Identifying and Managing Eating Disorders in Persons Presenting for Addiction Treatment
Bibliographic record
Abstract
ABSTRACT Objectives: Eating disorders (ED) are common in substance use disorders (SUD), yet often go unrecognized when presenting for addiction treatment. Unrecognized ED can potentially worsen treatment outcomes for both SUD and ED. Means to screen, diagnose, and manage ED when a person presents for addiction treatment are reviewed. Methods: Systematic searches using MEDLINE, Google Scholar, and PubMed augmented by references of found articles were completed using the search terms: eating disorder, anorexia nervosa, bulimia nervosa, alcohol, drugs, substance-related disorders, comorbidity, screening, diagnosis, management and treatment. Screening instruments and treatment options applicable to ED or SUD were reviewed for their applicability to persons with comorbid ED and SUD. Results: The SCOFF, Eating Attitudes Test-26 item version and Eating Disorder Examination-Questionnaire are means to screen for ED in persons with SUD. There were no screening instruments designed for both ED and SUD nor were there any pharmacologic treatment trials for comorbid ED and SUD. Psychotherapy trials of DBT and mindfulness incorporated into CBT for comorbid ED and SUD are supportive. Data from studies of ED or SUD alone suggest potential roles for specific medications and other psychotherapies for comorbid ED and SUD. Conclusions: ED often go undetected when a person enters addiction treatment, potentially worsening treatment outcomes. Standardized screening for ED is recommended for all persons, particularly women, entering addiction treatment followed by monitoring of ED behaviors during recovery. Pharmacotherapy currently is only adjunctive, whereas DBT or mindfulness incorporated into CBT have best evidence for comorbid ED and SUD. Objectifs: Les troubles de l’alimentation (TA) sont courants dans les troubles liés à l’utilisation de substances (TUS), mais passent souvent inaperçus lorsqu’ils se présentent pour un traitement de la dépendance. Un TA non reconnu peut potentiellement aggraver les résultats du traitement pour le TUS et le TA. Les moyens de dépister, de diagnostiquer et de gérer la dysfonction érectile lorsqu’une personne se présente pour un traitement de l’addiction sont examinés. Méthodes: Des recherches systématiques utilisant MEDLINE, Google Scholar et PubMed complétées par des références d’articles trouvés ont été complétées en utilisant les termes de recherche: trouble de l’alimentation, anorexie mentale, boulimie nerveuse, alcool, drogues, troubles liés à la substance, comorbidité, dépistage, diagnostic, gestion et traitement. Les instruments de dépistage et les options de traitement applicables aux TA ou TUS ont été examinés pour leur applicabilité aux personnes présentant des comorbidités de TA et TUS. Résultats: Le SCOFF, Eating Attitudes Test-26 item version (EAT-26) et Eating Disorder Examination-Questionnaire (EDE-Q) sont des moyens de dépister la dysfonction érectile chez les personnes atteintes de TUS. Il n’y avait aucun instrument de dépistage conçu à la fois pour les TA et TUS, ni d’essais de traitement pharmacologique pour les TA et TUS comorbides. Les essais de psychothérapie sur la DBT et la pleine conscience incorporés dans la CBT pour les comorbidités des TA et TUS sont favorables. Les données d’études sur les TA ou TUS seuls suggèrent des rôles potentiels pour des médicaments spécifiques et d’autres psychothérapies pour les comorbidités des TA et TUS. Conclusions: La dysfonction érectile passe souvent inaperçue lorsqu’une personne entame un traitement contre l’addiction, ce qui peut aggraver les résultats du traitement. Un dépistage standardisé de la dysfonction érectile est recommandé pour toutes les personnes, en particulier les femmes, entrant dans un traitement d’addiction suivi d’une surveillance des comportements du TA pendant la récupération. La pharmacothérapie n’est actuellement qu’un complément, alors que la DBT ou la pleine conscience incorporée à la CBT ont les meilleures preuves de comorbidité des TA et TUS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".