Disturbi della condotta alimentare e adolescenza. Dalla diagnosi al trattamento

Journal title RIVISTA SPERIMENTALE DI FRENIATRIA
Author/s Annalisa Signorelli
Publishing Year 2022 Issue 2022/3
Language English Pages 23 P. 81-103 File size 226 KB
DOI 10.3280/RSF2022-003005
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Eating Disorders (EDs) are potentially serious disabling, pervasive, and life-threatening mental disorders that can greatly impair physical health and significantly alter an individual's psychosocial functioning. They are some of the most prevalent disorders during adolescence and often take a chronic and disabling course, although they can occur across the whole lifespan. Prevalence appears to be higher in Western populations and in the female sex. They play a key role in the origin and maintenance of symptomatology, predominantly: distorted beliefs, distorted perceptions, dysfunctional attitudes toward weight, body shape, and nutrition, which take hold beginning in childhood or adolescence, but also genetic bases, socio-cultural and environmental factors. Given the complexity of the etiology of such psychopathologies and maintenance factors, treatment must contemplate a multidimensional and multidisciplinary approach. To date, the deep understanding of the pathophysiology and psychobiology of EDs remains to be further investigated.

Keywords: Eating disorders, adolescence, risk factor, maintenance factors, treatment.

  1. Giornata Mondiale d'azione sui Disturbi dell’Alimentazione 2022 -- https://www.salute.gov.it/.
  2. Treasure J, A. D. (2020). Eating disorders. Lancet, Volume 395: 899-911. DOI: 10.1016/S0140-6736(20)30059-3
  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Washington, DC: American Psychiatric Association, 2013.
  4. Diedrichs PC, von Ranson KM, Thomas JJ. Innovation in eating disorders research and practice: Expanding our community and perspectives at the 2018 International Conference on Eating Disorders. Wiley, Inernational Journal of Eating Disorder. 2018:1-3.
  5. Litmanen J, Fröjd S, Marttunen M, Isomaa R, Kaltiala-Heino R. Are eating disorders and their symptoms increasing in prevalence among adolescent population? Nord J Psychiatry 2017; 71: 61-66.
  6. Javaras KN, Runfola CD, Thornton LM, et al. Sex- and age-specific incidence of healthcare-register-recorded eating disorders in the complete Swedish 1979- 2001 birth cohort. Int J Eat Disord 2015; 48: 1070-81.
  7. Balestrieri M, Bellantuono C, Berardi D, DI Giannantonio M, Rigatelli M, Siracusano A, Zoccali RA, ed. Manuale di Psichiatria, seconda edizione. Roma: Il Pensiero Scientifico Editore; 2015.
  8. Weiselberg EC, Gonzalez M, Fisher M. Eating disorders in the twenty-first century. Minerva Ginecol. 2011;63(6): 531-545 PMID: 22036757.
  9. Fairburn CG, Harrison PJ. Eating disorders. The Lancet, 2003; volume 361: 407-416. DOI: 10.1016/S0140-6736(03)12378-1
  10. Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR. Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry. 2011; 68(7): 714-723.
  11. Herpertz Dahlmann B, Adolescent Eating Disorders. Update on Definitions, Symptomatology, Epidemiology, and Comorbidity. Child and Adolescent Psychiatric Clinics of North America, Volume 24, Issue 1, 2015, Pages 177- 196.
  12. Hudson JI, Hiripi E, Pope HG Jr, et al. The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biol Psychiatry 2007; 61(3): 348-58.
  13. Marie Galmiche, Pierre Déchelotte, Grégory Lambert, Marie Pierre Tavolacci, Prevalence of eating disorders over the 2000-2018 period: a systematic literature review, The American Journal of Clinical Nutrition, Volume 109, Issue 5, May 2019, Pages 1402-1413,
  14. Keski-Rahkonen A, Mustelin L. Epidemiology of eating disorders in Europe: prevalence, incidence, comorbidity, course, consequences, and risk factors. Curr Opin Psychiatry. 2016 Nov;29(6):340-5. DOI: 10.1097/YCO.0000000000000278
  15. Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor L, Touyz S, Ward W; Royal Australian and New Zealand College of Psychiatrists. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Aust N Z J Psychiatry. 2014 Nov; 48(11):977- 1008. DOI: 10.1177/0004867414555814
  16. Herpertz-Dahlmann B, Dempfle A, Konrad K, et al. Eating disorder symptoms do not just disappear: the implications of adolescent eating-disordered behaviour for body weight and mental health in young adulthood. Eur Child Adolesc Psychiatry 2015; 24:675-684.
