BACKGROUND: Both eating disorders and excessive internet use represent significant health issues for contemporary adolescents. Yet, the link between them has seldom been investigated. We aim to study this association through their common underlying psychological factors: internalising problems and externalising problems. METHODS: A representative sample of 7,083 adolescents (Mage = 13.48 years; SDage = 1.32; 50.3% girls) from Slovakia was obtained from the Health Behaviour in School-aged Children (HBSC) project in 2018. Study variables included the Excessive Internet Use Scale (EIU) and the Strength and Difficulties Questionnaire (SDQ). Eating disorders symptoms (EDS) were assessed by SCOFF and selected items from the Eating Disorder Screen for Primary Care (ESP). Data were analysed separately for boys and girls with Structural Equation Modelling. RESULTS: There was a partial correlation between EDS and EIU (r = 0.36 for boys and r = 0.29 for girls) after controlling for the internalising and externalising of problems. Internalising and externalising problems were positively associated with EDS, while EIU was only associated with externalising problems. The results were comparable for both genders. CONCLUSION: The study provides evidence that, during adolescence, EDS and EIU are related and have a tendency to occur together. Also, they are related even when controlled for their shared underlying psychological factors, namely the emotional and attentional/behavioural difficulties.

The study found that, in adolescents, eating disorders symptoms are associated with excessive internet use even when controlled for their shared psychological factors. Self-control issues were associated with both the eating disorder symptoms and excessive internet use, while emotional issues were only associated with the eating disorder symptoms. The strength of the relationship was similar for boys and girls, even though the prevalence of eating disorders symptoms was double in girls.

• Klíčová slova
• Adolescents, Eating disorders symptoms, Excessive internet use, Externalising problems, Internalising problems,
• Publikační typ
• časopisecké články MeSH

PURPOSE: People with eating disorders (EDs) have difficulties understanding their own emotions and recognizing the emotions of others, especially in ambiguous settings. We examined the neuronal mechanisms underlying the emotion processing of ambiguous interpersonal stimuli in EDs and healthy controls (HCs). METHODS: The fMRI data were acquired by a blocked experimental design with 28 women (14 EDs) during the visual presentation of a modified Thematic Apperception Test. RESULTS: EDs showed very strong associations between experienced and inferred emotions evoked by the stimuli; no such relationship was found in HCs. HCs displayed elevated left anterior insula activity during the mentalizing condition; EDs showed increased activity in the right supramarginal gyrus and medial prefrontal cortex. CONCLUSION: The two groups seem to apply different strategies for judging emotionally ambiguous stimuli, albeit resulting in equivalent judgments. We assume that activity in the supramarginal gyrus and insula in EDs is linked with suppressing their own perspective while considering emotional states, probably due to alexithymia and the lack of awareness of their own mental states. We hypothesize that the strong correlation between experienced and inferred emotions in EDs could reflect their tendency to use others as a reference point for perceiving themselves and gaining information about their affective state. LEVEL OF EVIDENCE: No level of evidence, this is a basic science study.

• Klíčová slova
• Ambiguity, Eating disorders, Mentalization, Right supramarginal gyrus, Thematic apperception test, fMRI,
• MeSH
• afektivní symptomy MeSH
• emoce MeSH
• lidé MeSH
• magnetická rezonanční tomografie * MeSH
• pilotní projekty MeSH
• poruchy příjmu potravy * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. AIMS: (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. METHODS: The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). RESULTS: Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. CONCLUSIONS: The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.

• Klíčová slova
• COVID-19 Isolation Eating Scale (CIES), COVID-19 lockdown, eating disorders, eating symptoms, psychological impact,
• MeSH
• COVID-19 prevence a kontrola   psychologie   MeSH
• dítě MeSH
• dospělí MeSH
• internacionalita MeSH
• karanténa psychologie   MeSH
• lidé MeSH
• longitudinální studie MeSH
• mladiství MeSH
• mladý dospělý MeSH
• poruchy příjmu potravy psychologie   MeSH
• SARS-CoV-2 MeSH
• sociální izolace psychologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH
• Geografické názvy
• Asie MeSH
• Evropa MeSH

OBJECTIVE: The goal of this study is to determine how a comprehensive approach comprising a combination of a particular psychotherapeutic programme and antidepressant treatment influences the signs and symptoms of eating disorders. METHODS: Inpatients entering a particular 6-week programme were assessed using body mass index (BMI), Eating Disorder Inventory (EDI), Eating Attitudes Test (EAT-26) and psychological symptoms using Symptom Checklist (SCL-90). RESULTS: In the whole group (n=84) the mean BMI remained stable (17.9, 17.8). There was a significant effect of TIME in the repeated measures ANOVA with most of dependent variables. The "TREATMENT" had no effect (antidepressants, no antidepressants) and there was no significant interaction between "TREATMENT" and "TIME". Post-hoc analysis revealed significant differences between baseline and end-point values of all but two EDI, all EAT items and some SCL dimensions in the antidepressant-treated group. CONCLUSIONS: The comprehensive and individualized approach is able to achieve weight stabilization, and improvement in attitudes, pathological eating behaviour and psychopathology.

