Suicidal ideation in a sample with a first-episode of restrictive eating disorders: the role of biomarkers

Abstract Background and aims Oxytocin, a nine amino acid peptide synthesised in the hypothalamus, has been widely recognised for its role in anxiolysis, bonding, sociality, and appetite. It binds to the oxytocin receptor (OXTR)—a G-protein coupled receptor—that is stimulated by the actions of oestrogen both peripherally and centrally. Studies have implicated OXTR genotypes in conferring either a risk or protective effect in autism, schizophrenia, and eating disorders (ED). There are numerous DNA variations of this receptor, with the most common DNA variation being in the form of the single nucleotide polymorphisms (SNPs). Two OXTR SNPs have been most studied in relation to ED: rs53576 and rs2254298. Each SNP has the same allelic variant that produces genotypes AA, AG, and GG. In this critical review we will evaluate the putative role of rs53576 and rs2254298 SNPs in ED. Additionally, this narrative review will consider the role of gene-environment interactions in the development of ED pathology. Findings The OXTR SNPs rs53576 and rs2254298 show independent associations between the A allele and restrictive eating behaviours. Conversely, the G allele of the OXTR rs53576 SNP is associated with binging behaviours, findings that were also evident in neuroanatomy. One study found the A allele of both OXTR SNPs to confer risk for more severe ED symptomatology while the G allele conferred some protective effect. An interaction between poor maternal care and rs2254298 AG/AA genotype conferred increased risk for binge eating and purging in women. Conclusions Individual OXTR SNP are unlikely in themselves to explain complex eating disorders but may affect the expression of and/or effectiveness of the OXTR. A growing body of G x E work is indicating that rs53576G homozygosity becomes disadvantageous for later mental health under early adverse conditions but further research to extend these findings to eating pathology is needed. The GWAS approach would benefit this area of knowledge.

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Gland New Psychosis: New Onset Adult Psychosis with Suicidal Ideation and Attempt in the Setting of Thyroid Storm

Case Reports in Psychiatry ◽

10.1155/2017/7402923 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Esteban Cota ◽

Jacob Lentz

Keyword(s):

Suicidal Ideation ◽

Psychiatric Illness ◽

Thyroid Storm ◽

First Episode ◽

Visual Hallucinations ◽

Self Injury ◽

Life Threatening ◽

Psychiatric Sequelae ◽

New Onset

We present a case of new onset psychosis in the setting of thyroid storm in a woman with no previous psychiatric history. The patient presented with ongoing suicidal ideation, a suicide attempt that was interrupted by her husband, and audio and visual hallucinations. The patient was placed on a psychiatric hold and treated for thyrotoxicosis as well as psychosis. Treatment of the thyroid hormone overload resulted in a rapid resolution of her symptoms; she was discharged in excellent condition, and she has had no repeat hallucinations or self-injury ideation or attempts since. Although rare, thyrotoxicosis is a potentially life-threatening cause of psychiatric illness and should always be kept on the differential diagnosis for a patient with a first episode of psychosis. This case highlights how thyroid storm physiology, beyond its well-studied hemodynamic and metabolic instability, can be potentially fatal due to psychiatric sequelae. It also highlights the crucial role of a thorough history and physical exam in all patients.

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Development of eating disorders among early-maltreated women: The role of attachment styles and maladaptive schemas

PsycEXTRA Dataset ◽

10.1037/e514412014-348 ◽

2007 ◽

Author(s):

Alla Skomorovsky ◽

Kimberly Matheson

Keyword(s):

Eating Disorders ◽

Attachment Styles ◽

Maladaptive Schemas

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A Family-based Intervention of Adolescents With Eating Disorders: the Role of Assertiveness

10.26226/morressier.58aaed5ad462b8028d8911dd ◽

2017 ◽

Author(s):

Gustavo Gonzalez-Cuevas

Keyword(s):

Eating Disorders ◽

Family Based

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Role of glia in prefrontal white matter abnormalities in first episode psychosis or mania detected by diffusion tensor spectroscopy

Schizophrenia Research ◽

10.1016/j.schres.2019.05.018 ◽

2019 ◽

Vol 209 ◽

pp. 64-71 ◽

Cited By ~ 5

Author(s):

Kathryn E. Lewandowski ◽

Fei Du ◽

Xiaoying Fan ◽

Xi Chen ◽

Polly Huynh ◽

...