  17. Carlson NR. Fisiologia del comportamento. Edizione italiana a cura di De Gennaro L. Padova: Piccin Nuova Libraria S.p.A. 2014.
  18. Caprara GV, Cervone D. Personalità. Determinanti, dinamiche, potenzialità. Milano: Raffello Cortina Editore. 2003.
  19. Berti A E, Bombi A S. Corso di psicologia dello sviluppo. Bologna: il Mulino. 2005. Kohlberg L. Moral stages and moralization: the cognitive-evelopmental approach, in T. Lickona (a cura di), Moral development and behavior, New York, Holt, Reinehart & Winston. 1976.
  20. Klump KL, Suisman J L, Culbert KM, Kashy DA, & Sisk CL (2011). Binge eating proneness emerges during puberty in female rats: a longitudinal study. Journal of Abnormal Psychology, 120(4), 948-55.
  21. Klump KL. Puberty as a critical risk period for eating disorders: a review of human and animal studies. Horm Behav. 2013 Jul; 64(2): 399-410.
  22. Bakalar JL, Shank LM, Vannucci A, Radin RM, Tanofsky-Kraff M. Recent Advances in Developmental and Risk Factor Research on Eating Disorders. Curr Psychiatry Rep. 2015 Jun;17(6):42.
  23. Schaumberg K, Welch E, Breithaupt L, Hübel C, Baker JH, Munn-Chernoff MA, Yilmaz Z, Ehrlich S, Mustelin L, Ghaderi A, Hardaway AJ, Bulik- Sullivan EC, Hedman AM, Jangmo A, Nilsson IAK, Wiklund C, Yao S, Seidel M, Bulik CM. The Science Behind the Academy for Eating Disorders’ Nine Truths About Eating Disorders. Eur Eat Disord Rev. 2017 Nov; 25(6): 432-450. -- http://www.aedweb.org/index.php/25-press-releases/163-press-release-aed- releases-nine-truths-about-eating-disorders?]quot.
  24. Duncan, AE, Ziobrowski, HN, & Nicol G (2017). The prevalence of past 12-month and lifetime DSM-IV eating disorders by BMI category in US men and women. European Eating Disorders Review,
  25. Mehler P S, Brown C (2015). Anorexia nervosa – Medical complications. Journal of Eating Disorders, 3, 11.
  26. Mehler P, Rylander M (2015). Bulimia nervosa – Medical complications. Journal of Eating Disorders, 3, 12.
  27. Currin, L, Schmidt U, Waller G (2007). Variables that influence diagnosis and treatment of the eating disorders within primary care settings: A vignette study. International Journal of Eating Disorders, 40, 257-262.
  28. Twomey C D, Baldwin D S, Hopfe M, Cieza A (2015). A systematic review of the predictors of health service utilization by adults with mental disorders in the UK. BMJ Open, 5, e007575.
  29. Westmoreland, P, Krantz, M J, & Mehler, P S (2016). Medical complications of anorexia nervosa and bulimia. American Journal of Medicine, 129, 30-37.
  30. Johnson, JG, Cohen P, Kasen S, Brook JS (2002). Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. American Journal of Psychiatry, 159, 394-400.
  31. Couturier J, Kimber M, & Szatmari P (2013). Efficacy of familybased treatment for adolescents with eating disorders: A systematic review and meta-analysis. International Journal of Eating Disorders, 46, 3-11.
  32. Treasure J, & Nazar B P. (2016). Interventions for the carers of patients with eating disorders. Current Psychiatry Reports, 18, 16.
  33. Ali K, Farrer L, Fassnacht D B, Gulliver A, Bauer S, & Griffiths K M (2017). Perceived barriers and facilitators towards helpseeking for eating disorders: A systematic review. International Journal of Eating Disorders, 50, 9-21.
  34. Caslini M, Crocamo C, Dakanalis A, Tremolada M, Clerici M, & Carrà G (2016). Stigmatizing attitudes and beliefs about anorexia and bulimia nervosa among Italian undergraduates. Journal of Nervous and Mental Disease, 204, 916-924. DOI: 10.1097/NMD.0000000000000606
  35. Dimitropoulos G, McCallum L, Colasanto M, Freeman VE, & Gadalla T (2016). The effects of stigma on recovery attitudes in people with anorexia nervosa in intensive treatment. Journal of Nervous and Mental Disease, 204, 370-380. DOI: 10.1097/NMD.0000000000000480
  36. Yilmaz Z, Hardaway JA, & Bulik, C M (2015). Genetics and epigenetics of eating disorders. Advances in Genomics and Genetics, 5, 131-150. https://doi. org/10.2147/AGG.S55776.
