Sensory science and chronic diseases: Clinical implications and disease management

The textbook provides an overview of the sensory science field in the context of diseases such as obesity and Coronavirus disease 2019 (COVID-19). This book brings a summary of the state of the science in key areas and provides examples of translational science from using cellular and rodent models to human clinical trials and community health. The volume structure leads the reader through the physiology of taste and smell into how sensory testing for taste and smell is studied, basic mechanisms, various protocols that are used throughout the field along with the pros/cons of the current methods used. This resource is intended for classroom teaching, for novice researchers in sensory research as well as students and postdoctoral fellows. Example of courses are nutrition, basic nursing, interdisciplinary health courses, sensory perception (psychology), neuroscience, and medical courses, dentistry, food science and others. © This is a U.S. government work and not under copyright protection in the U.S.;foreign copyright protection may apply 2021. All rights reserved.

Complementary and Integrative Medicine and Eating Disorders in Youth: Traditional Yoga, Virtual Reality, Light Therapy, Neurofeedback, Acupuncture, Energy Psychology Techniques, Art Therapies, and Spirituality.

Eating disorders (EDs) are a non-heterogeneous group of illnesses with significant physical and mental comorbidity and mortality associated with maladaptive coping. With the exception of lisdexamfetamine (Vyvanse) for binge eating disorder, no medications have been effective for the core symptoms of ED. ED requires a multimodal approach. Complementary and integrative medicine (CIM) can be helpful as an adjunct. The most promising CIM interventions are traditional yoga, virtual reality, eye movement desensitization and reprocessing, Music Therapy, and biofeedback/neurofeedback.

Assessment and treatment of eating disorders in adolescents

Pediatric health care providers understand that eating disorders are not lifestyle choices but lifethreatening mental health conditions Among patients of all ages, anorexia nervosa (AN) has the second-highest mortality rate of all mental health conditions, after substance abuse.1 Both suicide and the physical effects of nutritional deficit are implicated. Prevalence Analyses of prevalence vary widely in their findings.2 One meta-analysis found lifetime prevalence of AN from 1.7% to 3.6% for female patients and 0.1% for male patients;lifetime prevalence of BN for female patients was about 2.1%.3 BED, with reported prevalence rates of approximately 2% to 4%, is almost as common among male as female patients.2 4 Among adolescents aged 13 to 18 years, one study found prevalence rates of 0.3% for AN, 0.9% for BN, and 1.6% for BED.5 Long characterized as affecting primarily affluent White adolescent girls, eating disorders now affect people from lower socioeconomic groups, members of non-White ethnic groups, preteen children, and boys.2 LGBTQIA+ young people may be at particular risk.6 During the early months of the COVID-19 pandemic, hospitalizations for eating disorders doubled,7 and patients reported significant increases in unhealthy behaviors.8 Screening Caregiver reports about a child's weight or eating habits or clinical observation of unexpected weight changes are likely to alert the pediatrician to the possibility of an eating disorder. Presence of any one of the following symptoms indicates the need for immediate medical hospitalization for refeeding2'14: O Heart rate less than 50 beats per minute (bpm) while awake;less than 45 bpm while asleep O Systolic pressure less than 90/45 mm Hg O Orthostatic changes: decrease in blood pressure of more than 20 mm Hg systolic or 10 mm Hg diastolic;heart rate increase of more than 20 bpm O ECG abnormalities: Prolonged corrected QT interval or other arrhythmia O Syncope O Temperature less than 96 °F (35.6 °C) O Electrolyte abnormalities O Uncontrollable binge eating and purging Dehydration Suicide risk O Less than 75% of expected body weight O Failed outpatient management O Acute weight loss and food refusal Communication Today's young people typically know what anorexia and bulimia are.

Locked down with my eating disorder: a retrospective study on the impact of COVID-19 lockdown on adolescents with eating disorders.

