Clinical heterogeneity of feeding and eating disorders: using personality psychopathology to differentiate "simplex" and "complex" phenotypes.

Autor: Colizzi M; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy. marco.colizzi@uniud.it.; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. marco.colizzi@uniud.it., Comacchio C; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Garzitto M; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Bucciarelli L; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Candolo A; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Cesco M; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Croccia V; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Ferreghini A; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Martinelli R; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Nicotra A; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Sebastianutto G; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy., Balestrieri M; Unit of Psychiatry and Eating Disorders, Department of Medicine (DMED), University of Udine, Udine, 33100, Italy.
Jazyk: angličtina
Zdroj: BMC psychiatry [BMC Psychiatry] 2024 Dec 04; Vol. 24 (1), pp. 888. Date of Electronic Publication: 2024 Dec 04.
DOI: 10.1186/s12888-024-06345-3
Abstrakt: Background: To investigate Feeding and Eating Disorders (FED) heterogeneity based on the co-occurrence of FED symptoms and personality psychopathology, on the hypothesis that empirical profiles would not confirm current FED categories but identify unique phenotypes carrying different levels of clinical complexity.
Methods: Latent Profile Analysis profiled FED patients based on the assessment of both FED symptoms, through the Eating Disorders Inventory, third version (EDI-3), and personality characteristics, through the Minnesota Multiphasic Personality Inventory-2. Then, profiles were compared across socio-demographic and clinical characteristics.
Results: Among 109 eligible patients, three FED profiles were identified: (i) FED simplex (low eating symptoms, absence of dysfunctional personality); (ii) FED simplex-severe (high eating symptoms only); and (iii) FED complex-severe (high eating symptoms and dysfunctional personality). Despite an uneven distribution (χ 2 (6) = 15.20, adjusted-p = 0.029), FED profiles did not unequivocally confirm clinical diagnoses (e.g., Anorexia Nervosa). A difference in Body Mass Index (BMI) was observed (K(2) = 15.06, adjusted-p = 0.001), but lower BMI did not identify the most severe group. Profiles differed in EDI-3 overall scores (e.g., Eating Disorder Risk Composite: K(2) = 43.08, adjusted-p < 0.001), Body Uneasiness Test Global Severity Index (GSI: K(2) = 29.33, adjusted-p < 0.001), Binge Eating Scale severity (K(2) = 25.49, adjusted-p < 0.001), number of psychiatric (K(2) = 8.79, adjusted-p = 0.021) and personality diagnoses (K(2) = 11.86, adjusted-p = 0.005), and Symptom Checklist-90-Revised GSI (F(2,103) = 37.68, adjusted-p < 0.001), with FED complex-severe patients being generally the most severely impaired in terms of FED symptoms, body concerns, depersonalization, and psychiatric comorbidities.
Conclusions: Findings support the hypothesis of distinguishing FED simplex and complex phenotypes, based on the co-occurrence of dysfunctional personality, with implications for FED severity and clinical practice.
Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of the Department of Medicine (DMED) at the University of Udine (133/2023). Participants provided their written informed consent to participate in this study. Competing interests: Marco Colizzi has been a consultant/advisor to GW Pharma Limited, GW Pharma Italy SRL, and F. Hoffmann-La Roche Limited, outside of this work. The other authors declare no conflict of interest.
(© 2024. The Author(s).)
Databáze: MEDLINE
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