Using an OCD formulation in the treatment of anorexia nervosa: a useful way to understand the illness?

AbstractAnorexia nervosa (AN) and obsessive compulsive disorder (OCD) have been shown to have a number of commonalities, such as genetics, neurobiology, and symptoms. Approaches to treatment of AN have recently been described that take such findings into account, extending interventions recommended for obsessive compulsive and anxiety disorders to AN. The current paper aims to outline a formulation model of AN in adults, derived from the literature on OCD, and introduce this topic as a fruitful area to build on existing treatment techniques, and to prompt further discussion of such techniques. A formulation model is described, followed by a discussion of how this might be applied to AN, using examples from clinical practice. Potential benefits and difficulties are discussed. A formulation model is suggested that can easily be adapted to AN, complementing existing models in eating disorders.

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Predicting Eating Disorder and Anxiety Symptoms Using Anorexia Nervosa and Obsessive-Compulsive Disorder Polygenic Scores

10.1101/2020.07.02.20142844 ◽

2020 ◽

Author(s):

Zeynep Yilmaz ◽

Katherine Schaumberg ◽

Matt Halvorsen ◽

Erica L. Goodman ◽

Leigh C. Brosof ◽

...

Keyword(s):

Eating Disorders ◽

Sex Differences ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Obsessive Compulsive Disorder ◽

Genetic Risk ◽

Anxiety Symptoms ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Polygenic Scores

Clinical, epidemiological, and genetic findings support an overlap between eating disorders, obsessive-compulsive disorder (OCD), and anxiety symptoms. However, little research has examined the role of genetic factors in the expression of eating disorders and OCD/anxiety phenotypes. We examined whether the anorexia nervosa (AN), OCD, or AN/OCD transdiagnostic polygenic scores (PGS) predict eating disorders, OCD, and anxiety symptoms in a large population-based developmental cohort. Using summary statistics files from the Psychiatric Genomics Consortium Freeze 2 AN and Freeze 1 OCD GWAS, we first conducted an AN/OCD transdiagnostic GWAS meta-analysis and then calculated PGS for AN, OCD, and AN/OCD in participants from the Avon Longitudinal Study of Parents and Children with available genetic and phenotype data on eating disorder, OCD, and anxiety diagnoses and symptoms (sample size 3,212-5,369 per phenotype). We observed sex differences in the PGS prediction of eating disorder, OCD, and anxiety-related phenotypes, with AN genetic risk manifesting at an earlier age and playing a more prominent role in eating disorder phenotypes in boys than in girls. Compulsive exercise was the only phenotype predicted by all three PGS (e.g., PAN(boys)=0.0141 at age 14; POCD(girls)=0.0070 at age 16; PAN/OCD(all)=0.0297 at age 14). Our results suggest that earlier detection of eating disorder, OCD, and anxiety-related symptoms could be made possible by including measurement of genetic risk for these psychiatric conditions while being mindful of sex differences.

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Behaviour

10.1093/med:psych/9780198528883.003.0006 ◽

2015 ◽

Author(s):

Allison G. Harvey ◽

Edward Watkins ◽

Warren Mansell ◽

Roz Shafran

Keyword(s):

Eating Disorders ◽

Anxiety Disorders ◽

Sleep Disorders ◽

Obsessive Compulsive Disorder ◽

Somatoform Disorders ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Substance Related Disorders ◽

Safety Signals

Chapter 6 reviews the literature on behavioural processes and draws conclusions about the extent to which they are transdiagnostic. Three behavioural processes considered are escape/avoidance, within-situation safety-seeking behaviours, and ineffective safety-signals. These processes are considered in the context of anxiety disorders and obsessive-compulsive disorder (OCD), somatoform disorders, eating disorders, sleep disorders, and substance-related disorders).

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Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

Psychiatry Journal ◽

10.1155/2015/186927 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Himanshu Tyagi ◽

Rupal Patel ◽

Fabienne Rughooputh ◽

Hannah Abrahams ◽

Andrew J. Watson ◽

...

Keyword(s):

Eating Disorders ◽

Eating Disorder ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Obsessive Compulsive Disorder ◽

Geographical Area ◽

Primary Diagnosis ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference

Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD) and other common anxiety disorders.Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups.Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group.Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population.

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Eating Disorders and Tourette Syndrome: A Case Series of Comorbidity and Associated Obsessive-Compulsive Symptomatology

CNS Spectrums ◽

10.1017/s109285290001141x ◽

1999 ◽

Vol 4 (2) ◽

pp. 77-80, 86 ◽

Cited By ~ 5

Author(s):

Angela S. Guarda ◽

Janet Treasure ◽

Mary M. Robertson

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Obsessive Compulsive Disorder ◽

Tourette Syndrome ◽

Case Series ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder

AbstractThere is a well-established overlap in phenomenology between anorexia nervosa and obsessive-compulsive disorder, and between obsessive-compulsive symptoms and Tourette syndrome (TS). Five cases of eating disorders in patients with obsessive-compulsive symptoms and TS are presented. The identification of four similar cases in the literature putatively marks a subset of eating disorders with a link to TS and to obsessive-compulsive symptomatology. This association may reflect a common underlying neurobiologic imbalance.

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