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Speed SN, Sherman GT, Wang T, Pince CL, Sanfilippo JE, Montemitro C, Giorgi S, Curtis BL, Farinelli LA, Farokhnia M, Leggio L. Bariatric surgery and alcohol and substance use: A case-control survey study. Drug Alcohol Depend 2025; 267:112529. [PMID: 39764929 PMCID: PMC11780309 DOI: 10.1016/j.drugalcdep.2024.112529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 12/13/2024] [Accepted: 12/15/2024] [Indexed: 01/25/2025]
Abstract
PURPOSE Studies suggest alcohol and/or other substance misuse may develop after bariatric surgery (BS), but findings are not consistent or conclusive. PROCEDURES This cross-sectional online survey investigated alcohol and other substance use, via a modified version of the Alcohol Use Disorders Identification Test, before and after bariatric surgery, compared to a non-bariatric surgery sample. Data were anonymously collected via Qualtrics from adults who reported alcohol or substance use (BS, n = 328; non-BS, n = 292). FINDINGS Problematic alcohol, opioid, amphetamine, and cannabis use were reduced post-surgery compared to pre-surgery. After surgery, participants expressed "guilt" associated with alcohol and other substance use (average 0.24 and 0.31 points higher, respectively) compared to pre-surgery. Compared to controls, the bariatric surgery group reported on average 1.99 points less problematic nicotine use pre-surgery (p = .012) and 2.42 points less post-surgery (p = .004). In contrast, compared to people without any history of bariatric surgery, the bariatric surgery group reported greater problematic use of alcohol, cannabis, hallucinogens, and/or inhalants pre-surgery (all p < .001); same results were found post-surgery for all drugs, (all p < .001) except for hallucinogens which was not significantly different between the two groups. RELEVANCE Unlike previous reports, these survey-based results do not show an increase in problematic alcohol and substance use following bariatric surgery. Recall biases and the survey-based methodology are however important limitations of the present study. The observed increase in "guilt" associated with substance use may align with growing evidence suggesting increased subjective response to alcohol and other substances following bariatric surgery.
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Affiliation(s)
- Shannon N Speed
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA
| | - Garrick T Sherman
- Office of the Clinical Director, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Tammy Wang
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA
| | - Claire L Pince
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA
| | - Jenna E Sanfilippo
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA
| | - Chiara Montemitro
- Center for Social and Affective Neuroscience. Linköping University, Linköping, Sweden
| | - Salvatore Giorgi
- Technology and Translational Research Unit, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Brenda L Curtis
- Technology and Translational Research Unit, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Lisa A Farinelli
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA
| | - Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, USA.
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Giel KE, Bulik CM, Fernandez-Aranda F, Hay P, Keski-Rahkonen A, Schag K, Schmidt U, Zipfel S. Binge eating disorder. Nat Rev Dis Primers 2022; 8:16. [PMID: 35301358 PMCID: PMC9793802 DOI: 10.1038/s41572-022-00344-y] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/30/2022]
Abstract
Binge eating disorder (BED) is characterized by regular binge eating episodes during which individuals ingest comparably large amounts of food and experience loss of control over their eating behaviour. The worldwide prevalence of BED for the years 2018-2020 is estimated to be 0.6-1.8% in adult women and 0.3-0.7% in adult men. BED is commonly associated with obesity and with somatic and mental health comorbidities. People with BED experience considerable burden and impairments in quality of life, and, at the same time, BED often goes undetected and untreated. The aetiology of BED is complex, including genetic and environmental factors as well as neuroendocrinological and neurobiological contributions. Neurobiological findings highlight impairments in reward processing, inhibitory control and emotion regulation in people with BED, and these neurobiological domains are targets for emerging treatment approaches. Psychotherapy is the first-line treatment for BED. Recognition and research on BED has increased since its inclusion into DSM-5; however, continuing efforts are needed to understand underlying mechanisms of BED and to improve prevention and treatment outcomes for this disorder. These efforts should also include screening, identification and implementation of evidence-based interventions in routine clinical practice settings such as primary care and mental health outpatient clinics.
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany.
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany.
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | | | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
| | - Ulrike Schmidt
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
- Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
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Spitzer C, Lübke L, Lindstädt T, Gallinat C, Tietze JK, Emmert S, Thiem A. Prevalence of pathological skin-picking in dermatological patients. J Psychiatr Res 2022; 147:232-236. [PMID: 35066291 DOI: 10.1016/j.jpsychires.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/24/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The prevalence of pathological skin-picking (PSP) has predominantly been studied in students and the community, but not yet in dermatological patients. However, those may be at increased risk of PSP because it is often triggered by the feel or look of the skin. Thus, its prevalence among patients with a physician-diagnosed dermatological disease remains to be determined. METHODS A consecutive series of 460 adult patients attending a dermatological university outpatient clinic was administered the 8-item Skin Picking Scale-Revised (SPS-R). They also reported demographic data and rated the severity of their skin disease. The dermatologist evaluating the patient provided his/her diagnosis. RESULTS PSP as defined by SPS-R scores ≥7 was reported by 121 participants (26.3%). It was significantly more frequent in patients with atopic dermatitis (AD, OR = 3.23; 95% CI: 1.95-5.68) and psoriasis (OR = 1.64; 95% CI: 1.00-2.67), but less frequent in those with malignant epithelial skin tumors (OR = 0.10; 95% CI: 0.02-0.43). PSP was not associated with female gender or younger age. CONCLUSIONS Our findings indicate that PSP affects about one in four patients with skin disease. In particular, individuals suffering from atopic dermatitis may represent a high-risk population for PSP deserving early recognition and adequate treatment.
