There are few data on the prevalence of subthreshold pediatric psychiatric disorders, when the child/adolescent doesn't qualify for any mental disorder according to the classification systems (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) and International Classification of Mental and Behavioral Disorders 10th Edition (ICD-10)), however the symptoms cause difficulties in the everyday life of the child/adolescent. The aim of the present study was to estimate the prevalence of subthreshold eating disorders among hospitalized children.

We examined 106 hospitalized children/adolescents aged under 18 in the Vadaskert Child and Adolescent Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary. Threshold (DSM-IV) and subthreshold disorders were evaluated with the Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid).

There was no single child hospitalized due to threshold eating disorder during the study period, but 7.5% of them had the diagnoses of current subthreshold eating disorder. In all cases it was subthreshold bulimia nervosa. Subthreshold bulimia nervosa was always a comorbid condition with a threshold disorder.

Our findings indicate, that clinicians should think about the presence of subthreshold eating disorder as a comorbid condition among hospitalized children.

Adolescence is a period of significant physical, emotional and intellectual changes, as well as changes in social roles, relations and expectations. Adolescent females, often preoccupied with physical appearance, express discontent with their figure, body weight and want to lose weight.

Our objective was to inquire eating attitudes among adolescent females.

Sample was consisted of adolescent females, age of 16 - 17, first grade Economic and Medical Secondary School pupils. Survey questionnaire is self-esteem scale of eating disorders designed by the author. Response rate was 389 out of 419 (92.8%).

Body Mass Index (BMI) less than 18.5 has 8.7 % female adolescents. More than half want to be thinner, while 1/3 of adolescents find themselves whether thin or obese. Forty-seven percent (47%) of adolescents exercise sometimes, 15.4% exercise often while 1/5 goes on a diet sometimes or regularly. About 43% adolescents are sometimes or often terrified about being overweight, while 60% sometimes or often lose weight. About 2/3 adolescents are not satisfied with figure. One-half adolescents are terrified with increasing in weight.

Statistically significant number in both schools does not have control in eating (p<0.5).

There is high level of discontent and dissatisfaction with figure among adolescent females.

This research indicate necessary education of adolescents to help them in accepting healthier nutrition and lifestyle in an earlier period of life, also developing programs for prevention which will encourage youth in adopting healthy lifestyles and related behavior.

purpose of the study to asses the relationship between psychiatric disorders and night eating syndrome.

subjects were recruited from psychiatric outpatient clinic at The Sisli Etfal Teaching and Research Hospital (n=384). Night Eating Syndrome Questionnaire and Structured Clinical Interview for DSM-IV diagnosis (SCID) researchers version were used as screening tools.

304 patient were female (%79,2), 80 were male (%20,8). Mean age of patients were 37,5±13,7.

Two hundred seven participants (%54) scored ≥20 on the Night Eating Syndrome Questionnaire. 168 of these were female, 39 were male.

Our sample was screened with SCID for psychiatric diagnosis and we found 51% depression (comorbid diagnosis also included); 13,5% bipolar disorder; 8,3% generalized anxiety disorder (GAD); 6,5% panic disorder; 4,7% obsessive compulsive disorder (OCD); 4,2% social phobia; 2,9 % adjustment disorder; 2,1% somatoform disorder, 1,6% schizophrenia; 0,5% eating disorders.

Statistically significant rates of bipolar disorder were found amoung patients diagnosed with NES (p=0,037). The relationship between NES and psychiatric disorders other than bipolar disorder were not statistically significant in our study.

There are limited published data about psychiatric comorbidity with NES. These studies reported comorbidity with depression, substance use disorders and sleep disorders . In our study we found strong relationship between bipolarity and NES. Despite high rate of depression with NES in our study and in the literature, our findings didn't support the relationship between NES and depression.

Dialectical Behaviour Therapy (DBT), an innovative method of treatment developed to treat severe emotion deregulation, shows benefit for individuals with borderline personality disorder. The purpose of this pilot study was to evaluate the efficacy of DBT in reducing Eating Disorders (ED) symptoms.

