Compulsive Disorder Research Articles

The comorbidity structure of fear, distress and compulsive disorders in an acute psychiatric sample

Body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD), collectively referred to as compulsive disorders, have typically not been included in structural research on the internalizing spectrum due to low prevalence in community samples. The current study examined the higher-order structure of anxiety, depressive and compulsive disorders among patients in a psychiatric partial hospital program (N = 2,178). We applied confirmatory factor analysis to diagnostic data obtained at admission and compared several competing models of the comorbidity structure. A one-factor model accounted well for the co-occurrence of all the disorders. A two-factor model comprised of fear and distress factors, wherein compulsive disorders loaded on fear, also fit the data well. However, a very large factor correlation (r = 0.86) suggested limited discriminant validity of fear and distress in the sample. Alternate models that featured a distinct compulsivity factor were not viable owing to large correlations between fear and compulsive disorders. Overall, our findings indicate that a broad internalizing dimensions underlies not only anxiety and depression, but also compulsive disorders, in an acute psychiatric population. Future studies using symptom-level data are needed to replicate these results and determine the structure of internalizing disorders from the bottom up, starting with narrowly defined symptom components.

Towards a definitive symptom structure of obsessive-compulsive disorder: a factor and network analysis of 87 distinct symptoms in 1366 individuals.

The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.

Review: Atopic Dermatitis - Exposome, Microbiome, Psyche,and Evolution

Atopic Dermatitis (AD) is probably the most common type of eczema. The quality of life assessment reveals a number of negative consequences for patients with AD and their families. AD is associated with high levels of stress, stigma, social withdrawal, anxiety, depression, and even suicide ideation. Atopic dermatitis is a multisystem inflammatory disease with a multifactorial, and still controversial etiology. Complex interactions between genetic, psychoneuroimmune and endocrine factors, microbiome, exposome and environment, mental and social factors, diet and lifestyle are proposed. AD is difficult to treat, has a chronic course with peaks of exacerbation and pronounced manifestation of mental factors. Such complexity requires deeper understanding of mechanisms behind AD. We consider a possible psychogenic component in diseaseexacerbation, andoffera different point of view onrelationships of human body with the colonizing microbiomein the context of AD etiology and pathogenesis. These relationships are interpreted in evolutionary terms in an attempt to shed some light on mechanisms of chronic and pathological skin processes. Keywords: Atopic Dermatitis; Microbiome; Exposome;Obsessive- Compulsive Disorder

Involvement of community paediatricians in the care of children and young people with mental health difficulties in the UK: implications for case ascertainment by child and adolescent psychiatric, and paediatric surveillance systems

ObjectiveTo ascertain the extent to which community paediatricians are involved in the care of children with mental health conditions in order to determine which difficulties are appropriate for single or...

A cross-species assessment of behavioral flexibility in compulsive disorders

Lack of behavioral flexibility has been proposed as one underlying cause of compulsions, defined as repetitive behaviors performed through rigid rituals. However, experimental evidence has proven inconsistent across human and animal models of compulsive-like behavior. In the present study, applying a similarly-designed reversal learning task in two different species, which share a common symptom of compulsivity (human OCD patients and Sapap3 KO mice), we found no consistent link between compulsive behaviors and lack of behavioral flexibility. However, we showed that a distinct subgroup of compulsive individuals of both species exhibit a behavioral flexibility deficit in reversal learning. This deficit was not due to perseverative, rigid behaviors as commonly hypothesized, but rather due to an increase in response lability. These cross-species results highlight the necessity to consider the heterogeneity of cognitive deficits in compulsive disorders and call for reconsidering the role of behavioral flexibility in the aetiology of compulsive behaviors.

