Psychopathological and psychiatric evaluation of patients affected by lipodystrophy

Calabrò, Pasquale Fabio; Ceccarini, Giovanni; Calderone, Alba; Lippi, Chita; Piaggi, Paolo; Ferrari, Federica; Magno, Silvia; Pedrinelli, Roberto; Santini, Ferruccio

doi:10.1007/s40519-019-00716-6

Cited by 21 publications

(14 citation statements)

References 31 publications

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“…While not a focus of the present study, our findings demonstrated that emotion/affect were often called out by patients with lipodystrophy. This result is consistent with a previous study where 16 patients with lipodystrophy were studied alongside 20 females with breast cancer and 20 obese patients [ 17 ]. Mood and anxiety disorders were observed at a high rate in the lipodystrophy patients.…”

Section: Discussionsupporting

confidence: 93%

Qualitative interviews in patients with lipodystrophy to assess the patient experience: evaluation of hunger and other symptoms

Martin

Sanchez

Olayinka-Amao

et al. 2022

J Patient Rep Outcomes

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Background New treatments are being evaluated for lipodystrophy; however, limited information is available on the patient experience. Results of a prior patient panel showed that hunger and temperature-related symptoms were an issue for participants. Therefore, evaluation of any changes in these symptoms is recommended for inclusion in new treatment options. The objective of this study was to further understand the patient experience and to evaluate newly developed items of hunger and temperature regulation. Methods Individual, in-depth telephone interviews were conducted via semi-structured discussion guide. Telephone interviews were conducted with 21 US patients with generalized lipodystrophy (GLD) or partial lipodystrophy (PLD). Eligibility requirements included self-reported PLD or GLD. Interviews included open-ended concept elicitation followed by a review of newly developed items assessing hunger, temperature sensations, and patient globals. Interviews were conducted in two rounds, with the newly developed items assessing hunger revised after each round of interviews based on participant feedback. Results Results indicated that hunger-related symptoms were considered a current issue for greater than half (N = 11) of participants, and all but one reported this as an issue at some point in their lives. Specifically, participants most often reported symptoms of increased appetite and not feeling full. The cognitive debriefing process indicated that the hunger-related symptoms, temperature, and global impression of change and severity items were correctly interpreted and easily completed by the participants. While not a focus of the interviews, the concept elicitation results demonstrated that pain was a frequently reported and bothersome symptom in this patient population. Conclusions This qualitative research provided evidence to support the use of clinical outcomes assessments such as hunger and temperature-related items in clinical trials.

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Section: Discussionsupporting

confidence: 93%

Qualitative interviews in patients with lipodystrophy to assess the patient experience: evaluation of hunger and other symptoms

Martin

Sanchez

Olayinka-Amao

et al. 2022

J Patient Rep Outcomes

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“…Only seven studies used semi-structured clinical interviews based on DSM-5 criteria to diagnose SSD (Calabro et al, 2019; Cao et al, 2020; Fergus, Kelley, & Griggs, 2019; Guidi et al, 2013; Huang et al, 2016; Hüsing et al, 2018; Umemura et al, 2019). Of these, Fergus et al, was conducted in primary care patients; the others were in specialized patient populations.…”

Section: Resultsmentioning

confidence: 99%

“…In studies examining different physical conditions, SSD criteria were met by 41.5% of patients with semantic dementia, 11.2% of patients with Alzheimer's disease (Gan, Lin, Samimi, & Mendez, 2016), 25% of female patients with non-HIV lipodystrophy (Calabro et al, 2019), and 18.5% of patients with congestive heart failure (Guidi et al, 2013). In individuals with fibromyalgia, 25.6% met SSD criteria (Häuser et al, 2015), and they had higher depression rates compared to fibromyalgia patients without SSD.…”

