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Background: Eating disorders (EDs) pose a significant risk to health, especially when not diagnosed early. For several years EDs and oral health has been extensively studied, and now it is quite clear the existence of a correlation between specific oral manifestations and these disorders. While these oral signs could potentially aid early diagnosis of EDs, their identification and the eventual establishment of a correlation is currently heavily limited to the clinician's experience. The present systematic review critically examines existing literature, offering an updated overview of oro-dental manifestations associated with EDs. Method: MEDLINE (via PubMed), Web of Science, Scopus, and grey literature were searched, and relevant epidemiological comparative studies were screened using the Rayyan software. No limitations have been imposed on the research regarding oro-dental outcomes, encompassing all medically diagnosed EDs. The quality of the studies was valuated using AXIS appraisal tool for cross-sectional studies. Result: Out of 3990 studies, 32 fulfilled the eligibility criteria and were included in the synthesis. The identified eating disorders include Anorexia Nervosa, Bulimia Nervosa and/or Eating Disorders Not Otherwise Specified, predominantly among female subjects, primarily originating from Europe. The evaluated oro-dental outcomes include dental erosion, caries, saliva assessment, hygiene-periodontal parameters, and mucosal tissue appearance. The association with erosion is confirmed while gingival recession, dentinal hypersensitivity, salivary flow thresholds and aspects relating to oral pathology are receiving increasing support from emerging evidence. Discussion: This trend emphasizes the critical role of the complete intraoral examination to detect significant oro-dental signs that may indicate the onset of an ED. Plain English summary: The article is a review of existing studies that explores the link between eating disorders and oral health issues. It found that people with eating disorders, including anorexia nervosa and bulimia nervosa, may experience dental problems such as tooth erosion, cavities, and altered saliva production. The review findings emphasize the importance of dental care providers recognizing these signs early and suggests better training for dental professionals. By doing so, they can help diagnose eating disorders sooner and recommend appropriate treatment. This approach aims to improve patients' overall wellbeing by addressing both the oral health issues and the underlying eating disorders, making it essential for patients and medical teams to be aware of the interconnectedness between oral health and eating disorders. [ABSTRACT FROM AUTHOR]

Objective: To map and examine the systematic review evidence base regarding the effects of cognitive‐behavioral therapy (CBT) for eating disorders (EDs), especially against active interventions. Method: This systematic review is an extension of an overview of CBT for all health conditions (CBT‐O). We identified ED‐related systematic reviews from the CBT‐O database and performed updated searches of EMBASE, MEDLINE, and PsychInfo in April 2021 and September 2022. Results: The 44 systematic reviews included (21 meta‐analyses) were of varying quality. They focused on "high intensity" CBT, delivered face‐to‐face by qualified clinicians, in BN, BED and mixed, not specifically low‐weight samples. ED‐specific outcomes were studied most, with little consensus on their operationalization. The, often insufficient, reporting of sample characteristics did not allow assessment of the generalizability of findings. The meta‐analytic syntheses show that high intensity one‐to‐one CBT produces better short‐term effects than a mix of active controls especially on ED‐specific measures for BED, BN, and transdiagnostic samples. There is little evidence favoring group CBT or low intensity CBT against other active interventions. Discussion: While this study found evidence consistent with current ED treatment recommendations, it highlighted notable gaps that need to be addressed. There were insufficient data to allow generalizations regarding sex and gender, age, culture and comorbidity and to support CBT in AN samples. The evidence for group CBT and low intensity CBT against active controls is limited, as it is for the longer‐term effects of CBT. Our findings identify areas for future innovation and research within CBT. Public Significance: This study provides a comprehensive mapping and quality assessment of the current large systematic review research base regarding the effects of cognitive behavioral therapy (CBT) for eating disorders (EDs), with a focus on comparisons to other active interventions. By transcending the more limited scope of individual systematic reviews, this overview highlights the gaps in the current evidence base, and thus provides guidance for future research and clinical innovation. [ABSTRACT FROM AUTHOR]

Objective: Atypical Anorexia Nervosa (AAN) is an ill-defined diagnosis. Little is known about how eating disorder clinicians perceive the utility of the diagnosis, and what changes they believe would add to that utility. This qualitative study aimed to explore clinicians' perspectives on refining the DSM-5 AAN diagnosis., Methods: Content analysis of text was used to categorise 47 responses to the questions: "What changes are required to the DSM-5 definition of AAN?", and "How do you think significant weight loss should be defined?"., Results: Over 27% of clinicians advocated removing the AAN diagnosis or combining it with Anorexia Nervosa, while nearly 15% reported concerns about the requirement for 'significant weight loss'. Over 87% of clinicians suggested ways (often inconsistent across clinicians) to define 'significant weight loss', with emphasis on the need for a specified rate (i.e., amount of loss/time) and consideration of physical health impacts., Conclusion: Clinicians broadly agree that revisions are necessary to the current AAN definition. However, while some propose specific modifications (e.g., defining 'significant weight loss'), others advocate for the complete removal of the diagnosis. The breadth of suggestions for how to define 'significant weight loss' highlights the ongoing lack of consensus on AAN's relevance as a diagnostic entity., (© 2024 The Author(s). European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.)

Motivation to change behavior is seen as an important factor in achieving a better treatment effect in patients with eating disorders (ED). The aim of this systematic review was to assess whether motivational interviewing (MI) and motivational enhancement therapy (MET) might (1) increase motivation to change behavior and (2) improve eating disorder psychopathology (EDP) and body mass index (BMI) in patients with ED. To investigate this, a literature search was conducted on 9 March 2021 on four scientific databases: Cochrane, Embase (Ovid), MEDLINE (PubMed), and PsycInfo (EBSCO). A total of 2647 publications were identified and following a rigorous stepwise procedure to assess titles and abstracts and, thereafter, full texts of relevant publications, 13 studies were included in the data extraction and analyses. A few individual studies (n = 5) found a significant increase in motivation, two a decrease in ED symptoms (n = 2), while none found an effect on BMI. However, the meta-analysis of each outcome found effect sizes near zero, thereby confirming the results of previous narrative reviews that have described a lack of effect of MET/MI on motivation in ED. Since the individual studies differ substantially in design, and the outcomes were inconsistently assessed with regards to instruments and duration, the effect of MET/MI on motivation for behavioral change, ED psychopathology, and BMI is still unclear. [ABSTRACT FROM AUTHOR]

