Eating Problems Research Articles

Emergency psychiatric care for children and adolescents: factors associated with multiple visits and hospital admissions.

Given the increased demand for mental health resources in the child and adolescent population, this study aims to describe the emergency psychiatric care of the children and adolescents and to explore factors associated with multiple visits and hospital admissions. All patients < 18 years of age who visited the psychiatric ED(ED) of a University Hospital in Madrid, Spain, during 2022 were included. Data were collected by the attending psychiatrist upon first 2022 ED visit (index visit) and during any ED revisit. Electronic health records of all included patients were revised to contrast information and complete missing data. Logistic regressions and correlation analyses were used to explore factors associated with multiple ED visits and hospitalisations. N = 397 patients were included. Factors associated with multiple ED visits were: being LGTBQ+, having eating problems, substance use, consulting for psychosis upon first visit, having a history of suicidal behaviour, previous mental health service use or previous hospitalisations, having two or more psychiatric diagnoses, and being diagnosed of eating disorders or depression. Factors associated with hospitalisation include female gender, older age, LGTBQ+, family conflicts, first or second-generation migrants, history of abuse, eating problems, drug use, history of suicidal behaviour, previous mental health service use or previous hospitalisations, psychiatric comorbidity, and eating disorders diagnosis. Identifying predictors that lead to different clinical pathways and use of mental health services can improve clinical outcomes and resource use.

Eating Problems Among Adolescent Boys and Girls Before and During the Covid-19 Pandemic.

Studies suggest that adolescents reported more eating problems during the pandemic. Using a population-based sample, we compared eating problems-and how they associate with a range of personal characteristics and genetic factors-among adolescents before (June 2017-April 2020) versus during (April 2020-December 2022) the pandemic. Based on a preregistered analysis plan, we used cross-sectional data collected from 22,706 14-16-year-olds over 6 years (55% during the pandemic) in the Norwegian Mother, Father, and Child Cohort. We used measurement invariance analyses to compare the level of eating restraint and body concern before and during the pandemic, and multi-group structural equation models to estimate pre-pandemic and pandemic patterns of associations. Pandemic responders generally reported more eating problems than pre-pandemic responders, specifically on dieting and body dissatisfaction. However, after adjusting for a general linear increase in eating problems across all 6 years of data collection, the pandemic itself seems to be associated with more eating problems only among girls, reporting more eating restraints (meanΔ = 0.14 [CI: 0.07, 0.20]) and body concern (meanΔ = 0.17 [CI: 0.11, 0.23]). Associations between eating problems and a range of other characteristics did not differ across the pandemic and pre-pandemic groups. There was a general increase in eating problems among 14-16-year-oldsover time. Adjusting for this trend, the pandemic seems to exacerbate problems among girls. Although the mechanisms are unclear, our results point to factors susceptible to change that could have been intensified during the pandemic (e.g., screen time, mental distress). Our results highlight the importance of recognizing sex-specific differences in eating problems.

Taste and smell are associated with dietary intake, eating behavior, nutritional status, and health-related quality of life in children with cancer

Background & aimsSmell and taste changes are frequently reported bothersome treatment symptoms during treatment for childhood cancer and assumed to influence outcomes such as food intake. Since nutritional status of children with cancer is already vulnerable, any detrimental effects on food intake should be prevented. Therefore, understanding the exact relationship between chemosensory changes and dietary intake, eating behavior, and other domains such as health-related quality of life (HRQoL), is important for improving outcomes. MethodsIn this longitudinal study, we followed 87 childhood cancer patients treated for hematological, solid, or brain malignancies. Smell (odor threshold and odor identification) and taste function (total taste score) were objectively investigated using commercial Sniffin’ Sticks and Taste Strips respectively, and by self-report. Dietary intake was measured using a 3-day food dairy. For nutritional status, BMI expressed as standard deviation scores was derived from medical records. Eating behavior and HRQoL were assessed by the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and PedsQL 4.0 Generic Core Scales, respectively. Measurements were taken approximately 6 weeks (T0), 3 months (T1), 6 months after starting chemotherapy (T2), and 3 months after termination of chemotherapy or maintenance phase for children with acute lymphoblastic leukemia (ALL) (T3). Dietary intake, eating behavior, nutritional status, and HRQoL were modelled over time using mixed model analysis. Associations between smell and taste (objective and self-report), as well as patient characteries were studied. ResultsEnergy intake significantly increased during the study period, with a higher age, BMI, and total taste scores associated to this increase. Boys had higher energy intake compared to girls. Eating behavior scores significantly declined, indicating less eating problems. Age, pre-diagnosis eating behavior, self-reported smell changes, and tube feeding were associated to eating behavior. BMI significantly increased, with a higher BMI at diagnosis to be related to a higher BMI during the study period. A lower BMI was found in children receiving tube feeding and self-reported taste changes. HRQoL improved during the study period, with lower HRQoL in children receiving tube feeding and self-reported taste changes. ConclusionBoth objective and subjective measures of taste and smell influence dietary intake, eating behavior, nutritional status, and HRQoL. Individual dietary advice and coping strategies are warranted to prevent detrimental effects of chemosensory changes on food intake and clinical outcomes in children with cancer.

