Epidemiology and risk factors of eating disorders: A two-stage epidemiologic study in a Spanish population aged 12-18 years

Objective The authors studied the prevalence rates of eating disorders (ED) and their risk factors in a Spanish population aged 12–18 years. Method A two-stage epidemiologic study was conducted in the province of Valencia. Educational centers, classrooms, and individuals were selected randomly. The initial sample comprised 544 subjects. During Stage 1, subjects were screened with the 40-item Eating Attitude Test and a sociodemographic questionnaire that evaluates risk factors. During Stage 2, a semistandardized clinical interview was conducted with each participant. A random control group was paired by class, age, and sex. Comorbid psychiatric disorders and partial and subclinical forms wer…

Comorbidity between obesity and attention deficit/hyperactivity disorder: Population study with 13–15-year-olds

Objective: This study analyzes whether obese children have a higher risk of attention deficit/hyperactivity “characteristics” (AD/HD) than do children with other nutritional states. Method: This study included 35,403 participants from 486 community schools. They completed the AD/HD scale of the Strengths and Difficulties Questionnaire (SDQ) and were weighed and measured. 2879 of the participants were obese and 78 were morbidly obese (BMI >40). Results: A discrete, nonsignificant, increment was found in the AD/HD characteristics of male participants with morbid obesity, as compared with the other nutritional states. Among morbidly obese females, the prevalence of AD/HD characteristics was sl…

Auditory hallucinations in anorexia nervosa

The paper describes two case studies of patients with anorexia nervosa who suffer from auditory hallucinations as the only psychotic symptom. A review of the literature regarding clinical cases of anorexic patients with hallucinations is discussed. Hallucinations in anorexic patients are conceptualized according to different theoretical models which point to a dimensional view of eating disorders. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

The effects of reward and frustration in patients with bipolar disorder: Evidence from a computerized task with non-contingent feedback.

Abstract Background: Bipolar disorder (BD) is characterized by mood changes that implies alterations in reward sensitivity and frustration tolerance. This study examined the effects of monetary reward and frustration on attentional performance and on affective experience across mood states in BD. Methods: An Affective Posner Task in which the nature of contingencies are divided in the three successive blocks (baseline condition, monetary reward and non-contingent feedback) was applied to BD individuals in their different episodes: mania (n = 30), depression (n = 30), and euthymia (n =  30) as well as to a group of healthy controls (n = 30). Results: Monetary reward improved performance (in …

Hypoesthesia of the malleolus as a soft sign in depression

Background: Physical signs often are present in many psychiatric conditions, making up a fundamental part of them and accompanying the psychiatric manifestations themselves. Identifying minor neurological signs is especially of interest due to they are easily accessible through simple neurological examination and could be a useful if underused tool for the diagnostic process and patient therapy. Method: A group of depressed patients (a =85) and group of healthy individuals (n=101) that served as control were examined using the Wartenberg wheel, a medical device for neurological use, in order to determine the presence of hypoesthesia on both sides of their ankles. Results.: The data revealed…

Is processing speed a valid neurocognitive endophenotype in bipolar disorder? Evidence from a longitudinal, family study.

[Background] Substantial evidence supports the existence of neurocognitive endophenotypes in bipolar disorder (BD), but very few longitudinal studies have included unaffected relatives. In a 5-year, follow-up, family study, we have recently suggested that deficits in manual motor speed and visual memory could be endophenotype candidates for BD. We aimed to explore whether this also applies to processing speed.

Influence of Stress in the Onset of Eating Disorders: Data From a Two-Stage Epidemiologic Controlled Study

Background We explore the role of stress in the onset of eating disorders (EDs) in a community sample of adolescents, the mediating role of psychiatric comorbidity and the quantitative evolution of stress in the year preceding the onset of an ED. Methods The Life Events and Difficulties Schedule interview was applied to a sample with 32 cases and 32 controls selected from a two-phase epidemiologic study among a representative population of adolescents, followed by a decay model to assess acute and chronic stress in the year preceding the onset of ED. Psychiatric comorbidity was assessed using the SCAN interview. Results Cases (46.9%) and 9.4% of controls were found to have associated psychi…

Attentional biases toward emotional images in the different episodes of bipolar disorder: an eye-tracking study.

