Eating-related Problems Research Articles

Negative effects on oral motor function after submandibular and parotid botulinum neurotoxin A injections for drooling in children with developmental disabilities.

To evaluate negative effects on oral motor function after concurrent submandibular and parotid (four-gland) botulinum neurotoxin A (BoNT-A) injections as a treatment for paediatric drooling. This was a retrospective cohort study of 125 children (median age 7 years 7 months [interquartile range 4 years 5 months]) with developmental disabilities, including cerebral palsy, treated with four-gland injections. Most children (90.4%) were previously exposed to submandibular injections. Frequency, severity, and duration of negative effects on oral motor function (i.e. saliva swallowing, eating, drinking, articulation) were evaluated and compared to a reference cohort treated with submandibular injections. Negative effects on oral motor function were reported in 45 children (36.0%), predominantly manifesting as eating-related problems (64.4%). Most negative effects (62.2%) were classified as mild and resolved within 4-weeks post-injunction (53.3%). Compared to the reference cohort, frequency (36.0% vs 33.0%) and duration (53.3% vs 53.6% resolving within 4 weeks) of negative effects were comparable, although problems were more often moderately severe (33.3% vs 10.1%). While negative effects on oral motor function were relatively common after four-gland BoNT-A injections, most problems were mild and resolved promptly. No substantial differences to a reference cohort treated with submandibular injections were observed, although further research should establish the generalizability of these findings in a treatment-naive population. Nevertheless, when submandibular injections prove ineffective, clinicians can confidently consider four-gland injections.

Long-term changes in eating-related problems and quality of life in children with overweight and obesity attending a 10-week lifestyle camp

BackgroundEating-related problems (e.g., binge eating (BE)) and impaired quality of life (QoL) is more prevalent in children with overweight and obesity. This study aimed to investigate changes in self-reported overeating (OE), BE, and QoL in children with overweight or obesity attending multicomponent 10-week lifestyle camps with a 52-weeks follow-up. Additionally, the study sought to investigate whether self-reported OE/BE before camp was associated with changes in QoL. MethodsChildren aged 7 to 14-years could attend camp if they had overweight/obesity, were lonely, unhappy, or had social or family-related problems. In this study only children with overweight and obesity were included (n:185). OE, BE, and QoL were measured using self-reported questionnaires. ResultsIn total, 38 % of the children reported regular BE at baseline. Regular OE, occasional BE, and occasional OE was reported by 14 %, 13 %, and 11 %, respectively, while 24 % reported no eating-related problems. The relative risk of experiencing eating-related problems decreased at 10-weeks compared to baseline. Additionally, the probability of regular OE (RR 0.12 (95 % CI 0.04;0.38) (X2 = 8.44, p = 0.004)) and regular BE (RR 0.01 (95 % CI 0.00;0.11) (X2 = 9.91, p = 0.002)) remained lower at 52-weeks relative to baseline. All QoL dimensions improved after camp, and the presence of self-reported OE and regular BE at baseline was significantly associated with lower QoL at baseline, 10 and 52-weeks. ConclusionChildren self-reporting OE and BE may be a particular vulnerable group that needs more support from camp staff and healthcare professionals to improve QoL. Clinical Trial Registrationclinicaltrials.gov with ID: NCT04522921

Relationship between Fear of COVID-19, Intolerance of Uncertainty, and Coping Strategies on University Students’ Mental Health

Background: the mental health of students was particularly affected by the COVID-19 pandemic. The present study therefore examined the relationships between anxiety and depressive symptoms, eating-related problems, coping, fear of COVID-19, and intolerance of uncertainty. Methods: 2139 French students of 54 universities were recruited in the different regions of France during a French lockdown (between 21 April and 3 May 2021). Six variables were measured: fear of COVID-19, intolerance of uncertainty, coping, anxiety and depressive symptoms, and eating-related problems. To explore the directions of the relationships between our variables of interest, we calculated a directed acyclic graph. Results: our data highlighted the central roles of intolerance of uncertainty in students’ anxiety and depressive symptoms, and the direct role of prospective intolerance of uncertainty on eating-related problems. Conclusions: these findings indicate that intolerance of uncertainty should be targeted by interventions designed to help students with high levels of anxiety, depressive symptoms, and/or eating-related problems.