Background: Individuals with eating disorders have a high mortality risk. Few population-based studies have estimated this risk in eating disorders other than anorexia nervosa.Aims: To investigate all-cause mortality in a population-based cohort of individuals who received hospital-based care for an eating disorder (anorexia nervosa, bulimia nervosa or eating disorder not otherwise specified) in Ontario, Canada.Method: We conducted a retrospective cohort study of 19 041 individuals with an eating disorder from 1 January 1990 to 31 December 2013 using administrative healthcare data. The outcome of interest was death. Excess mortality was assessed using standardised mortality ratios (SMRs) and potential years of life lost (PYLL). Cox proportional hazards regression models were used to examine sociodemographic and medical comorbidities associated with greater mortality risk.Results: The cohort had 17 108 females (89.9%) and 1933 males (10.1%). The all-cause mortality for the entire cohort was five times higher than expected compared with the Ontario population (SMR = 5.06; 95% CI 4.82-5.30). SMRs were higher for males (SMR = 7.24; 95% CI 6.58-7.96) relative to females (SMR = 4.59; 95% CI 4.34-4.85) overall, and in all age groups in the cohort. For both genders, the cohort PYLL was more than six times higher than the expected PYLL in the Ontario population.Conclusions: Patients with eating disorders diagnosed in hospital settings experience five to seven times higher mortality rates compared with the overall population. There is an urgent need to understand the mortality risk factors to improve health outcomes among individuals with eating disorders. [ABSTRACT FROM AUTHOR]

Background: Until recently, research into Chew and Spit (CHSP) behavior has predominantly focused on clinical samples, and little is known of its prevalence in the community. The current study aimed to bridge this gap by exploring CHSP features in a representative sample of the general population. We hypothesized that the point‐prevalence of CHSP would be less than 1%; concurrent with other eating disorder symptomology, and associated with poorer health related quality of life (HRQoL). Methodology: Using the 2016, respondent‐based, South Australian Health Omnibus Survey (HOS), data were collected on 3047 participants aged ≥15 years old. HRQoL was assessed with the Short‐Form health‐questionnaire‐v1 (SF‐12). Results: CHSP point prevalence was 0.4% (95% CI.23 to.69%; n = 13), and was more prevalent in people with compensatory disordered eating behaviors. The median age of those with CHSP was 39, and both mental and physical HRQoL were reduced compared with the general population (Mdn: MHQoL = 49; HRQoL = 50), with MHQoL being significantly lower in those with symptoms of a clinically diagnosable ED and concurrently engaged in CHSP (z = –2.33, p = .020). Conclusions: Due to the low prevalence of CHSP, the reliability of inferential statistics may increase the chance of Type II errors, therefore, future studies should use larger samples. Although CHSP is not "common" in a wider community sample, its prevalence appears to be similar to other ED associated symptoms. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study seeks to examine the long‐term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. Method: Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case–control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. Results: Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p < .05), the general population (p < .05), and closest‐aged sisters (p < .05). Women previously diagnosed with BN experienced more moderate reductions and delays to their reproduction, and had similar reproductive outcomes as their discordant sisters. Discussion: Clinicians should consider ED type and family fertility histories when addressing the long‐term reproductive health needs of women with prior AN, BN, or EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS. [ABSTRACT FROM AUTHOR]

Objective Changes in the DSM-5 eating disorders criteria sought to increase the clarity of the diagnostic categories and to decrease the preponderance of nonspecified eating disorders. The first objective of this study was to analyze how these revisions affect threshold and EDNOS/OSFED eating disorder diagnoses in terms of prevalence, sex ratios, and diagnostic distribution in a student sample. Second, we aimed to compare the impairment levels of participants with a threshold, an EDNOS/OSFED and no diagnosis using both DSM-IV and DSM-5. Method A sample of 1654 7th and 8th grade students completed self-report questionnaires to determine diagnoses and impairment levels in the context of an eating disorder prevention program in nine German secondary schools. Height and weight were measured. Results The prevalence of threshold disorders increased from .48% (DSM-IV) to 1.15% (DSM-5). EDNOS disorders increased from 2.90 to 6.23% when using OSFED-categories. A higher proportion of girls was found throughout all the diagnostic categories, and the sex ratios remained stable. The effect sizes of DSM-5 group differences regarding impairment levels were equal to or larger than those of the DSM-IV comparisons, ranging from small to medium. Discussion We provide an in-depth overview of changes resulting from the revisions of DSM eating disorder criteria in a German adolescent sample. Despite the overall increase in prevalence estimates, the results suggest that the DSM-5 criteria differentiate participants with threshold disorders and OSFED from those no diagnosis as well as or even more distinctly than the DSM-IV criteria. [ABSTRACT FROM AUTHOR]

Background: Early experiences of traumatic events (TEs) may be associated with subsequent eating disturbance. However, few studies have investigated overall exposure and trauma-type frequency in various types of eating disorders (EDs). Objective: This study aimed to investigate the prevalence and type of TEs in a nationally representative sample of Swedish ED patients. Method: Data from a database (Stepwise) for specialized ED care were used. Trauma history was assessed as a part of the routine, initial assessment. Participants over the age of 18 with a diagnosed DSM-IV ED were included (N=4,524). Results: The number of patients having experienced at least one TE was 843 (18.6%), and 204 (24.2%) reported at least one additional trauma. Sexual trauma was the most common form of TE (6.3%). There was no difference in overall traumatic exposure or in type of experienced trauma between the ED diagnostic subgroups (AN, BN, EDNOS, and BED). Overall traumatic exposure was linked to self-reported severity of ED symptoms, more secondary psychosocial impairment, psychiatric comorbidity, and negative self-image. Conclusions: Trauma history in ED patients merits attention. Results are partly in line with and partly in contrast to previous research. Measurement of trauma history has varied substantially in research on EDs, and this study adds to the indistinct literature on trauma history in ED.

Aim: Body image disturbances are associated with eating disorders to a large extent. The aim of this study was to compare body image disturbances between patients with anorexia nervosa (AN), bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS). Method: A Norwegian sample of 122 female patients admitted to two specialized units was included in the study. There were 61 (50%) patients with AN, 31 (25%) with BN and 30 (25%) with EDNOS. At admission patients fill out the Body Attitude Test (BAT). BAT is a self-report form capturing different body image dimensions. Results: A majority of the patients reported severe body image disturbances. The extent of the problems in means did not differ between the diagnostic groups, neither on total score nor subscales on BAT, but there was great variation in distribution within the diagnostic groups. Conclusion: As the extent of body image disturbances vary more in than between diagnostic groups, it is important in the clinical practice to have more focus on individual differences and needs than on diagnoses.