  37. Duncan L, Yilmaz Z, Gaspar H, Walters R, Goldstein J, Anttila V, Bulik-Sullivan B, Ripke S; Eating Disorders Working Group of the Psychiatric Genomics Consortium, Thornton L, Hinney A, Daly M, Sullivan PF, Zeggini E, Breen G, Bulik CM. Significant Locus and Metabolic Genetic Correlations Revealed in Genome-Wide Association Study of Anorexia Nervosa. Am J Psychiatry. 2017 Sep 1;174(9):850-858.
  38. Bould H, Sovio U, Koupil, I, Dalman C, Micali, N, Lewis G, & Magnusson. (2015). Do eating disorders in parents predict eating disorders in children? Evidence from a Swedish cohort. Acta Psychiatrica Scandinavica, 132, 51-59.
  39. Trace S., Baker JH, Peñas-Lledó E, & Bulik, C (2013). The genetics of eating disorders. Annual Review of Clinical Psychology, 9, 589-620.
  40. Collantoni E, Michelon S, Tenconi E, Degortes D, Titton F, Manara R, et al. (2016). Functional connectivity correlates of response inhibition impairment in anorexia nervosa. Psychiatry Research, 247, 9-16.
  41. Lavagnino, L., Arnone, D., Cao, B., Soares, J. C., & Selvaraj, S. (2016). Inhibitory control in obesity and binge eating disorder: A systematic review and meta-analysis of neurocognitive and neuroimaging studies. Neuroscience and Biobehavioral Reviews, 68, 714-726.
  42. Bulik CM (2016). Towards a science of eating disorders: Replacing myths with realities: The fourth Birgit Olsson lecture. Nordic Journal of Psychiatry, 70, 224-230. DOI: 10.3109/08039488.2015.1074284
  43. Culbert KM, Racine SE, & Klump KL (2015). Research review: What we have learned about the causes of eating disorders – A synthesis of sociocultural, psychological, and biological research. Journal of Child Psychology and Psychiatry, 56, 1141-1164.
  44. Brown JD, Witherspoon EM (2002). The mass media and American adolescents’ health, Journal of Adolescent Health, Volume 31, Issue 6, Supplement, Pages 153-170. DOI: 10.1016/S1054-39X(02)00507-4
  45. Stenholm A & Hellström E (2018). En studie om relationen mellan kroppsmissnöje, sociokulturella influenser och motion. (Dissertation). -- Retrieved from http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-36253.
  46. Stice E, Shaw H, & Marti CN (2007). A meta-analytic review of eating disorder preventionprograms:Encouragingfindings.Annu.Rev.Clin.Psychol.,3,207-231.
  47. Thompson JK, Coovert MD, & Stormer SM (1999). Body image, social comparison, and eating disturbance: A covariance structure modeling investigation. International Journal of Eating Disorders, 26(1), 43-51.
  48. Eisenberg ME, Neumark-Sztainer, D, Story M, & Perry C (2005). The role of
  49. social norms and friends’ influences on unhealthy weight-control behaviors among adolescent girls. Social Science & Medicine, 60(6), 1165-1173.
  50. Klump KL, Bulik CM, Kaye WH, Treasure J, & Tyson, E. (2009). Academy for Eating Disorders position paper: Eating disorders are serious mental illnesses. International Journal of Eating Disorders, 42, 97-103.
  51. Smith AR, Ortiz SN, Forrest LN, Velkoff EA, Dodd DR. Which Comes First? An Examination of Associations and Shared Risk Factors for Eating Disorders and Suicidality. Curr Psychiatry Rep. 2018 Aug 9;20(9):77.
  52. Holland LA, Bodell LP, Keel PK. Psychological factors predict eating disorder onset and maintenance at 10-year follow-up. Eur Eat Disord Rev. 2013 Sep;21(5): 405-10.
  53. Taborelli E, Krug I, Karwautz A, Wagner G, Haidvogl M, Fernandez-Aranda F, Castro R, Jimenez-Murcia S, Anderluh, M, Collier D, Treasure JL, & Micali N (2013). Maternal Anxiety, Overprotection and Anxious Personality as Risk Factors for Eating Disorder: A Sister Pair Study. Cognitive Therapy and Research, 37(4), 820-828. [N/A].
  54. Mitchell KS, Mazzeo SE, Schlesinger MR, Brewerton TD, Smith BN. Comorbidity of partial and subthreshold ptsd among men and women with eating disorders in the national comorbidity surveyreplication study. Int J Eat Disord. 2012;45(3): 307-15.
  55. Hornberger LL, Lane MA. 2020. Committee on adolescence. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics. 2021 Jan; 147(1): e2020040279.
  56. Hornberger LL, Lane MA; COMMITTEE ON ADOLESCENCE. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics. 2021 Jan; 147(1): e2020040279.