Food Insecurity and Food Addiction in a Large, National Sample of Lower-Income Adults

BackgroundGrowing research has highlighted associations between food insecurity and eating-related problems. Food addiction is one important, clinically significant pattern of problematic eating, which is related to, but distinct from, eating disorders. To date, there is only one study examining the association between food insecurity and food addiction, to our knowledge. Additional research is needed to understand the complexities of this association. ObjectiveWe examined the association between food insecurity and food addiction in a large, national convenience sample of lower-income adults and potential heterogeneity in this association by age, gender, race, and ethnicity. DesignA cross-sectional, web-based study was conducted among 1780 US adults (≥18 y) with household incomes <250% of the federal poverty guideline. Household food security was assessed using the Household Food Security Survey Module. Food addiction was assessed using the modified Yale Food Addiction Scale (mYFAS), version 2.0. Multivariate logistic regression models examined the associations between food insecurity and food addiction, adjusting for sociodemographic covariates. ResultsThe prevalence of food addiction was 7.3%, and the prevalence of food insecurity was 51%. Compared with adults with food security, adults with food insecurity endorsed each mYFAS symptom with significantly greater frequency, including failure to fulfill major role obligations (20%), continued use despite social or interpersonal problems (18%), and craving or strong desire to use (16%). After adjustment, food insecurity was associated with 3.82-fold higher odds of food addiction (95% CI 2.36, 6.19), with no significant heterogeneity by age, gender, or race and ethnicity. The most problematic foods reported by adults with food insecurity were chips, nondiet soda, chocolate, pizza, and ice cream. ConclusionThese findings provide additional support for the association between food insecurity and food addiction. Mechanistic studies are needed to explore the role of psychosocial factors, eating behaviors, and the food environment in contributing to these associations.

Patients’ Perspectives on Dietary Patterns and Eating Behaviors During Weight Regain After Gastric Bypass Surgery

PurposeFood quality, energy intake, and various eating-related problems have been highlighted as some of the components influencing weight after bariatric surgery. This study aimed to increase our knowledge of patients’ perspectives on dietary patterns and eating behaviors during weight regain after bariatric surgery.Materials and MethodsWe recruited 4 men and 12 women with obesity and the experience of weight regain after bariatric surgery at an obesity clinic in Stockholm, Sweden. Data were collected during 2018–2019. We conducted a qualitative study, carried out individual semi-structured interviews, and analyzed the recorded and transcribed interview data with thematic analysis.ResultsParticipants had regained 12 to 71% from their lowest weight after gastric bypass surgery performed 3 to 15 years before. They perceived their dietary challenges as overwhelming and had not expected weight management, meal patterns, increasing portion sizes, and appealing energy-dense foods to be problematic after surgery. In addition, difficulties with disordered eating patterns, emotional eating, and increased alcohol intake further contributed to the weight management hurdles. Insufficient nutritional knowledge and lack of support limited participants’ ability to avoid weight regain, leading to restrictive eating and dieting without sustained weight loss.ConclusionEating behavior and dietary factors such as lack of nutritional knowledge, emotional eating, or disorganized meal patterns contribute to difficulties with weight management after gastric bypass surgery. Improved counseling may help patients prepare for possible weight regain and remaining challenges with food and eating. The results highlight the importance of regular medical nutrition therapy after gastric bypass surgery.Graphical

Psychosocial Factors and the Need for Multidisciplinary Support in Nutrition Counselling for Cancer Chemotherapy Patients.

This study aims to identify the background factors and experiences of patients with cancer with eating-related problems who require nutrition counselling. Using a mixed-methods approach, this secondary analysis study was conducted on patients with head and neck, oesophageal, gastric, colorectal, or lung cancers who were receiving outpatient chemotherapy. They completed a questionnaire measuring nutrition impact symptoms, eating-related distress, and quality of life (QOL). Patients who required nutrition counselling were interviewed to identify the specific issues they experienced. We reported on nutritional status and nutrition impact symptoms in a previous study. Of the 151 participants, 42 required nutrition counselling. Background factors associated with nutrition counselling were related to the following psychosocial variables: small number of people in the household, undergoing treatment while working, low QOL, and eating-related distress. Four themes were extracted from the specific issues experienced by patients: motivation for self-management, distress from symptoms, seeking understanding and sympathy, and anxiety and confusion. The desire for nutrition counselling was attributable to 'anxiety caused by the symptoms' and 'confusion about the information on eating'. Healthcare professionals should promote multidisciplinary collaboration after considering the factors associated with the required nutrition counselling to provide nutritional support.

