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Treatment Approaches to Eating Disorders Among LGBTQIA+ Population: A Narrative Review
- S. Tempia Valenta, C. Bronte, F. Panariello, F. Bonazzoli, D. De Ronchi, A. R. Atti
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S427
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Introduction
Historically, eating disorders (ED) have been regarded as the diseases of heterosexual, affluent white women. Instead, research shows that the population most at risk of ED is lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/aromantic/agender (LGBTQIA+). Indeed, in addition to many of the same sociocultural influences on body dissatisfaction faced by their peers, LGBTQIA+ individuals experience unique body- and gender-related concerns as well as high levels of stress due to interpersonal prejudice and discrimination.
ObjectivesThis narrative review presents an overview of current research on treatment approaches to ED among LGBTQIA+ individuals.
MethodsWe conducted a PubMed search for studies published after 1990 using terms that aimed to represent the primary concepts of “eating disorder” and “LGBTQIA+” and “therapy.” Next, we inductively created relevant macro-themes by synthesizing the data from the included articles.
ResultsOf 123 PubMed studies, we included 12 studies and identified three relevant macro-themes. The first macro-theme, “ordinary treatments,” focused on efficacy studies of conventional ED therapies applied to this category of patients. In particular, the first study proved the efficacy of the dissonance-based intervention, engaging participants to induce cognitive dissonance concerning the thin-ideal standard of beauty; the second study showed that sexual minorities patients accessing day hospital treatment reported greater overall ED and comorbid symptoms but started treatment with higher scores and improved at a faster rate compared to heterosexual patients; the third study provided evidence that transgender/nonbinary individuals and cisgender individuals showed similar improvement in ED symptoms during higher levels of care treatment, but the first group had less improvement in depression and no improvement in suicidality during ED treatment. The second macro-theme, “relational approach,” investigated newer treatment paradigms involving family and school support, both revealing positive implications for eating and weight-related behaviors. The third macro-theme, “gender-affirming therapy,” focused on medical and surgical treatment toward gender transition, which has been shown to correlate with improvements in body image, ED psychopathology, and psychological functioning.
ConclusionsMembers of the LGBTQIA+ community are at greater risk for ED; to our knowledge, there is no targeted treatment that considers the entirety of their experience. These findings denote the need to focus future research efforts on effective treatment strategies specific to sexual and gender identity groups.
Disclosure of InterestNone Declared
The Fear of Smell: The Relationship Between Obsessive Traits and Self-odor Concern
- S. Tempia Valenta, C. Bronte, F. Panariello, F. Bonazzoli, D. De Ronchi, A. R. Atti
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S931
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Introduction
DSM-5’s framing of Obsessive-Compulsive and Related Disorders (OCRDs) paved the way for the increasingly structured definition of obsessive-compulsive spectrum disorders. The spectrum would include, among others, body dysmorphia, hair-pulling, skin-picking, obsessional jealousy, and olfactory reference syndrome (ORS). ORS – i.e., persistent concern about emitting a foul or offensive body odor – causes clinically significant distress or impairment in several areas of functioning.
ObjectivesThis study aimed to investigate the relationship between obsessive traits and self-odor concern in a clinical sample that did not meet the diagnostic criteria for either OCRDs or ORS.
MethodsIn a sample of 220 adults referring to an outpatient Mental Health Service in Bologna, Northern Italy, we measured (1) self-odor concern through two specific items – sweat hatred (SH) and body odor hatred (BOH) – on the Body Uneasiness Test (BUT) and (2) obsessive traits through the total score of the Obsessive-Compulsive Inventory-Revised (OCI-R). Therefore, we performed correlation and regression analysis to examine the relationship between obsessive-compulsive traits and self-odor concern.
ResultsWe found a positive correlation between OCI-R and SH scores (r = 0.330) and OCI-R and BOH scores (r = 0.188). Linear regression analysis demonstrated that OCI-R score significantly predicted SH score [F(1, 218) = 26.455, R2 = 0.109, p < 0.001] and BOH score [F(1, 218) = 8.017, R2 = 0.035, p = 0.005], highlighting that obsessive-compulsive traits predict both sweat and body odor hatred.
ConclusionsThese results demonstrate that obsessive traits and self-odor concern are strictly connected. This knowledge may allow us, even in the absence of an overt diagnosis of OCRDs or ORS, to better identify an at-risk population before it suffers impairment in functioning. Overall, further research is needed to help characterize obsessive-compulsive spectrum disorders before symptom exacerbation.
Disclosure of InterestNone Declared
The role of GSK-3 in mood disorders: Preliminary data from an experimental study
- G. Di Salvo, G. Rosso, E. Hoxha, E. Teobaldi, I. Balbo, F. Tempia, G. Maina
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S382-S383
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Introduction
The identification of potential biomarkers is crucial to improve the management and treatment of mood disorders. Glycogen synthase kinase-3 (GSK-3) is a multifunctional enzyme with an important role in the etiology of mood disorders. Recent findings suggested GSK-3 as a putative biomarker in mood disorders.
ObjectivesThe aims of the study are: - to evaluate GSK3 as potential biomarker for differential diagnosis (MDD and BD); - to analyze the regulation of GSK3 by psychopharmacological treatments.
MethodsPatients included fulfill the following criteria: (a) principal diagnosis of MDD or BD (DSM-5); (b) age ≥ 18 years; (c) drug-free for at least 4 weeks before the inclusion. For each patient included a healthy control is enrolled, matched by gender and age. All included subjects at the study entry point (t0) are assessed through: - semistructured clinical interview and clinical rating scales (Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale; Young Mania Rating Scale, Clinical Global Impression) - blood draw, to measure GSK-3 levels Patients with MDD or BD are assessed again after 1 week (T1) and after 2 month (T2) of specific pharmacological treatment.
ResultsSo far, we enrolled 16 patients and 16 healthy controls. The enrollment is still ongoing.
ConclusionsWe expect to find GSK-3 levels differently expressed between healthy controls, patients with DDM and patients with BD. This finding would be crucial as it could contribute to the improvement of differential diagnosis. Moreover, we expect to observe a change in GSK-3 levels after psychopharmacological treatments.