Introduction: eating disorders are a group of syndromes that have in common,psychopathological traits that are largely determined by their physical appearance. Theyare much more common in women than in men, predominantly in young people. Thereis increased incidence of eating disorders, which are the result of improved knowledgeand the increasingly early implementation of better instruments for symptoms, riskfactors and the availability of well defined diagnostic criteria.Objective: to identify key validated scales to detect symptoms and risk behaviors foreating disorders in adolescents and adults.Methodology: thematic review of publications in which they occur, validate andanalyze different scales to assess symptoms and risk behaviors for ED. Electronicsearch was conducted from 1984 to 2011 in English and Spanish. We included all typesof publications. We reviewed the abstracts and full papers were selected that addressedscales to assess symptoms and risk factors for eating behavior disorders.Results: 539 abstracts were obtained on TCA. We reviewed 75 articles identified sixcomplete and validated scales to identify symptoms and risk behaviors. Scale SCOFF(Sick, Control, Outweigh, Fat, Food). Scale EDE-Q. (Eating Disorder Examination-Questionnaire self-report). Scale EAT (Eating Attitudes Test) in versions 40 and 26questions. Scale EDI (Eating Disorder Inventory). Scale BULIT (Bulimia Test) andversion revised (BULIT-R). Scale BITE (Bulimia Test of Edinburg).Conclusion: the SCOFF scale stands out to be simple and easy to apply orally orin writing. EAT scale, in both versions, is considered the gold standard to identifysymptoms and risk behaviors for eating disorder behavior.RESUMEN:Introducción: los trastornos de comportamiento alimentario (TCA) son un grupo desíndromes que tienen en común rasgos psicopatológicos fuertemente determinadospor la apariencia física. Son mucho más frecuentes en mujeres que en varones,predominando en jóvenes. Hay aumento en la incidencia de los TCA, como producto delmejoramiento en el conocimiento y en la implementación cada vez más temprana demejores instrumentos de búsqueda de síntomas, factores de riesgo y la disponibilidadde criterios diagnósticos bien definidos.Objetivo: identificar las principales escalas validadas que permiten detectar síntomasy conductas de riesgo para trastornos del comportamiento alimentario en adolescentesy adultos.Metodología: revisión temática de publicaciones en las que se presentan, validan yanalizan diversas escalas para evaluar síntomas y conductas de riesgo para TCA. Serealizó búsqueda electrónica desde 1984 al 2011, en inglés y español. Se incluyerontodas las modalidades de publicaciones. Se revisaron los resúmenes y se escogieron losdocumentos completos que trataban sobre escalas para valorar síntomas y factores deriesgo para trastornos del comportamiento alimentario.Resultados: se obtuvieron 539 resúmenes sobre TCA. Se revisaron 75 artículoscompletos y se identificaron seis escalas validadas para identificar síntomas y conductasde riesgo: SCOFF (Sick, Control, Outweight, Fat, Food), EDE-Q (Eating DisorderExamination-self-report Questionnaire), EAT (Eating Attitudes Test), en versionesde 40 y 26 preguntas, además de una escala específica para niños (ChEAT-26). EDI(Eating Disorder Inventory), BULIT (Bulimia Test) y su versión revisada (BULIT-R), BITE(Bulimia Test of Edimburg).Conclusión: la escala SCOFF se destaca por ser sencilla y fácil de aplicar ya sea de formaoral o escrita. La escala EAT, en ambas versiones, es considerada como el estándar deoro para identificar síntomas y conductas de riesgo para TCA. BULIT o BULIT-R y BITEson específicas para bilimia

This study aims at better understanding the subjective experience, the so-called Erlebnis, in individuals diagnosed with Eating Disorders (ED). We shall highlight the particular way in which people with such disorders perceive their own bodies and specifically how they perceive their bodies in the presence of other people. To this end we shall analyze the subjective experience by means of two concepts as described by French philosopher Jean-Paul Sartre: "body-self" and "body-forothers". Our hypothesis is that some people suffering from eating disorders, especially those with a diagnosis of Eating Disorders Not Otherwise Specified (EDNOS), experience their body mainly as body-for-others. Rather than a diagnostic category, EDNOS could be conceived as an anthropological configuration vulnerable to ED. Eating disorders appear as an "identity disorder" characterized by a suspension of the experiential polarity between self and other-than-self.

Background: This systematic review is an evaluation of the empirical literature relating to the disordered eating behaviour Chew and Spit (CHSP). Current theories postulate that CHSP is a symptom exhibited by individuals with recurrent binge eating and Bulimia Nervosa. Aims: The review aimed to identify and critically assess studies that have examined the distribution of CHSP behaviour, its relationship to eating disorders, its physical and psychosocial consequences and treatment. Methods: A systematic database search with broad inclusion criteria, dated to January 2016 was conducted. Data were extracted by two authors and papers appraised for quality using a modified Downs and Black Quality Index. Results: Nine studies met the inclusion criteria. All were of clinical samples and majority (n = 7) were of low quality. The pathological action of chewing food but not swallowing was reported more often in those with restrictive type eating disorders, such as Anorexia Nervosa, than binge eating type disorders. CHSP also was reported to be an indicator of overall severity of an eating disorder and to appear more often in younger individuals. No studies of treatment were found. Conclusions: Conclusions were limited due to the low quality and small numbers of studies based on clinical samples only. Further research is needed to address gaps in knowledge regarding the physiological, psychological, social, socioeconomic impact and treatment for those engaging in CHSP. [ABSTRACT FROM AUTHOR]

Background: Clinical anecdote suggests that rates of eating disorders (ED) vary between schools. Given their high prevalence and mortality, understanding risk factors is important. We hypothesised that rates of ED would vary between schools, and that school proportion of female students and proportion of parents with post-high school education would be associated with ED, after accounting for individual characteristics.Method: Multilevel analysis of register-based, record-linkage data on 55 059 females born in Stockholm County, Sweden, from 1983, finishing high school in 2002-10. Outcome was clinical diagnosis of an ED, or attendance at a specialist ED clinic, aged 16-20 years.Results: The 5-year cumulative incidence of ED diagnosis aged 16-20 years was 2.4%. Accounting for individual risk factors, with each 10% increase in the proportion of girls at a school, the odds ratio for ED was 1.07 (1.01 to 1.13), P = 0.018. With each 10% increase in the proportion of children with at least one parent with post-high school education, the odds ratio for ED was 1.14 (1.09 to 1.19), P < 0.0001. Predicted probability of an average girl developing an ED was 1.3% at a school with 25% girls where 25% of parents have post-high school education, and 3.3% at a school with 75% girls where 75% of parents have post-high school education.Conclusions: Rates of ED vary between schools; this is not explained by individual characteristics. Girls at schools with high proportions of female students, and students with highly educated parents, have higher odds of ED regardless of individual risk factors. [ABSTRACT FROM AUTHOR]

