Co-occurrence Of Eating Disorders Research Articles

Psychotherapeutic Treatment of Co-Occurring Eating Disorders and Posttraumatic Stress Disorder

This article reviews the considerations for treating co-occurring eating disorders (EDs) and posttraumatic stress disorder (PTSD) concurrently. EDs are serious psychiatric disorders that interfere with one's physical, mental, and social well-being and require intensive treatment. When a patient presents with co-occurring disorders in addition to an ED, unique treatment considerations must be made. Patients with co-occurring PTSD are likely to use ED behaviors to manage PTSD symptoms. As such, it is important that clinical attention be paid to both disorders. Although a gold standard treatment for the ED/PTSD patient population has not yet been established, there are promising results from emerging research. Of note is the implementation of cognitive processing therapy (CPT), an evidenced-based practice used to treat PTSD in patients with ED/PTSD. CPT can be efficacious in simultaneously treating ED and PTSD symptomology. This article offers a clinical perspective on this issue. [ Psychiatr Ann. 2018;48(10):473–476.]

Putative Risk Factors for Non-Suicidal Self-Injury in Eating Disorders.

Evidence suggests a common association between eating disorders (EDs) and non-suicidal self-injury (NSSI). The present study aimed to investigate the potential risk factors for NSSI among ED patients. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. The results showed that 33% of ED patients reported NSSI in their lifetime. NSSI appeared to occur more frequently among binge eating/purging type ED patients than among patients with other ED and to be related to a more severe eating pathology. A younger age at the onset of eating problems, more negative self-evaluation, suicide attempts, substance abuse, parents' low weight, family tension at mealtime, parental alcohol problems, childhood abuse, peer aggression, and negative antecedent life events were more common among patients with co-occurring EDs and NSSI than among patients without NSSI. The results may inform the risk assessment and treatment of NSSI in EDs in the early detection period. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Emotional reactivity in a clinical sample of patients with eating disorders and nonsuicidal self-injury

Emotional reactivity is theorized to contribute to both eating disorders (ED) and nonsuicidal self-injury (NSSI). Although EDs and NSSI frequently co-occur, no study has examined emotional reactivity in individuals with both conditions. This study examined the following hypotheses in a large clinical sample (N = 648): (1) patients with co-occurring ED and NSSI would report higher emotional reactivity and more severe clinical characteristics; (2) among those with EDs, patients with bulimia nervosa (BN) would be more likely to report NSSI and evidence higher emotional reactivity compared to those with anorexia nervosa (AN); and (3) higher emotional reactivity would be associated with worse treatment outcomes. Data were collected at admission and discharge from inpatient, partial hospitalization, and intensive outpatient treatment programs for EDs or NSSI. The NSSI-only and co-occurring groups reported significantly higher emotional reactivity than the ED-only group. Among those with EDs, individuals with BN reported higher emotional reactivity and were more likely to engage in NSSI compared to those with AN. Emotional reactivity was inconsistently related to treatment outcomes among the co-occurring and ED-only groups. In sum, results highlight the importance of emotional reactivity in clinical presentations, particularly when NSSI is present.

Predictors of Comorbid Eating Disorders and Diabetes in People with Type 1 and Type 2 Diabetes.

The objective of this study was to identify psychosocial predictors of comorbid eating disorders (EDs) in individuals with type 1 and type 2 diabetes. In this cross-sectional study, 140 people with diabetes answered an online survey covering sociodemographic information, body esteem, restrictive eating, medication omission, coping styles and depressive symptoms. Participants were recruited through advertisements on more than 100 websites, including forums, community organizations and Facebook groups focusing on either diabetes or EDs. Recruitment took place in Canada, Europe, Australia and the United States. On average, EDs developed after diabetes diagnoses in participants with type 1 diabetes but prior to diabetes diagnosis in participants with type 2 diabetes. In type 1 diabetes, avoidance coping styles and depressive symptoms predicted an additional diagnosis of EDs. Co-occurring EDs and type 2 diabetes were predicted by body mass indexes and task-oriented coping strategies. Variables potentially influencing the development of EDs in people with diabetes differ according to the type of diabetes, body mass indexes, coping styles and depressive symptoms; they should be more systematically evaluated and closely monitored. In the context of diabetes management, prevention strategies for ED onset based on increased knowledge of the risk factors associated with EDs are necessary and could help decrease the risk for the health complications of diabetes.

Multidisciplinary Residential Treatment of Type 1 Diabetes Mellitus and Co-Occurring Eating Disorders

Research on treatment for diabetes and co-occurring eating disorders is sparse. We examined outcomes from multidisciplinary residential treatment for women with type 1 diabetes and eating disorders and the impact of treatment duration on outcomes. Participants were 29 women with type 1 diabetes and eating disorders receiving residential treatment. Repeated measures analyses of variance examined changes in blood glucose and psychological symptoms over treatment. Analyses were repeated to include treatment by duration interactions. Treatment produced significant reductions in blood glucose, eating disorder symptoms, and psychological concerns. Longer treatment duration was associated with greater improvements in psychological symptoms.