Altered sex differences related to food intake, hedonic preference, and FosB/deltaFosB expression within central neural circuit involved in homeostatic and hedonic food intake regulation in Shank3B mouse model of autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder accompanied by narrow interests, difficulties in communication and social interaction, and repetitive behavior. In addition, ASD is frequently associated with eating and feeding problems. Although the symptoms of ASD are more likely to be observed in boys, the prevalence of eating disorders is more common in females. The ingestive behavior is regulated by the integrative system of the brain, which involves both homeostatic and hedonic neural circuits. Sex differences in the physiology of food intake depend on sex hormones regulating the expression of the ASD-associated Shank genes. Shank3 mutation leads to ASD-like traits and Shank3B −/− mice have been established as an animal model to study the neurobiology of ASD. Therefore, the long-lasting neuronal activity in the central neural circuit related to the homeostatic and hedonic regulation of food intake was evaluated in both sexes of Shank3B mice, followed by the evaluation of the food intake and preference. In the Shank3B +/+ genotype, well-preserved relationships in the tonic activity within the homeostatic neural network together with the relationships between ingestion and hedonic preference were observed in males but were reduced in females. These interrelations were partially or completely lost in the mice with the Shank3B −/− genotype. A decreased hedonic preference for the sweet taste but increased total food intake was found in the Shank3B −/− mice. In the Shank3B −/− group, there were altered sex differences related to the amount of tonic cell activity in the hedonic and homeostatic neural networks, together with altered sex differences in sweet and sweet-fat solution intake. Furthermore, the Shank3B −/− females exhibited an increased intake and preference for cheese compared to the Shank3B +/+ ones. The obtained data indicate altered functional crosstalk between the central homeostatic and hedonic neural circuits involved in the regulation of food intake in ASD.

Disordered eating behaviors and associated factors in children and adolescents with type 1 diabetes

ObjectAs part of their treatment, patients with type 1 diabetes mellitus (DM) have to be very careful with what they eat and with their insulin doses. Therefore, the risk of eating disorders increases in this patient group. In this study, we aimed to determine the disordered eating behaviors of patients with type 1 DM and to evaluate the sociodemographic characteristics, diabetes care behaviors, and quality-of-life scale results that these behaviors may be related to. MethodThe sociodemographic characteristics and diabetes treatment data of 191 patients aged 9–18 years with type 1 DM were analyzed. The Pediatric Quality of Life Inventory (PedsQL), the PedsQL 3.0 Diabetes Module, and the Diabetes Eating Problem Survey-Revised (DEPS-R) were applied. ResultsThe median DEPS-R score of the patients was 18 (19.00), and 44.5 % had a DEPS-R score above 20. A significant correlation was found between age, duration of diabetes, frequency of blood glucose measurement, hemoglobin A1c (HbA1c) level, body mass index standard deviation score (BMI-SDS), and DEPS-R score. There was no significant difference between girls and boys. Patients with a high DEPS-R score had low scores on the PedsQL and on the PedsQL 3.0 Diabetes Module. ConclusionThe DEPS-R scale is a diabetes-specific, easy-to-use, and effective method for screening patients with type 1 DM for disordered eating behaviors. It can help prevent the progression of disordered eating behaviors to clinical eating disorders in patients with type 1 DM. It would be beneficial to use this scale as a routine screening, especially in clinics where access to a psychologist is not possible.

