3 research outputs found
Psychiatric and medical comorbidities of eating disorders : findings from a rapid review of the literature
Background: Eating disorders (EDs) are potentially severe, complex, and life-threatening illnesses. The mortality rate
of EDs is signifcantly elevated compared to other psychiatric conditions, primarily due to medical complications and
suicide. The current rapid review aimed to summarise the literature and identify gaps in knowledge relating to any
psychiatric and medical comorbidities of eating disorders.
Methods: This paper forms part of a rapid review) series scoping the evidence base for the feld of EDs, conducted
to inform the Australian National Eating Disorders Research and Translation Strategy 2021–2031, funded and released
by the Australian Government. ScienceDirect, PubMed and Ovid/Medline were searched for English-language studies
focused on the psychiatric and medical comorbidities of EDs, published between 2009 and 2021. High-level evidence
such as meta-analyses, large population studies and Randomised Control Trials were prioritised.
Results: A total of 202 studies were included in this review, with 58% pertaining to psychiatric comorbidities and
42% to medical comorbidities. For EDs in general, the most prevalent psychiatric comorbidities were anxiety (up
to 62%), mood (up to 54%) and substance use and post-traumatic stress disorders (similar comorbidity rates up to
27%). The review also noted associations between specifc EDs and non-suicidal self-injury, personality disorders, and
neurodevelopmental disorders. EDs were complicated by medical comorbidities across the neuroendocrine, skeletal,
nutritional, gastrointestinal, dental, and reproductive systems. Medical comorbidities can precede, occur alongside or
emerge as a complication of the ED.
Conclusions: This review provides a thorough overview of the comorbid psychiatric and medical conditions cooccurring with EDs. High psychiatric and medical comorbidity rates were observed in people with EDs, with comorbidities contributing to increased ED symptom severity, maintenance of some ED behaviours, and poorer functioning
as well as treatment outcomes. Early identifcation and management of psychiatric and medical comorbidities in
people with an ED may improve response to treatment and overall outcomes
Informing the development of Australia's national eating disorders research and translation strategy : a rapid review methodology
Background Eating disorders (EDs) are highly complex mental illnesses associated with significant medical complications. There are currently knowledge gaps in research relating to the epidemiology, aetiology, treatment, burden, and outcomes of eating disorders. To clearly identify and begin addressing the major deficits in the scientific, medical, and clinical understanding of these mental illnesses, the Australian Government Department of Health in 2019 funded the InsideOut Institute (IOI) to develop the Australian Eating Disorder Research and Translation Strategy, the primary aim of which was to identify priorities and targets for building research capacity and outputs. A series of rapid reviews (RR) were conducted to map the current state of knowledge, identify evidence gaps, and inform development of the national research strategy. Published peer-reviewed literature on DSM-5 listed EDs, across eight knowledge domains was reviewed: (1) population, prevalence, disease burden, Quality of Life in Western developed countries; (2) risk factors; (3) co-occurring conditions and medical complications; (4) screening and diagnosis; (5) prevention and early intervention; (6) psychotherapies and relapse prevention; (7) models of care; (8) pharmacotherapies, alternative and adjunctive therapies; and (9) outcomes (including mortality). While RRs are systematic in nature, they are distinct from systematic reviews in their aim to gather evidence in a timely manner to support decision-making on urgent or high-priority health concerns at the national level. Results Three medical science databases were searched as the primary source of literature for the RRs: Science Direct, PubMed and OVID (Medline). The search was completed on 31st May 2021 (spanning January 2009-May 2021). At writing, a total of 1,320 articles met eligibility criteria and were included in the final review. Conclusions For each RR, the evidence has been organised to review the knowledge area and identify gaps for further research and investment. The series of RRs (published separately within the current series) are designed to support the development of research and translation practice in the field of EDs. They highlight areas for investment and investigation, and provide researchers, service planners and providers, and research funders rapid access to quality current evidence, which has been synthesised and organised to assist decision-making
The what and the how: A pilot study of feedback from service providers and consumers about service development in new urban mental health hub
Objective An inner-city hospital purchased a local hotel to provide support, digital engagement, skill development groups and referrals to partner agencies. Being aware of the hotel’s importance to the local community, we sought feedback on a model of care relevant to perceived gaps and needs in support for mental health. Methods Four online focus groups included healthcare professionals, nominated opinion leaders from local Non-Government Organisations (NGOs), consumers and carers to reflect a range of views. Focus group data were qualitatively analysed. Results Participants made useful suggestions about WHAT educational, preventative and therapeutic services were needed. They emphasised the importance of HOW people engage with the service, the balance between accessibility and security. Other themes included targeting people with limited health literacy, integration with existing services, building on site heritage and ongoing evaluation of objectives and needs. Conclusions This pilot study demonstrated clear support for providing safe and welcoming access to services, with resources and access to services to improve their health and wellbeing built on principles of social justice and inclusion. Participants had constructive ideas of what was needed, and ongoing patient and public research is anticipated