Section: Resultsmentioning

confidence: 99%

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Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis

et al. 2021

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Background In 2013, the diagnosis of somatic symptom disorder (SSD) was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This review aims to comprehensively synthesize contemporary evidence related to SSD. Methods A scoping review was conducted using PubMed, PsycINFO, and Cochrane Library. The main inclusion criteria were SSD and publication in the English language between 01/2009 and 05/2020. Systematic search terms also included subheadings for the DSM-5 text sections; i.e., diagnostic features, prevalence, development and course, risk and prognostic factors, culture, gender, suicide risk, functional consequences, differential diagnosis, and comorbidity. Results Eight hundred and eighty-two articles were identified, of which 59 full texts were included for analysis. Empirical evidence supports the reliability, validity, and clinical utility of SSD diagnostic criteria, but the further specification of the psychological SSD B-criteria criteria seems necessary. General population studies using self-report questionnaires reported mean frequencies for SSD of 12.9% [95% confidence interval (CI) 12.5–13.3%], while prevalence studies based on criterion standard interviews are lacking. SSD was associated with increased functional impairment, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Relevant research gaps remain regarding developmental aspects, risk and prognostic factors, suicide risk as well as culture- and gender-associated issues. Conclusions Strengths of the SSD diagnosis are its good reliability, validity, and clinical utility, which substantially improved on its predecessors. SSD characterizes a specific patient population that is significantly impaired both physically and psychologically. However, substantial research gaps exist, e.g., regarding SSD prevalence assessed with criterion standard diagnostic interviews.

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“…Similar to genetic leptin deficiency, patients with severe forms of lipodystrophy show alterations in eating behaviour characterized by constant increased energy intake and voracious appetite, which is more notorious in CGL patients given the extreme scarcity of fat mass and severe reduction in circulating leptin. [130][131][132] Studies conducted in patients with different forms of lipodystrophy show that a high percentage of them present eating disorders, 137 contributing to further aggravate the poor glycaemic and lipid control of these patients. 122 In addition to the well-accepted role of hypoleptinemia, it is also speculated that differences in the circulating levels of soluble leptin receptor, which is a known regulator of leptin availability, may also play a role in the abnormal eating behaviour of patients with CGL.…”

Section: Obesity and Eating Behaviour In Mc4r And Pomc Genetic Defimentioning

confidence: 99%

Eating behaviour in contrasting adiposity phenotypes: Monogenic obesity and congenital generalized lipodystrophy

Santos

Cortés

2020

Obesity Reviews

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Summary Most known types of nonsyndromic monogenic obesity are caused by rare mutations in genes of the leptin‐melanocortin pathway controlling appetite and adiposity. In contrast, congenital generalized lipodystrophy represents the most extreme form of leanness in humans caused by recessive mutations in four genes involved in phospholipid/triglyceride synthesis and lipid droplet/caveolae structure. In this disease, the inability to store triglyceride in adipocytes results in hypoleptinemia and ectopic hepatic and muscle fat accumulation leading to fatty liver, hypertriglyceridemia and severe insulin resistance. As a result of hypoleptinemia, patients with lipodystrophy show alterations in eating behaviour characterized by constant increased energy intake. As it occurs in obesity caused by genetic leptin deficiency, exogenous leptin rapidly reduces hunger scores in patients with congenital generalized lipodystrophy, with additional beneficial effects on glucose homeostasis and metabolic profile normalization. The melanocortin‐4 receptor agonist setmelanotide has been used in the treatment of monogenic obesities. There is only one report on the effect of setmelanotide in a patient with partial lipodystrophy resulting in mild reductions in hunger scores, with no improvements in metabolic status. The assessment of contrasting phenotypes of obesity/leanness represents an adequate strategy to understand the pathophysiology and altered eating behaviour associated with adipose tissue excessive accumulation/paucity.

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Psychopathological and psychiatric evaluation of patients affected by lipodystrophy

Cited by 21 publications

References 31 publications

Qualitative interviews in patients with lipodystrophy to assess the patient experience: evaluation of hunger and other symptoms

Qualitative interviews in patients with lipodystrophy to assess the patient experience: evaluation of hunger and other symptoms

Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis

Eating behaviour in contrasting adiposity phenotypes: Monogenic obesity and congenital generalized lipodystrophy

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