Psychiatric Comorbidity in Women with Disordered Eating Behavior: A National Study

ABSTRACT

This study used data collected by Statistics Canada in the Mental Health and Well-being cycle of the Canadian Community Health Survey (N = 20,211) to examine the associations between disordered eating behavior and selected mood, anxiety and substance use disorders in adult women grouped in three age groups. Significant associations between disordered eating behaviors and major depression, substance dependence and psychological distress were found for women in all three age ranges. Prevalence of specific classes of anxiety disorders in women who reported disordered eating behaviors differed according to their age. Having disordered eating behaviors was significantly associated with both 12-month and lifetime prevalence of social phobia for women above 25 years of age. Lifetime prevalence of agoraphobia was associated with disordered eating behaviors in women 15–44 years old, and the 12-month prevalence was associated with disordered eating behaviors only in women 15–24 years of age. Disordered eating behaviors were significantly associated with lifetime prevalence of panic disorder in women in all three age ranges and with 12-month prevalence of panic disorder in women in two age ranges, 15–24 and 45 and above. The findings highlight the importance of taking age into consideration when developing assessment instruments and treatment strategies to address the co-occurrence of eating disorders and other psychiatric disorders.     

Prevention series introduction

Abstract

A group of 29 obese women with Binge Eating Disorder (OB-BED) and 35 obese subjects without this disorder (OB) were compared on the presence or absence of traumatic experiences and dissociative symptoms with the Dissociation Questionnaire (DIS-Q). OB-BED subjects showed significantly higher scores on two subscales of the DIS-Q (identity confusion and loss of control). They also reported significantly more traumatic experiences than the OB sample. These data further support the assumption that among eating disorder patients, both traumatic experiences and dissociative symptoms are more prevalent when patients show serious binge eating.     

Outpatient treatment of symptomatic pulmonary embolism: A systematic review and meta-analysis

Background

Patients with acute deep vein thrombus (DVT) can safely be treated as outpatients. However the role of outpatient treatment in patients diagnosed with a pulmonary embolism (PE) is controversial. We sought to determine the safety of outpatient management of patients with acute symptomatic PE.

Materials and Methods

A systematic literature search strategy was conducted using MEDLINE, EMBASE, the Cochrane Register of Controlled Trials and all EBM Reviews. Pooled proportions for the different outcomes were calculated.

Results

A total of 1258 patients were included in the systematic review. The rate of recurrent venous thromboembolism (VTE) in patients with PE managed as outpatients was 1.47% (95% CI: 0.47 to 3.0%; I²: 65.4%) during the 3 month follow-up period. The rate of fatal PE was 0.47% (95% CI: 0.16 to 1.0%; I²: 0%). The rates of major bleeding and fatal intracranial hemorrhage were 0.81% (95% CI: 0.37 to 1.42%; I²: 0%) and 0.29% (95% CI: 0.06 to 0.68%; I²: 0%), respectively. The overall 3 month mortality rate was 1.58% (95% CI: 0.71 to 2.80%; I²: 45%). The event rates were similar if employing risk stratification models versus using clinical gestalt to select appropriate patients for outpatient management.

Conclusions

Independent of the risk stratification methods used, the rate of adverse events associated with outpatient PE treatment seems low. Based on our systematic review and pooled meta-analysis, low-risk patients with acute PE can safely be treated as outpatients if home circumstances are adequate.     

Feminist identity,body image,and disordered eating

ABSTRACT

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.     