BACKGROUND: Negative effects of COVID-19 lockdowns have been reported in adult patients with feeding and eating disorders (FED) whereas evidence of its impact on young clinical populations is still limited and somewhat inconsistent. The present study aims to investigate the effect of the first COVID-19 lockdown on a range of FED symptoms in children and adolescents: (a) already receiving treatment in our specialist service for FED when the pandemic hit, and (b) prospectively evaluated in our service from October 2020 to July 2021. METHODS: Out of sixty-one eligible patients with a broad spectrum of FED invited, forty-five young patients (aged 11-18) consented to participate and were included. An ad-hoc survey, consisting of open questions, multiple choice questions, yes/no questions, and a symptoms checklist, was administered online. RESULTS: About half of the participants (46.7%) reported a positive effect of lockdown on FED symptomatology. Patients with anorexia nervosa (AN) reported the highest rate of symptomatology worsening (58.6%). Younger patients (11-13 years) showed a greater improvement of symptoms compared to older ones (14-18 years of age). COVID-19 lockdown was identified as the precipitating factor for FED onset in 60.7% of newly evaluated patients. CONCLUSIONS: Evidence from our investigation points out that although the COVID-19 pandemic was a precipitating factor for a FED for many active and newly referred patients, it had a positive impact on youth who were already in treatment and younger participants.

Simultaneous Individual Complicated Grief Treatment With a Couple

Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.Copyright © The Author(s) 2022.

COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses.

PURPOSE: The COVID-19 pandemic has been a leading cause of stress and feelings of loss of control, both of which have been related to eating disorder (ED) pathology onset and deterioration. We aim to estimate the magnitude of changes in the prevalence rates of, and indicators for, ED psychopathology in the face of the COVID-19 pandemic. METHOD: Pre-registered systematic review with frequentist and Bayesian meta-analyses. Searches for eligible studies were performed in PubMed, Web of Science and pre-print servers until January 15 2023. RESULTS: Our searches yielded 46 eligible studies reporting on a total of 4,688,559 subjects. These data provide strong evidence indicating increased rates of diagnosed and self-reported ED's and a concordant increased need for care in the face of the pandemic. ED symptom severity scores in patients were not elevated during the pandemic, except for those related to anorexia nervosa. On average, people in the general population report relatively high levels of emotional and binge eating during the pandemic, although the evidential strength for these associations is only anecdotal to moderate. Moderators of between-study heterogeneity were not detected. CONCLUSIONS: Altogether, our results suggest that the COVID-19 pandemic is associated with a wide spread negative effect on ED pathology in patient samples and the general population. The development of online prevention and intervention programs for EDs during stressful times like a pandemic is encouraged. A limitation is that the results reported here may be prone to biases, amongst others, self-report bias. LEVEL OF EVIDENCE: Level I, systematic review and meta-analysis. PREREGISTRATION: Prospero [ https://www.crd.york.ac.uk/prospero ] ID: CRD42022316105.

Shifting age of child eating disorder hospitalizations during the Covid-19 pandemic.

BACKGROUND: We studied the effect of the Covid-19 pandemic on child eating disorder hospitalizations in Quebec, Canada. Quebec had one of the strictest lockdown measures targeting young people in North America. METHODS: We analyzed eating disorder hospitalizations in children aged 10-19 years before and during the pandemic. We used interrupted time series regression to assess trends in the monthly number of hospitalizations for anorexia nervosa, bulimia nervosa, and other eating disorders before the pandemic (April 2006 to February 2020), and during the first (March to August 2020) and second waves (September 2020 to March 2021). We determined the types of eating disorders requiring hospital treatment and identified the age, sex and socioeconomic subgroups that were most affected. RESULTS: Hospitalization rates for eating disorders increased during the first (6.5 per 10,000) and second waves (12.8 per 10,000) compared with the period before the pandemic (5.8 per 10,000). The increase occurred for anorexia nervosa as well as other types of eating disorders. The number of girls and boys aged 10-14 years admitted for eating disorders increased during wave 1. Wave 2 triggered an increase in eating disorder admissions among girls aged 15-19 years. Hospitalization rates increased earlier for advantaged than disadvantaged youth. CONCLUSIONS: The Covid-19 pandemic affected hospitalizations for anorexia nervosa as well as other eating disorders, beginning with girls aged 10-14 years during wave 1, followed by girls aged 15-19 years during wave 2. Boys aged 10-14 years were also affected, as well as both advantaged and disadvantaged youth.