MEDIA VIDEO ANIMASI MINDFUL EATING DAPAT DIGUNAKAN UNTUK MEMBANTU MENGATASI DISORDERED EATING PADA MAHASISWA

Disordered Eating (DE) or eating behavior problems are one of the issues that are increasingly significant among college students. Academic pressures and cultural changes influence the concept of the ideal body, leading to unhealthy eating behaviors. Mindful Eating (ME), which emphasizes awareness and appreciation of eating behaviors, effectively addresses disordered eating behaviors. However, there are still many cases of DE among collage students, especially women. This research aimed to develop a canvas-based animation video to help college students overcome DE. The type research method in this study used Research and Development (R&amp;D) with the ADDIE (Analyze, Design, Development, Implementation, and Evaluation) model, but only up to the development stage in this study. Canva-based animation video validation involves three experts: expert materials, linguists, and media experts, with an average result of 80.3 (decent category, revised as necessary). Next, it was tested on prospective users (n = 37) who were selected by simple random sampling. The results of product assessment by prospective users amounted to 91.1 (very feasible category, no need to revise). The ME Knowledge Questionnaire measured the impact of video use (reliability = 0.621). The results of the comprehension score based on the pre-test and post-test on students obtained an average N-Gain score of 0.84 with an average score of 0.84 with a high category. Based on the analysis results, it can be concluded that ME video products are feasible to use as learning media to increase ME knowledge and overcome ED problems in collage students.

The structure of motivation: Assessing readiness to change dimensions and their predictive value with the network validation of the Italian version of the Anorexia Nervosa Stages of Change Questionnarie.

Motivation to change is an important predictor for treatment outcomes in individuals with anorexia nervosa (AN), however, the existence and clinical relevance of distinct motivational dimensions are understudied. This study aimed to structurally validate the AN Stage of Change Questionnaire (ANSOCQ) in the Italian adult AN population to identify separate motivational dimensions and their association with clinical variables and outcomes. Inpatients and outpatients with AN (N=300) completed the ANSOCQ and measures assessing eating and depressive psychopathology. Unique Variable Analysis and Exploratory Graph Analysis were employed to identify dimensions in the network structure of ANSOCQ. Cross-sectional associations with clinical variables were assessed in the whole sample. Predictive value on weight and psychopathology was assessed in inpatients. Two dimensions were identified, one comprising items relative to weight gain, and the second items regarding attitudes towards eating, body, and emotional problems. Feelings associated with eating resulted as most central in the network. Higher scores in the first dimension and ANSOCQ total predicted weight gain during hospitalisation. No significant predictors emerged for changes in eating psychopathology. These findings confirm the robust psychometric properties of ANSOCQ and provide support for the use of its subdimensions in clinical practice.

Assessment of barriers to the dietary adherence among type 2 diabetic patients in Pakistan: A cross-sectional study.

To assess the common barriers responsible for non-adherence to dietary recommendations among type 2 diabetic patients. The cross-sectional study was conducted from October 4, 2021, to March 6, 2022, at the National Institute of Diabetes and Endocrinology, Dow University of Health Sciences, Karachi, and comprised type 2 diabetes patients of either gender aged 18-80 years who had previously been given recommended dietary advice. Dietary barriers were assessed using a 27-item validated questionnaire, and the subjects were compared in terms of age and diabetes duration. Anthropometric measurements and laboratory parameters were also measured. Data were analysed using Stata 17. Of the 312 subjects, 234(75%) were females. The overall mean age was 52.2±11.2 years, and mean body mass index was 27.2±5.5kg/m2. The reliability of the questionnaire was established with Cronbach's alpha 0.89. Factor analysis yielded 8 common barriers; lack of knowledge about dietary recommendations (variance: 14.7%), situational barrier (variance: 10.7%), lack of family support (variance: 9.5%), stress-related eating problems (variance: 9.1%), boring and monotonous diet (variance: 8.0%), expensive and ineffective diet recommended (variance: 6.5%), work conditions/don't like food in diet (variance: 5.5%), and feeling hungry and weak (variance: 5.4%). The total variation explained by all the 8 factors was 69.4%. Lack of knowledge regarding dietary recommendations was reported to be the most common barrier towards recommended dietary adherence.