Objective: To examine a new socio-family risk model of Eating Disorders (EDs) using path-analyses.Method: The sample comprised 1264 (ED patients = 653; Healthy Controls = 611) participants, recruited into a multicentre European project. Socio-family factors assessed included: perceived maternal and parental parenting styles, family, peer and media influences, and body dissatisfaction. Two types of path-analyses were run to assess the socio-family model: 1.) a multinomial logistic path-model including ED sub-types [Anorexia Nervosa-Restrictive (AN-R), AN-Binge-Purging (AN-BP), Bulimia Nervosa (BN) and EDNOS)] as the key polychotomous categorical outcome and 2.) a path-model assessing whether the socio-family model differed across ED sub-types and healthy controls using body dissatisfaction as the outcome variable.Results: The first path-analyses suggested that family and media (but not peers) were directly and indirectly associated (through body dissatisfaction) with all ED sub-types. There was a weak effect of perceived parenting directly on ED sub-types and indirectly through family influences and body dissatisfaction. For the second path-analyses, the socio-family model varied substantially across ED sub-types. Family and media influences were related to body dissatisfaction in the EDNOS and control sample, whereas perceived abusive parenting was related to AN-BP and BN.Discussion: This is the first study providing support for this new socio-family model, which differed across ED sub-types. This suggests that prevention and early intervention might need to be tailored to diagnosis-specific ED profiles. [ABSTRACT FROM AUTHOR]

Background: This study compares the DSM-IV and DSM-5 diagnostic criteria for eating disorders. DSM-IV resulted in a large number of patients being diagnosed with Eating Disorder Not Otherwise Specified (EDNOS). In DSM-5 the residual category is renamed Other Specified Feeding and Eating Disorders (OSFED) and Unspecified Eating Disorders (UFED) however the diagnostic criteria for the residual category in each of the diagnostic systems remains the same. This study aims to evaluate the changes in percentages of patients in a residual DSM-IV category compared to a residual DSM-5 category by retrospectively applying DSM-5 criteria to the clinical records of a patient population in a clinical setting. It also aims to compare the psychopathology between the EDNOS and OSFED/UFED groups. Methods: 285 participants were recruited from a specialised eating disorder clinic in Australia over a 5-year period from 2009 until 2014. The clinical records of patients with diagnoses of anorexia nervosa (AN), bulimia nervosa (BN) and EDNOS were retrospectively assessed using the DSM-5 criteria. All patients who had attended the clinic and received an eating disorder diagnosis during this period were included in the study. No patients were diagnosed with binge eating disorder during the study period. This is surprising given the prevalence of binge eating disorder in the community. It is possible that individuals with binge eating disorder were not referred to the clinic following the initial referral and assessment due to the lack of binge eating specific interventions available. The referral process may also have been skewed towards AN, BN and EDNOS due to a perception by referring parties that binge eating disorder was a 'milder' condition that did not require specialist intervention. Information in the clinical records included structured clinical interviews, and self-rating scales of eating disorder and other psychiatric symptoms and a longitudinal narrative of patient performance and attitude during observed meals. Results: We observed a 23.5% reduction in the diagnosis of OSFED/UFED with the implementation of DSM-5 compared to EDNOS with DSM-IV. The removal of Criterion D, amenorrhoea, was the leading cause for transition from EDNOS to AN. Conclusions: DSM-5 has reduced the reliance on EDNOS. However this study was unable to examine the reliability of the new diagnostic criteria or the impact of DSM-5 on binge eating disorder. [ABSTRACT FROM AUTHOR]

Background: Enhanced Cognitive Behaviour Therapy (CBT-E) (Fairbum, Cooper and Shafran, 2003) was developed as a treatment approach for eating disorders focusing on both core psychopathology and additional maintenance mechanisms. Aims: To evaluate treatment outcomes associated with CBT-E in a NHS Eating Disorders Service for adults with bulimia and atypical eating disorders and to make comparisons with a previously published randomized controlled trial (Fairbum et ah, 2009) and "real world" evaluation (Byme, Fursland, Allen and Watson, 2011). Method: Participants were referred to the eating disorder service between 2002 and 2011. They were aged between 18-65 years, registered with a General Practitioner within the catchment area, and had experienced symptoms fulfilling criteria for BN or EDNOS for a minimum of 6 months. Results: CBT-E was commenced by 272 patients, with 135 completing treatment. Overall, treatment was associated with significant improvements in eating disorder and associated psychopathology, for both treatment completers and the intention to treat sample. Conclusions: Findings support dissemination of CBT-E in this context, with significant improvements in eating disorder psychopathology. Improvements to global EDE-Q scores were higher for treatment completers and lower for the intention to treat sample, compared to previous studies (Fairbum et ah, 2009; Byrne et ah, 2011). Level of attrition was found at 40.8% and non-completion of treatment was associated with higher levels of anxiety. Potential explanations for these findings are discussed. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To date, studies of stigma relating to eating disorders have been largely confined to surveys of the public. We sought to examine the prevalence and correlates of stigma as reported by individuals with eating disorders. Method An online survey designed to assess frequency of exposure to potentially stigmatizing attitudes and beliefs as well as the perceived impact of this on health and well-being was completed by a cross-national sample of 317 individuals with anorexia nervosa ( n = 165), bulimia nervosa ( n = 66), or Eating Disorder Not Otherwise Specified (EDNOS; n = 86). Results Participants rated two beliefs as both particularly common and particularly damaging, namely 'I should be able to just pull myself together' and 'I am personally responsible for my condition'. Participants with bulimia nervosa more commonly experienced the belief that they had 'no self-control' and male participants more commonly experienced the belief that they were 'less of a man'. More frequent stigmatization was associated with higher levels of eating disorder psychopathology, a longer duration of disorder, lower self-esteem, and more self-stigma of seeking psychological help. Discussion Stigma towards individuals with eating disorders, as experienced by sufferers, is common and associated with numerous adverse outcomes. The perceptions that eating disorders are trivial and self-inflicted should be a focus of destigmatization interventions. Efforts to reduce stigma towards individuals with bulimia nervosa may need to focus on perceptions of self-control, whereas efforts to reduce stigma towards males with eating disorders may need to focus on perceptions of masculinity/manhood. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:767-774) [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To investigate which parental mental illnesses are associated with eating disorders in their offspring. Method We used data from a record-linkage cohort study of 158,679 children aged 12-24 years at the end of follow-up, resident in Stockholm County from 2001 to 2007, to investigate whether different parental mental illnesses are risk factors for eating disorders in their offspring. The outcome measure was diagnosis of any eating disorder, either from an ICD or DSM-IV code, or inferred from an appointment at a specialist eating disorder clinic. Results Mental illness in parents is a risk factor for eating disorders in female offspring (Adjusted Hazard Ratio (AHR) 1.57 (95% CI 1.42, 1.92), p < 0.0001). Risk of eating disorders is increased if there is a parental diagnosis of bipolar affective disorder (AHR 2.28 (95% CI 1.39, 3.72), p = 0.004), personality disorder (AHR 1.57 (95% CI 1.01, 2.44), p = 0.043) or anxiety/depression (AHR 1.57 (95% CI 1.32, 1.86), p < 0.0001). There is a lack of statistical evidence for an association with parental schizophrenia (AHR 1.41 (95% CI 0.96, 2.07), p = 0.08), and somatoform disorder (AHR 1.25 (95% CI 0.74, 2.13), p = 0.40). There is no support for a relationship between parental substance misuse and eating disorders in children (AHR 1.08 (95% CI 0.82, 1.43), p = 0.57). Discussion Parental mental illness, specifically parental anxiety, depression, bipolar affective disorder, and personality disorders, are risk factors for eating disorders in their offspring. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:383-391) [ABSTRACT FROM AUTHOR]

