Child ; Adolescent ; Humans ; Feeding and Eating Disorders/diagnosis*

Child ; Adolescent ; Humans ; Feeding and Eating Disorders/diagnosis*

Eating disorders are disorders of unknown etiology characterized by disturbed eating behavior. Many comorbidity studies of eating disorders have consistently supported an association between various psychiatric disorders and eating disorders. There are many strategies for testing the relationship between one disorder and another disorder. Family study is a useful method for testing and establishing such relationship. Strategies for conducting genetic investigation of eating disorders including twin studies, adoption studies, and family studies. These studies have been used to test the relationship between eating disorders and other psychiatric disorders. Despite widely discrepant views about the characteristics of families of eating disorders patients and many methodological difficulties, most researchers and clinicians would agree to the role of familial factors in the pathogenesis and maintenance of eating disorders. For the most part, theoretical speculation in this area has focused on the link between eating disorders and specific patterns of intrafamilial boundaries, conflict management, role dysfunction, affective expression, and broader aspects of the family psychological resources and competencies. Furthermore, in the light of the family environment for eating disorders, high prevalence rates of other psychiatric disorders in the family members may add the risk for the chance of expressing psychopathology to the biologically determined vulnerable subjects. Understanding the relationships between eating disorders and other psychiatric disorders is also important to diagnosis, subclassification, and treatment of the patients with eating disorders. In the present paper, the author first reviewed some methodological issues in family study of eating disorders. Second, the author reviewed the previous literature regarding the family study of eating disorders and the possible implication of their results. Third, the author discussed several conceptual models that offer explanations for the observed results. Fourth, the author proposed the hypothesis which could integrate the various comorbid conditions and their genetic relations to eating disorders.
Comorbidity ; Diagnosis ; Feeding and Eating Disorders* ; Eating* ; Feeding Behavior ; Humans ; Prevalence ; Psychopathology

OBJECTIVES: One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of psychiatric diagnoses using the results of this study. METHODS : The study subjects, aged from 18 to 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. RESULTS : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence. withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%, female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. CONCLUSION : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.
Anxiety Disorders ; Appointments and Schedules ; Surveys and Questionnaires ; Diagnosis ; Feeding and Eating Disorders ; Epidemiology ; Female ; Hospitals, Psychiatric ; Humans ; Mental Disorders* ; Mental Health* ; Mood Disorders ; Prevalence* ; Psychiatric Nursing ; Psychotic Disorders ; Schizophrenia ; Somatoform Disorders ; Tobacco Use Disorder

OBJECTIVE: Accurate diagnosis and assessment for psychiatric disorders is crucial for research, as well as for clinical practice. Structured Clinical Interview for DSM-IV(SCID-RV) is a less time-consumimg and more accurate structured diagnostic interview form. It can be used by clinical professions and is known for a reliable diagnostic tool. Present study was conducted to develop Korean version of SCID-RV and to test the inter-rater reliability. METHOD: The authors have translated original SCID-RV into Korean, and revised in parallel with sociocultural background of Korea. Ninety patients from two psychiatric hospitals, both outpatient and inpatient, were interviewed and rated independently by three raters. RESULT: The kappa coefficients for most of illnesses, such as major depressive disorder, dysthymia, schizophrenia, alcohol abuse and dependency, anxiety disorder and eating disorder were excellent (>0.70) in the evaluation of current disorders. And the kappa coefficients for bipolar disorder, delusional disorder, agoraphobia, undifferentiated somatoform disorder, and hypochondriasis were acceptable (>0.40) in the evaluation of current disorders. In the evaluation of lifetime disorders, the concordant rates of all the diagnoses except bipolar disorder and undifferentiated somatoform disorder were excellent. Lack of hierarchy in DSM-IV allows for multiple Axis I diagnoses. Mean numbers of Axis I diagnoses per subject assigned by the three raters were 1.5-1.7. CONCLUSION: Our findings confirm that SCID-RV yields highly reliable diagnoses. SCID-RV is recommended for accurate diagnosis in clinical practice and research on psychiatric disorders.
Agoraphobia ; Alcoholism ; Anxiety Disorders ; Appointments and Schedules* ; Axis, Cervical Vertebra* ; Bipolar Disorder ; Depressive Disorder, Major ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders* ; Feeding and Eating Disorders ; Hospitals, Psychiatric ; Humans ; Hypochondriasis ; Inpatients ; Korea ; Outpatients ; Schizophrenia ; Schizophrenia, Paranoid ; Somatoform Disorders