Consulta remota a pessoas com transtornos alimentares durante a pandemia de COVID-19

Objectives: to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic. Methods: a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence. Results: the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations. Final Considerations: the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders. Objetivos: analizar experiencias subjetivas relacionadas a la adaptación a la atención remota por usuarios con trastornos alimenticios durante la pandemia de COVID-19. Métodos: estudio descriptivo de abordaje cualitativo realizado con usuarios de un ambulatorio especializado en trastornos alimenticios. Fue aplicada una entrevista semiestructurada remota, utilizándose el aplicativo Google Meet. Los datos fueron sometidos al análisis lexical mediante software ALCESTE y discutidos a la luz de las evidencias científicas. Resultados: la consulta remota es una estrategia positiva, pero no substitutiva de la presencial. Ventajas como economía financiera, mayor contacto con los profesionales y flexibilización de horarios de atenciones fueron citadas. Dificultad de evaluación clínica en relación al peso, signos vitales y poco dominio de tecnología fueron apuntados como limitaciones. Consideraciones Finales: el estudio induce la discusión sobre sistematización de atenciones remotas, las cuales, durante la pandemia de COVID-19, fueron responsables por fornecer mayor sensación de soporte a personas con trastornos alimenticios. Objetivos: analisar as experiências subjetivas relacionadas à adaptação ao atendimento remoto por usuários com transtornos alimentares durante a pandemia de COVID-19. Métodos: estudo descritivo de abordagem qualitativa realizado com usuários de um ambulatório especializado em transtornos alimentares. Foi aplicada uma entrevista semiestruturada remota, utilizando-se o aplicativo Google Meet. Os dados foram submetidos à análise lexical por meio do software ALCESTE e discutidos à luz das evidências científicas. Resultados: a consulta remota é uma estratégia positiva, mas não substitutiva da modalidade presencial. Vantagens como economia financeira, maior contato com os profissionais e flexibilização de horários de atendimentos foram citadas. Dificuldade de avaliação clínica em relação ao peso, sinais vitais e pouco domínio da tecnologia foram apontados como limitações. Considerações Finais: o estudo induz a discussão sobre sistematização dos atendimentos remotos, os quais, durante a pandemia de COVID-19, foram responsáveis por fornecer maior sensação de suporte às pessoas com transtornos alimentares.

Assessment and management of cardiovascular complications in eating disorders.

BACKGROUND: Eating disorders (EDs) are serious conditions predominantly affecting adolescents and young adults (AYAs) and pose a considerable threat to their health and wellbeing. Much of this increased morbidity and mortality is linked to medical compromise, especially cardiovascular abnormalities. Rates of presentation to both community and inpatient medical settings have increased in all age groups following the Covid-19 pandemic and subsequent "lockdowns", with patients presentations being more medically compromised compared to previous years. This has implications for clinicians with regard to the performance of competent cardiovascular assessments and management of findings. AIMS: This paper is a practical resource for clinicians working with AYAs in whom EDs may present. It will provide a brief summary of the physiological context in which cardiovascular complications develop, systematically outline these complications and suggest a pragmatic approach to their clinical evaluation. METHODS: Relevant literature, guidelines and academic texts were critically reviewed. Conclusions were extracted and verified by a Child and Adolescent Psychiatrist and Adolescent Paediatrician, with suitable expertise in this clinical cohort. CONCLUSIONS: The cardiovascular complications in EDs are primarily linked to malnutrition, and patients presenting with Anorexia Nervosa are most often at greatest risk of structural and functional cardiac abnormalities, including aberrations of heart rate and rhythm, haemodynamic changes and peripheral vascular abnormalities. Other cardiovascular abnormalities are secondary to electrolyte imbalances, as seen in patients with Bulimia Nervosa. More recently defined EDs including Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder are also likely associated with distinct cardiovascular complications though further research is required to clarify their nature and severity. Most cardiovascular abnormalities are fully reversible with nutritional restoration, and normalisation of eating behaviours, including the cessation of purging, though rare cases are linked to cardiac deaths. A detailed clinical enquiry accompanied by a thorough physical examination is imperative to ensure the medical safety of AYAs with EDs, and should be supported by an electrocardiogram and laboratory investigations. Consideration of cardiovascular issues, along with effective collaboration with acute medical teams allows community clinicians identify those at highest risk and minimise adverse outcomes in this cohort.

