Exploring quality of life in the eating disorders

Bamford, Bryony; Sly, R. Michael

doi:10.1002/erv.975

Cited by 64 publications

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“…An irrational overvaluation of the importance of controlling food, weight, and body shape represent the specific clinical features [1]. Severe EDs impair quality of life and interpersonal relations [2], and increase the number of productive years lost to disability [3].The standardized mortality rate is about five times higher than in the general population [4,5], and it takes six to nine years before 70% of the patients no longer meet the diagnostic criteria for an ED [6,7].Comorbid personality disorders (PDs) are frequently encountered in the treatment of EDs, and may become as protracted and impairing as the EDs. Previous studies [8][9][10] show that a comorbid borderline, avoidant, or obsessive-compulsive PD may worsen the long-term treatment-outcome of EDs.…”

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The comorbidity of personality disorders in eating disorders: a meta-analysis

et al. 2016

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Purpose: The present meta-analysis summarized the proportion of comorbid personality disorders (PDs) in patients with anorexia (AN) and bulimia nervosa (BN), respectively, and examined possible moderating variables. Methods:A search of the databases PsychINFO, Embase, and Medline for the period 1980 -2016 identified 87 studies from 18 different countries. Results:The mean proportion of PDs among patients with any type of eating disorder (ED) was .52 compared to .09 in healthy controls. There were no statistically significant differences between AN (.49) and BN (.54) in proportions of any PD or PD clusters except for obsessive compulsive PD (.23 vs .12 in AN and BN respectively).Conclusions: Both ED diagnoses had a similar comorbidity profile with a high prevalence of borderline and avoidant PDs. Moderator analyses conducted for any ED and any PD yielded significant differences for diagnostic systems with respect to EDs, method for assessing PD as well as patient weight and age.Keywords: personality disorders, anorexia nervosa, bulimia nervosa, meta-analysis, comorbidity Running head: EATING-AND PERSONALITY DISORDERS 3The Comorbidity of Personality Disorders in Eating Disorders: A Meta-Analysis Eating disorders (EDs), notably anorexia (AN) and bulimia nervosa (BN), are characterized by self-inflicted weight loss and recurrent episodes of bingeing and purging,respectively. An irrational overvaluation of the importance of controlling food, weight, and body shape represent the specific clinical features [1]. Severe EDs impair quality of life and interpersonal relations [2], and increase the number of productive years lost to disability [3].The standardized mortality rate is about five times higher than in the general population [4,5], and it takes six to nine years before 70% of the patients no longer meet the diagnostic criteria for an ED [6,7].Comorbid personality disorders (PDs) are frequently encountered in the treatment of EDs, and may become as protracted and impairing as the EDs. Previous studies [8][9][10] show that a comorbid borderline, avoidant, or obsessive-compulsive PD may worsen the long-term treatment-outcome of EDs. Moreover, a comorbid PD may complicate treatment challenges by increasing the risk of premature treatment termination due to a fragile therapeutic alliance [9,11], prolonging treatment for non-therapeutic reasons [12][13][14] or resulting in insufficient focus on alleviating ED-symptoms due to the need to address the PD. However, there are inconsistent findings from studies [15,16] and reviews [17,18] as to whether a concurrent PD predicts a poor outcome of an ED, whether PDs improve at the same rate as the ED or tend to persist after the alleviation of ED symptoms [19][20][21][22].In order to develop and examine comprehensive treatment models in terms of their cost-effectiveness, ability to overcome treatment challenges, and to prevent an unfavourable ED outcome, it is essential to determine how frequently or likely comorbid PDs are expected to appear in EDs. Research to date h...

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The comorbidity of personality disorders in eating disorders: a meta-analysis

et al. 2016

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“…In the study by Bamford et al, predictors of low quality of life in the study group of women were found to be severity of the eating disorders and the BMI, whereas -contrary to clinical expectations -the duration of the disease did not reveal itself as a major predictive factor in this respect [18].…”

Section: Anorexia and Bulimiamentioning

confidence: 66%

Impact of eating disorders on quality of life of women during the perimenopausal period