Résultats d’une intervention pluridisciplinaire en thérapie comportementale, psycho-nutrition et activité physique sur les troubles alimentaires d’adultes en surpoids entre 2016 et 2018

ObjectivesThere is a growing need to build healthcare program addressed to overweighed and obese people suffering from eating disorders. The program named “Surpoids Objectif Forme Training” (SOFT) is dedicated to eating disorders care in overweighed people. In this study we wanted to assess severity of eating disorder before, and after the intervention with measuring Three Factors Eating Questionnaire (TFEQ) score in all patients who attended the program between years 2016 and 2018. Materials and methodsSOFT is a multidisciplinary intervention organised for outpatients in Hospital La Casamance located in Aubagne, France. For each SOFT intervention lasting 10 weeks, patients were attending 40 sessions: 10 sessions in cognitive therapy in order to understand compulsive eating and to increase emotions skills (to recognize and to face emotions) and alternative behaviours; 10 sessions in psycho-nutrition with working on cognitive flexibility, connection to present and to senses (mindful eating) and recognizing sensations of hunger and satiating; 10 sessions of physiotherapy to get aware of body needs with hypopressive gymnastics and proprioceptive training; 10 sessions in adapted physical activity to encourage daily moderate physical activity and to introduce changes in patients way of living. This study was a prospective cohort study, in which we included all overweighed adults patients suffering from compulsive eating disorder including binge eating disorder and night eating syndrome. We wanted to assess TFEQ score before and after the program. We also measured Body Mass Index (BMI), bioelectrical impedance (muscle and fat mass), waist and hip circumferences, waist-hip ratio, endurance with 6minutes walking test and muscle strength. ResultsTwo hundred and one patients were included and 168 followed the entire program. The average BMI in our group was 35kg/m2. Less than 25% of patients were suffering of binge eating disorder but most of patients had compulsive eating (65%). More than 50% of them had a TFEQ score higher than 25 before entering the program (average TFEQ was 25.2). After the program average TFEQ score had decreased from 25.2 to 20.0 (P<10−4), with only 17.9% of patients with a TFEQ score above 25. These results showed improvement of severity of eating disorders with our multidisciplinary intervention. The cognitive restraint factor (F1) was not significantly decreased after intervention (P=0.884), but disinhibition factor (F2) and hunger factor (F3) were significantly decreased (P<10−4 for both) showing less compulsive behaviours and better hunger perception. BMI was also decreased after the intervention from 35.8 to 35.5 (P=0.003). Waist hip ratio decreased from 0.86 to 0.85 (P=0.002) but muscle and fat mass were not significantly changed. Physical activity parameters were also improved, with 586 meters distance in 6minutes walking test instead of 499 meters (P<10−4) and 30 repetitions instead of 25 (P<10−4) in one minute sit-to-stand test. ConclusionsMost of patients were female, usually more frequent in eating disorders patients. More than 65% of patients had compulsive disorders without BED, which shows probably numerous atypical forms. Severity of eating troubles was decreased after intervention in disinhibition and perception of hunger, but cognitive restriction was increased in some patients, probably because they were trying to lose weight during SOFT program. In the same way, despite of a significant loss of weight, there was no change in muscle and fat mass proportions after intervention. By the way reducing restriction was sometimes inducing increase of intakes in some patients, and as a result no change observed in average body fat mass and muscle mass. After intervention we also noticed that waist circumference, hip circumference and waist-hip ratio were significantly decreased, probably thanks to physical activity targeting posture and improving global physical condition. We observed also best performances in muscle strength (sit to stand test) and in endurance (6minutes walking test). Main limitations in this study were: a non-randomized non controlled study design; lack of long term assessment (which is very important for maintaining weight and avoid medical complications of overweighting) and no assessment of patient's quality of life after intervention as we think this is a great part of motivation to maintain long term changes of way of life. Despite these limitations, we hope that this program could be extended to all patients suffering from obesity and eating disorders with efficiency on eating behaviour. Changes in eating behaviour and in physical activity seem to be the first step to maintain weight at a long term perspective.