Eating disorders (EDs) are serious medical conditions predominantly affecting adolescents and young adults (AYAs). They are often associated with considerable threat to the patient's health and wellbeing, with Anorexia Nervosa (AN) having the second highest mortality rate of all mental disorders. The cardiovascular system, which includes the heart and blood vessels, is vulnerable to damage and may contribute to this. There are significant concerns that rates of EDs have been increasing, especially in adolescents. Following the onset of the Covid-19 pandemic and subsequent "lockdowns", there has been an increase in numbers of people of all ages attending community and acute medical settings. Furthermore, presentations are considered to be more medically unwell, with patients presenting with lower weights than previous years. This means that clinicians who might be assessing this group need to be competent in cardiovascular assessments of this cohort. The aim of this paper is to discuss the ways the cardiovascular system is affected in AYAs with various types of EDs, especially AN. The paper aims to provide advice to clinicians on how to assess and cardiovascular problems in this group. This practical summary should be useful to clinicians working in mental health community care who may be less familiar with treating potentially serious physical health problems. The most common cardiovascular issues in young people with low weight or weight loss include slow heart rates, low blood pressure, and problems with sudden changes in blood pressure which can result in fainting. Usually these problems resolve as the patient gains weight. However sometimes more serious changes in heart structure and function may occur and persist causing severe medical issues, like heart failure, which partly explains the high death-rate in AN. For this reason it is important that clinicians know how to spot cardiovascular problems in young people with AN and other EDs and provide them with the best medical care as soon as possible.

The challenges of the COVID-19 pandemic on young people with eating disorders: our experience in Qatar

ObjectivesThis study examined the impact of the COVID-19 pandemic on adolescents with eating disorders, mainly anorexia nervosa, and Bulimia nervosa, using data collection pre-pandemic and during the pandemic in the outpatient clinics in Sidra hospital, Qatar.MethodsMedical records of the patients with eating disorders were reviewed for the period between August 2017 and April 2022. Diagnosis of Anorexia Nervosa and Bulimia Nervosa was done using the DSM-V criteria. For the purpose of this study, August 2017 to March 2020 is considered ‘pre-pandemic' and April 2020 to April 2022 is ‘post-pandemic'.The clinical assessment in the pre-pandemic period was carried out face to face in the clinic, while a hybrid model of clinical care that uses telephone consultations and a limited number of patients' physical appointments was adapted during the pandemic period. The number of clinical appointments increased gradually as the number of COVID-19 cases decreased in the country.The study compared the numbers of diagnosed patients with eating disorders between the two mentioned periods and investigated their specific characteristics (including age, gender, and specific type of eating disorder) and associated comorbidities, like depression and anxiety.ResultsIn the pre-pandemic period, 58 adolescents aged between 8–18 years old were assessed and diagnosed with an eating disorder. Out of the 58 diagnosed with an eating disorder, 16 patients were diagnosed with co-morbid depression and 11 patients with anxiety. During the pandemic, 79 adolescents were diagnosed with an eating disorder and 37 out of the 53 were diagnosed with co-morbid depression. The majority of cases were adolescent females above 12 years of age. This study shows a 27% increase in the number of cases diagnosed with anorexia and bulimia nervosa during the pandemic. In addition, there's a rise in the number of associated psychiatric comorbidities, including depression, anxiety, and other conditions like irritability and inattention.ConclusionsThis study showed an increased rate of eating disorders and co-morbid mental health diseases in Qatar during the COVID-19 pandemic. The increase of young people with an eating disorder could be attributed to disruptions of their routines, quarantine, and interruptions of treatment. Our results agree with previous research suggesting that mental health disorders such as depression, anxiety, substance misuse, PTSD, and suicidal tendencies increase in times of economic instability and natural disasters.1 long term impact must be further examined to prevent long term detrimental mental health effects on the young generation and the health care system in Qatar.ReferenceGuerra O, Eboreime E. The impact of economic recessions on depression, anxiety, and trauma-related disorders and illness outcomes—A scoping review. Behavi Sciences. 2021;11(9):119. doi:10.3390/bs11090119