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Affiliation(s)
- Carsten Spitzer
- Department of Psychosomatic Medicine, University Medical Center Rostock, Rostock, Germany.
| | - Laura Lübke
- Department of Psychosomatic Medicine, University Medical Center Rostock, Rostock, Germany
| | - Tereza Lindstädt
- Department of Psychosomatic Medicine, University Medical Center Rostock, Rostock, Germany
| | - Christina Gallinat
- Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia K Tietze
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Alexander Thiem
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
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Dickhut C, Hase C, Gruner-Labitzke K, Mall JW, Köhler H, de Zwaan M, Müller A. No addiction transfer from preoperative food addiction to other addictive behaviors during the first year after bariatric surgery. EUROPEAN EATING DISORDERS REVIEW 2021; 29:924-936. [PMID: 34460134 DOI: 10.1002/erv.2857] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate whether the remission of preoperative food addiction is associated with increases or new onset of other addictions within the first year following bariatric surgery. METHODS One hundred and twenty-five bariatric surgery patients were assessed before surgery (t1) and at 6 months (t2) and 1 year (t3) follow-ups. The assessments included the Yale Food Addiction Scale 2.0 (YFAS 2.0) and standardized questionnaires to measure symptoms of problematic alcohol use, gambling disorder, internet-use disorder, buying-shopping disorder, hypersexual disorder and exercise dependence. RESULTS Forty-nine (39.2%) patients were assigned to the food addiction (FA+ ) and 76 patients (60.8%) to the non-food addiction group (FA- ) based on their preoperative YFAS scores. Overall, BMI and symptoms of food addiction decreased significantly from baseline to follow-ups. Preoperative food addiction status was not associated with postoperative increases or new onset of other addictions. Elevated symptoms of buying-shopping disorder, internet-use and hypersexual behaviour at baseline in the FA+ -group decreased over time and were comparable to the FA- -group at follow-ups. CONCLUSION The 'addiction transfer' or 'cross addiction' hypothesis was not supportive for alcohol addiction, gambling addiction or other behaviours that may be addictive. Further studies are needed that investigate larger samples and longer observation periods, as well as other substance-use disorders.
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Affiliation(s)
- Clemens Dickhut
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology & Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Carolin Hase
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | | | - Julian W Mall
- Department of General, Vascular and Bariatric Surgery, KRH Klinikum Nordstadt, Hannover, Germany
| | - Hinrich Köhler
- Department of Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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van Buuren M, Hinnen C. Are Morbid Obesity and Insomnia Related? Investigating Associated Factors in a Clinical Setting. J Clin Psychol Med Settings 2019; 27:190-198. [DOI: 10.1007/s10880-019-09635-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Gallinat C, Moessner M, Claes L, Müller A. Skin picking in patients with obesity: Associations with impulsiveness and self-harm. Scand J Psychol 2019; 60:361-368. [PMID: 31006888 DOI: 10.1111/sjop.12536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
Abstract
Previous studies suggest elevated prevalence rates of skin picking and self-harm in patients with obesity compared to individuals in the general population. Hence, further studies should investigate prevalence rates and correlates of skin picking in this population - especially its differentiation to self-harm. Skin picking and obesity are both associated with specific facets of impulsiveness. This relation should be explored to shed light on potentially shared mechanisms in etiology. Therefore, the present study examined the occurrence of skin picking and its associations with impulsiveness and self-harm in a sample of pre-bariatric surgery patients with obesity class II/III. Within the routine preoperative psychiatric evaluation, a total of 139 bariatric surgery candidates (78% female, BMI range 35-69) completed a self-report questionnaire assessing sociodemographic variables, anxiety, depression, self-harm, impulsiveness, and skin picking severity (urges: frequency, intensity, controllability; behavior: frequency, intensity, controllability; resistance, emotional distress, impairment, and avoidance). Ten participants (7.2% of the sample) reported recurrent skin picking leading to skin damage, repeated attempts to decrease skin picking, and psychosocial impairment (emotional distress, impairment in functional areas, avoidance) due to skin picking. In line with previous findings, skin picking severity shows a medium correlation with attentional impulsiveness. The majority of self-harm types were not associated with skin picking severity. The current study reveals a high occurrence of skin picking compared to the general population. The results indicate an association between skin picking severity and attentional impulsiveness. Further research is needed to investigate the differentiation of skin picking and self-harm in more detail.
