Collaborative care skills training workshops : helping carers cope with eating disorders from the UK to Australia

Purpose

The Collaborative Care Skills Training workshops, developed by Treasure and associates aim to improve the well-being, coping strategies and problem-solving skills of carers of someone with an eating disorder. Evidence has demonstrated the effectiveness of the workshops in the UK where it was developed. The aim of this pilot study was to examine whether conducting the workshops in different contexts by facilitators trained in its delivery could lead to similar impact.
Methods

The workshops were conducted with 15 carers in VIC, Australia and delivered by experienced health professionals trained in its content and delivery. A non-experimental research design with repeated measures was implemented. Quantitative data were collected at pre-and post-intervention and 8 weeks after completion of the workshops.
Results

Participation led to significant reductions in carers’ reported expressed emotion, dysfunctional coping, distress, burden and accommodation and enabling of the eating disorder behaviour, which were maintained at the 8-week follow-up.
Conclusion

Results suggest the workshops are effective in reducing carer distress and burden as well as modifying unhelpful emotional interactional styles when caring for family members with an eating disorder. The content of the workshops and its delivery, once experienced facilitators have received training, are transferable to other contexts.

A new social-family model for eating disorders: A European multicentre project using a case-control design

OBJECTIVE: To examine a new socio-family risk model of Eating Disorders (EDs) using path-analyses. METHOD: The sample comprised 1264 (ED patients = 653; Healthy Controls = 611) participants, recruited into a multicentre European project. Socio-family factors assessed included: perceived maternal and parental parenting styles, family, peer and media influences, and body dissatisfaction. Two types of path-analyses were run to assess the socio-family model: 1.) a multinomial logistic path-model including ED sub-types [Anorexia Nervosa-Restrictive (AN-R), AN-Binge-Purging (AN-BP), Bulimia Nervosa (BN) and EDNOS)] as the key polychotomous categorical outcome and 2.) a path-model assessing whether the socio-family model differed across ED sub-types and healthy controls using body dissatisfaction as the outcome variable. RESULTS: The first path-analyses suggested that family and media (but not peers) were directly and indirectly associated (through body dissatisfaction) with all ED sub-types. There was a weak effect of perceived parenting directly on ED sub-types and indirectly through family influences and body dissatisfaction. For the second path-analyses, the socio-family model varied substantially across ED sub-types. Family and media influences were related to body dissatisfaction in the EDNOS and control sample, whereas perceived abusive parenting was related to AN-BP and BN. DISCUSSION: This is the first study providing support for this new socio-family model, which differed across ED sub-types. This suggests that prevention and early intervention might need to be tailored to diagnosis-specific ED profiles.

Effects of eating disorders on oral fungal diversity

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of eating disorders on oral fungal diversity

Background. The eating disorders anorexia and bulimia nervosa can cause several systemic and oral alterations related to poor nutrition and induced vomiting; however, the oral microflora of these patients is poorly studied. Objective. The aim of this study was to evaluate fungal microflora in the oral cavity of these patients by culture-dependent and culture-independent methods. Study Design. Oral rinse samples were cultured to assess the prevalence of Candida species, and the isolates were identified by API system. Microorganism counts were compared by the Mann-Whitney test (5%). Ribotyping, a type of molecular analysis, was performed by sequencing the D1/D2 regions of 28S rRNA. Results. Our results demonstrated that the eating disorder group showed higher oral Candida spp. prevalence with culture-dependent methods and higher species diversity with culture-independent methods. Conclusions. Eating disorders can lead to an increased oral Candida carriage. Culture-independent identification found greater fungal diversity than culture-dependent methods. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113:512-517)

Occurrence of bipolar spectrum disorder and comorbidities in women with eating disorders

Abstract Background Eating disorder (ED) patients often have comorbidities with other psychiatric disorders, especially with mood disorders. Although recent studies suggest an intimate relationship between ED and bipolar disorder (BD), the study on a broader bipolar spectrum definition has not been done in this population. We aimed to study the occurrence of bipolar spectrum (BS) and comorbidities in eating disorder patients of a tertiary service provider. Methods Sixty-nine female patients diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified were evaluated. The assessment comprised the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), clinical criteria for diagnosis of the Zurich bipolar spectrum. Mann–Whitney tests compared means of continuous variables. The association between categorical variables and the groups was described using contingency tables and analyzed using the chi-square or Fisher's exact test. The level of significance alpha was set at 5%. Results The results showed that 68.1% of patients had comorbidity with bipolar spectrum, and this was associated with higher family income, proportion of married people, and comorbidity with substance use. The ED with BS group showed higher rates of substance use comorbidity (40.4%) than the ED without BS group (13.6%). Discussion These results showed that the bipolar spectrum is a common comorbidity in patients with eating disorders and is associated with correlates of clinical importance, notably the comorbidity with substance use. Due to the pattern of similarity between the groups with and without comorbid bipolar spectrum in relation to various outcomes evaluated, the identification of comorbidity can be difficult. However, the precise diagnosis and careful identification of clinical correlates may contribute to future advances in treating these conditions. Further studies are necessary to evaluate the association of other clinical correlates and its possible causal association.

No association of the neuropeptide Y (Leu7Pro) and ghrelin gene (Arg51Gln, Leu72Met, Gln90Leu) single nucleotide polymorphisms with eating disorders

Genetic factors likely contribute to the biological vulnerability of eating disorders.