Association between Body Image Focused Social Media Usage (BSMU), Resilience, Attachment and Eating-related Problems among High School Students in Bangkok

Objective: This study aimed to find the association among body image focused social media usage (BSMU), resilience, attachment, and eating-related problems among Thai adolescents. Materials and Methods: Cross-sectional descriptive research was conducted with a sample of 495 high school students from three schools in Bangkok. The participants answered an online questionnaire comprised of age, sex, height/weight, BSMU, Body-esteem Scale for Adolescents and Adults, Eating Attitudes Test, Inventory of Parent and Peer Attachment for Children, and the Thai Resilience Quotient. Descriptive statistics were used to analyze demographic information, body satisfaction, resilience, attachment, and eating-related problems. T-tests, chi-square, and multivariate logistic regression analysis were performed to explore the associations between these variables. Results: Mean (SD) age was 17.06 (0.805), with 307 female participants (62%). Time spent on social media was found to be associated with increased risk of binging (AOR (CI) = 1.71 (1.14-2.56)). BSMU was associated with increased risk of inappropriate eating attitudes, binging, purging and using laxative (AOR (CI) = 1.14 (1.03-1.27), 1.14 (1.06-1.22), 1.20 (1.04-1.40), and 1.21 (1.09-1.34) respectively). Higher resilience was found to associated with lower risk in binging (AOR (CI) = 0.45 (0.21-0.97)). However, attachment is not associated with any of eating-related problems. Conclusion: BSMU usage was associated with inappropriate eating attitudes and behavior. Findings also suggest that higher resilience and stronger attachment were associated with lower risk of eating-related problems. The effectiveness of resilience and attachment improvement programs should be explored to help protect against eating problems.

161. THE EFFECTIVENESS OF TELEPHONE AND INTERNET-BASED SUPPORTIVE CARE FOR PATIENTS WITH ESOPHAGEAL CANCER ON ENHANCED RECOVERY AFTER SURGERY IN CHINA

Abstract Esophageal cancer patients face problems related to eating and surgery-related symptoms. The eating-related problems are characterized by dysphagia, appetite loss, and nausea/vomiting linked to anatomic changes and the reconfiguration of their upper GI tract. Of all the surgery-related problems, 30% of patients reported fatigue/pain symptom cluster (pain, fatigue, insomnia, dyspnea), and 27% of patients reported the reflux/cough cluster (dry mouth, taste changes, cough, reflux). Evidence shows that the supportive care needs of esophageal cancer patients are very high. The study was designed as an open-label, randomized controlled trial to value the efficacy of a nurse-led supportive care program in comparison with conventional care. The control group received conventional care. Patients from the intervention group received conventional care and one-on-one phone calls from nurses following their discharge assessments and education about nutrition and symptoms. Nurses also set up a WeChat group, which they invited patients to join in before discharge. Nutritional status, quality of life, the helpfulness of the follow-up service, and the patients’ satisfaction were compared 6 months after discharge to assess for differences between the two groups. 168 patients were included in the study, with 86 patients in the intervention group and 82 in the control group. Significant differences between the intervention and control groups were found in the Nutrition Risk Screening 2002 and simple diet self-assessment tool scores. The changes in blood albumin, prealbumin, and transferrin were also statistically significant. All QLQ-C30 results of the intervention group were better than those of the control group. The patients’ scores on the helpfulness of the follow-up service and their satisfaction with it were both significantly higher in the intervention group than in the control group. This study highlighted the important role of nurse-led supportive care based on telephone and Internet-based support for patients after ERAS. The supportive care improved patients’ nutritional status, elevated their quality of life, and improved their satisfaction with the care provided to them.