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Affiliation(s)
- Christina Gallinat
- University Hospital Heidelberg, Center for Psychotherapy Research, Heidelberg, Germany
| | - Markus Moessner
- University Hospital Heidelberg, Center for Psychotherapy Research, Heidelberg, Germany
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University Antwerp, Antwerp, Belgium
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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Müller A, Leukefeld C, Hase C, Gruner-Labitzke K, Mall JW, Köhler H, de Zwaan M. Food addiction and other addictive behaviours in bariatric surgery candidates. EUROPEAN EATING DISORDERS REVIEW 2018; 26:585-596. [DOI: 10.1002/erv.2629] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | - Crispin Leukefeld
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | - Carolin Hase
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | | | - Julian W. Mall
- Department of General, Vascular and Bariatric Surgery; KRH Klinikum Nordstadt; Hannover Germany
| | - Hinrich Köhler
- Department of Surgery; Herzogin Elisabeth Hospital; Braunschweig Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
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Nunes-Neto PR, Köhler CA, Schuch FB, Solmi M, Quevedo J, Maes M, Murru A, Vieta E, McIntyre RS, McElroy SL, Gearhardt AN, Stubbs B, Carvalho AF. Food addiction: Prevalence, psychopathological correlates and associations with quality of life in a large sample. J Psychiatr Res 2018; 96:145-152. [PMID: 29049971 DOI: 10.1016/j.jpsychires.2017.10.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/05/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the prevalence of food addiction in a large Brazilian non-clinical sample. Sociodemographic and psychopathological correlates of food addiction as well as associations with quality (QoL) domains were also investigated. METHODS This cross-sectional study obtained data from a Brazilian anonymous web-based research platform (N = 7639; 71.3% females). Participants provided sociodemographic data and completed the modified Yale Food Addiction Scale 2.0, PHQ-9, hypomania checklist (HCL-32), Fagerström Test for Nicotine Dependence, AUDIT, modified Skin picking-Stanford questionnaire, Minnesota impulsive disorders interview, Symptom Checklist-90-Revised inventory (SCL-90R), early trauma inventory self report-short form, and the WHO Quality of Life instrument-Abbreviated version (WHOQOL-Bref). Associations were adjusted to potential confounders through multivariable models. RESULTS The prevalence of food addiction was 4.32% (95%CI: 3.89-4.80%), and was more common among females. Food addiction was associated with a positive screen for a major depressive episode (OR = 4.41; 95%CI: 3.46-5.62), bipolar spectrum disorder (OR = 1.98; 95%CI: 1.43-2.75), and skin picking disorder (OR = 2.02; 95%CI: 1.31-3.09). Food addiction was also independently associated with exposure to early life psychological and sexual abuse (P = 0.008) as well as with reduced physical, psychological, social, and environment QoL (all P < 0.001). CONCLUSIONS Food addiction may be common in low and middle-income countries, though possibly less prevalent than in the US. Food addiction was associated with co-occurring mood disorders and skin picking disorder as well as with early life psychological and sexual abuse. Finally, food addiction was independently associated with broad reductions in QoL. Public health efforts towards the early recognition and management of food addiction are warranted.
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Affiliation(s)
- Paulo R Nunes-Neto
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Cristiano A Köhler
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Felipe B Schuch
- Mestrado em Saúde e Desenvolvimento Humano, Universidade La Salle, Canoas, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Marco Solmi
- Neuroscience Department, University of Padua, Padova, Italy; Institute for Clinical Research and Education in Medicine (IREM), Padua, Italy
| | - João Quevedo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; IMPACT Research Center, Deakin University, Geelong, Australia
| | - Andrea Murru
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Ontario, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada; Department of Pharmacology, University of Toronto, Ontario, Canada
| | - Susan L McElroy
- Lindner Center of HOPE, Mason, OH, USA; University of Cincinnati College of Medicine Department of Psychiatry and Behavioral Neuroscience, Cincinnati, OH, USA
| | | | - Brendon Stubbs
- Institute for Clinical Research and Education in Medicine (IREM), Padua, Italy; South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom;; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8 AF, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, CM1 1SQ, United Kingdom
| | - André F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil; Institute for Clinical Research and Education in Medicine (IREM), Padua, Italy.
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Thompson JR, Gustafsson HC, DeCapo M, Takahashi DL, Bagley JL, Dean TA, Kievit P, Fair DA, Sullivan EL. Maternal Diet, Metabolic State, and Inflammatory Response Exert Unique and Long-Lasting Influences on Offspring Behavior in Non-Human Primates. Front Endocrinol (Lausanne) 2018; 9:161. [PMID: 29740395 PMCID: PMC5924963 DOI: 10.3389/fendo.2018.00161] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/27/2018] [Indexed: 12/15/2022] Open
Abstract
Nutritional status influences brain health and gestational exposure to metabolic disorders (e.g. obesity and diabetes) increases the risk of neuropsychiatric disorders. The aim of the present study was to further investigate the role of maternal Western-style diet (WSD), metabolic state, and inflammatory factors in the programming of Japanese macaque offspring behavior. Utilizing structural equation modeling, we investigated the relationships between maternal diet, prepregnancy adiposity, third trimester insulin response, and plasma cytokine levels on 11-month-old offspring behavior. Maternal WSD was associated with greater reactive and ritualized anxiety in offspring. Maternal adiposity and third trimester macrophage-derived chemokine (MDC) exerted opposing effects on offspring high-energy outbursts. Elevated levels of this behavior were associated with low maternal MDC and increased prepregnancy adiposity. This is the first study to show that maternal MDC levels influence offspring behavior. We found no evidence suggesting maternal peripheral inflammatory response mediated the effect of maternal diet and metabolic state on aberrant offspring behavior. Additionally, the extent of maternal metabolic impairment differentially influenced chemokine response. Elevated prepregnancy adiposity suppressed third trimester chemokines, while obesity-induced insulin resistance augmented peripheral chemokine levels. WSD also directly increased maternal interleukin-12. This is the first non-human primate study to delineate the effects of maternal diet and metabolic state on gestational inflammatory environment and subsequent offspring behavior. Our findings give insight to the complex mechanisms by which diet, metabolic state, and inflammation during pregnancy exert unique influences on offspring behavioral regulation.
