Rapporti tra spettro bipolare, disturbi della condotta alimentare e obesità
Year: 2005
Type: article
Abstract: Summary Co-morbidity between BD and EDs is very common in clinical practice and it is proba- bly underestimated in epidemiological studies conducted with structured diagnostic in- terviews. Reviewed data indicate a significant clinical, biologic, and treatment response overlap between EDs and BD especially when soft symptoms of either spectrum disorders are considered, suggesting that the two disorders may share a common diathesis. Obesity, which may be a possible complication of this co-morbidity, also shows interesting over- lapping areas with these two disorders. Considerable non-affective psychopathology has also been reported in patients with EDs, especially in bulimics. These include alco- hol or substance abuse/dependence, panic disorder, phobias, and obsessive-compulsive symptoms. This wide range of co-morbidity is seen not only in ED populations, but also in BP-II patients without EDs. Although this complex co-morbidity does not appear to be coincidental, the precise relationship between these disorders is not clear. Mood instability usually precedes the onset of ED, suggesting an important role of bipolar spectrum dis- order in the development and course of the eating behaviour disorder. Many patients with EDs report binging in an attempt to improve their mood, which may decrease anxiety and depression. Patients with Bipolar II disorder are unusually reactive to changes in their en- vironment and they often attempt to improve their low mood with food, alcohol, drugs, ex- ercise, and/or sexual activity, in a more or less unconscious way. These abnormal behaviours could be seen as developing into persistent addictive states or abnormally motivated be- haviours, under the influence of the mood disorder. Conclusion Recognizing the co-occurrence of an eating disorder and a bipolar spectrum disorder has important pathogenetic, clinical and therapeutic implications. In our opinion, the recog- nition of a broad spectrum of conditions presenting as a cyclothymic-anxious-sensitive dis- position, with mood reactivity and interpersonal sensitivity, and ranging from mood, anx- iety, impulse control and eating disorders, will greatly enhance both clinical practice and research endeavours. Further perspective studies are needed in order to establish the re- lationships between BD, EDs and obesity both in clinical features and therapeutic response.
Authors: C. Sanna Passino, Giulio Perugi
Language: Italian
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W2266236198