Behavioural Patterns and Their Relationship to Autism Children's Eating Problems

Behavioural Patterns and Their Relationship to Autism Children's Eating Problems

The impact of emotion regulation strategies on disordered eating behavior in children and adolescents with type 1 diabetes: a cross-sectional study.

Difficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D. For this cross-sectional study, 128 patients (aged 8-16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs). The mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores. The prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.

Head and neck cancer survivors: Long-term nutrition impact symptoms, eating problems, and barriers to care impact psychosocial health.

12044 Background: Head and neck cancer (HNC) survivors experience significant long-term side effects of their treatment, and health-related quality-of-life (HRQoL) assessments of HNC survivors are still early in development. This survey captured long-term nutrition impact symptoms, eating problems, psychosocial impact, and barriers to accessing health care of HNC survivors. Methods: The Cancer Support Community (CSC) conducted an online survey with participants from CSC, Head and Neck Cancer Alliance, and Support for People with Oral and Head and Neck Cancer (SPOHNC). 172 “long-term survivors” (LTS), at least 2 years past initial diagnosis completed the survey. Most respondents were white (94%) &amp; female (58%). The average age was 64. The most common treatments reported were radiation (93%), surgery (66%), and chemotherapy (59%). Results: Physical and psychosocial issues are prevalent and persistent among LTS. Almost all (99%) LTS reported experiencing eating problems since diagnosis, and 92% had symptoms persist into the last 7 days. Dry mouth (85% ever/68% in last week) and problems swallowing (82%/62%) were most common. Prevalence of side effects was independent of stage of cancer and time since initial diagnosis. 42% of LTS reported still not eating a solid food diet (30% “soft” food; 9% feeding tube; 4% liquid or pureed food). 63% ever used a feeding tube. For those no longer using a feeding tube, 71% used it for ≤6 months. Current users had feeding tubes for a median of 39 months. Weaning from a feeding tube was most likely before 14 months. 62% of LTS reported still feeling self-conscious when eating, 45% feeling embarrassed about their eating habits, 44% having their daily activities affected by eating problems, 37% said they avoid going out in public when it involves eating or drinking. Despite this, 27% reported never seeing a health care professional (HCP) or mental health professional (MHP) to manage their eating problems &amp; psychosocial impact. Only 11% of LTS ever met with MHPs to address their distress. Female LTS of younger age and those with Medicare insurance were more likely to meet with HCPs (except dentists for Medicare recipients) and MHPs. Financial, transportation, &amp; logistical concerns were top barriers to receiving care. 19% reported cost of care as a moderate to great barrier to cancer treatment. LTS reported difficulty paying for dental work (29%), supplemental nutrition drinks (11%), and other products to manage eating problems (9%). Conclusions: Although HNC’S are generally considered “curable,” the nature of the disease and the required aggressive treatment regimens leave LTS with a broad range of common physical and psychosocial issues that are rarely addressed. Survey data highlight almost universal, long-term persistence of eating and nutrition problems which cause significant psychosocial impact over LTS’s lifetime.

DRA dengan Token Ekonomi untuk Menurunkan Perilaku Makan yang Menyimpang: Sebuah Studi Kasus pada Anak

Children of homeless people often experience various issues, one of which is eating behavior problems. Eating food from trash cans is a common eating behavior problem encountered. Therefore, an intervention is needed to reduce this issue. This case study aims to test the effectiveness of differential reinforcement of alternative behavior (DRA) with token economy in reducing eating behavior problems. Assessment is conducted through interviews, observations, and psychological tests, while the intervention is carried out over nine sessions. The results of the intervention show a decrease in the behavior of taking food from trash cans. In addition to replacing old behavior with more adaptive behavior, the role of attention from adults around them is one of the main contributors to the effectiveness of the intervention.

Disordered eating in adolescents with type 1 diabetes: risk factors and screening recommendations.