Maternal autoimmunity and inflammation are associated with childhood tics and obsessive-compulsive disorder: Transcriptomic data show common enriched innate immune pathways

Although genetic variation is a major risk factor of neurodevelopmental disorders, environmental factors during pregnancy and early life are also important in disease expression. Animal models demonstrate that maternal inflammation causes fetal neuroinflammation and neurodevelopmental deficits, and brain transcriptomics of neurodevelopmental disorders in humans show upregulated differentially expressed genes are enriched in immune pathways. We prospectively recruited 200 sequentially referred children with tic disorders/obsessive–compulsive disorder (OCD), 100 autoimmune neurological controls, and 100 age-matched healthy controls. A structured interview captured the maternal and family history of autoimmune disease and other pro-inflammatory states. Maternal blood and published Tourette brain transcriptomes were analysed for overlapping enriched pathways. Mothers of children with tics/OCD had a higher rate of autoimmune disease compared with mothers of children with autoimmune neurological conditions (p = 0.054), and mothers of healthy controls (p = 0.0004). Autoimmunity was similarly elevated in first- and second-degree maternal relatives of children with tics/OCD (p < 0.0001 and p = 0.014 respectively). Other pro-inflammatory states were also more common in mothers of children with tics/OCD than controls (p < 0.0001). Upregulated differentially expressed genes in maternal autoimmune disease and Tourette brain transcriptomes were commonly enriched in innate immune processes. Pro-inflammatory states, including autoimmune disease, are more common in the mothers and families of children with tics/OCD. Exploratory transcriptome analysis indicates innate immune signalling may link maternal inflammation and childhood tics/OCD. Targeting inflammation may represent preventative strategies in pregnancy and treatment opportunities for children with neurodevelopmental disorders.

Predictors of Obsessive – Compulsive Disorder in clinical and non- clinical samples: A Meta – Analysis

Objective: cognitive models of OCD proposed that inflated responsibility/threat, importance/control of thought, and perfectionism/certainly are a vulnerability and maintenance cognitive factors specific to OCD symptoms. Attachment theory assumed that those cognitive factors are obsessive beliefs that can be explained within a family-attachment relationship. Although several studies have been conducted on the specificity of cognitive factors and family–attachment relative to OCD, a meta-analysis on this issue does not exist yet. Using meta-analytic techniques, the current study summarized cross-sectional data to examine: (a) which stronger predictors are related to OCD symptoms in clinical and non-clinical samples. Method: Online databases were searched. Cross-sectional studies were included if they (a)assessed OCD symptoms in clinical or non-clinical samples, (b) reported correlations or between-groups data (predictors of OCD symptoms). Seventeen studies (n= 6238) were included in random-effect meta-analyses. Results: Effect size on relation of predictors to OCD symptoms was medium. predictors were strongly associated with OCD symptoms [r= 0.456, p=.0001], Conclusions: Using meta-analytic technique, the current study examined predictors of obsessive - compulsive disorder, and it revealed that cognitive factors such as “inflated responsibility/threat, importance/control of thought, and perfectionism/certainly “and family- attachment are predictors of OCD.

Optogenetically-inspired neuromodulation: Translating basic discoveries into therapeutic strategies.

Optogenetic tools allow for the selective activation, inhibition or modulation of genetically-defined neural circuits with incredible temporal precision. Over the past decade, application of these tools in preclinical models of psychiatric disease has advanced our understanding the neural circuit basis of maladaptive behaviors in these disorders. Despite their power as an investigational tool, optogenetics cannot yet be applied in the clinical for the treatment of neurological and psychiatric disorders. To date, deep brain stimulation (DBS) is the only clinical treatment that can be used to achieve circuit-specific neuromodulation in the context of psychiatric. Despite its increasing clinical indications, the mechanisms underlying the therapeutic effects of DBS for psychiatric disorders are poorly understood, which makes optimization difficult. We discuss the variety of optogenetic tools available for preclinical research, and how these tools have been leveraged to reverse-engineer the mechanisms underlying DBS for movement and compulsive disorders. We review studies that have used optogenetics to induce plasticity within defined basal ganglia circuits, to alter neural circuit function and evaluate the corresponding effects on motor and compulsive behaviors. While not immediately applicable to patient populations, the translational power of optogenetics is in inspiring novel DBS protocols by providing a rationale for targeting defined neural circuits to ameliorate specific behavioral symptoms, and by establishing optimal stimulation paradigms that could selectively compensate for pathological synaptic plasticity within these defined neural circuits.

Recent Developments in the Habit Hypothesis of OCD and Compulsive Disorders.