• MeSH
• analýza rozptylu MeSH
• antidepresiva terapeutické užití   MeSH
• časové faktory MeSH
• dospělí MeSH
• index tělesné hmotnosti * MeSH
• individualizovaná medicína * metody   MeSH
• kombinovaná terapie MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• osobnostní dotazník MeSH
• pacienti hospitalizovaní MeSH
• poruchy příjmu potravy diagnóza   patofyziologie   psychologie   terapie   MeSH
• prospektivní studie MeSH
• psychoterapie * metody   MeSH
• tělesná hmotnost * účinky léků   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antidepresiva MeSH

A substantive literature has drawn a compelling case for the functional involvement of mesolimbic/prefrontal cortical neural reward systems in normative control of eating and in the etiology and persistence of severe eating disorders that affect diverse human populations. Presently, we provide a short review that develops an equally compelling case for the importance of dysregulated frontal cortical cognitive neural networks acting in concert with regional reward systems in the regulation of complex eating behaviors and in the presentation of complex pathophysiological symptoms associated with major eating disorders. Our goal is to highlight working models of major eating disorders that incorporate complementary approaches to elucidate functionally interactive neural circuits defined by their regulatory neurochemical phenotypes. Importantly, we also review evidence-based linkages between widely studied psychiatric and neurodegenerative syndromes (e.g., autism spectrum disorders and Parkinson's disease) and co-morbid eating disorders to elucidate basic mechanisms involving dopaminergic transmission and its regulation by endogenously expressed morphine in these same cortical regions.

• MeSH
• fenotyp MeSH
• kognice fyziologie   MeSH
• lidé MeSH
• nervový přenos fyziologie   MeSH
• odměna * MeSH
• poruchy příjmu potravy patofyziologie   MeSH
• prefrontální mozková kůra patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). METHODS: Eleven ED services located in seven European countries recruited patients with an ED. Clinicians administered an adapted version of the World Health Organization "Encounter Form," a standardized tool to assess the pathways to care. The unadjusted overall time needed to access the ED unit was described using the Kaplan-Meier curve. RESULTS: Four-hundred-nine patients were recruited. The median time between the onset of the current ED episode and the access to a specialized ED care was 2 years. Most of the participants did not directly access the specialist ED unit: primary "points of access" to care were mental health professionals and general practitioners. The involvement of different health professionals in the pathway, seeking help for general psychiatric symptoms, and lack of support from family members were associated with delayed access to ED units. CONCLUSIONS: Educational programs aiming to promote early diagnosis and treatment for EDs should pay particular attention to general practitioners, in addition to mental health professionals, and family members to increase awareness of these illnesses and of their treatment initiation process.

• Klíčová slova
• Barriers, eating disorders, educational, health care policy, pathways to care,
• MeSH
• lidé MeSH
• poruchy příjmu potravy * diagnóza   terapie   MeSH
• rodina MeSH
• zdravotnický personál MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

Comorbid psychopathology, including self-harm and suicidal behavior, is often found in patients with eating disorders. To better understand the reasons for high comorbid psychopathology among eating disorders, self-harm, and suicidal behavior, we examined this comorbidity in female patients hospitalized with eating disorders. In a sample of 47 girls admitted for anorexia nervosa, atypical anorexia nervosa, and bulimia nervosa, 72% had depressive symptoms, 11% had obsessive-compulsive symptoms, 9% had anxiety disorder, 23% had substance abuse, and 57% had disharmonious personality development. Suicidal behavior was present in 60% of patients and self-harm in 49%. Association was found between self-harm and suicidality. In all, 68% of girls with eating disorders had a positive score in the Children's Depression Inventory questionnaire and 62% of them in the Child Adolescent Suicidal Potential Index questionnaire. Clinical examination of girls with eating disorders should focus on identifying the risk of suicidal behavior and self-harm.