Communication and Psychiatric Overlay

According to the National Alliance on Mental Illness (NAMI/ nami.org) Borderline Personality Disorder (BPD) may be a seriously underdiagnosed mental illness. Given it appears we might be living with periods of calm interrupted by periods of sharply rising COVID infection rates, disseminating these good strategies is sure to be helpful to others. [...]this work helps assure that when others face this problem, whether COVID related or no, they have an ethically sound model to emulate, avoiding having to start from scratch. Since the pandemic, many hospitals and hospital systems have designed plans to one degree of completeness or another.

Exploring the Impact of COVID-19 on Individuals with Eating Disorders in Saudi Arabia: A Thematic Analysis.

Food and sleep are critical for human survival. However, for individuals with eating disorders, they face two critical disruptions in terms of abnormal feeding patterns as well as poor sleep. These difficulties are exacerbated as a result of the recent coronavirus pandemic, which caused drastic changes in daily life schedules and living arrangements. The current study therefore aims to explore, through qualitative means, how individuals with eating disorders are affected during the subsequent lockdowns, with a particular emphasis on the pandemic's impact on their sleep in Saudi Arabia. Two groups of participants were recruited: participants with eating disorders and healthy controls. Based on thematic analysis of focus group discussion data, it was found that both types of participants experienced poorer sleep and poorer mental health. Participants with eating disorders too showed a deterioration of their symptoms. However, healthy participants tended to show greater levels of recovery and coping. Based on the study findings, recommendations for future studies are made.

Women's mental health during the COVID 19 pandemic and the problem of domestic violence in a lockdown situation

Introduction: The current situation caused by restrictive measures related to the COVID-19 pandemic provokes the high level of aggressiveness and all forms of domestic violence. These results in mental health problems. Objective(s): The purpose of this study was to find out the consequences of domestic violence against women and to identify psychological problems and mental disorders in women. Method(s): Acohort of 18 females was examined by psychiatrists and psychologists. All women turned to specialists at the Moscow Institute of Psychiatry for help. Result(s): All women were victims of violence by their husbands and partners. Lockdown situation associated with COVID 19 pandemic has exacerbated the problem of domestic violence. Clinical assessment has revealed different depressive symptoms, anxiety, fear, suicidal tendencies forming the clinical picture of adjustment disorder (2 cases), acute reaction to stress (3 cases), posttraumatic stress disorder (2 cases), depressive episode (8 cases), eating disorders behavior in the form of bulimia and anorexia (3 cases). Conclusion(s): The research has revealed that domestic abuse against women associated with lockdown situation during the COVID 19 pandemic often results in psychological and longterm mental health problems. In these cases, prevention is needed to combat violence against women with the participation of public health specialists, psychologists, psychiatrists, sociologists.

