Skin Signs due to Psychiatric Morbidity: Psychogenic Skin Excoriations in Eating Disorders

OBJECTIVE Eating disorders (EDs) are serious, complex illnesses with both behavioral and physical health features. EDs have high rates of medical and psychiatric morbidity, and a 6% mortality rate, the highest of any mental illness. Early detection of EDs offers the best opportunity for recovery; yet, estimates are that as few as one in 10 individuals with an ED receive treatment. The purpose of this article is to provide an ED identification and management overview for inpatient nurse clinicians in general psychiatric and medical settings, helping to facilitate timely recognition and care. METHOD An overview of ED diagnostic criteria and two evidence-based ED tools are introduced for consideration. RESULTS Opportunities to identify and help manage an ED are numerous. Most individuals with an ED make several health care visits in either medical or psychiatric settings without ever being screened for an ED. General ED screening and assessment tool familiarization can facilitate a treatment trajectory for these patients, improve overall quality of life, and may potentially result in a life-saving intervention for this often-deadly cluster of medical and psychiatric disorders. CONCLUSION Screening and assessment in general clinical settings, identifying patients with undiagnosed EDs, beginning basic treatment plans, and referrals for appropriate follow-up care, have the potential to reduce ED recidivism and related health care costs. Simultaneously, and most important, long-term outcomes for patients with EDs may improve.

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Prevalence of eating disorders and minor psychiatric morbidity in Central Europe before the political changes in 1989: a cross-cultural study

Psychological Medicine ◽

10.1017/s0033291700037521 ◽

1995 ◽

Vol 25 (5) ◽

pp. 1027-1035 ◽

Cited By ~ 27

Author(s):

G. Rathner ◽

F. Túry ◽

P. Szabó ◽

M. Geyer ◽

G. Rumpold ◽

...

Keyword(s):

Eating Disorders ◽

Bulimia Nervosa ◽

Psychological Health ◽

Western Europe ◽

Psychiatric Morbidity ◽

Epidemiological Studies ◽

Eating Attitudes ◽

Political Organization ◽

The Political ◽

Western Democracy

SYNOPSISThe prevalence of culture-bound syndromes such as eating disorders in the countries of Central and Eastern Europe is unclear and comparative epidemiological studies are lacking. Before the political changes in 1989 we therefore investigated eating disorders, eating attitudes and psychological health in two Eastern European countries and in one Western democracy. A total of 1225 female and male medical students in Hungary, the German Democratic Republic (GDR) and Austria were surveyed. The instruments included the Eating Disorder Inventory and the GHQ. The prevalence of eating disorders was calculated on the basis of simulated DSM-III-R diagnosis. In females, bulimia nervosa prevalence rates of 0·6% (95% CI 0·02, 3·46), 1% (0·2, 2·95) and 0% (0, 2·07) were calculated for Austria, Hungary and the GDR, respectively. For subclinical bulimia nervosa, the rate for Hungary (3·8%; 1·95, 6·72) was twice as high as for Austria (1·9%; 0·39, 5·5) and the GDR (1·7%; 0·36, 4·88). Hungarian subjects indicated more psychiatric ‘caseness’ than their GDR or Austrian counterparts. We conclude that eating disorders represented at least as common a problem in Eastern as Western Europe before the changes in political organization. This may be due to an identification process with Western values. A further increase of eating disorders in these countries induced by the recent changes may be possible.

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Skin signs in eating disorders: a literature review

Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity ◽

10.1007/s40519-021-01241-1 ◽

2021 ◽

Author(s):

Tonia Samela ◽

Francesca Sampogna ◽

Mariantonietta Fabbricatore ◽

Luca Fania ◽

Elena Sofia Papanikolaou ◽

...

Keyword(s):

Eating Disorders ◽

Literature Review ◽

Skin Signs

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Is There An Overlap Between Eating Disorders and Neurodevelopmental Disorders in Children with Obesity?

Nutrients ◽

10.3390/nu11102496 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2496 ◽

Cited By ~ 3

Author(s):

Elisabet Wentz ◽

Anna Björk ◽

Jovanna Dahlgren

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Medical Records ◽

Psychiatric Morbidity ◽

Autism Spectrum ◽

Eating Disorder Inventory ◽

Eating Disorder Examination Questionnaire ◽

Eating Disorder Examination ◽

Hyperactivity Disorder ◽

Weight And Shape Concerns

This study aimed at assessing the prevalence of eating disorders (EDs) and ED symptomatology in children with obesity, and at investigating whether EDs occur more often among individuals with a comorbid attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Seventy-six children (37 girls, 39 boys, age 5–16 years) were recruited at an outpatient obesity clinic. The adolescents completed ED instruments including The Eating Disorder Examination Questionnaire (EDE-Q) and The Eating Disorder Inventory for children (EDI-C). The parents of all participants were interviewed regarding the child’s psychiatric morbidity. Diagnoses of ADHD and ASD were collected from medical records. Anthropometric data were compiled. Eight participants (11%) fulfilled the criteria for a probable ED and 16 participants (21%) had ADHD and/or ASD. Two adolescent girls had a probable ED and coexistent ADHD and ASD. No other overlaps between EDs and ADHD/ASD were observed. Loss of control (LOC) eating was present in 26 out of 40 (65%) adolescents, seven of whom had ADHD, ASD or both. LOC eating was not overrepresented among teenagers with ADHD and/or ASD. Weight and shape concerns were on a par with age-matched adolescents with EDs. EDs and ED behavior are more common among children/adolescents with obesity than in the general population. There is no substantial overlap between EDs and ADHD/ASD in adolescents with obesity.