Background: Follow-up visits of patients recovering from anorexia nervosa (AN) have shown that some patients do not resume menstrual cycles despite returning to the normal weight for their age and height. Aim: To verify whether leptin, insulin-like growth factor 1 (IGF-1) or another hormonal marker could be a good predictor of the return of menses. Patients and Methods: This prospective study included female adolescents diagnosed with AN or eating disorders not otherwise specified (EDNOS) and who were being treated in an ambulatory care unit during nutritional recovery. Body mass index and leptin, luteinizing hormone, estradiol and IGF-1 levels of these patients were evaluated. Blood samples were collected in the 1st (T1), 5th (T2), 10th (T3), 15th (T4) and 20th (T5) weeks of treatment. The hormone levels during nutritional recovery and at the time of the resumption of menses were analyzed. Results: The hormonal profiles improved after nutritional recovery, with IGF-1 correlating the most with the resumption of menses and nutritional recovery (p = 0.0001). At the resumption of menstruation, the patients showed IGF-1 levels >342.8 ng/ml. Conclusion: IGF-1 was the best predictor of the return of menses in female adolescents with AN or EDNOS. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

ABSTRACT Objective The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a considerably revised eating disorder section. The aim of this study was to establish the prevalence and severity of eating disorders based on the new DSM-5 criteria in a community cohort of adolescents. Method This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch cohort study on mental health and social development from preadolescence into young adulthood. At baseline, the participants ( n = 2,230) were about 11 years old. Body mass index was measured at all four assessment waves. At age 19, the Composite International Diagnostic Interview was administered to 1,584 of the participants. A two-stage screening approach was used to estimate the prevalence of DSM-5 eating disorders. Adolescents at high risk for eating disorders ( n = 312) were selected for an additional interview administered by eating disorder experts. Results Of the high-risk group n = 296 (95%) could be interviewed. Among the women, the lifetime prevalence of DSM-5 anorexia nervosa was 1.7%, of bulimia nervosa 0.8% and of binge eating disorder 2.3%. Eating disorders were relatively rare among the men. The severity of most cases was mild to moderate and detection and treatment rates depended on the level of severity. Discussion The most common DSM-5 eating disorder diagnoses in adolescents in the community are anorexia nervosa and binge eating disorder. Severity ratings for eating disorders seem valid in terms of both the distribution in the community and the correlation with detection and treatment by health care services. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:610-619) [ABSTRACT FROM AUTHOR]

Eating disorders in dancers are thought to be common, but the exact rates remain to be clarified. The aim of this study is to systematically compile and analyse the rates of eating disorders in dancers. A literature search, appraisal and meta-analysis were conducted. Thirty-three relevant studies were published between 1966 and 2013 with sufficient data for extraction. Primary data were extracted as raw numbers or confidence intervals. Risk ratios and 95% confidence intervals were calculated for controlled studies. The overall prevalence of eating disorders was 12.0% (16.4% for ballet dancers), 2.0% (4% for ballet dancers) for anorexia, 4.4% (2% for ballet dancers) for bulimia and 9.5% (14.9% for ballet dancers) for eating disorders not otherwise specified (EDNOS). The dancer group had higher mean scores on the EAT-26 and the Eating Disorder Inventory subscales. Dancers, in general, had a higher risk of suffering from eating disorders in general, anorexia nervosa and EDNOS, but no higher risk of suffering from bulimia nervosa. The study concluded that as dancers had a three times higher risk of suffering from eating disorders, particularly anorexia nervosa and EDNOS, specifically designed services for this population should be considered. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Abstract: Increasing number of individuals is being diagnosed with eating disorders, as social media and western culture portray thinness as signs of happiness and well-being. Individuals with eating disorders are obsessed with food, body image, and weight loss. Depending on the severity and duration of their illness, they may display physical symptoms such as weight loss, amenorrhea, loss of interest in sex, low blood pressure, depressed body temperature, chronic and unexplained vomiting and the growth of soft, fine hair on the body and face. There are four types of behavioral manifestations occurring from eating disorders: a) Anorexia nervosa b) Bulimia nervosa c) Binge eating disorder d) Eating disorder not otherwise specified. Today's theorists usually apply a multidimensional risk perspective to explain eating disorders, and identity several key factors that place a person at risk for an eating disorder: society's emphasis on thinness, family environment, ego deficiencies and cognitive disturbances, mood disorders and biological factors (including hypothalamic reactions to excessive dieting). Treatments for anorexic nervosa include increasing caloric intake and restoring the person's weight quickly. The next step is to address the underlying psychological problems, so that improvement may be lasting, by employing a mixture of individual, group and family therapies. Treatments for bulimia nervosa focus on eliminating the binge-purge pattern and addressing the underlying causes of the disorder. Often several treatment strategies are combined, including individual insight therapy, group therapy, behavioral therapy and antidepressant medications. [Copyright &y& Elsevier]

Objective This study explored the outcome of introducing Compassion Focused Therapy (CFT) into a standard treatment programme for people with eating disorders. In particular, the aim was to evaluate the principle that CFT can be used with people with eating disorders and improve eating disorder symptomatology. Method Routinely collected questionnaire data were used to assess cognitive and behavioural aspects of eating disorders and social functioning/well being ( n = 99). Results There were significant improvements on all questionnaire measures during the programme. An analysis by diagnosis found that people with bulimia nervosa improved significantly more than people with anorexia nervosa on most of the subscales. Also, in terms of clinical significance, 73% of those with bulimia nervosa were considered to have made clinically reliable and significant improvements at the end of treatment (compared with 21% of people with anorexia nervosa and 30% of people with atypical eating disorders). Conclusion This study demonstrates the potential benefits of using CFT with people with eating disorders and highlights the need for further research on this new approach. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message CFT offers new ways to conceptualize and formulate some of the self-critical and shame-based difficulties associated with eating disorders., CFT offers a framework that can enable people with eating disorders to conceptualize their difficulties in different ways., CFT can be combined with standard therapies especially cognitive behavioural therapy., CFT can be especially useful in a group context where the relationships between members can become increasingly compassionate, validating, supportive and encouraging. [ABSTRACT FROM AUTHOR]

