Daily and Nightly Anxiety Among Patients Affected by Night Eating Syndrome and Binge Eating Disorder

Abstract

We tested if there were any differences about nocturnal and diurnal anxiety between patients either affected by Binge Eating Disorder (BED) or Night eating Syndrome (NES). Fifty four patients affected by BED, 13 by NES and 16 by both BED and NES were tested using the Self Rating Anxiety Scale (SAS) and the Sleep Disturbance Questionnaire (SDQ). Their nocturnal eating behavior was ascertained through the Night Eating Questionnaire (NEQ). Patients affected by both BED and NES scored significantly higher on SAS than other patients. Among NES patients we found a correlation between a SDQ subscale and two subscales of the NEQ. Among BED patients we found a correlation between SAS scores and the nocturnal ingestion subscale of the NEQ. Nocturnal eating is related to nocturnal anxiety among NES patients while it is related to diurnal anxiety among patients affected by BED. These findings support the hypothesis that BED and NES are distinct syndromes sharing overeating but with different pathways to excessive food intake.

Alexithymia is not related to severity of night eating behavior: A useful distinction from other eating disorders

“…Subsequently it was found (Pawlow, O'Neil, & Malcolm, 2003) that both state and trait anxiety levels were above the normal range and consistent with increased stress in NES patients, this datum was confirmed using an ecological momentary assessment (Boseck et al, 2007). Additionally, our group found a correlation between Nocturnal Anxiety levels reported by NES patients on the Mental Anxiety subscale of the Sleep Disturbance Questionnaire (SDQ) (Espie, Inglis, Harvey, & Tessier, 2000) and their scores on the Evening Hyperphagia and Mood and Sleep Disturbances subscales of the Night Eating Questionnaire (Sassaroli et al, 2009). Also depression was widely described among nocturnal eaters.…”

“…This is quite surprising given the well-known presence of alexithymic traits in patients affected by insomnia (Allison et al, 2010) and overeating (Da Ros et al, 2011), both symptoms shared by NES patients. Our results are not easily understood in light of the current knowledge on nocturnal eating which suggests that nocturnal eating is a way of dealing with high levels of anxiety (Sassaroli et al, 2009) and with the dysfunctional belief that it is not possible to sleep again without eating (Vinai et al, 2013).…”

“…High levels of anxiety (Boseck et al, 2007;Sassaroli et al, 2009;Stunkard et al, 1955), mood (Boseck et al, 2007;De Zwaan et al, 2006) and insomnia (Allison et al, 2010) (all factors linked to alexithymia) (Bazydlo et al, 2001;Hendryx et al, 1991;Honkalampi et al, 2000) have been described among NES patients. According to these reports we expected those with NES would have difficulties in managing their emotions; however our results did not confirm this hypothesis.…”

“…Moreover individuals either affected by NES or BED do not consistently differ on their report of depressive symptoms (Allison, Grilo, Masheb, & Stunkard, 2007). However, other significant differences have been reported: compared with persons with BED, persons with NES have lower levels of daily anxiety (Sassaroli et al, 2009) and are more convinced that their achievement of sleep is dependent on eating (Vinai et al, 2013). The results of this study are useful in tracing the borders between these syndromes: NES subjects may be better able than BED patients to manage their emotions, suggesting that their eating behaviors have different pathways.…”

Psychopathological characteristics of patients seeking for bariatric surgery, either affected or not by binge eating disorder following the criteria of the DSM IV TR and of the DSM 5

“…An increasing number of researchers and clinicians have recognized Binge Eating Disorder (BED) as a stable pathology with specific characteristics (Vinai & Todisco, 2007) and also individuals affected by subthreshold forms of the syndrome have shown to share typical traits of BED patients (Striegel-Moore et al, 2000), (Masheb & Grilo, 2006), (Clyne, Latner, Gleaves, & Blampied, 2010): low self-esteem (Flückiger et al, 2011), impulsivity (Yip, White, Grilo, & Potenza, 2011), difficulties in regulating emotions (Sassaroli et al, 2009) (De Zwaan et al, 1994), psychosocial impairment, frequent psychiatric co-morbidity (Peterson, Miller, Crow, Thuras, & Mitchell, 2005) and medical problems needing a specific treatment (Allison et al, 2006). In light of these results the American Psychiatric Association has included BED with less restrictive diagnostic criteria in the fifth edition of the DSM (American Psychiatric Association, 2013).…”