Editorial: Recent advances in diagnosis and treatment of comorbid conditions in eating disorders
Bibliographic record
Abstract
The study by Devoe et al. presents a large systematic review and meta-analysis that includes 35 studies and a total of 9,646 individuals with a clinically diagnosed ED, and examined the prevalence rates of impulse control disorders and behavioral addictions. The authors found a 22% prevalence for any impulse control disorder, especially for pathological/compulsive buying, predominantly in individuals with EDs of the binge-purge phenotype. This study supports the need for screening and monitoring of comorbid impulse control disorders and behavioral addictions in individuals with EDs. Riquin et al. investigated psychiatric comorbidities in adults with anorexia nervosa (AN) and found that more than half of the cohort had experienced major depressive disorder (MDD) over their lifetime, almost a third had had generalized anxiety disorder (GAD) or social phobia (SP), and more than a quarter had OCD. Interestingly, the study showed that individuals with AN had more severe symptoms when comorbid MDD and GAD were diagnosed prior the diagnosis of the AN. The authors also reported that the greatest clinical severity (i.e., ED-related symptoms), general clinical condition, and quality of life in individuals with AN was associated with lifetime comorbidity for MDD, GAD, or SP.Li et al. evaluated treatment outcomes based on self-reported assessment of autistic traits -high autistic traits (HAT) vs. low autistic traits (LAT)-in individuals with AN in either an inpatient or day treatment program. In individuals with AN, HAT was a positive predictor for clinical improvement of the ED symptoms in an inpatient treatment program, but a negative predictor for those in a day treatment program. The authors argued that the individualized and structured routine care in an inpatient setting may be more suitable for the treatment of individuals with comorbid AN and HAT.While research in this area is growing, these findings suggest that treatment adaptations for individuals with comorbid AN and autistic traits are needed.Nobile et al. examined cognitive functions including attention, decision making, set shifting, and central coherence in women with bulimia nervosa (BN) who were receiving hormonal contraceptives (HC) compared to those who were not. The authors adjusted their analyses for a variety of variables that might influence cognitive performance and found that women with BN on HC (all types) showed better selection abilities and global sustained attention, and better understood the rules of the Iowa gambling task for decision making, while no differences between the groups were found for set shifting and central coherence. The authors argued that by limiting sex hormone changes by means of HC, cognitive functions might appear less prone to fluctuations. This Special Issue highlights recent literature on the implications of psychiatric and medical comorbidities reported in individuals with EDs. Individuals with EDs have a higher mortality rate compared to the general population and death is often due to the medical and/or psychiatric comorbidity -suicide or severe medical complications. The studies in the issue illustrate that comorbidities, some that precede the ED and others that are the consequence of the ED, can impact the clinical presentation, diagnosis, and treatment. Further, the comorbidity associated with EDs makes treatment a challenging task. This issue adds to the existing knowledge and provides stimuli to improve early diagnosis and treatment interventions to reduce the burden of suffering in individuals with EDs and comorbid conditions.
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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 | 0.008 | 0.038 |
| Meta-epidemiology (narrow) | 0.004 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.007 | 0.005 |
| Open science | 0.006 | 0.002 |
| Research integrity | 0.013 | 0.016 |
| Insufficient payload (model declined to judge) | 0.020 | 0.008 |
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".