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05-16-2014 | Psychosocial care | Article

Treatment outcome of patients with comorbid type 1 diabetes and eating disorders

Journal: BMC Psychiatry

Authors: Nuria Custal, Jon Arcelus, Zaida Agüera, Francesca I Bove, Jackie Wales, Roser Granero, Susana Jiménez-Murcia, Isabel Sánchez, Nadine Riesco, Pino Alonso, José M Crespo, Nuria Virgili, Jose M Menchón, Fernando Fernandez-Aranda

Publisher: BioMed Central

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Abstract

Background

Co-morbidity between Type 1 Diabetes Mellitus (T1DM) and eating disorders (ED) has been previously described; however the effect of this illness on the outcomes for conventional ED treatments has not been previously investigated. This study aims to compare clinical, psychopathological and personality features between two samples of ED individuals: those with comorbid T1DM and those without (No-DM); and to identify differences in treatment outcomes between the groups.

Methods

This study compares treatment outcome, dropouts, ED psychopathology and personality characteristics for 20 individuals with ED and T1DM and 20 ED patients without diabetes, matched for diagnostic and treatment type.

Results

The study found higher dropout rates from therapy in individuals with T1DM and worse treatment outcome in spite of having no significant differences in eating disorder psychopathology, although individuals with T1DM report misusing insulin.

Conclusions

The low levels of motivation to change, and insulin abuse in T1DM patients, may suggest that treatment for patients with ED and T1DM should consider the individual’s personality and role of insulin abuse when determining the appropriate intervention.
Literature
1.
Lawrence JM, Liese AD, Liu L, Dabelea D, Anderson A, Imperatore G, Bell R: Weight–loss practices and weight related issues among youth with Type 1 or type 2 diabetes. Diabetes Care. 2008, 31 (12): 2251-2257. 10.2337/dc08-0719. CrossRefPubMedPubMedCentral
2.
Mannucci E, Rotella F, Ricca V, Moretti S, Placidi GF, Rotella CM: Eating disorders in patients with type 1 diabetes: a metaanalysis. J Endocrinol Invest. 2005, 28: 417-419. 10.1007/BF03347221. CrossRefPubMed
3.
Ackard DM, Vik N, Neumark-Sztainer D, Schmitz KH, Hannan P, Jacobs DR: Disordered eating and body dissatisfaction in adolescents with type 1 diabetes and a population-based comparison sample: comparative prevalence and clinical implications. Pediatr Diabetes. 2008, 9 (4 Pt 1): 312-319. CrossRefPubMed
4.
Pinhas-Hamiel O, Levy-Shagra Y: Eating disorders in adolescents with type 2 and type 1 diabetes. Curr Diab Rep. 2013, 13 (2): 289-297. 10.1007/s11892-012-0355-7. CrossRefPubMed
5.
Larrañaga A, Docet MF, Garcia Mayor RV: Disordered eating behaviors in type 1 diabetic patients. World J Diabetes. 2011, 2 (11): 189-195. PubMedPubMedCentral
6.
Krug I, Root T, Bulik C, Granero R, Penelo E, Jiménez-Murcia S, Fernandez-Aranda F: Redefining phenotypes in eating disorders based on personality: A latent profile analysis. Psychiatry Res. 2011, 188: 439-445. 10.1016/j.psychres.2011.05.026. CrossRefPubMed
7.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 1994, Washington, DC: American Psychiatric Association, 4
8.
Cloninger CR: The Temperament and Character Inventory–Revised. 1999, St. Louis, MO: Center for Psychobiology of Personality, Washington University
9.
Garner DM: Inventario de Trastornos de la Conducta Alimentaria (EDI-2)-Manual. 1998, Madrid: TEA
10.
Casasnovas C, Fernández-Aranda F, Granero R, Krug I, Jiménez-Murcia S, Bulik CM, Vallejo-Ruiloba J: Motivation to change in eating disorders: clinical and therapeutic implications. Eur Eat Disord Rev. 2007, 15 (6): 449-456. 10.1002/erv.780. CrossRefPubMed
11.
Fernandez-Aranda F, Turon V: Trastornos alimentarios. Guia basica de tratamiento en anorexia y bulimia. 1998, Barcelona: Masson
12.
Agüera Z, Riesco N, Jiménez-Murcia S, Islam MA, Granero R, Vicente E, Peñas-Lledó E, Arcelus J, Sánchez I, Menchon JM, Fernández-Aranda F: Cognitive Behaviour therapy response and dropout rate across purging and nonpurging Bulimia nervosa and Binge eating disorder: DSM-5 implications. BMC Psychiatry. 2013, 13 (1): 285-10.1186/1471-244X-13-285. CrossRefPubMedPubMedCentral
13.
Gutierrez-Zotes JA, Bayon C, Montserrat C, Valero J, Labad A, Cloninger CR, Fernandez-Aranda F: Temperament and Character Inventory Revised (TCI-R). Standardization and normative data in a general population sample. Actas Esp Psiquiatr. 2004, 32 (1): 8-15. PubMed
14.
Jones J, Lawson ML, Daneman D, Olmsted MP, Rodin G: Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study. BMJ. 2000, 320: 1563-1566. 10.1136/bmj.320.7249.1563. CrossRefPubMedPubMedCentral
15.
Skinner TC, Bruce DG, Davis TM, Davis WA: Personality traits, self-care behaviours and glycaemic control in Type 2 diabetes: The Fremantle Diabetes Study Phase II. Diabet Med. 2014, 31: 487-492. 10.1111/dme.12339. CrossRefPubMed
16.
Powers MA, Richter S, Ackard D, Critchley S, Meier M, Criego A: Determining the influence of type 1 diabetes on two common eating disorder questionnaires. Diabetes Educ. 2013, 39 (3): 387-396. 10.1177/0145721713482737. CrossRefPubMed
The pre-publication history for this paper can be accessed here: http://​www.​biomedcentral.​com/​1471-244X/​14/​140/​prepub

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