Effectiveness of an online self-help program, expert-patient support, and their combination for eating disorders: Results from a randomized controlled trial.

Many individuals with an eating disorder do not receive appropriate care. Low-threshold interventions could help bridge this treatment gap. The study aim was to evaluate the effectiveness of Featback, a fully automated online self-help intervention, online expert-patient support and their combination. A randomized controlled trial with a 12-month follow-up period was conducted. Participants aged 16 or older with at least mild eating disorder symptoms were randomized to four conditions: (1) Featback, a fully automated online self-help intervention, (2) chat or email support from a recovered expert patient, (3) Featback with expert-patient support and (4) a waiting list control condition. The intervention period was 8 weeks and there was a total of six online assessments. The main outcome constituted reduction of eating disorder symptoms over time. Three hundred fifty five participants, of whom 43% had never received eating disorder treatment, were randomized. The three active interventions were superior to a waitlist in reducing eating disorder symptoms (d= -0.38), with no significant difference in effectiveness between the three interventions. Participants in conditions with expert-patient support were more satisfied with the intervention. Internet-based self-help, expert-patient support and their combination were effective in reducing eating disorder symptoms compared to a waiting list control condition. Guidance improved satisfaction with the internet intervention but not its effectiveness. Low-threshold interventions such as Featback and expert-patient support can reduce eating disorder symptoms and reach the large group of underserved individuals, complementing existing forms of eating disorder treatment. Individuals with eating-related problems who received (1) a fully automated internet-based intervention, (2) chat and e-mail support by a recovered individual or (3) their combination, experienced stronger reductions in eating disorder symptoms than those who received (4) usual care. Such brief and easy-access interventions play an important role in reaching individuals who are currently not reached by other forms of treatment.

Which came first? Bulimia and emotional symptoms: A cross-lagged panel analysis

PurposeResearchers have found growing evidence for the comorbidity link between bulimia and emotional symptoms among Chinese female youth. However, the prospective effect of one on the other is still unclear. Therefore, a cross-lagged model was used to examine the possible underlying mechanism between bulimia and two typical emotional problems (i.e., anxiety symptoms and depressive symptoms), respectively, in the present study. MethodsA total of 471 female college students participated in the three waves of the present study. Self-reported questionnaires were delivered to assess their bulimia, anxiety symptoms, and depressive symptoms. ResultsAfter controlling for earlier levels of symptoms, our finding indicated that anxiety symptoms triggered more bulimia symptoms from Time 1 to Time 2. In turn, the reciprocal cycles occurred between anxiety symptoms and bulimia symptoms from Time 2 to Time 3. More interestingly, a similar pattern was found between depressive symptoms and bulimia. ConclusionsThe persistence and reciprocal cycle between bulimia and emotional symptoms are worthy of attention. Specifically, female youth with higher levels of emotional symptoms appear to be more profound at high risk for eating-related problems afterward. Further eating-related intervention programs may also need to take the level of female youth's emotional symptoms into consideration.

Prevalence of food addiction using the Yale-C scale in Mexican children with overweight and obesity.

BackgroundThe prevalence of excess weight and obesity in children has increased significantly worldwide. The concept of food addiction (FA) has been associated with eating-related problems and obesity. Studies on this topic have primarily examined adult samples and little is known about addictive-like eating among Mexican children and adolescents.MethodsWe conducted this study to examinate the prevalence of FA in a group of 291 overweight and obese children and adolescents using YFAS scale for children (YFAS-C) in Mexico.ResultsAccording to the YFAS-C approximately 14.4% of participants met for FA diagnosis. Forty-two (14.4%) received a FA diagnosis: 14 children and 28 adolescents. The number of FA symptoms in participants who received an FA diagnosis (M = 4.35, SD = 1.07) compared to participants with no FA diagnosis (M = 1.70, SD = 1.53) was significantly higher (p ≤ 0.001). There were no statistically significant gender differences and the proportion of subjects with an FA diagnosis did not differ by age between children and adolescents. FA is a focus of interest in attempting to explain certain behaviors that may contribute to the development of obesity and explain the failure of the weight loose programs in children.