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Affiliation(s)
- Jacqueline R. Thompson
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Hanna C. Gustafsson
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Madison DeCapo
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Diana L. Takahashi
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Jennifer L. Bagley
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Tyler A. Dean
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Paul Kievit
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
| | - Damien A. Fair
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Elinor L. Sullivan
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, United States
- Division of Cardiometabolic Health, Oregon National Primate Research Center, Beaverton, OR, United States
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- Department of Human Physiology, University of Oregon, Eugene, OR, United States
- *Correspondence: Elinor L. Sullivan,
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Ural C, Belli H, Akbudak M, Solmaz A, Bektas ZD, Celebi F. Relation of binge eating disorder with impulsiveness in obese individuals. World J Psychiatry 2017; 7:114-120. [PMID: 28713689 PMCID: PMC5491476 DOI: 10.5498/wjp.v7.i2.114] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 05/05/2017] [Accepted: 05/18/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate the levels of impulsiveness, and the relationship between the binge eating disorder (BED) and the levels of impulsiveness in obese individuals. METHODS Two hundred and forty-one obese patients who were included in the study and candidate for bariatric surgery (weight loss surgery) were clinically interviewed to identify the BED group, and patients were divided into two groups: Those with BED and those without BED. The comorbidity rate of groups was determined by using structured clinical interview for DSM-IV (SCID-I). A sociodemographic data form including the story of previous psychiatric treatment, structured clinical interview for DSM-IV (SCID-I), Beck Anxiety Inventory, Beck Depression Inventory (BDI) and Barratt Impulsiveness Scale-11 were applied to both of the groups. RESULTS In regard to 241 obese individuals included in the study, total score and score of attention subscale for BED (+) group were significantly high (P < 0.05). In addition, suicide attempt, story of psychiatric consultation, and score for BDI were again significantly high in the BED (+) group (P < 0.05). CONCLUSION In assessment of obese individuals, assessment of associated psychopathology such as impulsive characteristics and suicide attempt in addition to disrupted eating behaviors will allow to have a more extensive view.
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Starcevic V, Khazaal Y. Relationships between Behavioural Addictions and Psychiatric Disorders: What Is Known and What Is Yet to Be Learned? Front Psychiatry 2017; 8:53. [PMID: 28439243 PMCID: PMC5383701 DOI: 10.3389/fpsyt.2017.00053] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/24/2017] [Indexed: 11/13/2022] Open
Abstract
This article provides a narrative review of the relationships between several behavioural addictions [pathological gambling, problematic Internet use (PIU), problematic online gaming, compulsive sexual behaviour disorder, compulsive buying, and exercise addiction] and psychiatric disorders. Associations between most behavioural addictions and depressive and anxiety disorders are strong and seem relatively non-specific. Strong links with substance use disorders may support the notion that some people are more prone to addictive behaviours, regardless of whether these involve substances or problematic activities. Other associations seem relatively specific, for example, those between PIU/online gaming and attention-deficit/hyperactivity disorder, between compulsive buying on the one hand and eating disorders and hoarding on the other hand and between exercise addiction and eating disorders. The quality of the research varies, but most studies suffer from methodological limitations, including a cross-sectional or correlational design, non-representative study populations, small sample sizes, reliance on self-report assessment instruments, diverse diagnostic criteria, and conceptual heterogeneity of most behavioural addictions. Due to these limitations, generalisability of the findings is questionable and the direction of causality, if any, is unknown in the relationships between behavioural addictions and psychiatric disorders. Regardless of the aetiological uncertainty, these relationships often call for a modified treatment approach. Prospective studies are needed to clarify the longitudinal relationships between behavioural addictions and psychiatric disorders.
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Affiliation(s)
- Vladan Starcevic
- Discipline of Psychiatry, Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - Yasser Khazaal
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
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Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis 2016; 12:731-749. [DOI: 10.1016/j.soard.2016.02.008] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
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Brockmeyer T, Hamze Sinno M, Skunde M, Wu M, Woehning A, Rudofsky G, Friederich HC. Inhibitory Control and Hedonic Response towards Food Interactively Predict Success in a Weight Loss Programme for Adults with Obesity. Obes Facts 2016; 9:299-309. [PMID: 27701173 PMCID: PMC5644782 DOI: 10.1159/000447492] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/01/2016] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Low inhibitory control and strong hedonic response towards food are considered to contribute to overeating and obesity. Based on previous research, the present study aimed at examining the potentially crucial interplay between these two factors in terms of long-term weight loss in people with obesity. METHODS BMI, inhibitory control towards food, and food liking were assessed in obese adults prior to a weight reduction programme (OPTIFAST® 52). After the weight reduction phase (week 13) and the weight loss maintenance phase (week 52), participants' BMI was re-assessed. RESULTS Baseline BMI, inhibitory control and food liking alone did not predict weight loss. As hypothesised, however, inhibitory control and food liking interactively predicted weight loss from baseline to week 13 and to week 52 (albeit the latter effect was less robust). Participants with low inhibitory control and marked food liking were less successful in weight reduction. CONCLUSION These findings underscore the relevance of the interplay between cognitive control and food reward valuation in the maintenance of obesity.
