Frequency of Eating Disorder Pathology Among Patients With Chronic Constipation and Contribution of Gastrointestinal-Specific Anxiety

Murray, Helen Burton; Flanagan, Ryan; Banashefski, Bryana; Silvernale, Casey J.; Kuo, Braden; Staller, Kyle

doi:10.1016/j.cgh.2019.12.030

Cited by 33 publications

(35 citation statements)

References 23 publications

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“…Despite this limitation, results are consistent with the idea that GI‐specific anxiety sensitivity may be a relevant factor across ED diagnoses that may contribute to or maintain transdiagnostic restrictive and compensatory ED behavior. Notably, across diagnoses, elevations in VSI scores were significantly higher than those of a past sample of IBS patients (Labus et al, 2004), and aligns with findings from a study showing significant associations between higher VSI scores and ED symptom presence among patients with chronic constipation (Murray et al, 2020). Elevated VSI scores suggest that individuals with EDs tend to be anxious and hypervigilant around GI sensations (Boyd et al, 2005; Brand‐Gothelf et al, 2016; Hetterich et al, 2019; Kerr et al, 2016; Perez et al, 2013; Zucker et al, 2013; Zucker & Bulik, 2020), perhaps even more so than in existing disorders of gut–brain interaction.…”

Section: Discussionsupporting

confidence: 81%

Validating the visceral sensitivity index in an eating disorder sample

Brown

Reilly

Murray

et al. 2021

Intl J Eating Disorders

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Objective Individuals with eating disorders (EDs) often have difficulty tolerating uncomfortable body sensations. As such, anxiety sensitivity specific to gastrointestinal (GI) sensations, has relevance for EDs. However, to date, no validated measures of this construct exist in EDs. Thus, the present study sought to validate the visceral sensitivity index (VSI), a 15‐item measure originally validated in an irritable bowel syndrome sample, in an ED sample and explore associations with ED symptoms. Method Two hundred and sixty‐six adolescents (n = 116) and adults (n = 150) in an ED partial hospital program completed the VSI and related measures at admission. Confirmatory factor analysis examined the factor structure of the VSI and hierarchical regression analyses explored associations between the VSI and ED symptoms. Results The original version of the VSI had adequate model fit. An alternative 13‐item model removing specific items with poor fit and less theoretical relevance to EDs also demonstrated good fit. The 15‐item and 13‐item VSI had strong internal consistency (α = .93–.94), and correlation results supported the convergent and divergent validity of both versions. Higher visceral sensitivity was associated with elevated body dissatisfaction, cognitive restraint, purging, restricting, and excessive exercise (p‐values <.05), beyond length of illness, body mass index, and trait anxiety. Discussion Results support the relevance of GI‐specific anxiety in EDs and suggest that the original 15‐item VSI and modified 13‐item VSI have strong psychometric properties in an ED sample. Given comparable model fit and psychometric properties, both versions of the VSI may be used for future ED research.

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Section: Discussionsupporting

confidence: 81%

Validating the visceral sensitivity index in an eating disorder sample

Brown

Reilly

Murray

et al. 2021

Intl J Eating Disorders

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“…ED pathology is common in DGBI samples: between 13 and 23% for shape/weight‐motivated ED symptoms (Murray et al, 2020; Murray, Jehangir, Silvernale, Kuo, & Parkman, 2020; Zia, Riddle, DeCou, McCann, & Heitkemper, under review) and between 24 and 43% for ARFID (Murray, Bailey, et al, 2020; Murray, Jehangir, et al, 2020; Zia et al, under review). However, research on the frequency of DGBI among ED groups has been limited to inpatient samples (e.g., Boyd, Abraham, and Kellow, 2005), one small outpatient sample (e.g., Santonicola et al, 2012), and samples solely focused on IBS (e.g., DeJong, Perkins, Grover, and Schmidt, 2011).…”

Section: Introductionmentioning

confidence: 99%

Disorders of gut–brain interaction common among outpatients with eating disorders including avoidant/restrictive food intake disorder