• Klíčová slova
• adolescent, child, eating disorders, self-harm, suicidal behavior,
• Publikační typ
• časopisecké články MeSH

Many relations are connecting obesity and eating disorders--one disease is often modifying the other. Anorexia Nervosa and Bulimia Nervosa are mostly treated by psychiatrists. Internal medicine specialists are mostly involved only in complications (e.g. malnutrition, ion disorders). Obesity is mostly treated only by internists. Psychiatrists are only involved in some depressive patients. Obese patients with eating disorders are mostly not sent to psychiatric diagnostics. In this article an overview of eating disorder symptoms and classification is given--binge eating disorder, night eating syndrome and grazing. These symptoms are defined and possibilities of diagnosis and treatment are described.

• MeSH
• lidé MeSH
• obezita komplikace   MeSH
• poruchy příjmu potravy komplikace   psychologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa and problem alcohol use (genetic correlation [rg ], twin-based = 0.23-0.53). We estimated the genetic correlation between eating disorder and substance use and disorder phenotypes using data from genome-wide association studies (GWAS). Four eating disorder phenotypes (anorexia nervosa [AN], AN with binge eating, AN without binge eating, and a bulimia nervosa factor score), and eight substance-use-related phenotypes (drinks per week, alcohol use disorder [AUD], smoking initiation, current smoking, cigarettes per day, nicotine dependence, cannabis initiation, and cannabis use disorder) from eight studies were included. Significant genetic correlations were adjusted for variants associated with major depressive disorder and schizophrenia. Total study sample sizes per phenotype ranged from ~2400 to ~537 000 individuals. We used linkage disequilibrium score regression to calculate single nucleotide polymorphism-based genetic correlations between eating disorder- and substance-use-related phenotypes. Significant positive genetic associations emerged between AUD and AN (rg = 0.18; false discovery rate q = 0.0006), cannabis initiation and AN (rg = 0.23; q < 0.0001), and cannabis initiation and AN with binge eating (rg = 0.27; q = 0.0016). Conversely, significant negative genetic correlations were observed between three nondiagnostic smoking phenotypes (smoking initiation, current smoking, and cigarettes per day) and AN without binge eating (rgs = -0.19 to -0.23; qs < 0.04). The genetic correlation between AUD and AN was no longer significant after co-varying for major depressive disorder loci. The patterns of association between eating disorder- and substance-use-related phenotypes highlights the potentially complex and substance-specific relationships among these behaviors.

• Klíčová slova
• eating disorders, genetic correlation, substance use,
• MeSH
• alkoholismus genetika   MeSH
• celogenomová asociační studie MeSH
• depresivní porucha unipolární genetika   MeSH
• fenotyp MeSH
• jednonukleotidový polymorfismus MeSH
• lidé MeSH
• poruchy příjmu potravy genetika   MeSH
• poruchy spojené s užíváním psychoaktivních látek genetika   MeSH
• poruchy vyvolané užíváním tabáku genetika   MeSH
• rizikové faktory MeSH
• schizofrenie genetika   MeSH
• vazebná nerovnováha MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Extramural MeSH

Haem oxygenase 1 (HO-1) plays a pivotal role in metabolic stress protecting cells in dependence on reactive oxygen species. This study investigated a potential gene environment interaction between the (GT)n repeat HO1 polymorphism and the stress perception in patients with eating disorder and in controls. Stress perception and (GT)n polymorphism were measured in 127 patients with eating disorders and in 78 healthy controls using Stress and Coping Inventory and genotyping. Based on the inventory, overall, specific and weighted stress scores were defined. Clinical stress score was generated according to the patient's history and interviews. According to our hypothesis, 1) all stress scores describing subjective stress perception were significantly higher in patients compared to controls (P ≤ 0.001; P ≤ 0.002; P ≤ 0.001), 2) the L/L genotype of GT promoter repeats (L < 25 GT repeats, S < 25 GT repeats) in the patients was associated with higher overall (P ≤ 0.001), specific (P ≤ 0.010) and weighted stress score (P ≤ 0.005) compared to the L/S variant, and 3) Pearson's correlation of clinical versus objective stress scores showed not very tight relationship (0.198; 0.287; 0.224, respectively). We assume potential risk of the L allele of HO1 promoter polymorphism for the stress response and contribution of the subjective stress perception together with the L/L genotype to the development of eating disorder. Decreased HO1 expression in the presence of L/L genotype plus more intensive stress perception in the patients can lead to secondary stress, with increasing severity of the symptoms and aggravation of the disease.

• MeSH
• hemoxygenasa-1 genetika   MeSH
• lidé MeSH
• poruchy příjmu potravy genetika   psychologie   MeSH
• promotorové oblasti (genetika) genetika   MeSH
• psychický stres psychologie   MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• hemoxygenasa-1 MeSH