Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified

DeJong, Hannah; Oldershaw, Anna; Sternheim, Lot; Samarawickrema, Nelum; Kenyon, Martha; Broadbent, Hannah; Lavender, Anna; Startup, Helen; Treasure, Janet; Schmidt, Ulrike

doi:10.1186/2050-2974-1-43

Cited by 72 publications

(58 citation statements)

References 44 publications

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“…Individuals with clinical/subclinical eating disorders (EDs) demonstrate markedly impaired quality of life compared to those with low ED psychopathology (DeJong et al, 2013; Hay 2003; Swanson, Crow, Le Grange, Swendsen, & Merikangas, 2011). EDs are highly comorbid with affective disorders such as depression and anxiety (Hudson, Hirpi, Pope, & Kessler, 2007), and impairment in psychosocial functioning tends to persist after treatment even after ED symptoms have remitted (Keel, Mitchell, Miller, Davis, & Crow, 2000; Sullivan, Bulik, Fear, & Pickering, 1998).…”

Section: Introductionmentioning

confidence: 99%

Perfectionism, emotion dysregulation, and affective disturbance in relation to clinical impairment in college-age women at high risk for or with eating disorders

et al. 2016

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Individuals with eating disorders (EDs) demonstrate impaired quality of life; however, less than one-third report severe clinical impairment. Thus, it is important to determine factors that may identify those who are most likely to report marked impairment. Perfectionism, emotion dysregulation, and aspects of affective disturbance, such as anxiety and depression, are independently associated with eating pathology and clinical impairment in eating and other disorders. However, little research has explored these three factors concurrently in relation to eating pathology. It is possible that the combined interaction effect of these constructs could be especially harmful. The current study examined the influence of these constructs and their interactions on clinical impairment in college-aged women at high risk for or with a DSM-5 clinical or subclinical ED. Although the three-way interaction of perfectionism, emotion dysregulation, and affective disturbance (i.e., anxiety or depression) was not significant, the two-way interaction between perfectionism and emotion dysregulation was significant such that those who were high in both perfectionism and emotion dysregulation reported the highest levels of clinical impairment. This suggests that the combination of perfectionism and emotion dysregulation may be especially problematic for those with or at high risk for EDs. Interestingly, perfectionism alone was not a predictor of clinical impairment when accounting for the other constructs, implying that perfectionism may have a greater impact when in conjunction with emotion dysregulation. Understanding the impact of combined perfectionistic tendencies and emotion dysregulation on clinical impairment may better inform treatment and more directly target contributors to impaired quality of life.

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Section: Introductionmentioning

confidence: 99%

Perfectionism, emotion dysregulation, and affective disturbance in relation to clinical impairment in college-age women at high risk for or with eating disorders

et al. 2016

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“…One prominent measure of impairment in EDs (the Clinical Impairment Assessment questionnaire; CIA, specifically aims to address impairment as a result of ED symptoms. The measure has been shown to correlate well with clinician ratings of impairment and degree of symptomatology, providing support that the CIA assesses impairment resulting from an ED (DeJong et al, 2013).…”

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confidence: 89%

“…As note, EDs "have profound and specific effects on psychosocial functioning" (p. 1105) and a number of studies have described disorderspecific associations with impaired functioning, poor physical health, limitations in daily activities, and psychosocial stressors (e.g., Bamford et al, 2015;Johnson et al, 2001;Striegel-Moore et al, 2003;Wilfley et al, 2003;see Jenkins et al, 2011 for a review). Although there is some uncertainty regarding the specific profiles of impairment across diagnoses (DeJong et al, 2013), impairment has been demonstrated in fullsyndrome and sub-threshold ED diagnoses (e.g., Stice et al, 2013).…”

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confidence: 99%

The Relation Between Eating Disorder Symptoms and Impairment

Jenkins

Rienecke

Conley

et al. 2015

Journal of Nervous &Amp; Mental Disease

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Although a number of studies have looked at what factors might mediate the relationship between symptoms and quality of life (QoL) in a number of psychiatric disorders, little research has addressed this issue in eating disorders. In the current study, female undergraduates (N = 339) completed questionnaires assessing eating disorder symptoms, social support, coping, QoL, and psychosocial impairment. Perceived family support and levels of substance misuse as a way of coping were identified as mediators of the symptom-impairment relationship and, in addition, maladaptive coping also mediated the relationship with QoL. These results highlight the role of coping and social support in impairment resulting from eating disorder symptoms.