Twenty-eight individuals with DSM- IV diagnoses of eating disorders and other concurrent disorders were randomly assigned to a DBT treatment modified to address eating disorders or treatment as usual (both one year duration). They were administered a series of eating disorders and mental health measures prior to and after treatment.

Data suggested that individuals in the DBT condition had decreased bulimic behaviour, weight and shape concerns and increased interoceptive awareness, treatment retention and overall health.

DBT can provide improvement of some eating disorders’ symptoms. Specific adaptations of DBT for individuals with eating disorders, ways to overcome challenges, and recommendations will be discussed.

The increasing prevalence of concurrent eating and substance use disorders has been well documented in both the eating disorders and in substance use disorders literature. Despite evidence for the important role of families and wider social networks in addiction and eating disorder treatment, concurrent eating and substance use disorder therapy has focused on treating the concurrent disorders, and largely overlooked the needs of families. This study explores the impact of concurrent eating and substance use disorders on family members to identify the family's needs in order to direct future intervention.

A series of semi-structured interviews were completed with family members of patients with concurrent eating and substance use disorders. A qualitative grounded theory approach was used to analyze the data and involved the coding of transcripts and the development of emerging themes.

Three major themes emerged from the analyses: 1) Families’ inability to cope; 2) Inadequate communication and involvement of family in therapy; 3) Lack of information about the disorders themselves.

Data suggest that greater emphasis in service provision must be placed on family members and wider social networks to: 1) help assist clients to engage and stay in treatment; 2) improve both disorder outcomes and family functioning, and 3) reduce impacts and harm for family members and others affected. Suggestions for helping clinicians and new avenues for service provision and research are presented.

Explore the prevalence of lifetime suicide attempts in women with bulimia nervosa (BN), and compare eating disorder symptoms, general psychopathology, impulsivity, personality, and genetic variants in four candidate genes of the serotonin pathway: the serotonin transporter (SLC6A4), serotonin receptors 1A (HTR1A) and 2A (HTR2A) and tryptophan hydroxylase 1 (TPH1) between individuals who had and had not attempted suicide. Determine the best predictors of suicide attempts.

566 consecutively admitted BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN). Patients completed a comprehensive assessment battery.

Lifetime prevalence of suicide attempts was 26.9% CI 95%: 23.2 to 30.5). BN subtype was not associated with lifetime suicide attempts (p=0.36). Compared to non-attempters, attempters exhibited higher unemployment, eating disorder symptomatology, general psychopathology, previous eating disorder treatment, impulsive behaviors, and lower educational level (p<0.004). In relation to personality traits, suicide attempters exhibited significantly (p<0.002) higher Harm Avoidance and lower Self-directedness, Reward Dependence and Cooperativeness. No significant differences in any of the genetic variants between attempters and non-attempters. The best predictors of suicide attempts were (p<0.006): lower education, minimum BMI, previous eating disorder treatment, family history of alcoholism and self-directedness.

Suicidality in BN patients appears to be within the range previously found. Our results support that internalizing personality traits combined with impulsivity may increase the probability of engaging in suicidal behaviors in these patients. Our data do not support the hypothesis that variants of SLC6A4, HTR1A, HTR2A or TPH1 are associated with suicide attempts in BN individuals.

There have been a few studies on epidemiology and related factors for eating disorders (ED), although they are frequently encountered in clinical practice in P. R. China. We conducted an investigation to draw the prevalence of eating disorders and its correlated factors in the Chinese female youths.

1378 female subjects were random sampling from 8 high schools and 6 universities in the 5 urban areas in Chengdu City of China. Eating Disorder Inventory-1 (EDI-1), BMI-based Silhouette Matching Test (BMI-SMT), Self-rating Depression Scale (SDS), Beck Anxiety Inventory (BAI) and a social-demographic questionnaire were applied to assess the subjects.