INTRODUCTIONElevated levels of psychopathology have been described in various groups of obese patients. This study aimed to describe the presence of depressive and binge eating symptoms in patients presented for clinical weight management at a general hospital in Singapore, as well as their health-related quality of life (HRQOL). Correlations between these symptoms and other demographic and clinical variables were also sought.

MATERIALS AND METHODSPatients presented at a clinical weight management programme were asked to complete the Beck Depression Inventory (BDI), Binge Eating Scale (BES) and the Short Form-36 (SF-36). Clinical and demographic data were also collected.

RESULTSOf the group, 17.1% reported moderate or severe binge eating symptoms and 9.7% reported moderate or severe depressive symptoms. HRQOL, mostly in physical health domains, was lower in this sample compared to local norms. Within the group, binge eating and depressive symptoms, but not increasing obesity, predicted poorer HRQOL.

CONCLUSIONSPsychological symptoms are significantly present in patients presented for clinical weight management and these contribute to poorer quality of life. Addressing these symptoms will improve the overall well-beings of these patients and the total benefits gained will exceed the benefits of weight loss per se.

Adult ; Aged ; Depression ; complications ; diagnosis ; epidemiology ; Feeding and Eating Disorders ; complications ; epidemiology ; Female ; Health Status Indicators ; Humans ; Male ; Mental Disorders ; epidemiology ; physiopathology ; Middle Aged ; Obesity ; complications ; ethnology ; psychology ; therapy ; Psychiatric Status Rating Scales ; Quality of Life ; psychology ; Singapore ; epidemiology ; Young Adult

INTRODUCTIONAnorexia nervosa (AN) and eating disorders not otherwise specified (EDNOS) are on the rise in Singapore. Abnormal liver function tests have been reported for up to 12.2% of patients with AN. These patients are also known to present with comorbid psychiatric disorders. This study aims to investigate the correlation between body mass index (BMI) and the severity of abnormal liver function tests, and between BMI and the presence of comorbid psychiatric disorders.

METHODSA retrospective cohort analysis of 373 patients diagnosed with AN or EDNOS at a tertiary hospital was performed. The clinical course of transaminitis and comorbid psychiatric disorders was correlated with the patient's BMI.

RESULTSPatients with a BMI of ≥ 16.6 kg/m(2) at their first consult had a significantly lower risk of having comorbid psychiatric disorders (χ(2) = 32.08, p < 0.001). These patients were five times less likely to have comorbid psychiatric disorders as compared to patients from the other BMI groups (odds ratio [OR] 0.21). On the other hand, patients with a BMI of < 14.6 kg/m(2) had a significantly higher risk of having transaminitis (χ(2) = 72.5, p < 0.001). They were 11.1 times more likely to develop transaminitis as compared to patients with a BMI of ≥ 14.6 kg/m(2) (OR 11.05).

CONCLUSIONSeverity of BMI can be used by clinicians as an indicator to assess for secondary psychiatric comorbidities and/or transaminitis during the first consultation. This could help reduce the morbidity and mortality rates in patients with AN or EDNOS.

Adolescent ; Adult ; Alanine Transaminase ; blood ; Alkaline Phosphatase ; blood ; Anorexia Nervosa ; complications ; diagnosis ; epidemiology ; Aspartate Aminotransferases ; blood ; Body Mass Index ; Child ; Comorbidity ; Diagnostic and Statistical Manual of Mental Disorders ; Feeding and Eating Disorders ; complications ; diagnosis ; epidemiology ; Female ; Humans ; Liver Diseases ; complications ; diagnosis ; epidemiology ; Liver Function Tests ; Male ; Mental Disorders ; complications ; diagnosis ; epidemiology ; Odds Ratio ; Prevalence ; Psychiatric Status Rating Scales ; Retrospective Studies ; Singapore