Objective The literature on later age of onset (LAO) in women with eating disorders is scarce. We compared the severity of eating disorders, eating disorder subtype, and personality profiles in a clinical sample of consecutively assessed women with eating disorders with later age of onset (LAO, > = 25 years) to women with typical age of onset (TAO, <25 years). Method All eating disorder patients met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria and were admitted to the Eating Disorder Unit of the University Hospital of Bellvitge in Barcelona, Spain. Ninety-six patients were classified as LAO and 759 as TAO. Assessment Measures included the Eating Attitude Test-40 (EAT-40), Eating Disorders Inventory-2 (EDI-2), Bulimic Investigatory Test Edinburgh (BITE), Symptom Checklist Revised (SCL-90-R), and the Temperament and Character Inventory-Revised (TCI-R), as well as other clinical and psychopathological indices. Results LAO individuals reported significantly fewer weekly vomiting episodes, fewer self-harming behaviours, less drug abuse, and lower scores on the BITE symptoms, the EDI-2 drive for thinness, and the TCI-R harm avoidance scales than TAO individuals. Conversely, the LAO group reported more current and premorbid obesity than the TAO group. Conclusion LAO eating disorder patients in this sample presented with milder symptomatology and less extreme personality traits. Premorbid obesity may be more relevant to LAO than TAO eating disorders and should be routinely assessed and considered when planning treatment. [ABSTRACT FROM AUTHOR]

Background: Eating disorders are a group of conditions characterised by abnormal eating habits. Greater than 50 % of patients with eating disorders have an ‘eating disorder not otherwise specified’ (EDNOS). No specific tools exist to evaluate EDNOS, and patients are identified only with a diagnosis of exclusion from the other eating disorders. The BioEnterics® Intragastric Balloon (BIB®) is used worldwide as a short-term treatment option in obese patients. A new frequency score was used to evaluate the influence of double consecutive BIB® treatment compared with single BIB® treatment followed by diet on four categories of EDNOS (grazing, emotional eating, sweet-eating and after-dinner grazing). Methods: A prospective study allocated 50 obese patients (age range 25–35, BMI range 40.0–44.9) into two groups: BIB® (6 months) followed by diet therapy (7 months; group A ( N = 25)) and BIB® placement for 6 months followed by another BIB® for 6 months, with a 1-month interval between placement (group B ( N = 25)). Baseline demographics were similar across both groups. Results: At the time of removal of the first BIB® device, EDNOS scores in both groups were not significantly different, but decreased significantly from baseline. By the end of the study, all EDNOS scores were significantly lower in patients undergoing consecutive BIB®, compared with single BIB® followed by diet therapy. Conclusions: The placement of an intragastric balloon in obese patients allows for a reduction in the intensity of grazing, emotional eating, sweet-eating and after-dinner grazing. A more significant reduction in the EDNOS score was observed with two consecutive BIBs®. [ABSTRACT FROM AUTHOR]

Early experiences of traumatic events (TEs) may be associated with subsequent eating disturbance. However, few studies have investigated overall exposure and trauma-type frequency in various types of eating disorders (EDs). This study aimed to investigate the prevalence and type of TEs in a nationally representative sample of Swedish ED patients. Data from a database (Stepwise) for specialized ED care were used. Trauma history was assessed as a part of the routine, initial assessment. Participants over the age of 18 with a diagnosed DSM-IV ED were included (N=4,524). The number of patients having experienced at least one TE was 843 (18.6%), and 204 (24.2%) reported at least one additional trauma. Sexual trauma was the most common form of TE (6.3%). There was no difference in overall traumatic exposure or in type of experienced trauma between the ED diagnostic subgroups (AN, BN, EDNOS, and BED). Overall traumatic exposure was linked to self-reported severity of ED symptoms, more secondary psychosocial impairment, psychiatric comorbidity, and negative self-image. Trauma history in ED patients merits attention. Results are partly in line with and partly in contrast to previous research. Measurement of trauma history has varied substantially in research on EDs, and this study adds to the indistinct literature on trauma history in ED. [ABSTRACT FROM AUTHOR]

Background: This systematic review evaluates the efficacy of internet-based interventions for the treatment of different eating disorders in adults. Method: A search for peer reviewed journal articles detailing Randomised Control Trials (RCT) and Controlled Trials (CT) addressing participants with eating disorders aged at least 16 was completed in the electronic databases Web of Science, PsycInfo and PubMed. The quality of the included articles was assessed, results were reviewed and effect sizes and corresponding confidence intervals were calculated. Results: Eight studies, including a total of N = 609 participants, fulfilled the selection criteria and were included. The majority of treatments applied in these studies were based on CBT principles. Six studies described guided self- help interventions that showed significant symptom reduction in terms of primary and secondary outcomes regarding eating behaviour and abstinence rates. These studies produced significant medium to high effect sizes both within and between the groups after utilisation of guided self-help programs or a self-help book backed up with supportive e-mails. The two remaining studies utilised a specific writing task or e-mail therapy that did not follow a structured treatment program. Here, no significant effects could be found. Treatment dropout rates ranged from 9% to 47.2%. Furthermore, reductions in other symptoms, for example depression and anxiety, and an increase in quality of life were found by four studies. Conclusions: Overall, the results support the value of internet-based interventions that use guided self-help to tackle eating disorders, but further research is needed due to the heterogeneity of the studies. [ABSTRACT FROM AUTHOR]

Eating disorders have proved resistant to therapy with high relapse rates. Enhanced cognitive behavior therapy (CBT-E) is the favored treatment of choice but has been criticized for placing a similar emphasis on controlling eating behavior as the psychopathology it seeks to counter. In contrast, narrative therapy focuses on the development of an anti-eating disorder lifestyle and values. Evidence for this approach primarily consists of informal case study material. This case study describes a 28-year-old woman with a recurring history of anorexia nervosa, who self-referred to a university psychology clinic, due to fears of imminent relapse. The client received 10 sessions of narrative therapy and made significant progress in externalizing her eating disorder, in lessening her adherence to the ascetic values underpinning it, and in developing/expressing her non-eating disorder character and values. This case study provides evidence of the potential effectiveness of narrative therapy and contains valuable learning for clinicians regarding its implementation. [ABSTRACT FROM AUTHOR]