Symptoms, problems and quality of life in patients newly diagnosed with oesophageal and gastric cancer \u2013 a comparative study of treatment strategy

BackgroundPatients with oesophageal and gastric cancer have a low likelihood of being cured and suffer from a broad spectrum of symptoms and problems that negatively affect their quality-of-life (QOL). Although the majority (67–75%) of patients at the time of diagnosis suffer from an incurable disease, research has primarily focused on the pre- and postoperative phase among patients treated with curative intent, with little attention to symptoms and problems in the diagnostic phase, especially in those who cannot be offered a cure.MethodsIn this cross-sectional study 158 patients newly diagnosed with oesophageal and gastric cancer visiting the surgical outpatient department for a preplanned care visit were included consecutively during 2018–2020. The validated instruments QLQ-C30 and QLQ-OG25, developed by the European Organization for Research and Treatment of Cancer (EORTC), and selected items from the Integrated Patient Outcome Scale (IPOS) were used to assess QOL, symptoms and problems. Differences between patients with a curative and a palliative treatment strategy were analysed using t-test and Mann–Whitney U test. The QLQ-C30 and QLQ-OG25 scores were compared to published reference data on the general Swedish population.ResultsAmong all, the QOL was markedly lower, compared with general Swedish population (mean ± SD, 55.9 ± 24.7 vs 76.4 ± 22.8, p < 0.001). Compared to general population, the patients had significant impairment in all QOL aspects, particularly for role and emotional functioning and for symptoms such as eating-related problems, fatigue, insomnia and dyspnea. Majority of patients also reported severe anxiety among family and friends. Among patients with oesophageal cancer those with a palliative treatment strategy, compared with curative strategy, reported significantly lower QOL (mean ± SD, 50.8 ± 28.6 vs 62.0 ± 22.9 p = 0.030), physical (65.5 ± 22.6 vs 83.9 ± 16.5, p < 0.001) and role functioning (55.7 ± 36.6 vs 73.9 ± 33.3, p = 0.012), and a higher burden of several symptoms and problems. No significant differences between treatment groups were shown among patients with gastric cancer.ConclusionsPatients newly diagnosed with oesophageal and gastric cancer, and especially those with incurable oesophageal cancer, have a severely affected QOL and several burdensome symptoms and problems. To better address patients’ needs, it seems important to integrate a palliative approach into oesophageal and gastric cancer care.

Double trouble? Associations of parental substance use and eating behaviors with pediatric disordered eating

ObjectiveComorbidity between substance use disorders and eating disorders is common and related to severity of psychopathology. Parents’ eating disorder or substance use disorder have been examined independently and appear to be related to psychopathology in their children. However, no prior work has examined whether co-occurring substance use and eating disorder behaviors in parents relate to eating-disorder psychopathology and weight in their children. MethodParticipants (N = 435) were parents who completed an online cross-sectional survey. Parents reported their personal substance use and eating-disorder behaviors. Relationships between parental substance use (SUD), parental binge eating (ED), and co-occurring parental substance use and binge eating (SUDxED) with child eating-disorder psychopathology and weight were examined using linear regression. Parent age and sex, child age and sex, parent impulsivity and parent depression scores were included as covariates in analyses. ResultsGreater severity of co-occurring parental SUDxED behavior was associated with greater child eating-related psychopathology, including child binge eating and child purging. Additionally, greater parental binge eating (ED) alone was associated with greater child binge eating and overeating. Parental SUD and/or ED behavior were not related to child weight. Child age did not moderate relationships between parent SUDxED behaviors and child binge eating or overeating. DiscussionOverall, parents with greater co-occurring substance use and eating disorder behaviors had children with more severe eating-disorder psychopathology. Clinicians working with families, and those seeking to prevent pediatric eating-related problems, should consider assessing and addressing parents’ psychopathology to improve prevention and treatment efforts.

Risk of Malnutrition upon Admission and after Discharge in Acutely Admitted Older Medical Patients: A Prospective Observational Study.