This chapter aims to familiarise the reader with a diverse and fast-growing literature concerning the role that habits play in obsessive-compulsive disorder (OCD). Core concepts will be introduced, including how the balance between habits and a more deliberate form of action selection (goal-directed control) has traditionally been measured and how cross-species translation, neuroscience tools, and computational modelling have been used to build on these basic principles and reveal core mechanisms under study today. Next, the application of these methods to the study of OCD and related disorders will be detailed, converging on a theory that enhanced habit expression, and indeed compulsions in OCD, might arise from deficits in goal-directed control systems. These basic findings will be contextualised in terms of major tide changes in the field, including the shift from categorical disease frameworks to dimensional ones. Mechanistically, recent research concerning how goal-directed deficits arise, perhaps through failures in the construction of a mental model, are discussed along with studies critically evaluating our ability to measure habits in humans, in a laboratory setting. The chapter ends with a nod to the future, focusing on the need for clinically oriented, longitudinal, and intervention-based research that aim to translate what is now a wealth of cross-sectional mechanistic insights to the clinic.

Fibromyalgia: A Review of Related Polymorphisms and Clinical Relevance.

Fibromyalgia (FM) is a chronic pain syndrome that affects the central nervous system and generates disability, which is characterized by generalized pain, fatigue, and functional decline. In this review, we aimed to identify the polymorphisms related to the pathophysiology of FM and the clinical characteristics generated by genetic influence. Only original studies with genes related to FM were considered, totaling 27 articles. The genes found were: MTHFR, RGS4, MYT1L, TACR1, SCN9A, DRD3, ADRB2, IL-4, HLA-DRB1, EDN1, CNR1, TAAR1, OPRM1, ADRA1A, ADRB3, BDNF, GRIA4, HTR3A, HTR3B, HTR2A, SERPINA 1 or A1AT, NRXN3, GCH1, MEFV, TRPV3, SLC6A4, ACE I/D, TSPO, COMT, and MAOA. Several genes related to different pain syndromes and altered pain thresholds have been identified and some polymorphisms were related to susceptibility to FM. It was observed that 73.33% of the genes related to FM were also associated with some psychological disorders, such as anxiety, depression, schizophrenia, and obsessive and compulsive disorder, and 40.00% with pain sensitivity and/or migraine, besides other disorders associated (drug addiction, autoimmune disorders, circulatory problems, and metabolic alterations). This review demonstrated an association of FM and genetic polymorphisms that can expand our knowledge about the pathophysiology of this disease.

Valence processing in the PFC: Reconciling circuit-level and systems-level views.

An essential component in animal behavior is the ability to process emotion and dissociate among positive and negative valence in response to a rewarding or aversive stimulus. The medial prefrontal cortex (mPFC)-responsible for higher order executive functions that include cognition, learning, and working memory; and is also involved in sociability-plays a major role in emotional processing and control. Although the amygdala is widely regarded as the "emotional hub," the mPFC encodes for context-specific salience and elicits top-down control over limbic circuitry. The mPFC can then conduct behavioral responses, via cortico-striatal and cortico-brainstem pathways, that correspond to emotional stimuli. Evidence shows that abnormalities within the mPFC lead to sociability deficits, working memory impairments, and drug-seeking behavior that include addiction and compulsive disorders; as well as conditions such as anhedonia. Recent studies investigate the effects of aberrant salience processing on cortical circuitry and neuronal populations associated with these behaviors. In this chapter, we discuss mPFC valence processing, neuroanatomical connections, and physiological substrates involved in mPFC-associated behavior. We review neurocomputational and theoretical models such as "mixed selectivity," that describe cognitive control, attentiveness, and motivational drives. Using this knowledge, we describe the effects of valence imbalances and its influence on mPFC neural pathways that contribute to deficits in social cognition, while understanding the effects in addiction/compulsive behaviors and anhedonia.

Prevalence of Mental Health Disorders Among Undergraduate University Students in the United States: A Review.

