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Background: Altered eating behaviors (AEBs) are not only associated with eating disorders but also play a role in obesity. This study assessed AEBs in individuals with obesity and their association with general and eating psychopathology, using the "Eating Behaviors Assessment for Obesity" (EBA-O). The hypothesis posited that a higher frequency of pathological eating behaviors would correlate with more severe psychopathology. Methods: Participants seeking weight loss treatment answered the EBA-O and other measures of eating and general psychopathology. The analysis employed MANOVA to estimate psychopathological variance based on AEBs and a cluster analysis to identify patient clusters by AEB type and number. Results: Out of the 244 participants, approximately two-thirds reported clinically relevant AEBs, with almost half exhibiting more than two AEBs. Predominant AEBs included sweet eating, binge eating, and hyperphagia. A significant impact of the numbers of AEBs on both eating and general psychopathology severity (p < 0.001; η2 = 0.167) was evident. Three clusters emerged, with Cluster 3 showing the highest AEB frequency and greater psychopathological impairment. Conclusions: The present findings confirm the correlation between the frequency of AEBs and the severity of general and eating psychopathology in individuals with obesity. AEBs deserve clinical attention, and their screening might aid their clinical characterization and foster more tailored treatments. [ABSTRACT FROM AUTHOR]

Background: Antipsychotic drugs appear to be related to reduced bone mineral density (BMD). We conducted a narrative review to collect the available literature investigating the relationship between antipsychotic use and bone fragility. Methods: A review of the published literature was conducted and reported through PubMed/Scopus/Cochrane libraries. We included studies using any antipsychotic treatment where the bone metabolism, osteoporosis, and/or risk of fractures has been assessed. Results: After screening 1707 items, we finally included 15 papers. A total of 3245 initial patients were identified, of whom 1357 patients with a mean age of 43.8 years underwent antipsychotic treatment and were analyzed. The mean antipsychotic treatment duration of the treated group was 15.8 ± 13.9 years. Among the included studies, two reported a statistically significant difference in lumbar BMD reduction between the antipsychotic exposed group and the control group. Femoral neck BMD levels had been reported in four of the case–control studies; two reported a statistically significant difference in femoral neck BMD reduction between the antipsychotic exposed group and the control group. Conclusions: Prolonged use of antipsychotic treatment seems to be associated with an increased risk of reduced BMD, and, consequentially, with an augmented risk of bone fragility and fractures. This effect is not limited to vulnerable groups, such as those with significant medical comorbidities, the elderly, and postmenopausal women, but may also apply to anyone using antipsychotics in the long-term. Clinicians' awareness of antipsychotic prescriptions should optimize their potential while reducing this risk. [ABSTRACT FROM AUTHOR]

Background: Clinical staging, already widespread in medicine, represents a new frontier in psychiatry. Our goal was to convert the existing theoretical staging model for schizophrenia into a feasible tool to have a timely assessment of patients' health status applicable in any psychiatric facility. Methods: We assessed the empirical soundness of a staging model for schizophrenia spectrum disorders (SSDs), primarily centered on their current status. This model delineated six sequential stages (1, 2A, 2B, 3A, 3B, and 4) based on factors like symptom recurrence, persistence, and progression, including functional decline. Our analysis involved data from 137 individuals affected by SSDs. We examined 22 baseline variables, 23 construct-related variables, and 31 potentially modifiable clinical variables. Results: The latter stages demonstrated significantly poorer outcomes compared to the early stages across various measures, indicating medium to large effect sizes and a dose-response pattern. This pattern confirmed the validity of the model. Notably, stages 2 and 3A exhibited pronounced differences in comparison to other stages, although variables from each validation category also distinguished between consecutive stages, particularly 3A and beyond. Conclusion: Baseline predictors, such as familial predisposition to schizophrenia, neurodevelopmental impairment, childhood adversities, treatment delay, negative symptoms, neurological impairment, and inadequate early response to treatment, independently largely explained the staging variance. The clinical staging model, grounded in the extended course of psychosis, exhibited sound validity and feasibility, even without the use of biological or neuroimaging markers, which could greatly improve the sensitivity of the model. These findings provide insights into stage indicators and predictors of clinical stages from the onset of psychosis. [ABSTRACT FROM AUTHOR]