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Affiliation(s)
- Timo Brockmeyer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
- *Dr. Timo Brockmeyer, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany,
| | - Maria Hamze Sinno
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Mandy Skunde
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Mudan Wu
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
- Department of Psychology, College of Education, Shanghai Normal University, Shanghai, China
| | - Annika Woehning
- Department of Endocrinology, Metabolism and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Gottfried Rudofsky
- Department of Endocrinology, Metabolism and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany
- Department of Internal Medicine, Medizinische Klinik, Kantonsspital Olten, Olten, Switzerland
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Yip SW, Mei S, Pilver CE, Steinberg MA, Rugle LJ, Krishnan-Sarin S, Hoff RA, Potenza MN. At-Risk/Problematic Shopping and Gambling in Adolescence. J Gambl Stud 2015; 31:1431-1447. [PMID: 25117852 PMCID: PMC4827601 DOI: 10.1007/s10899-014-9494-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Elevated levels of both pathological gambling (PG) and problem shopping (PS) have been reported among adolescents, and each is associated with a range of other negative health/functioning measures. However, relationships between PS and PG, particularly during adolescence, are not well understood. In this study, we explored the relationship between different levels of problem-gambling severity and health/functioning characteristics, gambling-related social experiences, gambling behaviors and motivations among adolescents with and without at-risk/problematic shopping (ARPS). Survey data from Connecticut high school students (n = 2,100) were analyzed using bivariate analyses and logistic regression modeling. Although at-risk/problematic gambling (ARPG) was not increased among adolescents with ARPS, adolescents with ARPG (vs non-gamblers) were more likely to report having experienced a growing tension or anxiety that could only be relieved by shopping and missing other obligations due to shopping. In comparison to the non-ARPS group, a smaller proportion of respondents in the ARPS group reported paid part-time employment, whereas a greater proportion of respondents reported excessive gambling by peers and feeling concerned over the gambling of a close family member. In general, similar associations between problem-gambling severity and measures of health/functioning and gambling-related behaviors and motivations were observed across ARPS and non-ARPS adolescents. However, associations were weaker among ARPS adolescents for several variables: engagement in extracurricular activities, alcohol and caffeine use and gambling for financial reasons. These findings suggest a complex relationship between problem-gambling severity and ARPS. They highlight the importance of considering co-occurring risk behaviors such as ARPS when treating adolescents with at-risk/problem gambling.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Songli Mei
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- School of Public Health, Jilin University, Changchun, China
| | - Corey E Pilver
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | | | | | | | - Rani A Hoff
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- VA CT Healthcare System, West Haven, CT, USA
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Steffen KJ, Engel SG, Wonderlich JA, Pollert GA, Sondag C. Alcohol and Other Addictive Disorders Following Bariatric Surgery: Prevalence, Risk Factors and Possible Etiologies. EUROPEAN EATING DISORDERS REVIEW 2015; 23:442-50. [DOI: 10.1002/erv.2399] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Kristine J. Steffen
- Department of Pharmaceutical Sciences, College of Pharmacy, Nursing, and Allied Sciences; North Dakota State University; Fargo ND USA
- Neuropsychiatric Research Institute; Fargo ND USA
| | | | | | | | - Cindy Sondag
- Department of Neuroscience; University of North Dakota; ND USA
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Abstract
OBJECTIVE Obesity is one of the leading causes of preventable morbidity and mortality, and young people are increasingly affected. The aim of this study was to examine relationships between obesity and dissociable forms of impulsivity in young adults. METHODS A group of young adults (511) was recruited from city areas in the United States using media advertisements. These young adults were administered careful and extensive clinical and neurocognitive assessment in order to quantify different aspects of impulsivity (behavioral/phenomenological-, cognitive-, and personality-related measures). Associations between obesity and impulsivity were explored using multivariate analysis of variance and discriminant function analysis. RESULTS 10.8% of the sample was obese, and 21.5% was overweight. Compared to controls, subjects with obesity showed significantly elevated rates of maladaptive gambling behaviors, monetary amounts lost to gambling, nicotine consumption, impulsive action (prolonged stop-signal reaction times in the Stop-Signal Test), and impulsive decision-making (reduced modulation of behavior as a function of risk in the Cambridge Gamble Test). Even accounting for potential confounding variables, obesity was significantly predicted by female gender, older age, more maladaptive gambling behaviors, and worse inhibitory control (stop-signal reaction times). CONCLUSION Obesity is associated with several dissociable forms of impulsivity in young people, especially gambling and impulse dyscontrol. Family doctors should screen for gambling problems in obese young adults. Successful treatment of nicotine dependence in young obese people is likely to require intensive weight management support. Neuropsychological deficits relating to impulsivity occur in obese people in early adulthood, and may represent vulnerability markers rather than being due to chronic untoward metabolic effects on brain function.
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Svaldi J, Naumann E, Biehl S, Schmitz F. Impaired Early-Response Inhibition in Overweight Females with and without Binge Eating Disorder. PLoS One 2015. [PMID: 26201025 PMCID: PMC4511767 DOI: 10.1371/journal.pone.0133534] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Several studies report increased reward sensitivity towards food in overweight individuals. By contrast, data is inconclusive with respect to response inhibition in overweight individuals without binge eating disorder (BED). Hence, the latter was addressed in the present study in a group of overweight/obese females with and without BED and a normal-weight control group without eating disorders. Method A group of women with BED (n = 29), a group of overweight women without BED (n = 33) and normal-weight females (n = 30) participated in a pictorial priming paradigm, with food items (relevant primes) and office utensils (neutral primes) and color blobs (neutral primes) as stimuli. Increased response priming effects (i.e. priming with switches between stimulus categories) were taken as indicators of deficient behavioral inhibition. Results Priming effects for neutral primes were moderate and comparable across all groups. However, primes associated with the food task set lead to increased priming effects in both overweight groups. But, effects were comparable for overweight/obese participants with and without BED. Discussion Results suggest that early response inhibition in the context of food is impaired in overweight individuals compared to normal-weight individuals.
