Outcomes in people with eating disorders: a transdiagnostic and disorder‐specific systematic review, meta‐analysis and multivariable meta‐regression analysis

World Psychiatry, Год журнала: 2024, Номер 23(1), С. 124 - 138

Опубликована: Янв. 12, 2024

Eating disorders (EDs) are known to be associated with high mortality and often chronic severe course, but a recent comprehensive systematic review of their outcomes is currently missing. In the present meta-analysis, we examined cohort studies clinical trials published between 1980 2021 that reported, for DSM/ICD-defined EDs, overall ED (i.e., recovery, improvement relapse, all-cause ED-related hospitalization, chronicity); same related purging, binge eating body weight status; as well mortality. We included 415 (N=88,372, mean age: 25.7±6.9 years, females: 72.4%, follow-up: 38.3±76.5 months), conducted in persons anorexia nervosa (AN), bulimia (BN), disorder (BED), other specified feeding (OSFED), and/or mixed from all continents except Africa. EDs pooled together, recovery occurred 46% patients (95% CI: 44-49, n=283, 44.9±62.8 months, no significant ED-group difference). The rate was 42% at <2 43% 2 <4 54% 4 <6 59% 6 <8 64% 8 <10 67% ≥10 years. Overall chronicity 25% 23-29, n=170, 59.3±71.2 33% 40% 23% 12% 18% Mortality 0.4% 0.2-0.7, n=214, 72.2±117.7 Considering observational studies, 5.2 deaths/1,000 person-years 4.4-6.1, n=167, 88.7±120.5 months; difference among EDs: p<0.01, range: 8.2 3.4 BN). Hospitalization 26% 18-36, n=18, 43.2±41.6 p<0.001, 32% AN 4% Regarding diagnostic migration, 8% migrated BN 16% OSFED; 2% AN, 5% BED, 19% 9% BED 7% OSFED 10% BN. Children/adolescents had more favorable across within than adults. Self-injurious behaviors were lower rates EDs. A higher socio-demographic index moderated countries. Specific treatments family-based therapy, cognitive-behavioral therapy (CBT), psychodynamic nutritional interventions AN; self-help, CBT, dialectical behavioral (DBT), pharmacological BN; interventions, DBT BED; CBT OSFED. treatment waiting list These results should inform future research, practice health service organization

Язык: Английский

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The current clinical approach to feeding and eating disorders aimed to increase personalization of management

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 4 - 31

Опубликована: Янв. 15, 2025

Feeding and eating disorders (FEDs) are a heterogeneous grouping of at the mind-body interface, with typical onset from childhood into emerging adulthood. They occur along spectrum disordered compensatory weight management behaviors, low to high body weight. Psychiatric comorbidities norm. In contrast other major psychiatric disorders, first-line treatments for FEDs mainly psychological and/or nutrition-focused, medications playing minor adjunctive role. Patients, carers clinicians all have identified personalization treatment as priority. Yet, FEDs, evidence base supporting this is limited. Importantly, related behaviors can serious physical consequences may put patient's life risk. these cases, immediate safety risk considerations least period need be prioritized over efforts care. This paper systematically reviews several key domains that relevant characterization individual patient FED aimed management. These include symptom profile, clinical subtypes, severity, staging, complications consequences, antecedent concomitant conditions, social functioning quality life, neurocognition, cognition emotion, dysfunctional cognitive schemata, personality traits, family history, early environmental exposures, recent stigma, protective factors. Where possible, validated assessment measures use in practice identified. The limitations current pointed out, possible directions future research highlighted. also novel approaches providing more fine-grained sophisticated ways personalize such those utilize neurobiological markers. We additionally outline remote measurement technologies designed delineate patients' illness recovery trajectories facilitate development intervention approaches.