Keyword(s):

White Matter ◽

Diffusion Tensor ◽

First Episode Psychosis ◽

First Episode ◽

White Matter Abnormalities ◽

Episode Psychosis

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Higher Caloric Refeeding Is Safe in Hospitalised Adolescent Patients with Restrictive Eating Disorders

Journal of Nutrition and Metabolism ◽

10.1155/2016/5168978 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 12

Author(s):

Elizabeth K. Parker ◽

Sahrish S. Faruquie ◽

Gail Anderson ◽

Linette Gomes ◽

Andrew Kennedy ◽

...

Keyword(s):

Eating Disorders ◽

Weight Gain ◽

Statistical Significance ◽

Caloric Intake ◽

Tube Feeding ◽

Retrospective Chart Review ◽

Refeeding Syndrome ◽

Restrictive Eating ◽

Weight Restoration ◽

The Mean

Introduction. This study examines weight gain and assesses complications associated with refeeding hospitalised adolescents with restrictive eating disorders (EDs) prescribed initial calories above current recommendations.Methods. Patients admitted to an adolescent ED structured “rapid refeeding” program for >48 hours and receiving ≥2400 kcal/day were included in a 3-year retrospective chart review.Results. The mean (SD) age of the 162 adolescents was 16.7 years (0.9), admission % median BMI was 80.1% (10.2), and discharge % median BMI was 93.1% (7.0). The mean (SD) starting caloric intake was 2611.7 kcal/day (261.5) equating to 58.4 kcal/kg (10.2). Most patients (92.6%) were treated with nasogastric tube feeding. The mean (SD) length of stay was 3.6 weeks (1.9), and average weekly weight gain was 2.1 kg (0.8). No patients developed cardiac signs of RFS or delirium; complications included 4% peripheral oedema, 1% hypophosphatemia (<0.75 mmol/L), 7% hypomagnesaemia (<0.70 mmol/L), and 2% hypokalaemia (<3.2 mmol/L). Caloric prescription on admission was associated with developing oedema (95% CI 1.001 to 1.047;p=0.039). No statistical significance was found between electrolytes and calories provided during refeeding.Conclusion. A rapid refeeding protocol with the inclusion of phosphate supplementation can safely achieve rapid weight restoration without increased complications associated with refeeding syndrome.

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The Role of Aerosol Pentamidine Prophylaxis

International Journal of STD & AIDS ◽

10.1177/095646249300400202 ◽

1993 ◽

Vol 4 (2) ◽

pp. 67-69

Author(s):

E L C Ong

Keyword(s):

Cell Count ◽

Pneumocystis Carinii Pneumonia ◽

Lymphocyte Count ◽

Pneumocystis Carinii ◽

Total Lymphocyte Count ◽

First Episode ◽

Cd4 Cell Count ◽

Drug Of Choice ◽

Cd4 Cell

Pneumocystis carinii pneumonia (PCP) is the most frequent opportunistic infection in patients with AIDS, occurring in 80% and recurring in 50% of patients within 12 months of the first episode. Prophylaxis for PCP is recommended if the CD4+ cell count is <200×106/l or 20% of the total lymphocyte count, or after an episode of PCP. The most effective prophylactic agent currently is trimethoprim-sulphamethoxazole and should be the drug of choice but alternatives such as aerosol pentamidine are being increasingly used for patients who cannot tolerate this combination or other oral preparations. If aerosol pentamidine is used and administered via a Respigard II Marquest nebulizer, the dosage should be higher than the currently recommended monthly dosage of 300 mg.