There is a lack of knowledge about malnutrition and risk of malnutrition upon admission and after discharge in older medical patients. This study aimed to describe prevalence, risk factors, and screening tools for malnutrition in older medical patients. In a prospective observational study, malnutrition was evaluated in 128 older medical patients (≥65 years) using the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment-Short Form (MNA-SF) and the Eating Validation Scheme (EVS). The European Society of Clinical Nutrition (ESPEN) diagnostic criteria from 2015 were applied for diagnosis. Agreement between the screening tools was evaluated by kappa statistics. Risk factors for malnutrition included polypharmacy, dysphagia, depression, low functional capacity, eating-related problems and lowered cognitive function. Malnutrition or risk of malnutrition were prevalent at baseline (59–98%) and follow-up (30–88%). The baseline, follow-up and transitional agreements ranged from slight to moderate. NRS-2002 and MNA-SF yielded the highest agreement (kappa: 0.31 (95% Confidence Interval (CI) 0.18–0.44) to 0.57 (95%CI 0.42–0.72)). Prevalence of risk factors ranged from 17–68%. Applying ESPEN 2015 diagnostic criteria, 15% had malnutrition at baseline and 13% at follow-up. In conclusion, malnutrition, risk of malnutrition and risk factors hereof are prevalent in older medical patients. MNA-SF and NRS-2002 showed the highest agreement at baseline, follow-up, and transitionally.

Eating Behaviors in Early Childhood (1-5 Years) and Their Association With Sociodemographic Characteristics in Turkey.

Eating problems are common in childhood and being seen in 25%-45% of healthy children. The period following the first year of life up to five years is when eating problems are most frequently reported and also when the child acquires eating habits. Several studies have shown that eating behavior is affected by the family environment, and by parental eating habits and modes of feeding their children.The purpose of this study was to investigate the eating behavior characteristics of children in early childhood, to determine the frequency of problematic eating behaviors, and to compare these with the family’s sociodemographic characteristics.The study consisted of 255 children aged 1-5 years, with no chronic disease, presenting to İzmir Tepecik Education and Research Hospital Child Health and Diseases Department general pediatric clinics between February and April, 2017, together with their parents. In the study, 39 questions were asked to parents related to children’s demographic characteristics and eating behaviour.Problematic eating behavior was present in 43.9% of the study group. Analysis identified feeding bottle use, feeding with the use of an assistant object, eating lasting longer than half an hour, and the child not feeding itself as the most frequent eating problems. Malnutrition was present in 104 (65.8%) of the children with problematic eating behavior. Examination of unhealthy eating behavior in the light of the study findings showed no significant association between eating behaviors and variables such as type and time of delivery, maternal education level, maternal employment status, maternal age, or the number of children in the family.In terms of nutrition status, Turkey appears to exhibit problems associated with both developed and developing countries. Public nutrition in Turkey fluctuates significantly depending on the region, the season, socioeconomic levels, and differences between urban and rural settlements. Early-onset of eating-related problems can have a negative effect on children’s subsequent physical, emotional, and social development.Determination in the early period of eating problems seen in children and investigation of the causes thereof is important in terms of identifying a potential solution. It is important to work with the family to that end, and for children to be followed-up by pediatricians at regular intervals.

Eating expectancies among trauma-exposed Latinx college students: The role of mindful attention

Objective: Emergent research suggests that trauma-exposed Latinx college students are a particularly at-risk group for eating-related problems. For this reason, there is a need to further understand the cognitive processes that may underpin maladaptive eating among this vulnerable segment of the population. Participants: Participants included 304 trauma exposed Latinx college students (84.5% females; Mage = 22.8 years, SD = 5.79). Methods: The current study examined the role of mindful attention in relation to several distinct expectancies related to eating. Results: Results indicated that lower reported levels of mindful attention were associated with greater levels of expectancies of eating to help manage negative affect, expectancies that eating will alleviate boredom, and expectancies that eating will lead to feeling out of control. Conclusions: These findings suggest that it may be beneficial to assess for mindful attention among Latinx college students with a history of trauma exposure presenting with problematic eating behaviors.

Digital Therapeutics for Obesity and Eating-Related Problems.

