Binge eating disorder

暴食症
  • 文章类型: Journal Article
    类似于成瘾性障碍,认知控制缺陷可能与暴饮暴食症(BED)的发生和发展有关。然而,目前尚不清楚一般或食物相关的抑制控制损害是否与暴饮暴食和暴饮暴食行为基本相关。因此,本研究旨在研究暴饮暴食行为个体中与食物相关的抑制控制的行为表现和电生理相关性。
    使用典型的停止信号任务评估了60名可能BED(pBED)和60名匹配良好的健康对照(HCs)的个体,修订后的Go/NoGo任务,和食物相关的Go/NoGo任务。此外,另一个单独的样本,包括35名pBED和35名HCs,当用事件相关电位(ERP)记录EEG信号时,完成了与食物相关的Go/NoGo任务。
    数据显示,与HC相比,pBED组在停止信号任务的SSRT更长的情况下表现较差(Cohen\sd=0.58,p=0.002)。此外,与食物相关的Go/NoGo任务,pBED组在无效试验中的抑制成功率较低(Cohen'sd=0.47,p=0.012).ERP数据显示,与HC相比,pBED组在与食物相关的Go/NoGo任务的no-go试验中表现出增加的P300潜伏期(FC1,FC2,F3,F4,FZ)(Cohen'sd0.56-0.73,均p<0.05)。
    这些研究结果表明,暴饮暴食的个体在非特异性和食物相关的抑制控制方面都可能受损,与食物相关的抑制控制的损害可能与P300异常有关,暗示与BED有关的行为神经生物学功能障碍机制。
    UNASSIGNED: Similar to addictive disorders, deficits on cognitive control might be involved in the onset and development of Binge Eating Disorder (BED). However, it remains unclear whether general or food-related inhibitory control impairments would be basically linked to overeating and binge eating behaviors. This study thus aimed to investigate behavioral performance and electrophysiological correlates of food-related inhibitory control among individuals with binge eating behavior.
    UNASSIGNED: Sixty individuals with probable BED (pBED) and 60 well-matched healthy controls (HCs) were assessed using the typical Stop-Signal Task, a revised Go/No Go Task, and a food-related Go/No Go Task. Besides, another separate sample, including 35 individuals with pBED and 35 HCs, completed the food-related Go/No Go Task when EEG signals were recorded with the event-related potentials (ERPs).
    UNASSIGNED: The data revealed that the pBED group performed worse with a longer SSRT on the Stop-Signal Task compared with HCs (Cohen\'s d = 0.58, p = 0.002). Moreover, on the food-related Go/No Go Task, the pBED group had a lower success rate of inhibition in no-go trials (Cohen\'s d = 0.47, p = 0.012). The ERPs data showed that in comparison with HCs, the pBED group exhibited increased P300 latency (FC1, FC2, F3, F4, FZ) in the no-go trials of the food-related Go/No Go Task (Cohen\'s d 0.56-0.73, all p < 0.05).
    UNASSIGNED: These findings suggested that individuals with binge eating could be impaired in both non-specific and food-related inhibitory control aspects, and the impairments in food-related inhibitory control might be linked to P300 abnormalities, implying a behavioral-neurobiological dysfunction mechanism implicated in BED.
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  • 文章类型: Journal Article
    目的:本研究的目的是调查大学生饮食失调(ED)的患病率及其与社会人口统计学和行为因素的关系。
    方法:在南京的大学生(中国和国际)中进行的横断面研究,中国。我们收集了877名学生的数据,其中811人符合本研究的条件.他们提交了一份与社会人口统计学相关的自我管理问卷(饮食失调检查问卷6(EDE-Q6),健康变量和生活方式因素。借助SPSS软件对数据进行评估。
    结果:共有401名中国大学生和410名国际大学生(49.44%vs.50.55%)参加了这项研究。二元Logistic回归分析显示,18~25岁的年轻女性患饮食失调的风险更大。较高的体重指数(BMI),比如超重和肥胖,是饮食失调的更有影响的危险因素(p<0.001)。在运动员的学生中发现了显着的风险(p<0.001)ED,身体活跃,并参与各种课外活动。饮酒和吸烟是与饮食失调相关的重要危险因素。
    结论:结果表明进食障碍的风险更高,其次是客观的暴饮暴食和代偿行为。在这种情况下,早期评估和治疗对于减轻饮食失调的负担和促进大学生的良好营养习惯是必要的。
    OBJECTIVE: The aim of the study was to investigate the prevalence of eating disorders (EDs) and their association with socio-demographic and behavioural factors among university students.
    METHODS: A cross-sectional study among university students (Chinese and international) in Nanjing, China. We collected the data from 877 students, of which 811 were eligible for this study. They submitted a self-administered questionnaire (Eating Disorder Examination Questionnaire 6 (EDE-Q6) related to socio-demographic, health variables and lifestyle factors. Data were assessed with the help of SPSS software.