Adolescents with Type 1 diabetes (T1D) are at significantly greater risk for disordered eating behaviors compared to their peers without T1D. Given that this is a dangerous and potentially lethal combination, this review aims to support pediatric medical providers in increasing competence in identification, assessment, and prevention of disordered eating behaviors in adolescents with T1D. This review provides an up-to-date synthesis of unique risk factors for disordered eating behaviors in adolescents with T1D, including the daily diabetes management tasks, effects of insulin on weight and hunger, family conflict, and reinforcement from their environment for disordered behaviors. This review recommends two brief screening tools, the Diabetes Eating Problems Survey-Revised (DEPS-R) and Modified SCOFF (mSCOFF), to be used in busy practices; it also provides practical strategies for providersto use with patients in the form of effective, nonjudgmental language. A clear understanding of unique experiences impacting adolescents with T1D may increase use of evidence-based screening tools and identification of disordered eating behaviors among a high-risk population in clinic/practice. In addition, providers' intentional use of nonjudgmental and de-stigmatizing language may lead to more positive interactions for adolescents and willingness to engage in further treatment.

Modeling the relationship between depression in people with cancer and perceived stress, with the mediating role of eating problems, sexual satisfaction, emotion regulation and self-compassion.

With the rising prevalence of cancer and the adverse physical and psychological experiences endured by affected individuals, this study aims to establish a model illustrating the relationship between depression in people with cancer and perceived stress. Additionally, it examines the mediating influence of eating problems, sexual satisfaction, emotional regulation, and self-compassion. This study employs a descriptive-correlational research method, utilizing structural equation analysis (modeling) to explore the role of mediators. The research sample comprised 200 individuals diagnosed with cancer, selected based on predetermined inclusion and exclusion criteria. Participants completed Beck's 13-item depression questionnaire, a 10-item perceived stress questionnaire, an 8-item appetite measurement questionnaire, a 25-item sexual satisfaction questionnaire, a 10-item emotion regulation questionnaire, and a 12-item compassion questionnaire. The data were subsequently analyzed using SPSS-24 and Lisrel 80/8 software. The research findings indicate a significant positive relationship between perceived stress and depression in people with cancer. Furthermore, eating problems exhibited a mediating role in the relationship between perceived stress and depression, with a direct effect coefficient of (t = 0.28, ß = 0.02). However, the path from perceived stress to depression, mediated by sexual satisfaction, was found to be statistically insignificant, with a standard coefficient of 0.01 at the p < 0.05 level. Emotion regulation demonstrated a direct effect coefficient of (t = -3.52, ß = -0.33) on depression. Likewise, self-compassion exhibited a direct effect coefficient of (t = -3.08, ß = -0.28) on depression, while the path from perceived stress to depression was mediated by self-compassion, with a standard coefficient of 0.12 at the p < 0.05 level. In conclusion, this study sheds light on the interplay between depression and perceived stress in individuals with cancer, revealing a significant positive association. Eating problems emerged as a mediating factor, directly influencing the manifestation of depressive symptoms. However, the mediation pathway through sexual satisfaction was found to be statistically insignificant. Emotion regulation and self-compassion were identified as influential factors, with direct effects on depression and self-compassion also serving as a mediator in the relationship between perceived stress and depression. The findings emphasize the importance of targeted interventions addressing eating problems, enhancing emotion regulation, and fostering self-compassion to alleviate the impact of depression and perceived stress in individuals facing cancer-related challenges. Further research is encouraged to refine and expand upon these insights, advancing holistic care for this population.

APPLICATION OF FUZZY VECTOR OPTIMIZATION METHODS FOR DIET COMPILATION

The purpose of this work is to study an approach to solving the problem of fuzzy vector optimization for compiling a diet. It is necessary to develop a daily ration that provides human needs in nutrients and energy and is the best in terms of costs and weight. For this purpose the problem of choosing the best alternative from a given fuzzy set of alternatives is solved, while the quality of the alternative is evaluated using several partial efficiency cri- teria. The goal in the task is fuzzily defined. According to the Zadeh – Bellman idea, a fuzzy solution to a problem is the intersection of a fuzzy goal and a fuzzy set of alternatives. The paper considers the problem of fuzzy two-criteria optimization. Partial criteria that are minimized are the weight and cost of the daily ration. Fuzzy needs for nutrients and kilocalories are determined by fuzzy triangular numbers. For an approximate solution of the problem, an algorithm is proposed according to which a sequence of linear programming problems is solved. The computer program was created that implements the solution of this problem in the Wolfram Matematica package. The following results were obtained: a set of products, their weight and cost were determined for the daily diet. The degree of confidence that the found plan is optimal is determined. On the basis of the proposed mathe- matical model and the method of its solution, a software application allowing to choose food products, enter the necessary restrictions in a user- friendly form, and receive one or more options for the daily ration at the output was created. Such an application will be useful for nutritionists, ath- letes, doctors and other people who are concerned with the problems of healthy eating.

