ABSTRACT
Objective • To explore the reliability and validity of self-rated Family Burden Scale (FBS) evaluating caregiver burden in families of the patients with anorexia nervosa (AN). Methods • The study included female AN patients (n=103) treated in the Eating Disorder Center of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from Jul. 2017 to Jul. 2019 and their caregivers (parents, n=148). General demographic information of the patients and their caregivers, the course of illness and body mass index (BMI) of patients, and the time each caregiver spent in caring for the patient per day were recorded. FBS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the MOS item short form health survey (SF-36) were self-rated by the caregivers. One-third of the caregivers were selected by random number method for FBS rating by specialists. The reliability of the scale was evaluated by calculating Cronbach's α coefficient, self-rating and other-rating consistency and the consistency between husband and wife (41 couples). The validity of the scale was evaluated by calculating the correlation of FBS score with the course of disease, patients' BMI, the time spent in caring per day, scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36. Results • The Cronbach's α coefficient of FBS was 0.921, the correlation coefficient between self-rating and other-rating by specialists was 0.705 (P=0.000), and the correlation coefficient of consistency score between couples was 0.547 (P=0.000). FBS score showed no correlation with the course of disease, %BMI and the time spent in caring per day. Scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36 showed low correlation with FBS score (all P<0.05). Conclusion • Self-rated FBS shows good reliability when used in families of AN patients. The validity is not as ideal, which suggests further revision of the scale.
ABSTRACT
Objective • To investigate the interaction among stress-related negative feelings, depressive symptoms and shape concern of the patients with anorexia nervosa (AN), and the mediating effect of depressive symptoms between negative feelings and shape concern. Methods • A total of 110 AN patients who met the diagnostic criteria of the Diagnosis and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) were recruited and their stress-related negative feelings were measured with Perceived Stress Scale (PSS), depressive symptoms were measured with Beck Depression Inventory (BDI), and shape concern was measured with Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0). Pearson's correlation test was used to examine the relation between the variables, and the Bootstrap method was used to test the mediating effect of depressive symptoms between negative feelings and shape concern. Results • Negative feelings of the AN patients were positively correlated with depressive symptoms and shape concern (r=0.537, r=0.729, both P=0.000), and depressive symptoms were positively correlated with shape concern (r=0.614, P=0.000). The mediating effect analysis showed that the mediating role of depressive symptoms between negative feelings and shape concern was 0.332 (95%CI 0.156-0.535), with the mediating effect ratio of 61.673%. Conclusion • The depressive symptoms of the AN patients may play a mediating effect between negative feelings and shape concern, and the mediating effect is greater than the direct effect.
ABSTRACT
Anorexia nervosa (AN) is an eating disorder characterized by low body mass and body image disturbance. The pathogenesis of AN is complex, which may be related to alterations in brain structures. In recent years, with the development of brain imaging technology, it is possible to explore the relationship between brain structure and clinical symptoms in patients with AN through magnetic resonance imaging. This paper reviewed the studies on the diffusion tensor imaging of AN in recent years, and introduced the alterations of white matter in the brain of AN patients and indi-viduals recovered from AN. It was found that AN patients had structural damage of white matter in the limbic system, thalamus, hypothalamus, cerebellum and other brain areas, and the individuals rehabilitated from AN had white matter alterations in insula and other brain areas. But there exists an inconsistency among the research results. Well-controlled studies with large sample size are needed in the future to provide theoretical foundation and instruction for the pathophysiological mechanism and clinical intervention of AN.