    RESULTS: A total of 401 Chinese and 410 international university students (49.44% vs. 50.55%) participated in this study. Binary logistic regression showed that young female adults of 18~25 years of age had more risk of developing eating disorders. Higher body mass index (BMI), such as overweight and obesity, were more influential risk factors (p < 0.001) for eating disorders. The significant risks (p < 0.001) EDs were found in students who were athletes, physically active, and involved in various extra-curricular activities. Alcohol and smoking were significant risk factors associated with eating disorders.
    CONCLUSIONS: The results indicated higher risks of eating disorders followed by objective binge eating and compensatory behaviour. In this scenario, early assessment and treatment are necessary to reduce the burden of eating disorders and to promote good nutritional practices among university students.
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  • 文章类型: Systematic Review
    背景:目前有几种选择性5-羟色胺再摄取抑制剂(SSRI)抗抑郁药用于治疗暴食症(BED)。但这些抗抑郁药的疗效和可接受性仍存在争议。因此,我们设计了一个网络荟萃分析(NMA)来比较不同SSRI抗抑郁药治疗BED的疗效和可接受性.方法:四个数据库,包括PubMed,Embase,Cochrane图书馆,和WebofScience进行了系统搜索,以获得符合标准的治疗BED患者的随机对照试验(RCTs).用Stata16软件进行分析。结果:该NMA包括9个RCT。研究结果表明,与安慰剂相比,舍曲林和氟西汀可以显着减少暴饮暴食的频率。氟西汀被证明是汉密尔顿抑郁量表(HAMD)评分降低最大的药物。此外,所有SSRI抗抑郁药对减肥均无效.此外,所有被调查的抗抑郁药均被认为是可以接受的,就辍学率所反映的可接受性而言.结论:就疗效和可接受性而言,氟西汀可能是最好的选择.
    Background: There are several selective serotonin reuptake inhibitor (SSRI) antidepressants currently used to treat binge eating disorder (BED), but the efficacy and acceptability of these antidepressants are still controversial. Therefore, we designed a network meta-analysis (NMA) to compare the efficacy and acceptability of different SSRI antidepressants for the treatment of BED. Methods: Four databases including PubMed, Embase, the Cochrane Library, and Web of Science were systematically searched for the eligible randomized controlled trials (RCTs) for the treatment of patients with BED. The analysis was performed with Stata16 software. Results: 9 RCTs were included in this NMA. The results of the study showed that compared with placebo, sertraline and fluoxetine could significantly reduce the frequency of binge eating. Fluoxetine was shown to be the drug with the greatest reduction in Hamilton Rating Scale for Depression (HAMD) score. Besides, all SSRI antidepressants were ineffective in losing weight. In addition, all the investigated antidepressants were found to be well acceptable in regards to the acceptability reflected by the dropout rate. Conclusion: As far as both efficacy and acceptability were concerned, fluoxetine might be the best choice.
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  • 文章类型: Journal Article
    未经批准:暴食症(BED)作为一种公共卫生问题已被纳入《精神疾病诊断和统计手册》,第五版(DSM-5)。类似于成瘾性障碍,与冲动性相关的神经心理学结构可能参与BED的发生和发展。然而,目前尚不清楚冲动的哪些方面与非临床人群的暴饮暴食和暴饮暴食行为有关.本研究旨在检测未确诊的年轻人的人格特质和行为选择水平上的冲动性和暴饮暴食之间的关系。
    未经证实:58名可能患有BED的个体和59名健康对照者,年龄相匹配,性别,和教育水平,通过一系列自我报告测量来评估,包括Barratt冲动量表(BIS-11),UPPS-P冲动行为量表(UPPS-P),延迟贴现测试(DDT),和概率贴现测试(PDT)。
    UASSIGNED:多变量方差分析模型显示,与健康对照相比,可能的BED组在BIS-11注意和运动冲动方面得分升高,关于UPPS-P负紧迫性,积极的紧迫性,缺乏毅力。然而,可能的BED受试者在DDT和PDT上的折现率与健康对照组相似。回归模型发现,负紧迫性是暴饮暴食行为的唯一积极预测因素。
    未经评估:这些研究结果表明,特质冲动的典型方面,在成瘾性疾病中已经被认识到,与年轻人的暴饮暴食有关,而在同一可能的BED样本中并未发现异常的选择冲动。这项研究可能会促进对BED发病机制的更好理解。
    UNASSIGNED: Binge eating disorder (BED) as a public health problem has been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Akin to addictive disorders, impulsivity-related neuropsychological constructs might be potentially involved in the onset and development of BED. However, it remains unclear which facets of impulsivity are connected to overeating and binge eating behaviors among non-clinical populations. The present study aimed to detect the relationship between impulsivity and binge eating both on the personality-trait and behavioral-choice levels in undiagnosed young adults.