Disordered Eating Behaviors and Eating Disorders in Youth With Type 2 Diabetes: A Systematic Review

OBJECTIVE This systematic review aimed to examine disordered eating behaviors (DEBs) in youth with type 2 diabetes. Specifically, we sought to describe the most common DEBs, identify risk and protective factors, and review screening tools and interventions that have been developed for and/or used in this population. RESEARCH DESIGN AND METHODS A systematic review was performed of randomized controlled, quasi-experimental, case, and qualitative studies focused on DEBs in youth with type 2 diabetes. All studies were rated for quality by the first and second authors. RESULTS Five reports from four unique studies were included in the review. Trends found in the reviewed studies included that approximately half of youth study participants with type 2 diabetes had elevated scores on the Diabetes Eating Problem Survey – Revised. Based on the limited data available, these youth were more likely to engage in DEBs than youth with type 1 diabetes. Risk factors for DEBs in youth with type 2 diabetes included obesity, body weight/shape concerns, and caregiver subclinical binge eating. CONCLUSION There is very limited published literature regarding DEBs in youth with type 2 diabetes, suggesting a need for further research to better develop a framework to illuminate key influential variables in the development of DEBs in this population, further develop screening tools, and to design effective interventions.

Profiles of disordered eating behaviour in type 1 diabetes using the DEPS-R and behaviour and glycaemic outcomes in a real-life setting.

The Diabetes Eating Problems Survey - Revised (DEPS-R) is commonly used to assess disordered eating behaviour (DEB) in individuals with type 1 diabetes and has advantages compared to other measures not specifically tailored to diabetes. A score ≥20 on the DEPS-R is used to indicate clinically significant DEB; however, it does not distinguish between eating disorder (ED) phenotypes necessary to guide treatment decisions, limiting clinical utility. The current study used latent class analysis to identify distinct person-centred profiles of DEB in adults with type 1 diabetes using the DEPS-R. Analysis of Variance with Games Howell post-hoc comparisons was then conducted to examine the correspondence between the profiles and binge eating, insulin restriction and glycaemic control (HbA1c, mean blood glucose, and percent time spent in hyperglycaemia) during 3 days of assessment in a real-life setting. Latent class analysis indicated a 4-class solution, with patterns of item endorsement suggesting the following profiles: Bulimia, Binge Eating, Overeating and Low Pathology. Differences in binge eating, insulin restriction and glycaemic control were observed between profiles during 3 days of at-home assessment. The Bulimia profile was associated with highest HbA1c and 3-day mean blood glucose. There are common patterns of responses on the DEPS-R that appear to reflect different ED phenotypes. Profiles based on the DEPS-R corresponded with behaviour in the real-life setting as expected and were associated with different glycaemic outcomes. Results may have implications for the use of the DEPS-R in research and clinical settings.

Psychometric properties of the Diabetes Eating Problem Survey-Revised among Dutch adults with type 1 diabetes and implications for clinical use.

Disordered eating behaviour (DEB) in people with type 1 diabetes (T1D) can be screened with the Diabetes Eating Problem Survey-Revised (DEPS-R). This study aimed to investigate the psychometric properties of the DEPS-R among Dutch adults with T1D and to explore the individual items alongside the standard cut-off score of ≥20 for clinical use. The construct validity of the DEPS-R was assessed with an exploratory factor analysis, through principal axis factoring and with Spearman correlations between clinical variables and the DEPS-R. Backward logistic regression identified clinical predictors for DEPS-R scores above the cut-off. DEPS-R item responses were summarized with frequencies, means and standard deviations. Participants were 145 adults with T1D, of whom 79.3% were women and 35.9% presented with DEB based on the cut-off. A single-factor solution of the DEPS-R showed good internal consistency, while a three-factor solution showed acceptable to good internal consistency within the factors. A younger age, a higher BMI and more diabetes distress were predictors for a DEPS-R cut-off score of ≥20. Clinically relevant items were identified that contributed minimally to the DEPS-R score. This study supports a single-factor and a three-factor structure of the DEPS-R while also suggesting an item-specific or factor-specific approach in clinical practice.