In recent years, digital technologies have rapidly advanced and are being applied to remedy medical problems. These technologies allow us to monitor and manage our physical and mental health in our daily lives. Since lifestyle modification is the cornerstone of the management of obesity and eating behavior problems, digital therapeutics (DTx) represent a powerful and easily accessible treatment modality. This review discusses the critical issues to consider for enhancing the efficacy of DTx in future development initiatives. To competently adapt and expand public access to DTx, it is important for various stakeholders, including health professionals, patients, and guardians, to collaborate with other industry partners and policy-makers in the ecosystem.

Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis.

Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention). We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number. 295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features. Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.

Depression, anxiety, and suicidal ideation in young adults 5\xa0years after undergoing bariatric surgery as adolescents

PurposeMetabolic and bariatric surgery (MBS) is increasingly used in adolescents. The aim was to explore symptoms of depression and anxiety in young adults over 5 years’ follow-up after undergoing MBS.MethodsBeck Depression Inventory-2 and the Beck Anxiety Inventory were used to assess symptoms of depression and anxiety in 62 patients 1, 2, and 5 years after having Roux-en-Y gastric bypass at 13–18 years of age. Mental health, eating-related problems, and weight outcomes were tested for association with suicidal ideation at the 5-year follow-up.ResultsAt the 5-year follow-up, the mean score for depression was 11.4 (± 12.4), indicating minimal symptoms of depression. The mean score for anxiety was 12.82 (± 11.50), indicating mild anxiety symptoms. Still, several participants reported moderate or severe symptoms of depression (26%) and anxiety (32%). Women reported more symptoms than men (P = 0.03 and 0.04). No significant changes were found in self-reported symptoms of depression and anxiety between the 1-year and the 5-year follow-up (P = 0.367 and 0.934). Suicidal ideation was reported by 16% at the 5-year follow-up. Participants reporting suicidal ideation had lost significantly less excess weight than participants without suicidal ideation (P = 0.009).ConclusionFive years after adolescent MBS, a substantial minority still struggles with mental health issues, and women are more burdened than men. Our results indicate an association between less optimal weight loss and suicidal ideation 5 years after MBS. The findings emphasize the importance of offering long-term follow-up and mental health treatment several years after MBS.Level of evidenceLevel III, cohort study.Clinical trial registrationThe study is registered with ClinicalTrials.gov (NCT00289705). First posted February 10, 2006.

304 - Prevalence of and factors related to eating problems in people with dementia

Background &amp; aims:Eating-related problems are common in people with dementia, and may have many adverse consequences. To provide a comprehensive assessment and understanding of these issues, we validated the Chinese version of the Abnormal Eating Behavior Questionnaire (AEBQ), and investigated the prevalence of and factors related to eating-related problems in people with dementia.Methods:A total of 129 people with dementia were recruited from a nursing home and a psychiatric hospital for a cross -sectional study. Internal consistency and test–retest reliability were tested using Cronbach’s α and intra-class correlation coefficient. Dimensionality was evaluated by principal component analysis. Concurrent validity was assessed using Spearman’s correlation coefficient to compare scores for AEBQ and the eating-related items in the Neuropsychiatric Inventory. Factors affecting the prevalence of eating-related problems were identified using logistic regression analysis.Results:The Chinese version of the AEBQ showed acceptable internal consistency, time stability, dimensionality, and concurrent validity. Overall, 86.8% of the participants showed eating-related problems. “Needs supervision” was the most common one, followed by “swallowing problems”. History of stroke (OR: 12.62, 95% CI: 1.58–101.06) and Clinical Dementia Rating (OR: 1.82, 95% CI: 1.02–3.24) were risk factors for “swallowing problems”. Use of antipsychotics protected against “decline in table manners” (OR: 0.21, 95% CI: 0.06–0.74), but was a risk factor for “decrease in appetite” (OR: 3.15, 95% CI: 1.35–7.38). Clinical Dementia Rating (OR: 9.27, 95% CI: 4.13–20.79) independently predicted “needs supervision”.Conclusion:The Chinese version of the AEBQ is a reliable and valid tool. People with dementia had a high prevalence of eating-related problems. Clinical assessment of eating-related problems in this group needs to screen for secondary causes or risk factors, such as psychotropic medications and comorbidities. Targeted interventions should be used to manage reversible eating-related problems among people with dementia.