Body Image in Patients with Posttraumatic Stress Disorder after Childhood Sexual Abuse and Co-Occurring Eating Disorder

Background: Body image is a multidimensional construct with cognitive-affective, behavioral and perceptive components. Survivors of childhood sexual abuse report a disturbance of the cognitive-affective component of their body image but not of the perceptive component. It has not yet been examined whether and how the behavioral component is affected. Also, it is still unknown whether the disturbances might be due to the influence of co-occurring eating disorders. Sampling and Methods: The cognitive-affective and behavioral components of the body image of 84 female participants with posttraumatic stress disorder (PTSD) after childhood sexual abuse (31 with a co-occurring eating disorder) and 53 healthy participants were assessed via the Dresden Body Image Inventory (Dresdner Körperbildfragebogen-35, DKB-35) and the Body Image Avoidance Questionnaire (BIAQ). Results: PTSD patients reported significantly higher negative scores on all DKB-35 subscales (p < 0.001) and the BIAQ (p = 0.002; p < 0.001). Results remained consistent after accounting for the influence of co-occurring eating disorders (p = 0.021; p = 0.001; p < 0.001). Conclusions: Results show for the first time that the behavioral component of the body image is impaired in female patients with PTSD in addition to the cognitive-affective component. This is not solely due to a comorbid eating disorder. The effect of established treatments on the body image of PTSD patients should be evaluated and new treatment modules should be developed and tested, if necessary.

Bipolar Disorder with Co-Occurring Eating Disorders: Prevalence and Pharmacotherapeutic Implications

Bipolar disorder and eating disorders co-occur more often than expected by chance alone, yet little is known about the recognition and treatment of these disorders when they co-occur. This article briefly reviews studies examining the co-occurrence of these disorders, compares studies of their treatment, and presents preliminary suggestions for the management of the patient with bipolar disorder with an eating disorder. The objective was to provide an update on the scientific evidence examining the comorbidity among bipolar disorder and eating disorders and potential treatments for patients with both disorders. The authors updated two earlier reviews of all published English language studies addressing the occurrence of anorexia nervosa, bulimia nervosa, and binge eating disorder in patients with bipolar disorder and studies of comorbidity of bipolar disorder in patients with eating disorders. In addition, the authors discuss treatment implications for the patient with comorbid conditions from reviewed studies of pharmacotherapy and psychotherapy strategies used in both conditions. Community and clinical population studies of the lifetime prevalence rates of eating disorders in patients with bipolar disorder and of bipolar disorder in patients with eating disorders indicate high rates of comorbidity among these illnesses, particularly when subthreshold and spectrum manifestations of these disorders are included. Pharmacological treatment approaches to patients with bipolar disorder and a co-occurring eating disorder require examination of the possible adverse effects of treatment of one syndrome on the other and attempts to manage both syndromes with agents that might be beneficial to both.

Eating disorders, substance use disorders and major depression in the Canadian population

Background: Significant associations between eating disorders (ED) and each of substance use disorders (SUD) and major depression (MD) have been established.Aims: To examine the comorbidity of all three disorders in a large nationally representative sample of Canadian men and women.Methods: This research used data collected by Statistics Canada in cycle 1.2 of the Canadian Community Health Survey (20,211 women and 16,773 men).Results: MD fully mediated the relationship between ED and alcohol dependence and partially mediated their relationship with alcohol interference for both men and women. The multivariate comorbidity of MD and illicit drug use exhibited different patterns for men and women with eating disorders symptomatology.Conclusion: Findings support the importance of developing assessment instruments and treatment strategies that address the co-occurrence of ED, MD and SUD for both women and men. Findings also indicate that it might be beneficial for prevention programs to target depression.

Assessment and Treatment of Co-occurring Eating Disorders in Publicly Funded Addiction Treatment Programs

Publicly funded addiction treatment programs were surveyed to increase understanding of treatment options for persons with co-occurring eating and substance use disorders. Data were collected between 2002 and 2004 from face-to-face interviews with program directors of a nationally representative sample of 351 addiction treatment programs. Half of the programs screen patients for eating disorders; 29% admit all persons with eating disorders, and 48% admit persons with eating disorders of low severity. Few programs attempt to treat eating disorders. Programs that admit and treat patients with eating disorders are more likely to emphasize a medical-psychiatric model of addiction, use psychiatric medications, admit patients with other psychiatric disorders, and have a lower caseload of African-American patients. Generally, patients with co-occurring eating and substance use disorders do not appear to receive structured assessment or treatment for eating disorders in addiction treatment programs. These results highlight the need for education of addiction treatment professionals in assessment of eating disorders.

Assessment and Treatment of Co-occurring Eating Disorders in Publicly Funded Addiction Treatment Programs

Publicly funded addiction treatment programs were surveyed to increase understanding of treatment options for persons with co-occurring eating and substance use disorders. Data were collected between 2002 and 2004 from face-to-face interviews with program directors of a nationally representative sample of 351 addiction treatment programs. Half of the programs screen patients for eating disorders; 29% admit all persons with eating disorders, and 48% admit persons with eating disorders of low severity. Few programs attempt to treat eating disorders. Programs that admit and treat patients with eating disorders are more likely to emphasize a medical-psychiatric model of addiction, use psychiatric medications, admit patients with other psychiatric disorders, and have a lower caseload of African-American patients. Generally, patients with co-occurring eating and substance use disorders do not appear to receive structured assessment or treatment for eating disorders in addiction treatment programs. These results highlight the need for education of addiction treatment professionals in assessment of eating disorders.