    UNASSIGNED: Fifty-eight individuals with probable BED and 59 healthy controls, matched on age, gender, and educational level, were assessed by using a series of self-report measurements, including the Barratt Impulsiveness Scale (BIS-11), UPPS-P Impulsive Behaviors Scale (UPPS-P), Delay Discounting Test (DDT), and Probability Discounting Test (PDT).
    UNASSIGNED: Multivariate analysis of variance models revealed that compared with healthy controls, the probable BED group showed elevated scores on the BIS-11 Attentional and Motor impulsiveness, and on the UPPS-P Negative Urgency, Positive Urgency, and Lack of Perseverance. However, the probable BED subjects had similar discounting rates on the DDT and PDT with healthy controls. Regression models found that Negative Urgency was the only positive predictor of binge eating behavior.
    UNASSIGNED: These findings suggested that typical facets of trait impulsivity, which have been recognized in addictive disorders, were associated with binge eating in young adults, whereas choice impulsivity was not aberrantly seen in the same probable BED sample. This study might promote a better understanding of the pathogenesis of BED.
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  • 文章类型: Journal Article
    Compulsive eating is the most obstinate feature of binge eating disorder. In this study, we observed the compulsive eating in our stress-induced binge-like eating rat model using a conflicting test, where sucrose and an aversively conditioned stimulus were presented at the same time. In this conflicting situation, the binge-like eating prone rats (BEPs), compared to the binge-like eating resistant rats (BERs), showed persistent high sucrose intake and inhibited fear response, respectively, indicating a deficit in palatability devaluation and stronger anxiolytic response to sucrose in the BEPs. We further analyzed the neuronal activation with c-fos mRNA in situ hybridization. Surprisingly, the sucrose access under conditioned fear did not inhibit the activity of amygdala; instead, it activated the central amygdala. In the BEPs, sucrose reduced the response of the paraventricular hypothalamic nucleus (PVN), while enhancing activities in the lateral hypothalamic area (LHA) to the CS. The resistance to devaluating the palatable food in the BEPs could be a result of persistent Acb response to sucrose intake and attenuated recruitment of the medial prefrontal cortex (mPFC). We interpret this finding as that the reward system of the BEPs overcame the homeostasis system and the stress-responding system.
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  • 文章类型: Journal Article
    BACKGROUND: Obsessive-compulsive and related disorders (OCRDs) are a group of intractable and chronic mental disorders. Trichotillomania (TTM) is a common type of OCRDs characterized by repetitive hair pulling, driven by escalating tension before the action and during the attempts to resist it. Binge eating disorder (BED) is a common type of eating disorder characterized by recurrent compulsive episodes of binge eating. Both have common psychological processes (tension or impulsion) and pathological manifestations (out of control), but the pathological mechanisms are still unclear and the current clinical treatments are often unsatisfactory for these two disorders.
    METHODS: A 25-year-old woman with TTM comorbid BED came to our hospital for treatment. She had accepted systematic cognitive behavioral therapy (CBT) and also monotherapy or multidrug therapy with sertraline, fluvoxamine, bupropion, risperidone in full dosage and duration for 2 years, but all of them did not work. We treated this case with N-acetylcysteine (NAC) as a synergist on the basis of recent treatment (fluvoxamine 150 mg/day and bupropion 300 mg/day). The pathological hair plucking behavior and binge eating symptoms were both significantly and rapidly improved, and the follow-up in next 14 weeks showed that the effect was still maintained.
    CONCLUSIONS: To our knowledge, this may be the first case report of using NAC as a synergist to treat TTM comorbid BED successfully, which suggest that these two disorders may have a common pathophysiological mechanism. Moreover, NAC can be one choice as a synergistic treatment for OCRDs.
