больных с ожирением и сахарным диабетом 2-го типа. Лекция для врачей

Obesity and type 2 diabetes mellitus (DM 2) that result from eating disorders (ED) which lead to weight gain are endocrine diseases provoked (caused) by psychopathology, and are psychosomatic diseases. The clinical features of ED in obesity and diabetes mellitus 2 are that they rarely occur as independent psychopathological units and are mainly represented by syndromic classification in the structure of other mental disorders. Preference of the predominant type of overeating for certain types of ED onset was revealed. Thus, fetal onset is characterized by permanent overeating, pubertal one – by compulsive overeating, psychogenic one – evening overeating and menopausal/age-related hypoandrogenic one – by polysyndromic overeating. Psychopharmacotherapy and psychotherapy combination is used to treat ED in patients with DM 2 and obesity. For prevention of obesity, it is recommended to diagnose early signs of ED which lead to weight gain, and to initiate psychiatric and psychotherapeutic care as soon as possible if ED occurred. Recent 2021 clinical guidelines for the treatment of obesity were updated with recommendation that all obese patients after secondary causes for weight gain were excluded, should be consulted by a psychiatrist-psychotherapist specializing in the general somatic network.

The potential use of N-methyl-3,4-methylenedioxyamphetamine (MDMA) assisted psychotherapy in the treatment of eating disorders comorbid with PTSD

Despite advances in the field, eating disorders (EDs) remain very challenging disorders to treat, especially when comorbid with posttraumatic stress disorder (PTSD). N-methyl-3,4-methylenedioxyamphetamine (MDMA)-assisted psychotherapy for treatment refractory PTSD shows great promise, with two-thirds of participants achieving full remission at 1 year or more at follow-up. PTSD is a common comorbidity associated with EDs, and patients with EDs and PTSD (ED-PTSD) are reported to have higher severities of illness, greater comorbidities, higher treatment dropouts, and poorer outcomes. We hypothesize that MDMA-assisted psychotherapy will be efficacious in the ED-PTSD population for both ED and PTSD symptoms. The rationales for and proposed mechanisms of MDMA-assisted psychotherapy for ED-PTSD are considered from neurobiological, psychological and social perspectives. MDMA is associated with unique psychopharmacological effects, including: 1) reduced fear, 2) enhanced wellbeing, 3) increased sociability/extroversion, 4) reduced self-criticism, 5) increased compassion for self/others, 6) increased interpersonal trust, and 7) alert state of consciousness. These anxiolytic and prosocial effects may counteract avoidance and hyperarousal in the context of psychotherapy for those with ED-PTSD. Other clinical features of EDs that may be amenable to MDMA-assisted psychotherapy include body image distortion, cognitive rigidity, and socio-emotional processing difficulties. To illustrate its potential, personal accounts of individuals with ED-PTSD symptoms reporting benefit from MDMA adjunctive to psychotherapy are described. In addition, the possible risks and challenges in conducting this work are addressed, and future implications of this proposal are discussed.