1,721,006 research outputs found
Rates of comorbid obsessive-compulsive disorder in eating disorders: A meta-analysis of the literature
No full textBackground: The high comorbidity between Eating Disorders (EDs) and Obsessive-Compulsive disorder (OCD) is well known, as well as its implications in terms of worse outcome and need to adapt treatment. Estimates of OCD comorbidities in EDs are variable in different studies and poorly informative for clinical purposes. In this study, we sought to derive more consistent estimates, taking into account potential methodological and sampling confounding factors. Methods: We searched published studies reporting lifetime and current rates of comorbid OCD in ED samples based on recent diagnostic criteria. Comorbidity rates were meta-analyzed using a binary random effects model. Heterogeneity among the studies and publication bias were systematically checked. Potential confounding factors were tested by meta-regression analysis and adjusted by sensitivity analysis. Results: Globally, respectively 18% and 15% of all patients with an ED had a lifetime and current comorbidity with OCD. Rates were slightly higher in anorexia (19% and 14%) than in bulimia nervosa (13% and 9%), although only the current comorbid OCD was significantly higher in anorexia than in bulimia. Prospective follow-up studies provided considerably higher lifetime estimates (EDs 38%, anorexia 44%, bulimia 19%). Limitations: Temporal/causal relationship between ED and OCD could not be defined. Conclusions: OCD comorbidity in EDs is a relevant phenomenon, affecting almost one fifth of the patients in cross-sectional observations and up to nearly 40% in prospective follow-up studies. These data indicate the need for focused attention to non-food or body-shape related OCD symptoms, for better diagnostic and prognostic accuracy, and targeted treatment
Young Women in the “Digital Generation”—New Risks and New Opportunities
No full textAdolescence is a hazardous bridge between childhood and adulthood representing one of the more complex phases of human development. During the “teen years” childhood experiences sediment to become the foundation of the adult identity. In this transitional period brains are particularly sensitive to surrounding influences. Digital natives, especially during adolescence, are in between new risks (hyper-connection and Internet addiction, Web-based unhealthy lifestyle promotion, cyberbullying, grooming) and new opportunities (Web-based professional help). Since the most of mental disorders start by the mid-teens and the mid-20s, and as less than half of adolescents with mental health problems receive an appropriate care, there’s a strong need for developing a proper digital education encompassing families, institutions, media, and therapists
Suicide in obsessive-compulsive related disorders: Prevalence rates and psychopathological risk factors
Get PDFObjectives To estimate prevalence rates of suicide attempts and suicidal ideation in individuals with a principal diagnosis of obsessive-compulsive related disorders (OCRDs); 2. to identify predictors of suicide risk among subjects with OCRDs (where available). Methods The systematic review was conducted by searching PubMed from the date of the first available article to December 31, 2018. The search terms [suicide] OR [suicidality] OR [suicide attempts] OR [suicidal ideation] OR [suicidal thoughts] were combined with the following: [BDD] OR [body dysmorphic disorder]; [HD] OR [hoarding disorder]; [trichotillomania] OR [hair pulling disorder]; [excoriation disorder] OR [skin picking disorder]. Results In BDD, data concerning lifetime suicide attempts are consistent across studies: mean rate is 21.5% (range 9-30.3%). Mean rate of current suicidal ideation is 37.4% (range 26.5-49.7%) and mean rate of lifetime suicidal ideation is 74.5% (range 53.5-85%). BDD-specific factors such as early onset, severity, poor insight and muscle dysmorphia and comorbid disorders increase the risk of suicide attempts or suicidal ideation. Only 2 studies recruited individuals with DSM-5 HD: suicidality appears to be low, with rates of current suicidal ideation comprised between 5% and 10%, although 19% of individuals attempted suicide during their lifetime. Concerning the grooming disorders, lifetime rates of suicide attempts are low as compared to rates in other OCRDs; approximately 40% of individuals, however, reported lifetime suicidal ideation. Conclusions OCRDs taken together may be at risk for suicide attempts and suicidal ideation independently from comorbid disorders (and specifically independently from comorbid OCD); BDD remains the disorder more strongly associated with an increased risk for suicide, followed by HD and then the grooming disorders
Treatment Approaches to Eating Disorders Among LGBTQIA plus Population: A Narrative Review
No full textClinical associations between severity of impulsivity, psychiatric morbidity, dysfunctional defences and personality disorder: A comparative study with axis-I disorders