The aim of the current review is to describe the prevalence and demographic correlates of mental health disorders among undergraduate university students in the United States. A search strategy was built and conducted using PubMed, PsycINFO, and CINAHL to identify studies published between 2009 and 2019 on the prevalence of mental health disorders, as defined in the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders, in undergraduate students in the United States. A total of 12 studies were included in the final data extraction. The highest prevalence rates were identified in eating disorders, which ranged from 19% to 48%, followed by compulsive disorders (2% to 12.27%), depression (22%), posttraumatic stress disorder (8%), and sleep disorders (9.4% to 36%). The identified prevalence of mental health disorders is high, and the subsequent impact on this population is worrying. There is an urgent need to develop strategies for early screening and management of mental health services in university settings. [Journal of Psychosocial Nursing and Mental Health Services, 59(2), 17-24.].

P.013 The neural signature of confidence abnormalities in compulsive disorders: obsessive-compulsive disorder and gambling disorder

We show that Γ-free fillings and lonesum fillings of Ferrers shapes are equinumerous by applying a previously defined bijection on matrices for this more general case and by constructing a new bijection between Callan sequences and Dumont-like permutations. As an application, we give a new combinatorial interpretation of Genocchi numbers in terms of Callan sequences.Further, we recover some of Hetyei’s results on alternating acyclic tournaments. Finally, we present an interesting result in the case of certain other special shapes.

Psychometric properties of the excoriation (skin‐picking disorder) dimensional scale

ObjectiveThe Excoriation (skin‐picking disorder) dimensional scale (SPD‐D) is a new measure of excoriation skin picking disorder (SPD). The 5‐item scale was developed by the Diagnostic and Statistical Manual (Fifth Edition) obsessive–compulsive spectrum disorders sub‐workgroup to assist in the dimensional assessment of SPD.MethodThe aim of the present study was to provide a psychometric evaluation of this new scale in a large community sample. 803 participants were recruited from online community noticeboards around Australia.ResultsThe results indicated that the SPD‐D demonstrated a unidimensional structure, high internal consistency (rs = .87, .86, and .92 across three samples), and good test–retest reliability (rs = .86). The SPD‐D also demonstrated good convergent validity with the Skin‐Picking Scale Revised (rs = .90) as well as divergent validity with the generalised anxiety disorder scale (rs = .40).ConclusionsOverall, the SPD‐D appears to be a brief and reliable measure of SPD symptomatology.

The Therapeutic Relationship with Clients with Phobic, Obsessive–Compulsive, Eating, and Depressive Disorders: Which Meanings Prevail?

Do clients with phobic, obsessive–compulsive, eating, and depressive disorders interact with their therapist using ways of relating whose respective meanings are characteristic of the semantics of freedom, goodness, power, or belonging? And does the therapist take a position in tune with clients’ dominant semantic? This study aims to answer these questions to verify the hypothesis, derived from Ugazio’s family semantic polarities theory: that there is no single way of building the therapeutic relationship, rather, there are as many ways as there are semantics and related disorders. We applied the Semantic Grid of Therapeutic Relationship to 120 video-recorded sessions, the first two sessions of 60 clients with phobic (12), obsessive–compulsive (12), eating (12), depressive or bipolar disorders (12) and problems with daily life (12). The SG-DTR allows the detection and classification of the interactive semantic polarities (ISPs), in which client and therapist, mainly nonverbally, move away from their ascribed roles. The results confirm that the lived story between therapist and client in the here and now of the session is constructed in different ways according to the patients’ disorder. This study opens a new research perspective on the therapeutic relationship and shows the application of a method which can also be used by clinicians, especially when they are facing an impasse during the therapy.

The COVID-19 Pandemic Impact on Patients with Obsessive Compulsive Disorder

The COVID-19 pandemic creates challenges for individuals with preexisting mental health conditions, such as those with depression, phobias, generalized anxiety, and obsessive-compulsive disorders. Patients with these preexisting disorders could experience increased fears about danger of contamination, and high level of distress. This report focuses on the diagnosis and the general treatment of obsessive-compulsive disorder and then describes specific interventions to prevent its clinical deterioration due to COVID-19 global pandemic. Keywords: COVID-19; OCD; Cognitive behavioral therapy; Psychotherapy; Psychopharmacology; Treatment; Guidelines

Probable Crucial Role of Alteration in Insulin signaling in the Pathophysiology of Myotonic dystrophy Type 1-A Systemic Review