Eating habits during quarantine: Investigating the role of emotions and loneliness in a sample of adults in Greece

Introduction: Imposing quarantine as a measure to manage the coronavirus pandemic is a stressful event that is often associatedwith negative psychological effects. Eating habits seemed to be significantly affected during the quarantine, while strong negative emotions were triggered as the feeling of loneliness increased at the same time. Objective(s): This study aims to investigate the eating habits of individuals during quarantine and the role of positive and negative emotions and loneliness in shaping these habits. Method(s): An online cross-sectional study was performed using 3 validated scales, EAT-26 (3 subscales: Dieting, Bulimia and Food Preoccupation, Oral Control), Modified Differential Emotions Scale and UCLA Loneliness Scale. Data was collected between April and May 2021 mainly from social media platforms. Statistical analyses included linear regression and mediation analyses. Result(s): Abnormal eating habits were detected in 25% of the participants (N= 450, ages 18-74) while the majority reported medium rates of negative/positive emotions and loneliness. Female sex is associated with abnormal eating habits (p=0.010) and mainly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) seemto be predictive factors of eating habits in general and bulimic behaviors.Negative emotions correlate directly with eating habits. However, we found a significant mediation of loneliness (p=0.032). Furthermore, the observed association between negative emotions and bulimia is partly mediated by loneliness (p=0.018). Conclusion(s): Negative emotions and loneliness seemed to play an important role in shaping eating habits during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemic in general.

Impact of COVID19 Lockdown in Eating Disorders: A Multicenter Collaborative International Study

Introduction: COVID19 lockdown is having a significant impact on mental health, patients with eating disorders (ED) are particularly vulnerable. Objective(s): 1) To explore changes in eating and other psychological features due to confinement in patients with ED from various European and Asian countries;and 2) to assess differences related to diagnostic subtypes, age and geography. Method(s): The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID19 Isolation Scale (CIES). Result(s): On one hand, patients with Binge Eating Disorder experienced the highest impact on weight and ED symptoms due to confinement. Together with subjects diagnosed with Other Specified Feeding and Eating Disorders (OFSED), they also experienced a deterioration in general psychological state. On the other hand, there was less symptomatic impact on people with Bulimia Nervosa or Anorexia Nervosa and asian and younger individuals appeared to be more resilient in this situation. Conclusion(s): The impact of COVID varied by cultural context and individual variation in age and form of illness. Services may need to target preventive measures and adapting therapeutic approaches for the most vulnerable patients.

ADHD in a patient with eating disorder. Case report

Introduction: 15-year-old female referred to outpatient unit after COVID lockdown for binge eating and purging with depressive symptoms and anxiety. Objective(s): To show the importance of a correct diagnosis in an impulsive patient with eating disorder Methods: case report and literature review Results: The patient presents emotional instability with interpersonal difficulties with high fear of rejection. She suffered from fear of gaining weight and desires to lose weight with rejection of her body image. Fluoxetine and lorazepam are started together with low doses of olanzapine. During the follow up she presented a worsening of mood, onset of self-injuries and an episode of suicidal attempt. A biographical examination was performed, expressing a feeling of academic failure with difficulty concentrating and performing simple tasks. As a child she is described as impulsive, with frequent arguments with classmates. CPT III was performed with a high probability of ADHD. Treatment was started with lisdexamfetamine up to 50 mg with good tolerance. From the beginning of the treatment the patient expressed a feeling of improvement in the control of emotions as well as in the management of her impulsivity. There was an improvement in her academic performance with a decrease in self-injury episodes. The patient was able to express improvement in the sense of incapacity she felt. Conclusion(s): This case shows how marked emotional dysregulation and impulsive symptoms improves after diagnosis and subsequent treatment of ADHD, also improving eating symptoms. ADHD is present in eating disorders, especially in those with impulse dyscontrol such as binge eating disorder or bulimia nervosa.