Eating problems in people with dementia with Lewy bodies: Associations with various symptoms and the physician's understanding.

Eating problems frequently occur in people with dementia with Lewy bodies (DLB), but few studies have investigated the clinical background of this phenomenon. This study examined the relationship between eating problems and various symptoms of DLB and the relation between the treatment needs for DLB people with eating problems and the understanding of their eating problems by caregivers and physicians. This was a subanalysis of a cross-sectional, questionnaire-based survey study. Two hundred sixty-one subjects with DLB were divided into subjects with or without eating problems. Logistic or linear regression analysis was used to investigate the factors influencing eating problems. The treatment needs of DLB people for their eating problems and the understanding of these needs by caregivers and physicians were calculated as participant-caregiver and participant-physician kappa coefficient. Of the 261 participants, 27% suffered from eating problems. The presence of eating problems in participants with DLB was related to depression (p = 0.01, OR : 2.19, 95% CI: 1.23-3.91) and apathy (p = 0.01, OR 2.15, 95% CI: 1.20-3.87), while the worsening of eating problems was related to dysphagia (β = 0.24, p = 0.03), apathy (β = 0.23, p = 0.05), and nighttime behavior (β = 0.24, p = 0.04). The participant-physician kappa coefficient for physician understanding of constipation, weight loss, dysphagia, weight gain, and increase in appetite was significantly lower than the corresponding participant-caregiver kappa coefficient (p-value of five symptoms < 0.01). Physicians need to pay more attention to eating problems and their neuropsychiatric background in the long-term support and management of DLB subjects.

Regulatory problems and developmental psychopathology within the first 2 years of living—a nested in cohort population-based study

BackgroundInfancy regulatory problems (RP) of sleep, feeding and eating, and excessive crying are thought to play a key role in the development of psychopathology in childhood, but knowledge of the early trajectories is limited.ObjectiveTo explore RP at ages 8–11 months and the associations with mental health problems at 1½ years, and assess the influences of maternal mental health problems and relationship problems.MethodsRP was explored in a nested in-cohort sample (N = 416) drawn from a community-based cohort (N = 2,973). Cohort children were examined by community health nurses, using a mental health screening, which included seven items of RP. Follow-up at 1½ years included diagnostic assessment according to the International Classification of Diseases, ICD-10, and the Diagnostic Classification of Mental Health and Developmental Disorders in Infancy and Early Childhood: Revised edition, DC:0-3R. Data analyses included logistic regression models and analyses of the mediation effect of maternal mental health and relationship problems.ResultsRP of sleep were associated with a 2-fold increased risk of child mental disorder specifically sleep disorders, adjusted odds ratio (OR) 9.3 [95% confidence interval (CI): 2.0–42.9], disorders of behavior and emotions, adjusted OR 2.9 (95% CI: 1.0–8.4), and DC:0-3R regulatory disorders, adjusted OR 2.7 (95% CI: 1.0–7.5). Children with RP of feeding and eating showed an increased risk of overall mental disorder, adjusted OR 1.4 (95% CI: 0.7–2.4), and specifically, feeding and eating disorders, adjusted OR 6.0 (95% CI: 1.6–21.7), disorders of behavior and emotions, adjusted OR 2.2 (95% CI: 0.9–5.8), as well as DC:0-3R regulatory disorders, adjusted OR 1.6 (1.0–7.5). RP of emotional regulation were associated with increased risk of any mental disorder, adjusted OR 1.5 (1.0–2.4), and specifically behavioral and emotional disorders, adjusted OR 2.2 (95% CI: 0.9–5.9) and DC:0-3R relationship disorders, adjusted OR 1.8 (95% CI: 0.9–3.8). The mediation effect of maternal mental health problems and relationship problems ranged between 0% and 48%.ConclusionRP at ages 8–11 months is associated with increased risk of ICD-10 and DC:0-3R disorders at 1½ years. Study findings highlight a group of vulnerable infants in need of preventive intervention to break the early trajectories of psychopathology.