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Affiliation(s)
- Jennifer Svaldi
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
- * E-mail:
| | - Eva Naumann
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Stefanie Biehl
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Florian Schmitz
- Institute of Psychology and Pedagogy, Ulm University, Ulm, Germany
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Müller A, Mitchell JE, de Zwaan M. Compulsive buying. Am J Addict 2015; 24:132-137. [DOI: 10.1111/ajad.12111] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 06/15/2013] [Accepted: 07/13/2013] [Indexed: 11/26/2022] Open
Affiliation(s)
- Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Center for Addiction Research (CARe)Hannover Medical SchoolHannoverGermany
| | - James E. Mitchell
- Department of Clinical NeuroscienceUniversity of North Dakota, School of Medicine and Health SciencesFargoNorth Dakota
- Neuropsychiatric Research InstituteFargoNorth Dakota
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Center for Addiction Research (CARe)Hannover Medical SchoolHannoverGermany
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Mole TB, Irvine MA, Worbe Y, Collins P, Mitchell SP, Bolton S, Harrison NA, Robbins TW, Voon V. Impulsivity in disorders of food and drug misuse. Psychol Med 2015; 45:771-82. [PMID: 25118940 PMCID: PMC4998952 DOI: 10.1017/s0033291714001834] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Evidence suggests some overlap between the pathological use of food and drugs, yet how impulsivity compares across these different clinical disorders remains unclear. Substance use disorders are commonly characterized by elevated impulsivity, and impulsivity subtypes may show commonalities and differences in various conditions. We hypothesized that obese subjects with binge-eating disorder (BED) and abstinent alcohol-dependent cohorts would have relatively more impulsive profiles compared to obese subjects without BED. We also predicted decision impulsivity impairment in obesity with and without BED. METHOD Thirty obese subjects with BED, 30 without BED and 30 abstinent alcohol-dependent subjects and age- and gender-matched controls were tested on delay discounting (preference for a smaller immediate reward over a larger delayed reward), reflection impulsivity (rapid decision making prior to evidence accumulation) and motor response inhibition (action cancellation of a prepotent response). RESULTS All three groups had greater delay discounting relative to healthy volunteers. Both obese subjects without BED and alcohol-dependent subjects had impaired motor response inhibition. Only obese subjects without BED had impaired integration of available information to optimize outcomes over later trials with a cost condition. CONCLUSIONS Delay discounting appears to be a common core impairment across disorders of food and drug intake. Unexpectedly, obese subjects without BED showed greater impulsivity than obese subjects with BED. We highlight the dissociability and heterogeneity of impulsivity subtypes and add to the understanding of neurocognitive profiles across disorders involving food and drugs. Our results have therapeutic implications suggesting that disorder-specific patterns of impulsivity could be targeted.
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Affiliation(s)
- T B Mole
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - M A Irvine
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - Y Worbe
- Behavioural and Clinical Neuroscience Institute,University of Cambridge,Cambridge,UK
| | - P Collins
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - S P Mitchell
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - S Bolton
- Department of Psychiatry,University of Cambridge,Cambridge,UK
| | - N A Harrison
- Brighton and Sussex Medical School,University of Sussex,Brighton,UK
| | - T W Robbins
- Behavioural and Clinical Neuroscience Institute,University of Cambridge,Cambridge,UK
| | - V Voon
- Department of Psychiatry,University of Cambridge,Cambridge,UK
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Georgiadou E, Gruner-Labitzke K, Köhler H, de Zwaan M, Müller A. Cognitive function and nonfood-related impulsivity in post-bariatric surgery patients. Front Psychol 2014; 5:1502. [PMID: 25566164 PMCID: PMC4271510 DOI: 10.3389/fpsyg.2014.01502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 12/05/2014] [Indexed: 12/11/2022] Open
Abstract
Initial evidence that cognitive function improves after bariatric surgery exists. The post-surgery increase in cognitive control might correspond with a decrease of impulsive symptoms after surgery. The present study investigated cognitive function and nonfood-related impulsivity in patients with substantial weight loss due to bariatric surgery by using a comparative cross-sectional design. Fifty post-bariatric surgery patients (postBS group) who had significant percent weight loss (M = 75.94, SD = 18.09) after Roux-en-Y gastric bypass (body mass index, BMI Mpost = 30.54 kg/m2, SDpost = 5.14) were compared with 50 age and gender matched bariatric surgery candidates (preBS group; BMI Mpre = 48.01 kg/m2, SDpre = 6.56). To measure cognitive function the following computer-assisted behavioral tasks were utilized: Iowa Gambling Task, Tower of Hanoi, Stroop Test, Trail Making Test-Part B, and Corsi Block Tapping Test. Impulsive symptoms and behaviors were assessed using impulsivity questionnaires and a structured interview for impulse control disorders (ICDs). No group differences were found with regard to performance-based cognitive control, self-reported impulsive symptoms, and ICDs. The results indicate that the general tendency to react impulsively does not differ between pre-surgery and post-surgery patients. The question of whether nonfood-related impulsivity in morbidly obese patients changes post-surgery should be addressed in longitudinal studies given that impulsive symptoms can be considered potential targets for pre- as well post-surgery interventions.