Of 1378 subjects, 61 subjects (eating disorders group, EDG) were scaled 14 or more than 14 for the Drive for Thinness subscale of EDI, in whom three-quarter subjects were estimated to be suffered from ED according to EDI manual. Therefore, the estimated prevalence rate of ED was 3.32% in the female youths. The EDG showed higher score in the body dissatisfaction of the BMI-SMT than the none-eating disorders group (N-EDG). The EDR scored higher on the SDS and the BAI than N-EDG (33.92±7.921/29.09±7.666, t=4.797, P=0.000; 31.82±9.991/29.31±7.205, t=2.603, P=0.009, respectively). We performed the logistic regression analysis to explore the related factors with ED which included concerning about the idol at media, non-harmonious parents relationships and being abused in childhood.

The prevalence of eating disorders in Chinese female youths is similar to that in west countries and more attention should be paid to them for their mental health.

The purpose of this study, was to identify the point prevalence of night eating syndrome (NES) in our psychiatric outpatient population.

subjects were recruited from psychiatric outpatient clinic at The Sisli Etfal Teaching and Research Hospital (n=384). Night Eating Syndrome Questionnaire was used as a screening tool.

304 patient were female (%79,2), 80 were male (%20,8). Mean age of patients were 37,5±13,7.

The mean weight of our population was 63,4±13,8; average BMI calculated 25,7±5,24 . %4,7 of patients were low weighted; %45,6 were normal wieghted; %32,6 were overweighted and %17,2 were obese.

Two hundred seven participants (%54) scored ≥20 on the night eating questionnaire. 168 of these were female, 39 were male; no significant differences were found between genders. No significant differences were found between total scores of Night Eating Questionnaire and BMI, weight, age and gender.

In our study we found point prevalence of NES %54. This high prevalance could be related with our sample features like higher female proportion and higher proportion of obese or overweighted patients. The prevalence of NES is estimated at 1,5% in general population, 6-% to 14% in obesity clinics and 8-42% in preoperative bariatric surgery patients in the US . Such a wide range of estimates is most certainly influenced by varying assessment methods and diagnostic criteria. Another limitation to be noted is related to the self-report nature of the data.

Patients treat with this therapy add 7-15 kilos in average during the period of two to three months, menstrual cycle and the change of psycho-pathological appearance are settled which makes good conditions for further psychotherapeutic interventions.

To assess the differences in comorbid lifetime substance use (tobacco, alcohol and drug use) between eating disorder (ED) patients and healthy controls.

Participants were a consecutive series of 779 ED cases, who had been referred to specialised ED units in five European countries. The ED cases were compared to a balanced control group of 785 healthy individuals. Assessment: Participants completed the Substance Use Subscale of the Cross Cultural Questionnaire (CCQ), a measure of lifetime tobacco, alcohol and drug use. In the control group, also the GHQ-28, the SCID-I interview and the EAT-26 were used.

ED patients had higher lifetime consumption of tobacco and drugs (p <0.01). The only insignificant result was obtained for alcohol (OR= 1.29; δ =0.157; N.S.) and cannabis use (OR= 1.21; δ = 0.037, N.S.). Significant differences across ED sub diagnoses also emerged for all of the assessed variables (p<0.01), with the BN and AN-BP patients generally presenting the highest prevalence rates. The only exception was detected for alcohol consumption where EDNOS patients demonstrated the highest values (p=0.008). Only a few cultural differences between countries emerged (p<0.05).

Lifetime tobacco and drug use but not alcohol consumption are more prevalent in ED patients than healthy controls. While alcohol appears to be more common in EDNOS, smoking and drug use are more frequent in patients with bulimic symptomatology. The differential risk observed in patients with bulimic features might be related to differences in temperament or might be the result of increased sensitivity to reward.

To examine whether there is an association between individual and family eating patterns during childhood and early adolescence and the likelihood of developing an eating disorder (ED) later in life.

Participants were a consecutive series of 879 ED cases from five different European countries. The ED cases were compared to a control group of 785 healthy individuals. Assessment: Participants completed the Early Eating Environmental Subscale of the Cross-Cultural (Environmental) Questionnaire (CCQ), a retrospective measure, which has been developed to detect dimensions associated with EDs in different countries. In the control group, also the GHQ-28, the SCID-I interview and the EAT-26 were used.