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“…It also is accompanied by much somatic and psychological comorbidity and results in poor quality of life. 111,112 Positive treatment outcomes are difficult to achieve because the disorder is valued by sufferers. In addition, the anxious and obsessional personality traits with which patients commonly present impede recovery.…”

Section: Introductionmentioning

confidence: 99%

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Schmidt

Sharpe

Bartholdy

et al. 2017

Programme Grants Appl Res

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BackgroundAnorexia nervosa (AN) is a severe psychiatric condition and evidence on how to best treat it is limited.ObjectivesThis programme consists of seven integrated work packages (WPs) and aims to develop and test disseminable and cost-effective treatments to optimise management for people with AN across all stages of illness.MethodsWP1a used surveys, focus groups and a pre–post trial to develop and evaluate a training programme for school staff on eating disorders (EDs). WP1b used a randomised controlled trial (RCT) [International Standard Randomised Controlled Trial Number (ISRCTN) 42594993] to evaluate a prevention programme for EDs in schools. WP2a evaluated an inpatient treatment for AN using case reports, interviews and a quasi-experimental trial. WP2b used a RCT (ISRCTN67720902) to evaluate two outpatient psychological therapies for AN. WP3 used a RCT (ISRCTN06149665) to evaluate an intervention for carers of inpatients with AN. WP4 used actimetry, self-report and endocrine assessment to examine physical activity (PA) in AN. WP5 conducted a RCT (ISRCTN18274621) of an e-mail-guided relapse prevention programme for inpatients with AN. WP6 analysed cohort data to examine the effects of maternal EDs on fertility and their children’s diet and growth. WP7a examined clinical case notes to explore how access to specialist ED services affects care pathways and user experiences. Finally, WP7b used data from this programme and the British Cohort Study (1970) to identify the costs of services used by people with AN and to estimate annual costs of AN for England.ResultsWP1a: a brief training programme improved knowledge, attitudes and confidence of school staff in managing EDs in school. WP1b: a teacher-delivered intervention was feasible and improved risk factors for EDs in adolescent girls. WP2a: both psychological therapies improved outcomes in outpatients with AN similarly, but patients preferred one of the treatments. WP2b: the inpatient treatment (Cognitive Remediation and Emotional Skills Training) was acceptable with perceived benefits by patients, but showed no benefits compared with treatment as usual (TAU). WP3: compared with TAU, the carer intervention improved a range of patient and carer outcomes, including carer burden and patient ED symptomatology. WP4: drive to exercise is tied to ED pathology and a desire to improve mood in AN patients. PA was not increased in these patients. WP5: compared with TAU, the e-mail-guided relapse prevention programme resulted in higher body mass index and lower distress in patients at 12 months after discharge. WP6: women with an ED had impaired fertility and their children had altered dietary and growth patterns compared with the children of women without an ED. WP7a: direct access to specialist ED services was associated with higher referral rates, lower admission rates, greater consistency of care and user satisfaction. WP7b: the annual costs of AN in England are estimated at between £45M and £230M for 2011.ConclusionsThis programme has produced evidence to inform future intervention development and has developed interventions that can be disseminated to improve outcomes for individuals with AN. Directions for future research include RCTs with longer-term outcomes and sufficient power to examine mediators and moderators of change.Trial registrationCurrent Controlled Trials ISRCTN42594993, ISRCTN67720902, ISRCTN06149665 and ISRCTN18274621.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 16. See the NIHR Journals Library website for further project information.

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Quality of life in anorexia nervosa, bulimia nervosa and eating disorder not-otherwise-specified

Cited by 72 publications

References 44 publications

Perfectionism, emotion dysregulation, and affective disturbance in relation to clinical impairment in college-age women at high risk for or with eating disorders

Perfectionism, emotion dysregulation, and affective disturbance in relation to clinical impairment in college-age women at high risk for or with eating disorders

The Relation Between Eating Disorder Symptoms and Impairment

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

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