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Affiliation(s)
- Ekaterini Georgiadou
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School Hannover, Germany
| | | | - Hinrich Köhler
- Department of Surgery, Herzogin Elisabeth Hospital Braunschweig, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School Hannover, Germany
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Mitchell JE, Steffen K, Engel S, King WC, Chen JY, Winters K, Sogg S, Sondag C, Kalarchian M, Elder K. Addictive disorders after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2014; 11:897-905. [PMID: 25862182 DOI: 10.1016/j.soard.2014.10.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Recent literature suggests that some patients may develop addictive disorders after bariatric surgery, in particular after Roux-en-Y gastric bypass (RYGB). These may include traditional addictions and so called "behavioral addictions," although prevalence data on the latter have not been published. The objective of this study was to establish the prevalence of addictive behaviors in adults after RYGB. METHODS Participants from a large observational study of bariatric surgery who had undergone RYGB were recruited to complete additional measures. Of 241 consented participants, 201 provided data (i.e., Structured Clinical Interview for DSM-IV Axis I [SCID], additional Impulsive Control Disorder Modules, and various self-report measures, including the Alcohol Use Disorder Identification Test [AUDIT]) to assess status before surgery and in the first 3 postoperative years. RESULTS Based on the SCID, 16 (8.0%) developed alcohol use disorder [AUD] within 3 years post-RYGB, 7 (43.8%) of whom had no history of AUD. When both the SCID and AUDIT were used to identify AUD, the corresponding numbers/percentages were 32 (18.4%) and 13 (40.6%). Data on other behavioral addictive disorders indicated 19 (9.5%) had a postsurgery disorder, 6 (31.6%) of whom had no history. CONCLUSION These data add to a growing literature suggesting there is a substantial risk for the development of AUD after bariatric surgery. Understanding the risk for nondrug-related addictive disorders requires more data from larger studies before clear conclusions can be drawn.
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Affiliation(s)
- James E Mitchell
- Neuropsychiatric Research Institute and the University of North Dakota School of Medicine, Fargo, North Dakota.
| | - Kristine Steffen
- Neuropsychiatric Research Institute and the University of North Dakota School of Medicine, Fargo, North Dakota
| | - Scott Engel
- Neuropsychiatric Research Institute and the University of North Dakota School of Medicine, Fargo, North Dakota
| | - Wendy C King
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jia-Yuh Chen
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ken Winters
- University of Minnesota Medical School, Minneapolis, Minnesota
| | - Stephanie Sogg
- Massachusetts General Hospital Weight Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Cindy Sondag
- Neuropsychiatric Research Institute and the University of North Dakota School of Medicine, Fargo, North Dakota
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Abstract
Obesity has become a global epidemic with associated physical, psychological, and cognitive deficits that tax the healthcare system and result in a significant economic burden. These costs have necessitated treatment measures to reduce the incidence of obesity as well as comorbidities associated with obesity. We review the current literature in order to describe the pre-surgical psychological and cognitive characteristics of individuals undergoing bariatric surgery and the possible changes in these functions following surgery. We discuss the importance of a pre-surgical evaluation that adequately evaluates cognitive and emotional functioning and what this evaluation should entail. Finally, we discuss recent trends in the types of bariatric surgeries being performed and how these changes may influence subsequent physical, cognitive, and emotional health.
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Müller A, Claes L, Wilderjans TF, de Zwaan M. Temperament Subtypes in Treatment Seeking Obese Individuals: A Latent Profile Analysis. EUROPEAN EATING DISORDERS REVIEW 2014; 22:260-6. [DOI: 10.1002/erv.2294] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 04/19/2014] [Accepted: 04/21/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
| | - Tom F. Wilderjans
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
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Food-independent tendency to disadvantageous decisions in obese individuals with regular binge eating. Compr Psychiatry 2014; 55:64-70. [PMID: 24139851 DOI: 10.1016/j.comppsych.2013.08.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 08/07/2013] [Accepted: 08/08/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to explore whether or not obese patients with and without regular binge eating differ with regard to their decision-making abilities. METHODS Decision-making was measured by using a computerized version of the Iowa Gambling task (IGT) in 34 obese patients with regular binge eating (BE(+)) and 34 obese individuals without binge eating (BE(-)) matched for age and sex. In addition, computerized versions of the Auditory Verbal Learning Test and the Corsi Block Tapping Test were administered. Participants further answered questionnaires concerning eating disorder symptoms (Eating Disorder Examination-Questionnaire) and depression (Patient Health Questionnaire depression scale). RESULTS The BE(+) group reported more eating disorder and depressive symptoms than the BE(-) group but did not differ with regard to BMI, working memory deficits, depressive symptoms, somatic comorbidity (i.e., hypertension, diabetes, sleep apnea, hyperlipidemia, pain disorder), or education. Binge eating participants showed poorer decision-making abilities based on the total IGT net scores. However, they did not differ from those without regular binge eating in improving their choice behavior over the task. CONCLUSIONS The group difference in total IGT net scores suggests more general, food-independent decision making problems in obese individuals with regular binge eating compared to those without. Treatment of obese patients with BED could be enhanced by training them to better control risky decisions, to delay gratification in an effortful way and to activate appropriate alternative behaviors.