Five individual CatPCA procedures revealed five predetermined dimensions which were labeled: 1.) food as individualization; 2.) control and rules about food; 3.) food as social glue; 4.) healthy eating and 5.) food neglect. Logistic regression analyses indicated that the domains with the strongest effects were: food used as individualization (p=0.001; OR=1.76) and control and rules about food (p=0.001; OR=1.76). Conversely, healthy eating was negatively related to a later ED (p=0.001; OR=0.629). The pattern of associated ED factors was found to very between countries. There was very little difference in early eating behavior on the subtypes of the ED.

The fragmentation of meals within the family and control and rules about food appears to be linked to the development of a subsequent ED. On the other hand mantaining a structured and balanced diet during infancy seems to protect from a later ED.

To examine whether drug use (DU) is higher in people with eating disorders (EDs) than in matched comparison groups and to collate, summarize and perform a meta analysis where possible on the literature related to DU in people with EDs.

We searched electronic databases including Medline, PsycINFO, Web of Science and CINAHL and reviewed studies published from 1994 to August, 2007, in English, German or Spanish against a priori inclusion/exclusion criteria. A total of 248 papers were eligible for inclusion. Only a total of 16 papers fulfilled all the inclusion criteria and were finally included in the systematic review.

The meta-analysis including all the different drugs for every sort of ED revealed a negligible albeit significant (z=2.34, p<.05), pooled standardized effect size of 0.119. The data showed a high degree of heterogeneity across the studies (X2(74)= 1267.61, p<.001). When ED subdiagnoses were assessed individually, DU was found to be higher in people with bulimia nervosa (BN) as a moderate sized increase in DU was found in this ED subtype (δ =0.462, z=6.69, p=<.001). People with binge eating disorder (BED) had a small increased risk of DU (δ =0.14, z=2.28, p<.05). In contrast, people with anorexia nervosa (AN) had a lower risk of DU (δ=-.167, z=1.81, p=.070, p=NS).

The differential risk observed in BN patients might be related to differences in temperament or might be the result of reward sensitisation as a result of the ED behaviours specifically associated with BN.

The feeders are usually people who encourage others (the "gainer") to increase their weight by the pleasure of seeing eat or see "fat" or, more often, because of the relationship of domination, control and dependency that this holds. Although still little studied, there are references to “feeding” as a fetishism, disturbance of eating, or even as a form of physical and psychological violence with special features.

Presentation of a clinical case (emerged in the consultation of general psychiatry) of a patient for 43 years, married, overweighted (because of imposed feeding of her husband) that presents depressive episodes. Hold a literature review based on the search Pubmed / Medline on the concepts of feeders and gainers and pharmacological approaches and psicotherapy.

There are numerous cases described in both sexes, weighing above normal and that fail to reach the ideal weight for food imposition of other persons, most often, someone close to the patient (spouse, parents, etc.). There is a need to distinguish this from the "fat lovers”, that as a sexual link. The imposition food can lead to an addiction control and the patient and the feeder often requires the psychiatry assistance in a systemic perspective.

Assessing the existence of risk behavior for the development of eating disorders in young people,

Cross study of students attending two schools (semi-urban and rural) and the university. There was registered individual weight and height and implemented questionnaires of food history, relationship with food, body image (BSQ) and the test of attitude towards food (EAT-26).

In the samples, there was a predominance of the female population (57%, 68%, 74% in Ceira, Pombal and the University). In samples with less than 18 years, the average weight is situated in the range 50-59 kg and the sample university in the range 60-69Kg. In all samples the height average is located in the range 1.60 m to 1.67 m. The satisfaction with the weight is higher in rural population (74%). It is, paradoxically, in the rural population, with mean age of 18 years who are the largest percentage of change in scales EAT-26 and BSQ (29 and 23%).

In all populations are uniform in terms of weight and height, and noted however, that the rural population, with an average of 18 years of age there is a predominance of abnormal behavior food and dissatisfaction with body image.