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  • 文章类型: Comparative Study
    世界卫生组织(WHO)疾病和相关健康问题国际分类(ICD)在全球194个世卫组织成员国中使用。它用于分配临床诊断,提供报告公共卫生数据的框架,并告知卫生服务的组织和报销。在增加临床效用和全球适用性的总体原则的指导下,ICD的第11次修订提出了重大更改,这些更改纳入了自1992年上一次修订以来的经验进展。为了测试建议的心理变化,行为,和神经发育障碍一章,我们进行了多个基于小插图的病例对照现场研究,这些研究检查了临床医生准确和一致地使用新指南的能力,并评估其整体临床效用.本手稿报告了拟议的ICD-11喂养和饮食失调(FED)指南的研究结果。
    参与者是在世卫组织全球临床实践网络注册的2288名精神卫生专业人员。这项研究是用中文进行的,英语,法语,日本人,和西班牙语。临床医生被随机分配以将FED的ICD-11或ICD-10诊断指南应用于一对旨在测试特定临床问题的病例小插曲。临床医生为每个小插图选择了他们认为正确的诊断,评估所选诊断的每个基本特征的存在,以及诊断指南的临床实用性。
    拟议的ICD-11诊断指南相对于ICD-10,显着提高了所有FED测试的准确性,并获得了更高的临床效用评级;在所有五种语言中都获得了类似的结果。包括暴饮暴食症和避免性限制食物摄入症减少了残留诊断的使用。确定了需要进一步完善的领域。
    拟议的ICD-11诊断指南在区分进食障碍病例方面始终优于ICD-10,并显示出全球适用性和适当的临床实用性。这些结果表明,拟议的FEDICD-11指南将有助于提高公共卫生数据的准确性,提高临床诊断,加强卫生服务的组织和提供。这是ICD修订中首次从大规模数据,审查拟议指南的实证研究及时完成,以告知最终的诊断指南。
    The World Health Organization (WHO) International Classification of Diseases and Related Health Problems (ICD) is used globally by 194 WHO member nations. It is used for assigning clinical diagnoses, providing the framework for reporting public health data, and to inform the organization and reimbursement of health services. Guided by overarching principles of increasing clinical utility and global applicability, the 11th revision of the ICD proposes major changes that incorporate empirical advances since the previous revision in 1992. To test recommended changes in the Mental, Behavioral, and Neurodevelopmental Disorders chapter, multiple vignette-based case-controlled field studies have been conducted which examine clinicians\' ability to accurately and consistently use the new guidelines and assess their overall clinical utility. This manuscript reports on the results from the study of the proposed ICD-11 guidelines for feeding and eating disorders (FEDs).
    Participants were 2288 mental health professionals registered with WHO\'s Global Clinical Practice Network. The study was conducted in Chinese, English, French, Japanese, and Spanish. Clinicians were randomly assigned to apply either the ICD-11 or ICD-10 diagnostic guidelines for FEDs to a pair of case vignettes designed to test specific clinical questions. Clinicians selected the diagnosis they thought was correct for each vignette, evaluated the presence of each essential feature of the selected diagnosis, and the clinical utility of the diagnostic guidelines.
    The proposed ICD-11 diagnostic guidelines significantly improved accuracy for all FEDs tested relative to ICD-10 and attained higher clinical utility ratings; similar results were obtained across all five languages. The inclusion of binge eating disorder and avoidant-restrictive food intake disorder reduced the use of residual diagnoses. Areas needing further refinement were identified.
    The proposed ICD-11 diagnostic guidelines consistently outperformed ICD-10 in distinguishing cases of eating disorders and showed global applicability and appropriate clinical utility. These results suggest that the proposed ICD-11 guidelines for FEDs will help increase accuracy of public health data, improve clinical diagnosis, and enhance health service organization and provision. This is the first time in the revision of the ICD that data from large-scale, empirical research examining proposed guidelines is completed in time to inform the final diagnostic guidelines.
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  • 文章类型: Journal Article
    饮食失调(ED)和超重/肥胖(OW/OB)是严重的公共卫生问题,具有共同的神经心理特征和饮食失调的模式。与奖励相关的决策作为基本的神经认知功能,可能在诊断上是病理性暴饮暴食和限制进食的基础。本荟萃分析综合了N=82项神经心理学研究中所有ED亚型的奖励相关决策改变的证据,OW和OB。目前患有ED的患者与OW/OB的患者和对照组之间的差异的总体效应大小为Hedge/sg=-0.49[CI:-0.63;-0.35],和对冲的g=-0.39[CI:-0.53;-0.25],分别。发现在所有ED亚型和OB中,决策的变化程度相似。效果大小,然而,不同的决策措施。青少年似乎比成年人受影响小。当食物被用作奖励刺激时,在OB中发现决策完好无损。研究结果支持,改变一般奖励相关的决策是成年后饮食和体重紊乱的一个显著的神经心理因素。
    Eating disorders (EDs) and overweight/obesity (OW/OB) are serious public health concerns that share common neuropsychological features and patterns of disturbed eating. Reward-related decision making as a basic neurocognitive function may trans-diagnostically underlie both pathological overeating and restricted eating. The present meta-analysis synthesizes the evidence from N=82 neuropsychological studies for altered reward-related decision making in all ED subtypes, OW and OB. The overall effect sizes for the differences between currently-ill ED patients and OW/OB people and controls were Hedge\'s g=-0.49 [CI: -0.63; -0.35], and Hedge\'s g=-0.39 [CI: -0.53; -0.25], respectively. Decision making was found to be altered to similar degrees in all ED subtypes and OB. Effect sizes, however, diverged for the different measures of decision making. Adolescents appear to be less affected than adults. When foods were used as rewarding stimuli, decision making was found to be intact in OB. The findings support that altered general reward-related decision making is a salient neuropsychological factor across eating and weight disorders in adulthood.
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