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“I’m truly free from my eating disorder”: Emerging adults’ experiences of FREED, an early intervention service model and care pathway for eating disorders

Journal of Eating Disorders ◽

10.1186/s40337-020-00354-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Rachel Potterton ◽

Amelia Austin ◽

Michaela Flynn ◽

Karina Allen ◽

Vanessa Lawrence ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Early Intervention ◽

Emerging Adults ◽

Care Pathway ◽

Support Network ◽

First Episode ◽

Service Model ◽

Access To Treatment ◽

Rapid Access

Abstract Background Eating disorders (EDs) typically start during adolescence or emerging adulthood, periods of intense biopsychosocial development. FREED (First Episode Rapid Early Intervention for EDs) is a service model and care pathway providing rapid access to developmentally-informed care for emerging adults with EDs. FREED is associated with reduced duration of untreated eating disorder and improved clinical outcomes, but patients’ experiences of treatment have yet to be assessed. Objective This study aimed to assess emerging adults’ experiences of receiving treatment through FREED. Method This study triangulated qualitative data on participants’ experiences of FREED treatment from questionnaires and semi-structured interviews. Participants were 106 emerging adults (aged 16–25; illness duration < 3 yrs) (questionnaire only = 92; interview only = 6; both = 8). Data were analysed thematically. Results Most participants reported psychological and behavioural changes over the course of treatment (e.g. reduction in symptoms; increased acceptance and understanding of difficulties). Participants identified five beneficial characteristics of FREED treatment: i) rapid access to treatment; ii) knowledgeable and concerned clinicians; iii) focusing on life beyond the eating disorder; iv) building a support network; v) becoming your own therapist. Conclusion This study provides further supports for the implementation of early intervention and developmentally-informed care for EDs. Future service model development should include efforts to increase early help-seeking.

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Role of SES on the association between childhood parental death and adulthood suicidal ideation: a mediation analysis using longitudinal dataset in South Korea

BMC Psychiatry ◽

10.1186/s12888-021-03146-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jaehong Yoon ◽

Ja Young Kim ◽

Ji-Hwan Kim ◽

Seung-Sup Kim

Keyword(s):

Suicidal Ideation ◽

South Korea ◽

Mediation Analysis ◽

Household Income ◽

Parental Death ◽

Middle Adulthood ◽

Late Adulthood ◽

Mediating Role ◽

Direct Association

Abstract Background We sought to examine the association between childhood experience of parental death (CEPD) and adulthood suicidal ideation, and the mediating role of adulthood SES in the association. Methods We analyzed a nationally representative dataset of 8609 adults from the Korea Welfare Panel Study, which is a longitudinal cohort dataset in South Korea. CEPD was measured using a question: “During your childhood (0-17 years old), have you experienced the death of parents?” We classified responses of CEPD during 2006–2011 into ‘yes,’ and the others into ‘no.’ Suicidal ideation over the past year was assessed annually during 2012–2019. As a potential mediator, adulthood educational attainment and household income in 2011 were included in the analysis. Logistic regression was applied to examine the association of CEPD with adulthood suicidal ideation across age groups (early adulthood, 19–39 years old; middle adulthood, 40–59 years old; late adulthood, ≥60 years old), after excluding people who reported lifetime suicidal ideation in 2011. Causal mediation analysis using a parametric regression model was applied to examine the mediating role of adulthood SES in the association between CEPD and adulthood suicidal ideation. Results After adjusting for potential confounders including childhood SES, CEPD was significantly associated with adulthood suicidal ideation among the late adulthood group (OR: 1.43; 95% CI: 1.13–1.81), while the association was not statistically significant among the early; and middle adulthood groups. In mediation analysis of adulthood household income, both indirect association (ORNIE: 1.05; 95% CI: 1.02–1.09) and direct association (ORNDE: 1.37; 95% CI: 1.09–1.73) were statistically significant among the late adulthood group. In the mediation analysis of adulthood education attainment among the late adulthood, only a direct association was statistically significant (ORNDE: 1.43; 95% CI: 1.14–1.80). Conclusions These results suggest that CEPD could be a risk factor for adulthood suicidal ideation. Furthermore, the findings imply that income security policy might be necessary to reduce suicide among the late adulthood group.

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