Get PDFObjective: Psychiatric morbidity, impulsive behaviour and use of dysfunctional and maladaptive defences are core features of personality disorder (PD). This study aims to evaluate the significance of the strength of the association between these three core dimensions and PD. Method: Using a cross-sectional design, a sample of co-morbid Axis-I &-II disorders, and a sample of Axis-I disorders with no co-morbid PD were recruited at three general psychiatric mental health resource centres and then compared. PD as dependent variable was analysed both as a categorical and as a dimensional entity using the Structured Clinical Interview for DSM-IV. The Symptoms Checklist 90-R general severity index (GSI), the Barratt Impulsivity Scale (BIS) and the Defense Style Questionnaire (DSQ) were used to measure severity of psychiatric morbidity, impulsivity and defensive style, respectively. Results: BIS was a highly significant predictor of categorical PD (β = .13, SE = .03, p < .001), but not GSI and DSQ. BIS and GSI significantly predicted PD as a dimensional construct (β = 0.32, SE = .08, t = 4.05, p < 0.001; and β = 5.04, SE = 1.54, t = 3.28, p = 0.002, respectively). The diagnostic efficiency statistics found that BIS had greater sensitivity (.82) and specificity (.79), and overall predictive power (.87) of correctly identifying true positive and true negative PD diagnosis compared to the other two measures. Conclusions: BIS may be used in routine clinical practice as a screening measure to identify the presence of PD in complex presentations
How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis
Get PDFInterstitial pneumonia was the first manifestation to be recognized as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, in just a few weeks, it became clear that the coronavirus disease-2019 (COVID-19) overrun tissues and more body organs than just the lungs, so much so that it could be considered a systemic pathology. Several studies reported the involvement of the conjunctiva, the gut, the heart and its pace, and vascular injuries such as thromboembolic complications and Kawasaki disease in children and toddlers were also described. More recently, it was reported that in a sample of 214 SARS-CoV-2 positive patients, 36.4% complained of neurological symptoms ranging from non-specific manifestations (dizziness, headache, and seizures), to more specific symptoms such hyposmia or hypogeusia, and stroke. Older individuals, especially males with comorbidities, appear to be at the highest risk of developing such severe complications related to the Central Nervous System (CNS) involvement. Neuropsychiatric manifestations in COVID-19 appear to develop in patients with and without pre-existing neurological disorders. Growing evidence suggests that SARS-CoV-2 binds to the human Angiotensin-Converting Enzyme 2 (ACE2) for the attachment and entrance inside host cells. By describing ACE2 and the whole Renin Angiotensin Aldosterone System (RAAS) we may better understand whether specific cell types may be affected by SARS-CoV-2 and whether their functioning can be disrupted in case of an infection. Since clear evidences of neurological interest have already been shown, by clarifying the topographical distribution and density of ACE2, we will be able to speculate how SARS-CoV-2 may affect the CNS and what is the pathogenetic mechanism by which it contributes to the specific clinical manifestations of the disease. Based on such evidences, we finally hypothesize the process of SARS-CoV-2 invasion of the CNS and provide a possible explanation for the onset or the exacerbation of some common neuropsychiatric disorders in the elderly including cognitive impairment and Alzheimer disease
Treating eating disorders in the LGBTQIA+ adult population: A scoping review
No full textIntroduction: The lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/aromantic/agender (LGBTQIA+) community faces a significantly higher risk of eating disorders (EDs). This review’s primary objective is to explore ED treatments for this population. Methods: We searched PubMed/MEDLINE and PsycINFO using the keywords “ED,” “LGBTQIA+,” and “therapy,” following the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews 2018 Checklist. Results: Out of 363 publications, we identified 14 articles and inductively categorized them into two key macro-themes. The primary macro-theme “conventional treatments applied to the LGBTQIA+ population” encompassed both treatment outcomes, which demonstrated overall effectiveness, and self-reported treatment evaluations, which consistently indicated negative experiences. The secondary macro-theme, “specific treatments for the LGBTQIA+ population,” centered on population-targeted treatments, which, while currently limited, displayed promising results, including improvements in ED psychopathology through gender transition. Conclusions: The existing literature indicates that conventional treatments are effective in symptom relief but occur within a context marked by perceived discrimination based on gender identity and sexual orientation. Concurrently, population-specific interventions hold promise in reducing ED symptoms, with gender transition emerging as a valuable treatment. Further research is needed to develop tailored treatments and address the challenges faced by the LGBTQIA+ community
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
- …