Attentional biases toward emotional information may represent vulnerability and maintenance factors in bipolar disorder (BD). The present experimental study examined the processing of emotional information in BD patients using the eye-tracking technology. Bipolar patients in their different states (euthymia, mania, depression) simultaneously viewed four pictures with different emotional valence (happy, neutral, sad, threatening) for 20 s while their eye movements were monitored. A group of healthy individuals served as the control. The data revealed the following: (i) a decrease in attention to happy images in BD patients in their depressive episodes compared to healthy individuals, and (ii…

Impulsivity, sensation seeking and aggressiveness in patients with bipolar I and II disorder

Abstract Objective Although impulsivity may seem to be strongly linked to bipolar disorder, few studies have directly measured this phenomenon. To determine its implications for the prognosis of this illness, we studied the relationship between impulsivity and other aspects that are probably related, such as sensation seeking and aggressiveness, and different clinical variables of bipolar disorder. Method Sixty-nine (type I, n = 42; type II, n = 27) outpatients from a unit specifically for bipolar patients in remission completed the Barratt Impulsiveness Scale (BIS), the Sensation Seeking Scale (SSS), the Buss–Durkee Hostility Inventory (BDHI) and the Bipolar Eating Disorder Scale (BEDS). S…

Are affective temperaments determinants of quality of life in euthymic patients with bipolar disorder?

Background: Bipolar disorder (BD) is a disabling illness that is associated with low quality of life (QoL). This low QoL goes further than mood episodes, which suggests that stable traits, such as affective temperaments, can cause functional impairment. Objective: Our study analyses the impact of affective temperaments on the Physical Component Summary (PCS) and Mental Component Summary (MCS) of QoL in euthymic BD patients. Methods: A multicentre study was conducted in 180 euthymic BD patients and 95 healthy controls. Firstly, statistical analyses were performed to compare QoL and affective temperaments between the two groups. Secondly, Adaptive Lasso Analysis was carried out to identify th…

Teasing and Disordered Eating Behaviors in Spanish Adolescents

The purpose of this study is to investigate the associations between peer teasing and body dissatisfaction (BD), emotional symptoms, drive for thinness (DT), and abnormal eating behaviors, as well as to analyze the mediating role of gender and body mass index (BMI) in such disorders. We screened 57,997 school children between 13 and 16 years of age. Scores in weight-related teasing and competency-related teasing were higher among girls, as well as overweight or obese individuals. Weight-teasing correlated more strongly with abnormal eating attitudes and behaviors, whereas competency-teasing correlated with emotional symptoms. Multiple linear regression analysis showed that weight-teasing is…

Teasing as a risk factor for abnormal eating behaviours: A prospective study in an adolescent population.

Abstract Introduction There are discrepancies in the literature about the role of teasing in the onset of eating pathology. This article aims to establish the influence of teasing in abnormal eating behaviours and attitudes in the adolescent population. Material and methods This is a two-year prospective study conducted in 7167 adolescents between 13 and 15 years of age. In a first assessment, teasing about weight and teasing about abilities were measured by means of the POTS.questionnaire. Its association with eating psychopathology after two years was analysed controlling nutritional status (BMI), body dissatisfaction, drive to thinness, perfectionism (EDI), emotional symptoms and hyperac…

Burlas como factor de riesgo para conductas alimentarias anómalas: estudio prospectivo en una población adolescente