Язык: Английский

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An advanced Artificial Intelligence platform for a personalised treatment of Eating Disorders

Frontiers in Psychiatry, Год журнала: 2024, Номер 15

Опубликована: Авг. 6, 2024

Eating Disorders (EDs) affect individuals globally and are associated with significant physical mental health challenges. However, access to adequate treatment is often hindered by societal stigma, limited awareness, resource constraints.

Язык: Английский

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Short- and long-term effects of Covid-19 pandemic on health care system for individuals with eating disorders

Frontiers in Psychiatry, Год журнала: 2024, Номер 15

Опубликована: Март 14, 2024

Introduction The Covid-19 pandemic and its consequences have negatively impacted the incidence of EDs, determining a substantial burden on patients, caregivers healthcare systems world-wide. This literature review aims to investigate short- long-term effects care provider systems, exploring possibility “rethinking” ED programs. Methods Records were systematically (following PRISMA guidelines) identified through PubMed, Google Scholar Scopus searching. Results led an abrupt increase in pediatric adolescent visits hospital admissions. Despite decline second-year post-onset, absolute visit volumes remained elevated relative pre-pandemic levels. Barriers access specialist emerged, including socio-economic status lack public outpatient services. Consequently, this situation has prompted providers explore innovative bridge plans multidisciplinary telehealth solutions face such challenges. Discussion Challenges insurance shifts, treatment disruptions discharge planning underscore need for comprehensive strategies care. Overall, our findings highlight importance adopting approaches, implementing location-specific plans, integrating effectively address evolving challenges posed by enhance efficiency

Язык: Английский

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Partnerships with primary care providers: Opportunities to prevent eating disorders and mitigate their progression in young people

Eating Disorders, Год журнала: 2024, Номер 32(6), С. 746 - 762

Опубликована: Авг. 22, 2024

Epidemiologic research has identified numerous interpersonal and individual risk factors for warning signs of emerging eating disorders in adolescents. These findings have informed public health prevention treatment strategies, including translation to clinical recommendations primary care providers (PCPs). A next step this translational work could include a comprehensive approach where PCPs are seen as partners efforts improve population outcomes. great potential implement high-yield interventions that prevent or attenuate the course adolescent disorders. To illustrate potential, we present case highlights missed opportunities PCP prevent, detect, intervene during patient's developing disorder. We then relate two programs utilize partnerships: one trains Strengths-Based Adolescent Healthcare disorder prevention; other adapts Family-Based Treatment early access evidence-based treatment. In addition these promising areas research, needed widen requirements curricula medical training address weight stigma care. Together will help become effective

Язык: Английский

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Still waiting: Referral patterns, delays, and key factors in accessing specialized eating disorder treatment in an italian cohort

Eating Behaviors, Год журнала: 2025, Номер unknown, С. 101968 - 101968

Опубликована: Март 1, 2025

Язык: Английский

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Eating disorders and psychiatric comorbidity among first-year university students in Sweden: Prevalence and risk factors

Journal of Eating Disorders, Год журнала: 2025, Номер 13(1)

Опубликована: Март 20, 2025

Abstract Background This study explored eating disorders (ED) prevalences, comorbidity of ED with other mental disorders, and risk factors for among university students. included binge disorder (BED), bulimia nervosa (BN), or specified feeding (OSFED). Methods A total 3425 first-year students in Sweden completed an online survey covering a range criteria psychiatric diagnoses, within the World Mental Health International College Student (WMH-ICS) initiative. Pearson’s χ 2 -tests were used to compare algorithm-based diagnostic prevalences comorbid between three groups: without (A), but no (B), (C). Multinomial logistic regression was calculate between-group comparisons odds ratios independent factors, where group B served as reference groups C. Results Of sample, 75% had at least one 28% lifetime diagnosis. Students (group A) reported higher anxiety depression, suicidal behavior, non-suicidal self-injury compared B). Group participants exhibited hazardous drinking, more likely have received medical treatment, identify bisexual. Compared B, C) report better physical health, less engage sought health treatment. Conclusions large proportion additional indicating that individuals suffer from multiple problems. It is crucial student services acquire competency offer effective assessment