Ostrzyżek¹

2013

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SummaryEating disorders pose a serious medical, clinical and social problem. In the recent years cases of the lack of appetite are more often diagnosed in reference to middle-aged and elderly women. A situation like this may result from an existing disease process, a continuation of experiencing such problems in the past, and also a reflection of the trends being created by the modern media advocating the need for keeping a woman's physical attractiveness in her late adulthood. It happens more and more often that the effort to reduce weight achieve a slimmer look is taken by women in their 50s, and even 60s. There is also an existing view that eating disorders among elderly women appear in a close connection to psychical disorders. Many women perceive menopause as a loss and a sign of an oncoming old age, thus they are focused mainly on negative emotions in this period of life. On the basis of depression-like disorders, there appear problems with controlling and maintaining the body mass. Although the scale of the phenomenon has still a limited range and character, its significant impact on life quality of women's population in the menopausal period justifies the execution of the current review of the subject literature in this matter.Key words: menopause, eating disorders, quality of life. StreszczenieZaburzenia odżywiania stanowią istotny problem medyczny, kliniczny i społeczny. W ostatnich latach przypadki występowania zaburzeń łaknienia coraz częściej diagnozuje się u kobiet w średnim i starszym wieku. Sytuacja taka może być wynikiem istniejącego procesu chorobowego, kontynuacją doświadczania problemów tego typu w przeszłości, jak również odzwierciedleniem kreowanych przez współczesne media trendów, głoszą-cych potrzebę zachowania atrakcyjności fizycznej przez kobiety w późnej dojrzałości. Coraz częściej zdarza się, że wysiłek obniżenia wagi i uzyskania szczupłego wyglądu podejmują kobiety po 50., a nawet 60. roku życia. Istnieje również pogląd, że zaburzenia odżywiania u kobiet w starszym wieku pojawiają się w ścisłym związku z innymi zaburzeniami psychicznymi. Wiele kobiet postrzega menopauzę w kategoriach straty i zapowiedzi bliskiej starości, dlatego skupia się w tym okresie życia głównie na negatywnych emocjach. Na podłożu zaburzeń o typie depresji pojawiają się problemy z kontrolą i utrzymaniem masy ciała. Jakkolwiek skala zjawiska ma wciąż ograniczony zasięg i charakter, jej znaczący wpływ na jakość życia populacji kobiet w okresie menopauzalnym uzasadnia dokonanie aktualnego przeglądu literatury przedmiotu w tym zakresie.Słowa kluczowe: menopauza, zaburzenia odżywiania, jakość życia. Impact of eating disorders on quality of life of women during the perimenopausal periodWp³yw zaburzeñ od¿ywiania na jakooeae ¿ycia kobiet w okresie oko³omenopauzalnym

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“…Severity of ED symptomatology, especially low body mass index (BMI), but not duration of illness has been found to be predictive of low QoL [24]. Moreover, in terms of differences across diagnostic groups, individuals with a diagnosis of AN were found to have lower psychological and physical/ cognitive QoL than those with an OSFED or BN diagnosis [24]. Even after long-term treatment or recovery from EDs, the expatients reported only a slight improvement in their QoL [18].…”

Section: Quality Of Lifementioning

confidence: 99%

The Patient’s Perspective: Exploring Factors that Contribute to Recovery from Eating Disorders

Gonidakis¹,

Karapavlou²

2017

Eating Disorders - A Paradigm of the Biopsychosocial Model of Illness

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Eating Disorders (EDs) are quite distinct and difficult to treat mental disorders. Remarkably, when reviewing studies on the recovery process of ED's, the patients' experience of the therapeutic process has rarely been taken into account. To address the issue of the patients perspective on their recovery a study was conducted among ED patients. The main aims of the study were to investigate treatment factors, according to the patients view, that contributed to their recovery. Also, if there was any significant improvement within the first six months of the treatment and whether subjective improvement was in accordance with objective ED improvement and finally possible, if any, differences between different diagnostic groups.Overall, four major conclusions were produced. First, most of the patients appreciate a structured therapy in a specialized unit for EDs with a caring therapist that can form a strong therapeutic alliance with them. Second, most of the patients regard as recovery a change that goes beyond ED symptomatology to a more "holistic" improvement. Third, the patients opinion on therapy and recovery is not influenced by the diagnosis of the ED. Finally, the opinion of the patient and the objective evaluation of recovery present more similarities than differences.

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Exploring quality of life in the eating disorders

Cited by 64 publications

References 30 publications

The comorbidity of personality disorders in eating disorders: a meta-analysis

The comorbidity of personality disorders in eating disorders: a meta-analysis

Impact of eating disorders on quality of life of women during the perimenopausal period

The Patient’s Perspective: Exploring Factors that Contribute to Recovery from Eating Disorders

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