Evaluation of humoral immune function in patients with bronchiectasis

Bronchiectasis is a chronic debilitating condition characterized by abnormal dilated thick-walled bronchi. To investigate humoral immune function in bronchiectatic patients, this study was performed. Forty patients with established diagnosis of bronchiectasis, who were referred from two tertiary care pulmonology centers in Tehran, were investigated in this study. Immunoglobulin isotypes concentrations and IgG-subclasses were measured by nephelometry and enzyme-linked immunosorbent assay (ELISA) methods, respectively. All patients received unconjugated pneumococcal vaccine, and blood samples were taken before and 21 days after vaccination. Specific antibodies against whole pneumococcal antigens were measured using the ELISA method. Fifteen (37.5%) out of 40 patients were diagnosed to have defects in antibody mediated immunity including 5 (12.5%) patients with immunoglobulin class deficiency (2 with common variable immunodeficiency and 3 with IgA deficiency), 3 (7.5%) with IgG subclass deficiency and 7 (17.5%) patients had Specific antibody deficiency (SAD) against polysaccharide antigen despite normal levels of serum immunoglobulins and IgG subclasses. Our study along with several other studies confirmed that all patients with bronchiectasis should undergo thorough immunological evaluation in order to identify the presence of the underlying immunologic defect. This evaluation should include serum immunoglobulins, IgG subclasses concentrations and also determination of serum antibodies against pneumococcal antigens. Early diagnosis and appropriate treatment will prevent the subsequent complications and improve quality of life of affected individuals.     

The incidence and natural history of knee osteoarthritis in the elderly,the framingham osteoarthritis study

Objective. To determine the incidence of radiographic knee osteoarthritis (OA) and symptomatic OA (symptoms plus radiographic OA), as well as the rate of progression of preexisting radiographic OA in a population-based sample of elderly persons. Methods. Framingham Osteoarthritis Study subjects who had knee radiographs and had answered questions about knee symptoms in 1983–1985 were reexamined in 1992–1993 (mean 8.1-year interval) using the same protocol. Subjects were defined as having new (incident) radiographic OA if they developed grade ≤2 OA (at least definite osteophytes or definite joint space narrowing). New symptomatic OA was present if subjects developed a combination of knee symptoms and grade ≤2 OA. Progressive OA was diagnosed when radiographs showing grade 2 disease at baseline showed grade ≤3 disease on followup. Results. Of 1,438 participants in the original study, 387 (26.9%) died prior to followup. Of the 1,051 surviving subjects, 869 (82.7%) participated in the followup study (mean ± SD age 70.8 ± 5.0 at baseline). Rates of incident disease were 1.7 times higher in women than in men (95% confidence interval [CI] 1.0–2.7), and progressive disease occurred slightly more often in women (relative risk = 1.4; 95% CI 0.8–2.5) but rates did not vary by age in this sample. Among women, approximately 2% per year developed incident radiographic disease, 1% per year developed symptomatic knee OA, and about 4% per year experienced progres- sive knee OA. Conclusion. In elderly persons, the new onset of knee OA is frequent and is more common in women than men. However, among the elederly, age may not affect new disease occurrence or progression.     

Evaluation of a day hospital program for eating disorders

The study describes the outcome results of the first 53 patients with an eating disorder referred to a day hospital program, an innovative group treatment for patients requiring hospital treatment. Among the program's completers, 19 fulfilled criteria for anorexia nervosa (AN), and 35 fulfilled criteria for bulimia nervosa (BN). There was a significant weight gain for the AN patients; 73.6% gained over 1 lb/week during the average 12 weeks of stay in the program. There was a significant decrease in the average number of binges per week in the BN group; a reduction of 75% in binges was present in 88% of patients within the study period, 9 AN and 12 BN patients completed a detailed assessment 1, 3, and 6 months postdischarge; for these patients clinical gains were maintained. Factors related to dropout and outcome, as well as clinical implications, are discussed.     

Association between left ventricular mass index and cardiac function in pediatric dialysis patients

Background  

Left ventricular mass index (LVMI) is a surrogate of left ventricular hypertrophy and a predictor of cardiac morbidity and mortality in adults with hypertension. LVMI has not been linked to cardiovascular endpoints in children. The aim of this study was to identify an association between elevated LVMI and echocardiographic markers of systolic and diastolic function.