Objective: Gastrointestinal complaints are common in Anorexia Nervosa (AN) and are often related with Body Image Disturbance (BID). Disgust is a primary emotion and some of its characteristics and complex derivatives (for example, shame) may play a role in Eating Disorders (EDs), for example inducing vomiting even in the absence of stimuli. This pilot study aimed to (a) investigate the prevalence of DGBIs in AN patients, (b) explore AN psychological aspects that might impact on DGBI. Methods: Thirty female patients (mean age=19.3±5.9; mean BMI=17.5±2.4) with newly-diagnosed AN were consecutively recruited in a devoted outpatient clinic. The presence of DGBIs were assessed according to Rome IV criteria and gastrointestinal symptoms were evaluated by a standardized questionnaire. Several psychological aspects were verified through clinical screening tests: Eating Disorder Inventory – 3(EDI-3), Hospital Anxiety and Depression Scale(HADS), Social Physique Anxiety Scale(SPAS) as well as Body Uneasiness Test(BUT), which measures body image concern (cut-off value>1.2) and Disgust Scale (cut-off value>26). Results: Eighty-three% AN patients fulfilled criteria for Postprandial Distress Syndrome (PDS), 57% for Functional Heartburn (FH), 47% for Irritable Bowel Syndrome predominant Constipation (IBS-C) and 43% as Epigastric Pain Syndrome (EPS). We observed a mean score on disgust scale m= 67.9 (SD=12.9) for IBS-C, m= 66.6 (SD=13.5) for PDS, m=65.7 (SD=12.0) for EPS and m=63.7 (SD=10.9) for FH. Mean Global Severity Index (GSI) of BUT was m=3.2 (SD=0.8) for PDS, m= 3.1 (SD=0.9) for IBS-C, m= 2.9 (SD=0.7) for FH and, m= 2.9 (SD=0.8) for EPS. A significant correlation (p<0.05) was found between disgust and postprandial nausea (r=.399) and between early satiety and BUT subscales Weight Phobia (r=.439), Compulsive Self-Monitoring (r=.434) and BIC (r=.439). Moreover, as expected, Body Image Concern (BIC) significantly correlated both with EDs risk scale (r=.716) and Global Psychological Maladjustment (r=.798). Conclusions: AN is a multifactorial disorder. Consequently, the presence of numerous contributing factors and variables can affect the outcomes of treatment and even the specific diagnosis. It is necessary to implement studies with an integrated approach taking into account DGBIs, as well as to monitor the emotional-cognitive structure that acts as a factor in maintaining the disorder.
Gut-brain interaction disorders (DGBIs), disgust and body image in anorexia nervosa: a pilot study
Carpinelli L.;Savarese G.;Pascale B.;Iovino P.
2022-01-01
Abstract
Objective: Gastrointestinal complaints are common in Anorexia Nervosa (AN) and are often related with Body Image Disturbance (BID). Disgust is a primary emotion and some of its characteristics and complex derivatives (for example, shame) may play a role in Eating Disorders (EDs), for example inducing vomiting even in the absence of stimuli. This pilot study aimed to (a) investigate the prevalence of DGBIs in AN patients, (b) explore AN psychological aspects that might impact on DGBI. Methods: Thirty female patients (mean age=19.3±5.9; mean BMI=17.5±2.4) with newly-diagnosed AN were consecutively recruited in a devoted outpatient clinic. The presence of DGBIs were assessed according to Rome IV criteria and gastrointestinal symptoms were evaluated by a standardized questionnaire. Several psychological aspects were verified through clinical screening tests: Eating Disorder Inventory – 3(EDI-3), Hospital Anxiety and Depression Scale(HADS), Social Physique Anxiety Scale(SPAS) as well as Body Uneasiness Test(BUT), which measures body image concern (cut-off value>1.2) and Disgust Scale (cut-off value>26). Results: Eighty-three% AN patients fulfilled criteria for Postprandial Distress Syndrome (PDS), 57% for Functional Heartburn (FH), 47% for Irritable Bowel Syndrome predominant Constipation (IBS-C) and 43% as Epigastric Pain Syndrome (EPS). We observed a mean score on disgust scale m= 67.9 (SD=12.9) for IBS-C, m= 66.6 (SD=13.5) for PDS, m=65.7 (SD=12.0) for EPS and m=63.7 (SD=10.9) for FH. Mean Global Severity Index (GSI) of BUT was m=3.2 (SD=0.8) for PDS, m= 3.1 (SD=0.9) for IBS-C, m= 2.9 (SD=0.7) for FH and, m= 2.9 (SD=0.8) for EPS. A significant correlation (p<0.05) was found between disgust and postprandial nausea (r=.399) and between early satiety and BUT subscales Weight Phobia (r=.439), Compulsive Self-Monitoring (r=.434) and BIC (r=.439). Moreover, as expected, Body Image Concern (BIC) significantly correlated both with EDs risk scale (r=.716) and Global Psychological Maladjustment (r=.798). Conclusions: AN is a multifactorial disorder. Consequently, the presence of numerous contributing factors and variables can affect the outcomes of treatment and even the specific diagnosis. It is necessary to implement studies with an integrated approach taking into account DGBIs, as well as to monitor the emotional-cognitive structure that acts as a factor in maintaining the disorder.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