Mental disorders and psychological problems of women-victims of domestic violence during selfisolation in the covid 19 pandemic

Introduction: Domestic violence is a troubling problem, but it has acquired a new, previously unknown significance during the COVID 19 pandemic. According to WHO, the number of calls from victims of domestic violence to hotlines during quarantine in many countries has increased by an average of 5 times. Objective(s): The purpose of this study was to find out the consequences of domestic violence against women and to identify psychological problems and mental disorders. Attention was paid to the mental health of victims of violence in self - isolation during COVID-19 pandemic. Method(s): We analyzed the psychological problems and mental disorders of women who applied to the newly created hotline for women at the Serbsky Center in Moscow during the COVID 19 pandemic. Result(s): The situation caused by restrictive quarantine measures related to the COVID-19 pandemic provokes aggressiveness and all forms of domestic violence.Clinical interview has revealed depression, anxiety, fear, low self-esteem, self-harm behavior, which formed the clinical picture of adaptation disorders, acute stress disorders, PTSR, psychosomatic disorders, substance abuse), sexual dysfunctions, eating disorders in the form of bulimia and anorexia. Conclusion(s): The study requires taking into account social, economic and gender characteristics. In all types of emergencies, including epidemics, violence against women tends to increase. This is facilitated by a number of factors, such as the crowding of the stay,a decrease in prosperity, provocation of alcohol abuse, state of uncertainty.

Sleep disruption as a potential contributor to the worsening of eating disorder pathology during the COVID-19-pandemic.

The acute phase of the COVID-19 pandemic was associated with significant increases in the prevalence and severity of eating disorders (EDs). Studies also highlighted changes to sleep quality and duration in many individuals throughout this period. Although these two phenomena have been examined separately, here we highlight the need to investigate the potential link between these outcomes. Sleep dysregulation and EDs have previously been hypothesized to interact via a positive feedback loop, wherein poor sleep exacerbates ED symptomatology which, in turn, further worsens sleep. Thus, we speculate that the aggravation of sleep disturbances and EDs during COVID-19 lockdowns may have been somewhat interdependent. We further hypothesize that the worsening of depression and anxiety symptomology during the acute phase of the pandemic may have served as an additional mediating variable. Altogether, in our view, these observations highlight a need for future work to examine the possible causal relationship between sleep and ED pathology, which may ultimately lead to improved clinical management of disordered eating.

Adapting integrative cognitive-affective therapy for adolescents with full and subthreshold bulimia nervosa: A feasibility study.

BACKGROUND: Integrative Cognitive Affective Therapy (ICAT) is an empirically supported treatment for bulimia nervosa (BN) in adults. However, it is unclear whether a modified version, Integrative Cognitive Affective Therapy-Adolescent (ICAT-A) is feasible and beneficial for adolescents. This study evaluated the feasibility of ICAT-A for adolescents with BN or subthreshold BN. METHODS: Eight adolescents with BN or subthreshold BN (mean age = 16.1) were enroled in the study. At baseline and end of treatment, adolescents who participated in ICAT-A completed the Eating Disorder Examination (EDE) and self-report measures of eating disorder symptoms, depression, anxiety, self-esteem and functional impairment. RESULTS: Retention for the intervention (75%) suggests that the majority of participants found the intervention acceptable. Although all treatment completers participated in the clinician-administered assessment (EDE), compliance with end of treatment self-report questionnaires was compromised by the COVID-19 pandemic, which occurred during the treatment course of the majority of the sample. At the end of treatment, all 6 adolescents who completed the ICAT-A intervention were in full eating disorder remission based on EDE scores, with large effect sizes identified for reductions in EDE global scores (d = 2.71), objective binge episodes (d = 0.91), subjective binge episodes (d = 1.06) and compensatory behaviours (d = 1.72). CONCLUSION: Results suggest that ICAT-A is a feasible treatment that has promise for the treatment of adolescents with BN. Future studies are necessary to establish the efficacy of ICAT-A for adolescent BN.