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Villarejo C, Jiménez-Murcia S, Álvarez-Moya E, Granero R, Penelo E, Treasure J, Vilarrasa N, Gil-Montserrat de Bernabé M, Casanueva FF, Tinahones FJ, Fernández-Real JM, Frühbeck G, de la Torre R, Botella C, Agüera Z, Menchón JM, Fernández-Aranda F. Loss of control over eating: a description of the eating disorder/obesity spectrum in women. EUROPEAN EATING DISORDERS REVIEW 2013; 22:25-31. [PMID: 24338827 DOI: 10.1002/erv.2267] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/08/2013] [Accepted: 10/11/2013] [Indexed: 11/11/2022]
Abstract
GOALS This study aimed to analyse the association, commonalities and differences between obesity and eating disorders (ED). METHOD A total of 150 female patients [50 obese with bulimia nervosa (OB + BN), 50 obese with binge eating disorders (OB + BED), 50 obese without eating disorders (OB)] and 50 female healthy-eating/weight control (CG) volunteers participated in this study. ASSESSMENT All participants were assessed by the Eating Disorders Inventory-2 (EDI-2), the Symptom Checklist-Revised (SCL-90-R) and the Temperament and Character Inventory-Revised. RESULTS In general, all the groups differed significantly and showed linear trends (OB + BN > OB + BED > OB > CG) on general and eating psychopathology (SCL-90-R and EDI-2). Regarding personality traits, statistically significant differences across all four groups were found on Harm Avoidance and Self-Directedness. Whereas some symptoms were shared in extreme weight conditions, others were specifically related to ED. CONCLUSIONS The presence of binge and purge symptomatology in obese patients is clinically relevant. These findings help to understand the relationship between Obesity and ED.
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Affiliation(s)
- Cynthia Villarejo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
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Abstract
While most conventional treatments for individuals with severe obesity have a modest and short lived impact bariatric surgery has been consistently shown to result in long-term marked weight loss and significant improvement in medical comorbidities. Empirical data suggest a high prevalence of mental disorders among bariatric surgery candidates. This article reviews specific areas of psychopathology, problems in using psychopharmacological medications post-surgery, body contouring, and recommendations for pre and post-surgery care. Available research indicates a decrease in psychiatric symptoms post-surgery. However, in some patients the improvement appears to erode over time. Therefore, bariatric surgery patients should be monitored not only before surgery but also following surgery and referred for mental health treatment if problems develop.
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Giel KE, Schag K, Plewnia C, Zipfel S. Antisaccadic training to improve impulsivity in binge eating disorder. EUROPEAN EATING DISORDERS REVIEW 2013; 21:488-92. [PMID: 23893405 DOI: 10.1002/erv.2245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 06/29/2013] [Indexed: 11/06/2022]
Abstract
Patients with binge eating disorder (BED) show generally increased impulsivity and especially increased food-related impulsivity. Both are closely linked to the core pathology of BED, which relates to regular binge eating episodes with experienced loss of control. The antisaccade task is an established paradigm assessing response inhibition as a pivotal component of impulsivity. It requires participants to execute antisaccades; that is, they are supposed to look in the opposite direction of a stimulus that automatically catches attention by appearing in the peripheral visual field. High rates of prosaccades to the peripheral stimuli are considered indicators of increased impulsivity. Presenting food pictures as peripheral stimuli, this task can be used to investigate food-related impulsivity. We propose modifications of this task in order to design it as an antisaccadic training in which BED patients practise the suppression of food-related responses, which should result in enhanced control over their eating behaviour.
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Affiliation(s)
- Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Germany
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Schag K, Schönleber J, Teufel M, Zipfel S, Giel KE. Food-related impulsivity in obesity and binge eating disorder--a systematic review. Obes Rev 2013; 14:477-95. [PMID: 23331770 DOI: 10.1111/obr.12017] [Citation(s) in RCA: 281] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/06/2012] [Accepted: 12/11/2012] [Indexed: 12/17/2022]
Abstract
Impulsivity towards food has been recognized as a potential factor leading to increased food intake in obesity. Patients suffering from binge eating disorder (BED) form a specific subgroup of obese people that might be characterized by increased impulsivity. These assumptions, although, have yet to be verified. Therefore, this review evaluates evidence for food-related impulsivity in obese people with and without BED and examines possible differences between both populations. More precisely, evidence for the two components of impulsivity is analyzed separately: evidence for reward sensitivity, specifically, the urge for appetitive stimuli and evidence for rash-spontaneous behaviour such as acting disinhibited with no regard for the consequences. Our search resulted in 51 articles demonstrating generally increased food-related impulsivity. We found particular emphasis on increased reward sensitivity in obese people, which appeared to be more pronounced in people with BED. There was little and conflicting evidence, however, concerning increased rash-spontaneous behaviour in obese people without BED, but consistent evidence of an increase in obese people with BED. All in all, the evidence supports the view that BED represents a specific phenotype of obesity with increased food-related impulsivity. Taking these specific deficits into account can enhance the effectiveness of weight reduction programmes and psychotherapy.
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Affiliation(s)
- K Schag
- Department of Psychosomatic Medicine and Psychotherapy, University of Tübingen, Tübingen, Germany.
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