Myotonic dystrophy type1(MD1) represents an autosomal dominant genetic disorder with the properties of multisystem getting involved. The organ systems implicated are skeletal muscle, heart, gastrointestinal tract( GIT), as well as brain There have been reports regarding the implications of changes in insulin signaling as well as their association with the clinical MD1 features. Thus we decided to conduct a systematic review regarding this. We utilized the PubMed search engine, Web of Science, Google Scholar, Embase, and Cochrane reviews using the MeSH terms like Myotonic dystrophy type1 &amp; type2; insulin signaling; insulin receptors(IR-A&amp;B); control of insulin signaling in the brain other disorders related to enhancing age comparison; insulin-like growth factor1IGFR 1receptor); comparison with alterations in diabetes type 2 (T2DM) as well as metabolic syndrome(MetS) from 1970 to date in 2020 on 31st August 2020. We found over 10,150 articles out of which we selected 112 articles for this review, No meta-analysis was done. It was seen that the clinical proof of implications of the insulin signaling pathway in MD1 is dependent regarding enhanced chances of IR observed during practice as well as current research proofs regarding the benefits of metformin with regards to muscular action. Further indirect proof comes via some central nervous system(CNS) obtained symptoms that are typical of MD1, like obsessive compulsive behaviours or obsessive-compulsive disorders( OCD), whose association with changes in insulin signaling was shown in different disorders. On ground system, various etiopathological along with physiological modes which are working in MD1 might interfere with the usual physiological action of insulin. With all this proof the significance of insulin signaling in association with clinical features of MD1 warrants more basic scientific as well as clinical along with therapeutically directed research.

Compulsivity is linked to reduced adolescent development of goal-directed control and frontostriatal functional connectivity

A characteristic of adaptive behavior is its goal-directed nature. An ability to act in a goal-directed manner is progressively refined during development, but this refinement can be impacted by the emergence of psychiatric disorders. Disorders of compulsivity have been framed computationally as a deficit in model-based control, and have been linked also to abnormal frontostriatal connectivity. However, the developmental trajectory of model-based control, including an interplay between its maturation and an emergence of compulsivity, has not been characterized. Availing of a large sample of healthy adolescents (n = 569) aged 14 to 24 y, we show behaviorally that over the course of adolescence there is a within-person increase in model-based control, and this is more pronounced in younger participants. Using a bivariate latent change score model, we provide evidence that the presence of higher compulsivity traits is associated with an atypical profile of this developmental maturation in model-based control. Resting-state fMRI data from a subset of the behaviorally assessed subjects (n = 230) revealed that compulsivity is associated with a less pronounced change of within-subject developmental remodeling of functional connectivity, specifically between the striatum and a frontoparietal network. Thus, in an otherwise clinically healthy population sample, in early development, individual differences in compulsivity are linked to the developmental trajectory of model-based control and a remodeling of frontostriatal connectivity.

EHealth Treatments for Compulsive Overeating: a Narrative Review

Electronic or eHealth technologies have resulted in a progressive transformation of healthcare delivery, leading to greater treatment access, and more informed and individualized clinician-patient relationships. These characteristics are especially important for individuals who suffer from compulsive overeating and related disorders such as binge-eating disorder and bulimia nervosa—where personal feelings of shame and fear, high costs and low treatment availability may deter individuals from obtaining appropriate care. In the following narrative review, the efficacy of eHealth interventions for the treatment of compulsive overeating is explored. The key benefits of the treatments—which mainly consist of internet cognitive behavioural therapy—are their convenience and ease of access; their ability for the individual to retain anonymity; and the provision of continuous support. Despite these advantages, high dropouts and low completion rates continue to pose a problem in eHealth therapies. Therefore, such treatments need to enhance engagement by including a diverse range of multimedia formats and to improve therapist interaction on these platforms. This is especially important considering that patients who exhibit compulsive overeating behaviours tend to have an elevated sensitivity to reward and pleasurable stimuli and a greater need for positive human support. The findings suggest that the more interactive, engaging and person-centered the treatment is, the more appealing it will be to those suffering from compulsive overeating. Therefore, in order to enhance adherence and therapeutic success, it will behoove future studies to assess the features of eHealth treatments to determine what could be modified in order to enhance their efficacy and appeal to patients.