  57. Eisler I, Simic M, Hodsoll J, Asen E, Berelowitz M, Connan F, Ellis G, Hugo P, Schmidt U, Treasure J, Yi I, Landau S. A pragmatic randomised multi-centre trial of multifamily and single family therapy for adolescent anorexia nervosa. BMC Psychiatry. 2016 Nov 24; 16(1): 422.
  58. Hodsoll J, Rhind C, Micali N, Hibbs R, Goddard E, Nazar BP, Schmidt U, Gowers S, Macdonald P, Todd G, Landau S, Treasure J. A Pilot, Multicentre Pragmatic Randomised Trial to Explore the Impact of Carer Skills Training on Carer and Patient Behaviours: Testing the Cognitive Interpersonal Model in Adolescent Anorexia Nervosa. Eur Eat Disord Rev. 2017 Nov;25(6): 551-561.
  59. Lock J, Le Grange D. Family-based treatment: Where are we and where should we be going to improve recovery in child and adolescent eating disorders. Int J Eat Disord. 2019 Apr;52(4): 481-487.
  60. Zeeck A, Herpertz-Dahlmann B, Friederich HC, Brockmeyer T, Resmark G, Hagenah U, Ehrlich S, Cuntz U, Zipfel S, Hartmann A. Psychotherapeutic Treatment for Anorexia Nervosa: A Systematic Review and Network Meta- Analysis. Front Psychiatry. 2018 May 1; 9:158.
  61. National Institute for Health and Care Excellence. Eating disorders: recognition and treatment (NICE Guideline 69). 2017. https://www.nice.org.uk/guidance/ ng69 (accessed July 18, 2019).
  62. Byrne S, Wade T, Hay P, Touyz S, Fairburn CG, Treasure J, Schmidt U, McIntosh V, Allen K, Fursland A, Crosby RD. A randomised controlled trial of three psychological treatments for anorexia nervosa. Psychol Med. 2017 Dec; 47(16): 2823-2833. DOI: 10.1017/S0033291717001349
  63. Zipfel S, Wild B, Groß G, Friederich HC, Teufel M, Schellberg D, Giel KE, de Zwaan M, Dinkel A, Herpertz S, Burgmer M, Löwe B, Tagay S, von Wietersheim J, Zeeck A, Schade-Brittinger C, Schauenburg H, Herzog W; ANTOP study group. Focal psychodynamic therapy, cognitive behaviour therapy, and optimized treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomized controlled trial. Lancet. 2014 Jan 11; 383(9912): 127-37. DOI: 10.1016/S0140-6736(13)61746-8
  64. Hilbert A, Pike KM, Goldschmidt AB, Wilfley DE, Fairburn CG, Dohm FA, Walsh BT, Striegel Weissman R. Risk factors across the eating disorders. Psychiatry Res. 2014 Dec 15; 220 (1-2): 500-6.
  65. Cooper, Z., & Dalle Grave, R. (2017). Eating disorders: Transdiagnostic theory and treatment. In The science of cognitive behavioral therapy (pp. 337-357). Academic Press. DOI: 10.1016/B978-0-12-803457-6.00014-3
  66. Fairburn, C. G., Cooper, Z., & Cooper, P. J. (1986). The clinical features and maintenance of bulimia nervosa. In K. D. Brownell, & J. P. Foreyt (Eds.), Physiology, psychology and treatment of the eating disorders (pp. 389-404). New York: Basic Books.
  67. Fairburn, C. G., Cooper, Z., Shafran, R., Bohn, K., & Hawker, D. M. (2008).
  68. Clinical perfectionism, core low self-esteem and interpersonal problems. In C.
  69. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 197- 221). New York: The Guilford Press.
  70. Fairburn, C. G., Cooper, Z., Shafran, R., Bohn, K., Hawker, D. M., Murphy, R., & Straebler, S. (2008). Enhanced cognitive behavior therapy for eating disorders: The core protocol. In C. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 47-193). New York: The Guilford Press.
  71. Cooper, Z., & Stewart, A. (2008). CBT-E and the younger patient. In C. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 221-231). New York: The Guilford Press.
  72. Dalle Grave, R., Calugi, S., Conti, M., Doll, H. A., & Fairburn, C. G. (2013). Inpatient cognitive behavior therapy for anorexia nervosa: A randomized controlled trial. Psychotherapy and Psychosomatics, 82 (6), 390-398. Available from DOI: 10.1159/000350058

Annalisa Signorelli, Eating disorders and adolescence. From diagnosis to treatment in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2022, pp 81-103, DOI: 10.3280/RSF2022-003005