Resumen Introduccion Existen discrepancias en la literatura sobre el papel de las burlas en la aparicion de clinica alimentaria. El objetivo de este articulo es establecer la influencia de las burlas sobre la aparicion de conductas alimentarias anomalas en una poblacion adolescente. Material y metodos Se trata de un estudio prospectivo a 2 anos en el que participaron 7.167 adolescentes de entre 13 y 15 anos. En una evaluacion basal se estudio su exposicion a burlas sobre el peso y sobre las capacidades, mediante el cuestionario POTS. Posteriormente, se analizo su asociacion con psicopatologia alimentaria (EAT) ulterior controlando el efecto del estado nutricional (IMC), la insatisfaccion co…

Mood-congruent bias and attention shifts in the different episodes of bipolar disorder

An "affective" go/no-go task was used in the different episodes of bipolar patients (euthymic, depressed, and manic) to examine (1) the presence of a mood-congruent attentional bias; and (2) the patients' ability to inhibit and invert associations between stimuli and responses through blocks. A group of healthy individuals served as controls. Results revealed a mood-congruent attentional bias: patients in the manic episode processed positive information faster, whereas those in the depressive episode processed negative information faster. In contrast, neither euthymic patients nor healthy individuals showed any mood-congruent biases. Furthermore, there was a shift cost across blocks for hea…

The effect of concomitant benzodiazepine use on neurocognition in stable, long-term patients with bipolar disorder

Objective: Neurocognitive dysfunction is a common feature of bipolar disorder even in euthymia, and psychopharmacological treatment could have an effect on cognition. Long-term prescription of benzodiazepines in bipolar disorder is a common practice, and their effect on neurocognition has not been well studied in this population. The aim of this study was to evaluate the impact of concomitant benzodiazepine long-term use on neurocognitive function in stable euthymic bipolar disorder patients. Methods: Seventy-three euthymic bipolar disorder outpatients and 40 healthy individuals were assessed using a neurocognitive battery. Patients were classified in two groups according to the presence of…

Abnormal emotional processing in maltreated children diagnosed of Complex Posttraumatic Stress Disorder.

Abstract Maltreated children usually show a specific pattern of emotional and behavioral symptoms that exceed those relating to posttraumatic stress disorder (PTSD). These symptoms have been defined as Complex PTSD (CPTSD). The underlying attentional mechanisms of abnormal emotional processing and their relation to the clinical presentation of CPTSD are not well understood. A visual dot-probe paradigm involving pre-attentive (i.e., 500 ms) and attentive (i.e., 1500 ms) presentation rates of neutral versus emotional (i.e., angry, happy or sad) facial expressions was applied. Twenty-one maltreated CPTSD children were compared with twenty-six controls. The results are as follows: an attention …

Impulsividad, búsqueda de sensaciones y agresividad en pacientes bipolares tipo I y II

Resumen Introduccion Aunque la impulsividad puede aparecer fuertemente relacionada con el trastorno bipolar, pocos estudios han medido directamente este fenomeno. Con el objetivo de conocer sus implicaciones pronosticas, estudiamos la relacion entre la impulsividad y otros aspectos probablemente relacionados con ella, como son la busqueda de sensaciones y la agresividad y diferentes variables clinicas del trastorno bipolar. Metodos 69 pacientes ambulatorios en remision (tipo I, n = 42; tipo II, n = 27) de una unidad especifica de trastornos bipolares completaron la Escala de Impulsividad Barratt (BIS), la Escala de Busqueda de Sensaciones (SSS), el Inventario de Hostilidad de Buss-Durkee (B…

Children's eating attitudes test: Validation in a sample of Spanish schoolchildren

Objective: To validate the Spanish version of the Children's Eating Attitudes Test (ChEAT). Method: The factor structure and other psychometric characteristics of the questionnaire were examined using the answers of 38,554 schoolchildren. Diagnostic efficiency was based on a standardized clinical interview of 968 schoolchildren who had previously completed the questionnaire. Results: Five factors (“preoccupation with thinness,” “dieting,” “social pressure to eat,” “purging,” and “preoccupation with food and oral control”) explained 46% of the variance. Cronbach's α was .858 for the total scale. The area under the receiver operating characteristic curve was .851. Sensitivity (SE) was 27% and…

Is melatonin an adjunctive stabilizer?

