IntroductionEating disorders (ED) and personality disorders (PD) are often interplayed in every-day clinical practice. Less is known on patient's emotional deregulation and impulsivity.AimsTo investigate whether clinical features of ED and PD correspond to a specific impulsivity and emotional background pattern.ObjectiveED, PD, impulsivity and emotional regulation.MethodsA group of outpatients with ED (n = 39) was compared to a group of healthy controls (n = 40) by means of semi-structured interviews and standardized questionnaires (BIS-11, DERS, Eat-26, SCID-II and STAI), in order to evaluate association between clinical features (ED and PD) and altered impulsivity or/and emotion regulation.ResultsSeventy-five percent of ED cases matched also diagnostic criteria for PD. Cluster B diagnoses occurred more frequently in Bulimia Nervosa (BN) and Binge eating disorders (BED) whereas Cluster C PD was strongly associated with restrictive anorexia (AN-R) (P < 0.001). BIS-11 scores were significantly higher in cluster B as compared to cluster C PD (P = 0.019). People with PD have a significantly higher DERS score compared to people without (P < 0.001). Mean DERS scores were similar in BN, BED and AN Binge purging (AN-BP) but lower in AN-R (P < 0.001).ConclusionsED is an iceberg top, of a three-step ladder. The intermediate step is built of personality traits and disorders forging the variety of ED clinical expressions. The hidden base of iceberg is represented by both the emotional (de)regulation and the level of impulsivity. Therapies focused on the base of this iceberg are needed for a clinical resolution of eating symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionStressful or traumatic events occurred during childhood do have a role in the genesis of personality disorders. Less is known about this remarkable association in people with addictive behaviors.AimsThis study aims to disentangle the relationship between childhood adverse experiences, personality disorders (PDs) and substance use disorders (SUDs).MethodsA cross-sectional naturalistic study of 320 consecutive SUDs outpatients attending an Italian addiction service. Participants were clinically evaluated by a semi-structured interview, the SCID-II (Structured Clinical Interview for DSM-IV Axis II PD), and the CECA-Q (Childhood Experience of Care and Abuse-questionnaire). Multivariate logistic regression analyses were used to estimate odds ratio (OR) and 95% confidence intervals (95% CI)ResultsThe prevalence rate of PDs in our sample of patients is 62.2%. PDs were associated with a history of physical punishment in childhood (OR = 1.82; CI 95%: 1.05–3.16; P = 0.034). Being exposed to three adverse events increases the risk of Cluster B PD (OR = 5.92; CI 95%: 2.21–15.92; P < 0.001). Heroin addiction increases the risk of Cluster B PD, both as previous (OR = 2.93; CI 95%: 1.49–5.75; P = 0.003) or current (OR = 4.34; IC 95%: 1.97–11.8; P = 0.004) consumption. Childhood institutionalization increases the probability of cluster B PD (OR: 2.15; CI 95%: 1.02–4.54; P = 0.041). Whereas being employed reduces the probability of both PDs and SUDs (OR = 0.54; CI 95%: 0.31–0.93; P = 0.027).ConclusionsPDs occurred in 62% of patients and were related to adverse childhood experiences and SUDs having detrimental effects on both social and occupational functioning. Being employed could be a protective factor on the development of PDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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