Alexithymia and Treatment Outcome in Anorexia Nervosa: A Scoping Review of the Literature

Alexithymia is of great interest as an outcome predictor of recovery from anorexia nervosa, since it may interfere with both treatment compliance and patients' ability to benefit from the adopted interventions. Using the PRISMA methodology, we performed a scoping review of the literature about treatment outcome in anorexia nervosa, in terms of changes in alexithymia as assessed by its most commonly used self-report measure, the Toronto Alexithymia Scale (TAS). The Medline and Scopus databases were searched, and articles were included if matching the following criteria: dealing with patients affected by anorexia nervosa, without limits of age; involving the application of any kind of targeted therapy or treatment; assessing alexithymia and the effect of a treatment intervention on alexithymia, using the TAS. Ten studies were eventually included; overall, according to the selected studies, alexithymia levels often remain high even after specific treatment. Further research aimed at a deeper understanding of the actual impact of alexithymia on the outcome of anorexia, as well as exploring alternative treatment strategies for alexithymia in eating disorders (EDs), are warranted

From the Roman Empire to the New Millennium. Data access and sharing from healthy ageing cohorts

Cohort studies are the best way to analyze the incidence and natural history of a disorder, permitting to assess associations between multiple exposures and multiple outcomes. A well-designed cohort may be particularly relevant regarding the study of the ageing processes of adult populations, allowing the study of processes and dynamics of the individual life course and the study of the effects of earlier exposures and characteristics on later outcomes. Moreover, cohort studies seem the best instrument to analyze the factors favoring active and healthy ageing, and to increase knowledge about the most appropriate interventions to enhance older population's wellness. Nonetheless, the number of cohorts on ageing is limited, because they are very expensive to develop, establish, and maintain, requiring long-term investment to be efficiently performed to obtain all the data needed to address the longitudinal research questions. Open data and data sharing should be encouraged to ensure verifiable, reproducible and transparent results, and to allow the generation of new knowledge in the context of earlier discoveries. Making cohort studies \u201copen\u201d can foster the efforts of the scientific community committed in the study of ageing and give a real contribution to the well-being of the ageing population. KEY-MESSAGE: \u2022 Cohort studies are the best way to analyze the incidence and natural history of a disorder, the factors favoring active and healthy ageing, and to increase knowledge about the most appropriate interventions to enhance older population's wellness. \u2022 Making cohort studies \u201copen\u201d can foster the efforts of the scientific community committed in the study of ageing and give a real contribution to the well-being of the ageing population

Cinema in the training of psychiatry residents: focus on helping relationships

Background: Medical schools are currently charged with a lack of education as far as empathic/relational skills and the meaning of being a health-care provider are concerned, thus leading to increased interest in medical humanities. Discussion. Medical humanities can offer an insight into human illness and in a broader outlook into human condition, understanding of one self, responsibility. An empathic relation to patients might be fostered by a matching approach to humanities and sciences, which should be considered as subjects of equal relevance, complementary to one another. Recently, movies have been used in medical - especially psychiatric - trainees education, but mainly within the limits of teaching a variety of disorders. A different approach dealing with the use of cinema in the training of psychiatry residents is proposed, based on Jung and Hillman's considerations about the relation between images and archetypes, archetypal experience and learning. Summary. Selected full-length movies or clips can offer a priceless opportunity to face with the meaning of being involved in a care-providing, helping profession

Surfactants, nanomedicines and nanocarriers: a critical evaluation on clinical trials

Advances, perspectives and innovation in drug delivery have increased in recent years; however, there is limited information available regarding the actual presence of surfactants, nanomed-icines and nanocarriers in investigational medicinal products submitted as part of a request for authorization of clinical trials, particularly for those authorized in the European Economic Area. We retrieve, analyze and report data available at the Clinical Trial Office of the Italian Medicines Agency (AIFA), increasing the transparency and availability of relevant information. An analysis of quality documentation submitted along with clinical trials authorized by the AIFA in 2018 was carried out, focusing on the key terms “surfactant”, “nanomedicine” and “nanocarrier”. Results suggest potential indications and inputs for further reflection and actions for regulators to actively and safely drive innovation from a regulatory perspective and to transpose upcoming evolution of clinical trials within a strong regulatory framework

The psychopathology of body image in orthorexia nervosa

The human body has a complex meaning and role in everybody\u2019s life and experience. Body image has two main components: body percept (the internal visual image of body shape and size) and body concept (the level of satisfaction with one\u2019s body), whose specific alterations may lead to different conditions, such as overestimation of one\u2019s own body dimensions, negative feelings and thoughts towards the body, body avoidance and body checking behavior. Moreover, body dissatisfaction can be associated with a variety of other mental health and psychosocial conditions, but only a few studies have explored the body image construct in orthorexia nervosa (ON). ON is a condition characterized by concern and fixation about healthy eating, with mixed results available in the literature about the presence of body image disorders. The aim of this manuscript is to present the main findings from the literature about the psychopathology of body image in ON. Summarizing, while theoretically the presence of body image disturbances should help clinicians to differentiate ON from eating disorders, further research is needed to confirm this finding. It is not clear whether the body image disorder in ON depends on an altered body percept or body concept, and the relationship between the disordered eating behavior and body image disorder still needs to be disentangled. Further studies regarding the relationship between ON and body image could be helpful to better understand the relevance of body image as a transdiagnostic factor and its potential value as target for treatment intervention

Anxiety and Expressed Emotion in a Sample of Obese Patients

INTRODUCTION Expressed Emotion (EE) is a measure of the intensity of the affective family climate and plays a role in disease course and outcome. Especially in urban settings, obesity is a severe problem with serious implications as far as health risks are concerned. Having a high EE caregiver has been suggested to correlate with a worse treatment compliance in obese patients. OBJECTIVES To measure level of EE, stressful events and anxiety in obese patients and their caregivers; to investigate the possible correlations between compliance with treatment and emotional temperature of families. METHODS We have already recruited more than 150 obese patients and their caregivers. Assessment included: Level of Expressed Emotion Scale (LEE), one version for patients and one for relatives in order to evaluate 4 dimensions: intrusiveness, emotional response, attitude toward disease, tolerance and expectation; the Paykel\u2019s Interview for Recent Life Events; STAI Y1 concerning state anxiety and STAI Y2 concerning trait anxiety. Furthermore we collected demographic characteristics and BMI (Body Mass Index). RESULTS Data collection and analyses are still ongoing. Preliminary results suggest a correlation between obesity and level of anxiety. We expect to find a correlation between level of EE and variation of BMI. CONCLUSIONS Levels of EE and anxiety should be considered when planning treatment interventions to enhance compliance in obese patients and to support change in their life-style

No correlation among expressed emotion, anxiety, stress and weight loss in patients with overweight and obesity

The onset of some types of obesity may correlate with specific familial relational patterns, and expressed emotion (EE). The aim of this study is to address the current gap in the literature about EE and obesity, assessing EE in a sample of patients with overweight or obesity and their relatives. A further objective is to assess patients' weight loss, patients' and relatives' anxiety, perceived stress and their possible correlation with EE and diet compliance. A total of 220 patients with overweight or obesity and 126 relatives were recruited. Patients' baseline body mass index (BMI) was negatively correlated with educational level, but we failed to find any correlation between BMI and the other variables assessed. We found a positive correlation between EE median and stressful life events, as well as between median EE and state and trait anxiety. Our results seem to suggest that other factors than the psychological ones we investigated may play a role in treatment adherence and outcome in patients with overweight and obesity