Grazing, or the uncontrolled, repetitive eating of small amounts of food is being increasingly recognised as an important eating behaviour associated with obesity. In spite of the need for a better understanding of this eating behaviour for improved obesity treatment, currently there is no empirically validated self-report measure to assess grazing. Therefore, to contribute to a better understanding of this relatively understudied eating pattern, a new self-report questionnaire of grazing was developed in this study. Questionnaire items were designed to reflect previous empirical descriptions of grazing. A group of 248 university students completed the Grazing Questionnaire, other measures of eating-related behaviours and cognitions, and negative emotion. Sixty-two participants completed the Grazing Questionnaire a second time to calculate its temporal stability. Exploratory factor analysis revealed a clear two-factor solution for the questionnaire, reflecting repetitive eating behaviour and a perception of loss of control. Scores on the Grazing Questionnaire were positively associated with other measures of disordered eating, especially with binge eating. Initial psychometric properties of the new questionnaire are promising. Future research is now needed to examine the prevalence of this eating behaviour in more diverse populations, including those with binge eating disorder and obesity. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study is to examine the prevalence of eating disorders (ED) among female and male adolescent elite athletes and nonathletic controls. Methods: This was a two-phase study, including a self-report questionnaire (part I) followed by clinical interviews (part II). The total population of first-year students at 16 Norwegian Elite Sport High Schools (n = 677) and two randomly selected high schools (controls, n = 421) were invited to participate. The questionnaire was completed by 611 (90%) athletes and 355 (84%) controls. The subjects reporting symptoms associated with ED were classified as "at risk" for ED. In part II, all "at-risk" athletes (n = 153), a random sample of not "at risk" (n = 153), and a random sample of 50% of the controls classified as "at risk" (n = 91) and not "at risk" {n = 88) were invited to the clinical interview to screen for ED (i.e., meeting the Diagnostic and Statistical Manual of Mental Disorders criteria for anorexia nervosa, bulimia nervosa, or ED not otherwise specified). Results: In part I, more controls than athletes were classified as "at risk" for ED (50.7% vs 25.0%, P < 0.001). In part II, the prevalence of ED among the total population of athletes and controls was estimated to be 7.0% versus 2.3%, with a difference of 4.7% (95% confidence interval, 3.4-6.0; P = 0.001), with the ED prevalence being higher for female than male athletes (14.0% vs 3.2%, P < 0.001) and female and male controls (5.1% vs 0%, P < 0.001). No difference in the prevalence of ED was detected between the females in weight-sensitive and less weight-sensitive sport groups (19.7% vs 11.9%, P- 0.136). Conclusion: The prevalence of ED is higher in adolescent elite athletes than controls and higher in female than male athletes. Clinical interview is needed to determine accurate prevalence of ED. [ABSTRACT FROM AUTHOR]

A 10-year retrospective case note study of adults with eating disorders at low weight examined levels of service consumption and the outcome in terms of body mass index. Records of 202 such patients, referred to a specialist secondary service, were studied. Just over one quarter of the patients failed to engage in treatment, attending five or fewer appointments. Of those who did engage, most were treated as out-patients and had an average contact with the service of almost 2.5 years and 46 sessions. Only about one in six patients was admitted as an in-patient at any time. These results suggest that most adults with eating disorder at low weight can be managed as out-patients. However, service providers should expect prolonged contact and high service consumption. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine whether there is an association between individual, social and family influences and dysfunctional eating patterns early in life and the likelihood of developing a subsequent underweight eating disorder (ED) or obesity. Method The total sample comprised 152 individuals (underweight ED, n = 45; obese patients, n = 65; healthy controls; n = 42) from Barcelona, Spain. The Cross-Cultural Questionnaire (CCQ) was used to assess early eating influences as well as individual and family eating patterns and attitudes towards food. Results Even though a few shared eating influences emerged for both groups, unique factors were also observed. Whereas relationship with friends, teasing about eating habits by family members and the mass media were of specific relevance to the underweight ED group, the patient's own physical appearance, body dissatisfaction, teasing about eating habits by friends, teasing about body shape by family members and dysfunctional eating patterns were unique to obesity. Conclusions Overlapping environmental risk factors provide evidence for integral prevention and intervention approaches that simultaneously tackle a range of weight-related problems. The unique factors might be important for targeting high-risk individuals. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objectives Eating disorder not otherwise specified (EDNOS) is the most prevalent eating disorder, yet its heterogeneity begs less reliance on this broad diagnostic category. The purpose of this study was to compare women with anorexia nervosa (AN) and EDNOS, AN type (EDNOS-AN) from a multisite study on eating-related and general psychopathology measures. Methods One hundred eighteen participants ( n = 59 with DSM-IV AN, n = 59 with EDNOS-AN) completed structured interviews, questionnaires and a physical examination at baseline. In addition, participants carried a handheld palm pilot computer for 2 weeks to provide ecological momentary assessment (EMA) information about mood and eating disorder behaviours. Results No significant differences between AN and EDNOS-AN were found on the self-report and interview measures, or on the EMA mood assessments. The only differences to emerge were that participants with AN reported higher rates of binge eating and purging on EMA compared with those with EDNOS-AN, whereas EDNOS-AN reported higher rates of checking thighs and joints on EMA compared with those with AN. For the physiological parameters, AN presented with lower white blood cell counts compared with EDNOS-AN. Conclusions Findings highlight the clinical significance of EDNOS-AN and support a closer look at the definition of AN as proposed by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective: Eating Disorder Not Otherwise Specified (EDNOS) constitute the most common eating disorder among those seeking treatment at eating disorder facilities; they are even more common among persons with eating disorders the community. This study compares the impact of applying the revised diagnostic criteria proposed by the DSM-5 workgroup, and the broad categories for the diagnosis of eating disorders (BCD-ED) proposed by Walsh and Sysko on the prevalence of EDNOS. Method: In two nationwide epidemiological studies the prevalence of eating disorders among female high school ( n = 2,028) and university students ( n = 1,020) was examined using DSM-IV criteria. We used a two-stage design, administering a questionnaire in the first stage and an interview in the second stage. Results: In the combined samples 118 cases of eating disorders (DSM-IV) were detected, of which 86 were diagnosed as EDNOS (72.9%). Application of the DSM-5 criteria reduced the number of EDNOS cases to 60 (50.8%) or to 52 (44%), when using a BMI <18.5 as cutoff for 'significantly low weight' criterion in AN; with the use of BCD-ED criteria, only 5 (4.2%) cases of EDNOS remained. Discussion: Proposed criteria set for DSM-5 substantially reduce the number of EDNOS cases. However, the BCD-ED scheme further reduces its proportion, almost eliminating it. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2013) [ABSTRACT FROM AUTHOR]

Abstract: The presence of eating disorders in adults and adolescents has long been recognized; their identification in children aged between 8 and 13 years is more recent. The emergence of eating problems among this age group is noted by clinicians and researchers [3,5,12–14]. Some authors have deepened their research with those clients to better document the clinical presentation. They have come to formulate a specific classification for this age group, which differs on some points from those proposed for infants and toddlers, and for adolescents and adults. The aim of this paper is to present a review of the literature on eating disorders in children aged between 8 and 13 and to expose the proposed classification of Bryant-Waugh and Lask [4] for this age group. Each of the categories suggested will be illustrated by a brief clinical vignette. In the last part of the article, a critical point of view is expressed regarding the proposed categories and also suggestions for future research. [Copyright &y& Elsevier]