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Gender differences in intimate partner violence and psychiatric disorders in England: results from the 2007 adult psychiatric morbidity survey

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796013000292 ◽

2013 ◽

Vol 23 (2) ◽

pp. 189-199 ◽

Cited By ~ 33

Author(s):

S. Jonas ◽

H. Khalifeh ◽

P. E. Bebbington ◽

S. McManus ◽

T. Brugha ◽

...

Keyword(s):

Eating Disorders ◽

Intimate Partner Violence ◽

Psychiatric Disorders ◽

Partner Violence ◽

Common Mental Disorders ◽

Psychiatric Morbidity ◽

Intimate Partner ◽

Post Traumatic Stress ◽

Alcohol Disorders ◽

Men And Women

Aims.To assess the extent to which being a victim of intimate partner violence (IPV) is associated with psychiatric disorders in men and women.Methods.A stratified multistage random sample was used in the third English psychiatric morbidity survey. Psychiatric disorders were measured by the Clinical Interview Schedule (Revised) and screening questionnaires. IPV was measured using British Crime Survey questions.Results.18.7% (95% CI 17.1–20.4; n = 595 of 3197) of men had experienced some form of IPV compared with 27.8% of women (95% CI 26.2–29.4; n = 1227 of 4206; p < 0.001). IPV was associated with all disorders measured (except eating disorders in men). Physical IPV was significantly linked to psychosis and with substance and alcohol disorders in men and women, but significant associations with common mental disorders (CMDs), post-traumatic stress disorder (PTSD) and eating disorders were restricted to women. Emotional IPV was associated with CMDs in men and women.Conclusions.The high prevalence of experiences of partner violence, and strength of the association with every disorder assessed, suggests enquiry about partner violence is important in identifying a potential risk and maintenance factor for psychiatric disorders, and to ascertain safety, particularly in women as they are at greatest risk of being victims of violence.

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Eating Disorders and Psychiatric Morbidity in Patients with Diabetes mellitus

Psychotherapy and Psychosomatics ◽

10.1159/000288052 ◽

1987 ◽

Vol 48 (1-4) ◽

pp. 189-195 ◽

Cited By ~ 11

Author(s):

G.G. Lloyd ◽

J.M. Steel ◽

R.J. Young

Keyword(s):

Diabetes Mellitus ◽

Eating Disorders ◽

Psychiatric Morbidity ◽

Patients With Diabetes

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Prognosis and Treatment of Skin Signs in Eating Disorders

Eating Disorders and the Skin ◽

10.1007/978-3-642-29136-4_17 ◽

2012 ◽

pp. 93-93

Author(s):

Renata Strumia

Keyword(s):

Eating Disorders ◽

Skin Signs

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Current and Emerging Directions in the Treatment of Eating Disorders

Substance Abuse Research and Treatment ◽

10.4137/sart.s7864 ◽

2012 ◽

Vol 6 ◽

pp. SART.S7864 ◽

Cited By ~ 8

Author(s):

Tiffany A. Brown ◽

Pamela K. Keel

Keyword(s):

Eating Disorders ◽

Affect Regulation ◽

Selective Serotonin Reuptake Inhibitors ◽

Behavioral Therapy ◽

Psychiatric Morbidity ◽

Stepped Care ◽

Future Directions ◽

Emerging Treatments ◽

Family Based ◽

High Comorbidity

Eating disorders are a significant source of psychiatric morbidity in young women and demonstrate high comorbidity with mood, anxiety, and substance use disorders. Thus, clinicians may encounter eating disorders in the context of treating other conditions. This review summarizes the efficacy of current and emerging treatments for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Treatment trials were identified using electronic and manual searches and by reviewing abstracts from conference proceedings. Family based therapy has demonstrated superiority for adolescents with AN but no treatment has established superiority for adults. For BN, both 60 mg fluoxetine and cognitive behavioral therapy (CBT) have well-established efficacy. For BED, selective serotonin reuptake inhibitors, CBT, and interpersonal psychotherapy have demonstrated efficacy. Emerging directions for AN include investigation of the antipsychotic olanzapine and several novel psychosocial treatments. Future directions for BN and BED include increasing CBT disseminability, targeting affect regulation, and individualized stepped-care approaches.

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