Murray

Kuo

Eddy

et al. 2020

Intl J Eating Disorders

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Objective Little research exists on Rome IV disorders of gut–brain interaction (DGBI; formerly called functional gastrointestinal disorders) in outpatients with eating disorders (EDs). These data are particularly lacking for avoidant/restrictive food intake disorder (ARFID), which shares core features with DGBI. We aimed to identify the frequency and nature of DGBI symptoms among outpatients with EDs. Method Consecutively referred pediatric and adult patients diagnosed with an ED (n = 168, 71% female, ages 8–76 years) in our tertiary care ED program between March 2017 and July 2019 completed a modified Rome IV Questionnaire for DGBI and psychopathology measure battery. Results The majority (n = 122, 72%) of participants reported at least one bothersome gastrointestinal symptom. Sixty‐six (39%) met criteria for a DBGI, most frequently functional dyspepsia—post‐prandial distress syndrome subtype (31%). DGBI were surprisingly less frequent among patients with ARFID (30%) versus EDs that are associated with shape or weight concerns (45%; X2[1] = 3.61, p = .058, Cramer's V = .147). Among those with ARFID, DGBI presence was associated with the fear of aversive consequences prototype and multiple comorbid prototype presence. Discussion We demonstrated notable overlap between DGBI and EDs, particularly post‐prandial distress symptoms. Further research is needed to examine if gastrointestinal symptoms predict or are a result of greater ED pathology, including ARFID prototypes.

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“…In the current study, the patients with digestive system dysfunction had a signi cantly higher anxiety and depression rate than those without digestive system complications. Studies have found that constipation and diarrhea often aggravate the anxiety of patients, and anxiety may affect the course of the disease through the neuroendocrine regulatory system, further aggravating the clinical symptoms of patients and exacerbating constipation [31,32]. A study on Parkinson's disease (PD) patients showed that severe constipation and motor symptoms were closely related to depression; the researchers explained that involvement of the enteric plexus of the gastrointestinal tract and dorsal motor nucleus of the vagus (DMV) initially causes constipation in PD patients, and subsequent spread to the raphe nuclei and locus coeruleus leads to depressive mood [33].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and Depression in School-age Patients With Spinal Muscular Atrophy: a Cross-sectional Study

Yao

Xia

Feng

et al. 2021

Preprint

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Background: Spinal muscular atrophy (SMA) is a rare neurogenetic disease which involves multisystem dysfunctions such as respiratory, digestive, and motor disorders. Anxiety, depression and other psychological disorders often accompany severe chronic physical diseases. The aim of this study was to investigate the prevalence of anxiety and depression along with their influencing factors among school-age patients with SMA.Methods: We conducted a cross-sectional study on school-age SMA patients in China. Patients aged 8–18 years with a genetic diagnosis of 5qSMA were invited to answer a questionnaire composed of sociodemographic and clinical questions, then to complete the Screen for Child Anxiety-Related Emotional Disorders and Depression Self-Rating Scale for depression and anxiety level evaluation. At the end of the questionnaire, further questions assessed the subjective anxiety and subjective depression of patients’ caregivers and their expectations for their child’s future. Results: Complete data were available for 155 patients. The sample included 45.8% boys and 54.2% girls; 65.2% were type II, 27.1% were type III, and the remainder were type I SMA. Rates of anxiety and depression in these school-age SMA patients were 40.0% and 25.2%, respectively. Gender, age, and disease type were not associated with anxiety or depression, but respiratory system dysfunction, digestive system dysfunction, skeletal deformity, rehabilitation exercise, academic delay, specialized support from school, household income level, caregivers’ subjective anxiety, and caregivers’ expectations were significantly related to both anxiety and depression. Conclusions: There was a high prevalence of anxiety and depression in school-age SMA patients in China. Professional psychological care maybe included in the standard of care. These results also call for possible targets for intervention such as reducing complications, improving drug accessibility, retaining normal schooling, strengthening school support, and enhancing the ability of the caregivers of SMA patients to assist in the diagnosis and treatment of the disease, so improving the mental health of SMA patients.

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Frequency of Eating Disorder Pathology Among Patients With Chronic Constipation and Contribution of Gastrointestinal-Specific Anxiety

Cited by 33 publications

References 23 publications

Validating the visceral sensitivity index in an eating disorder sample

Validating the visceral sensitivity index in an eating disorder sample

Disorders of gut–brain interaction common among outpatients with eating disorders including avoidant/restrictive food intake disorder

Anxiety and Depression in School-age Patients With Spinal Muscular Atrophy: a Cross-sectional Study

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