Язык: Английский

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A Narrative Review of Early Intervention for Eating Disorders: Barriers and Facilitators

Adolescent Health Medicine and Therapeutics, Год журнала: 2023, Номер Volume 14, С. 217 - 235

Опубликована: Дек. 1, 2023

Abstract: Eating disorders (EDs) are serious psychiatric illnesses that typically develop during adolescence and emerging adulthood. Early intervention is important for improved outcomes young people with EDs, yet help-seeking low individuals often have a significantly protracted start to treatment, suggesting early not well established in the ED field. Previous reviews on facilitators barriers EDs largely cover perceived related patient variables perspectives, whereas clinician-, service-, healthcare system-related less frequently reviewed. The aim of this review synthesize literature regarding patient-, factors. A narrative was conducted by searching relevant peer-reviewed, English-language articles published up until July 2023 PubMed PsychINFO. search two steps. First, key terms were used identify existing meta-analyses EDs. Then, additional added primary secondary research patient/family, clinician, service, facilitators. identified shows that, after overcoming intrinsic, motivational (such as self-stigma, denial, ambivalence), may be met long service waiting lists limited treatment options. Despite these barriers, there ongoing into practice, which aims reach underserved populations facilitate despite high demands shortages trained professionals. Funding services has historically been low, also research-practice gap. This highlights need increased consideration of, funding remove discussions around how make programs scalable sustainable. Keywords: anorexia nervosa, bulimia help-seeking, seeking, mental health

Язык: Английский

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Attitudes and gaps in knowledge of the diagnosis, treatment, and psychopathology of eating disorders among different health professionals

Journal of Eating Disorders, Год журнала: 2024, Номер 12(1)

Опубликована: Июнь 28, 2024

Abstract Background Health professionals from different specialties in medical and psychological areas play an important role diagnosis treatment of eating disorders (EDs). This study aimed to identify gaps knowledge about the diagnosis, etiology, management EDs assess health professionals’ attitudes towards these illnesses. Methods A new questionnaire was developed validated. Residents consultants working disciplines involved (namely, internal medicine, general practitioners, psychiatric area, surgical area) completed questionnaire. Knowledge were compared among groups through one-way ANCOVA chi-square tests. Results The final version consisted 54 items assessing following areas: stigma, treatment, physical complications, aetiopathogenesis EDs. For all area most deficiency aetiopathogenesis, while best one complications. All showed less than psychiatrists terms lack evidence-based psychotherapies, psychopathology, family members’ emerged professionals. Stigma found non-mental who considered patients be others responsible for their abnormal behaviors. Conclusions Clarifying specific occurring individuals may inform educational programs improve early detection

Язык: Английский

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Early intervention in eating disorders: introducing the chronopathogram

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity, Год журнала: 2025, Номер 30(1)

Опубликована: Янв. 23, 2025

Abstract Eating disorders (EDs) pose significant challenges to mental and physical health, particularly among adolescents young adults, with the COVID-19 pandemic exacerbating risk factors. Despite advancements in psychosocial pharmacological treatments, improvements remain limited. Early intervention EDs, inspired by model developed for psychosis, emphasizes importance of timely identification treatment initiation improve prognosis. Challenges identifying prodromal phases measuring duration untreated illness highlight complexity early efforts EDs. Current research focuses on reducing eating disorder (DUED) understanding cognitive behavioral symptoms preceding ED onset. However, current programs EDs showed mixed results, necessitating further investigation. We introduce here chronopathogram, a tool that may aid precisely investigating role development A chronopathogram is graphical representation pathological events as they unfold over time. Understanding neurodevelopmental aspects utilizing tools like can tracking unfolding time, facilitating detection efforts. Overall, addressing key factors influencing onset course essential effective these conditions. Level evidence : V narrative review.

Язык: Английский

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