Objective The aim of the study was to pilot a brief form of interpersonal psychotherapy (IPT) for the treatment of patients with bulimic disorders. Method Ten patients with bulimic disorder treated with a new brief version of IPT (IPT-BN10) completed measurements of eating disorders psychopathology (Eating Disorders Examination Questionnaire, Bulimic Investigatory Test Edinburgh) and depression (Beck Depression Inventory). The results were matched with a group of patients treated with conventional IPT and with waiting list control. Results Statistical differences were found between starting and ending of therapy for those patients treated with IPT-BN10. Statistical difference was also found when comparing with waiting list control. Discussion The pilot study suggests that IPT-BN10 may be an effective treatment for patients having bulimic disorders; however, this hypothesis needs to be tested in an experimental way. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The Eating Disorder Diagnostic Scale (EDDS) is a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa and binge eating disorder. Research has provided evidence of the reliability and validity of this scale in non-clinical populations. Our study is the first to examine the psychometric features of the EDDS in a clinical population of eating disordered patients. We identified a cut-off point that differentiates clinical patients from healthy controls. A clinical group of 59 Dutch female eating disordered patients and a control group of 45 Dutch students completed the EDDS, the Eating Disorder Examination Interview, the Body Attitude Test and the Beck Depression Inventory-II. The EDDS showed good test-retest reliability, internal consistency, criterion validity and convergent validity with other scales assessing eating and general pathology. An overall symptom composite cut-off score of 16.5 accurately distinguished clinical patients from healthy controls. The EDDS may be a useful instrument in clinical settings and in aetiologic, prevention and treatment research. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective: To examine prevalence and clinical correlates of eating disorder not otherwise specified (EDNOS) in the US population. Method: Two cross-sectional surveys of adults and adolescents used the WHO CIDI to assess DSM-IV criteria for anorexia nervosa (AN), bulimia nervosa (BN), and EDNOS. Results: Lifetime prevalence of EDNOS was 4.78% in adolescents and 4.64% in adults. The majority of adolescents and adults with an eating disorder presented with EDNOS. Three-quarters of participants with EDNOS met criteria for comorbid disorders, while one-quarter endorsed suicidality. Severity correlates were equally prevalent in EDNOS and AN, whereas comparisons between EDNOS and BN varied by specific correlate and sample. Adolescents with subthreshold AN (SAN) endorsed more anxiety than AN ( p < .05), and adolescents and adults with SAN endorsed more suicidal plans than AN ( p's < .05). Discussion: Findings increase our understanding of the clinical relevance of EDNOS. Eating disorder diagnostic nomenclature requires modification to capture the full spectrum. © 2012 by Wiley Periodicals, Inc. Int J Eat Disord 2012. [ABSTRACT FROM AUTHOR]

Research evidence has been accumulating for the efficacy of dialectical behaviour therapy (DBT) for binge eating. However, support for its effectiveness and transportability beyond efficacy trials is lacking. The current study evaluated the feasibility of group-based DBT for binge eating within the context of an operating community clinic. Women ages 24-49 (M = 39.60, SD = 9.53) with either subthreshold and full-threshold binge eating disorder or bulimia nervosa formed the group and comprised the sample ( n = 5 treatment completers). Positive outcomes included significant improvement in both binge eating and secondary outcomes with the Eating Disorder Inventory subscales of Bulimia, Ineffectiveness, Perfectionism and Interpersonal Distrust. Attrition was elevated compared with previous efficacy trials, suggesting the need for increased attention to how to improve retention within routine practice settings. Given our limited sample size, these findings are viewed as promising but preliminary. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective: Problems with the current DSM-IV eating disorder (ED) section have resulted in proposed changes toward the upcoming DSM-5 (). We investigated consequences of these by implementing the proposal in a large naturalistic database. Method: Patients were 2,584 children/adolescents and adults enrolled at specialized ED clinics in Sweden. DSM-IV diagnoses anorexia nervosa, bulimia nervosa, and 'not otherwise specified' examples were compared with DSM-5 anorexia, bulimia, and binge ED, as well as atypical anorexia, subthreshold bulimia, and binge eating, purging disorder, and the residual unspecified category. Assessment methods included a semistructured diagnostic interview and self-ratings of ED and psychiatric symptoms. Results: We studied age-separated diagnostic distributions and explained variance in clinical variables associated with the two systems. Results showed some improvement of diagnostic specification as well as a slight increase in explained variance. Discussion: Remaining problems with the proposed changes were also highlighted, and possible further refinement is discussed. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012) [ABSTRACT FROM AUTHOR]

Objective: Revised Eating Disorder (ED) diagnostic criteria have been proposed for the Diagnostic and Statistical Manual (DSM)-5 to reduce the preponderance of eating disorder not otherwise specified (EDNOS) and increase the validity of diagnostic groups. This article compares DSM-IV and proposed DSM-5 diagnostic criteria on number of EDNOS cases and validity. Method: Participants ( N = 397; 91% female) completed structured clinical interviews in a two-stage epidemiological study of EDs. Interviewers did not follow standard skip rules, making it possible to evaluate alternative ED diagnostic criteria. Results: Using DSM-IV versus DSM-5 criteria, 34 (14%) versus 48 (20%) had anorexia nervosa, 43 (18%) versus 44 (18%) had bulimia nervosa, and 163 (68%) had EDNOS versus 20 (8%) had binge eating disorder (BED), and 128 (53%) had EDNOS, respectively, reflecting a significant decrease in EDNOS. Validation analyses supported significant differences among groups with some improvement associated with delineation of BED. Discussion: Proposed revisions to EDs in the DSM-5 significantly reduced reliance on EDNOS without loss of information. © 2011 by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Abstract: To conduct a latent profile analysis (LPA) in eating disorder (ED) patients using temperament and character (TCI-R) measures as indicators. 1312 ED patients including those with anorexia nervosa (AN), bulimia nervosa (BN) and EDNOS were assessed. The final LPA solution was validated using demographics, clinical variables, ED symptomatology (EDI-2) and impulsive behaviors. The best-fitting model consisted of a six-profile solution using the seven subscales of the TCI-R. These profiles were labeled: “self-focused”, “inhibited”, “average”, “impulsive”, “adaptive” and “maladaptive”. Validation analyses indicated that the “inhibited” and “maladaptive” profiles generally presented with the highest values for ED symptomatology and impulsive behaviors. Whereas high levels of Harm Avoidance and low levels of Novelty Seeking and Persistence characterized the “inhibited” profile, the “maladaptive” profile presented with low levels of Reward Dependence, Self-Directedness and Cooperativeness. The most favorable results on the other hand were exhibited by the “adaptive” profile, characterized by high scores on Reward Dependence, Self-Directedness, Cooperativeness and low levels on Novelty Seeking. Finally, when our six-profile solution was compared with the DSM-IV ED diagnoses, significant differences among profiles and ED diagnoses were observed. Our study shows that ED patients can be meaningfully grouped according to temperament and character. [Copyright &y& Elsevier]