Hypoesthesia in generalised anxiety disorder and major depression disorder

Objective: The determination of soft signs can be a conducive practice to understand the differential etiology between depression and anxiety. This study aims at examining malleolar hypoesthesia ro...

Do affective episodes modulate moral judgment in individuals with bipolar disorder?

Abstract Background Bipolar disorder (BD) patients experience altered emotional states and deficits in social adaptation that may also be involved in deontological moral judgments in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. Methods In the present study we compared the utilitarian responses of BD patients in their different states (euthymia, mania, depression) and healthy controls to moral dilemmas with low (impersonal dilemma) and high (personal dilemma) emotional saliency. Results Our findings revealed an increased tendency to utilitarian judgments in the three groups of BD patients in impersonal dilemmas relative to …

Comparative neurocognitive effects of lithium and anticonvulsants in long-term stable bipolar patients

Background: The aim of choosing a mood-stabilizing drug (lithium or anticonvulsants) or a combination of them with minimal neurocognitive effects is to stimulate the development of criteria for a therapeutic adequacy, particularly in Bipolar Disorder (BD) patients who are clinically stabilized. Method: Three groups of BD patients were established according to their treatment: (i) lithium monotherapy (n=29); (ii) lithium together with one or more anticonvulsants (n=28); and (iii) one or more anticonvulsants (n=16). A group of healthy controls served as the control (n=25). The following tests were applied: Wechsler Adult Intelligence Scale, Trail Making Test, Wechsler Memory Scale, Rey Comple…

Pregabalin in the Treatment of Refractory Bipolar Disorders

Neurocognitive endophenotypes in schizophrenia and bipolar disorder: A systematic review of longitudinal family studies

Although there is substantial evidence supporting the existence of neurocognitive impairment in patients diagnosed with schizophrenia (SZ) and bipolar disorder (BD), few studies have explored the field from an endophenotypic perspective. The present systematic review sought to identify longitudinal family studies exploring suitable neurocognitive endophenotypes in unaffected relatives of patients with SZ and/or BD. Following the PRISMA statement, only five follow-up studies met the inclusion criteria, comprising 79 SZ patients, 159 SZ unaffected relatives of SZ, 131 BD patients, 77 unaffected relatives of BD, and 248 controls. Verbal memory, auditory attention, face memory and emotion proce…

Prevalence and comorbidity of eating disorders among a community sample of adolescents: 2-year follow-up

The previous literature about comorbidity between eating disorders (ED) and other DSM-IV psychiatric disorders in adolescence has employed cross-sectional studies with clinical samples, where the comorbid disorders were diagnosed retrospectively. The present study aims to overcome these limitations by the analysis of comorbidity in a community population during 2-year follow-up. A semi-structured interview was applied to a teenager sample. Firstly, a cross-sectional and nonrandomized study on psychiatric morbidity was conducted with 993 teenagers between the ages of 12 and 16 from five schools. Secondly, 326 students between 14 and 17 years old of one school were reassessed 2 years later in…

Sexual Dysfunction and Mood Stabilizers in Long-Term Stable Patients With Bipolar Disorder.

Abstract Background In addition to factors intrinsic to bipolar disorder (BD), sexual functioning (SF) can be affected by extrinsic causes, such as psychotropic drugs. However, the effect of mood stabilizers on SF and quality of life (QoL) is an underexplored research area. Aim To analyze SF in BD outpatients in euthymia for at least 6 months treated only with mood stabilizers and the association between SF and QoL. Methods A multicenter cross-sectional study was conducted in 114 BD outpatients treated with (i) lithium alone (L group); (ii) anticonvulsants alone (valproate or lamotrigine; A group); (iii) lithium plus anticonvulsants (L+A group); or (iv) lithium plus benzodiazepines (L+B gro…