Background: Metacognition is a crucial aspect of understanding and attributing mental states, playing a key role in the psychopathology of eating disorders (EDs). This study aims to explore the diverse clinical profiles of metacognition among patients with EDs using latent profile analysis (LPA). Method: A total of 395 patients with a DSM-5 diagnosis of ED (116 AN-R, 30 AN/BP, 100 BN, 149 BED) participated in this study. They completed self-report measures assessing metacognition, eating psychopathology, depression, emotional dysregulation, personality traits, and childhood adversities. LPA and Welch ANOVAs were conducted to identify profiles based on metacognition scores and examine psychological differences between them. Logistic regression models were employed to explore associations between personal characteristics and different profiles. Results: A 3-class solution had a good fit to the data, revealing profiles of high functioning (HF), intermediate functioning (IF), and low functioning (LF) based on levels of metacognitive impairments. Participants in the IF group were older and had a higher BMI than those in the HF and LF groups. Individuals with BN were largely categorized into HF and LF profiles, whereas participants with BED were mainly included in the IF profile. Participants in the LF group reported an impaired psychological profile, with high levels of depression, emotional dysregulation, childhood adversity, and personality dysfunction. Multinomial logistic regression analyses showed significant associations between metacognitive profiles and emotional and neglect abuse, emotion dysregulation, and detachment. Conclusion: This exploratory study unveils distinct metacognitive profiles in EDs, providing a foundation for future research and targeted interventions. In this light, metacognitive interpersonal therapy could be a valid and effective treatment for EDs, as suggested by the initial promising results for these patients. [ABSTRACT FROM AUTHOR]

Diet and exercise intervention are the first strategies to counteract obesity. An online home-based exercise program may be a feasible approach in an obese population. Therefore, this study aimed to investigate the effects of twelve weeks of online Pilates plus diet on body composition in individuals affected by obesity. Thirty-five females were randomly assigned to a home-based Pilates group (PG, n = 18) or a group without intervention (control group, CG, n = 17). All participants followed a Mediterranean diet. The PG followed a twelve-week online Pilates Matwork program (three times/week; 180 min/week), while the CG was not involved in any structured physical exercise program. Body composition and handgrip strength were evaluated at baseline (T0) and after the intervention (T1). A significant group × time interaction (p < 0.05) was found for the fat mass percentage (pFM). Specifically, the pFM was significantly lower at T1 than at T0 in the PG. Significant group × time interactions for fat-free mass (p < 0.05), appendicular skeletal muscle mass (p < 0.05), and skeletal muscle mass (p < 0.01) were found. All these variables were significantly higher at T1 than at T0 in the PG (p < 0.05). Home-based Pilates combined with diet intervention may represent an effective strategy to improve body composition in terms of fat mass reduction and muscle mass gain in adults affected by obesity. [ABSTRACT FROM AUTHOR]

Background and aims: Existing research suggests that food addiction (FA) is associated with binge eating disorder (BED) and obesity, but the clinical significance of this relationship remains unclear. This study aims to investigate the different clinical profiles of FA symptoms among patients who have obesity with/without BED using latent class analysis (LCA). Methods: 307 patients (n 5 152 obesity and BED, n 5 155 obesity without BED) completed a battery of self-report measures investigating eating psychopathology, depression, emotional dysregulation, alexithymia, schema domains, and FA. LCA and ANOVAs were conducted to identify profiles according to FA symptoms and examine differences between classes. Results: LCA identified five meaningful classes labeled as the "non-addicted" (40.4%), the "attempters" (20.2%), the "interpersonal problems" (7.2%), the "high-functioning addicted" (19.5%) and the "fully addicted" (12.7%) classes. Patients with BED and obesity appeared overrepresented in the "high-functioning addicted" and "fully addicted" classes; conversely, patients with obesity without BED were most frequently included in the "non-addicted" class. The most significant differences between the "high-functioning addicted" and "fully addicted" classes versus the "non-addicted" class regarded heightened severity of eating and general psychopathology. Discussion and conclusions: The results bring to light distinct clinical profiles based on FA symptoms. Notably, the "high-functioning addicted" class is particularly intriguing as its members demonstrate physical symptoms of FA (i.e., tolerance and withdrawal) and psychological ones (i.e., craving and consequences) but are not as functionally impaired as the "fully addicted" class. Identifying different profiles according to FA symptoms holds potential value in providing tailored and timely interventions. [ABSTRACT FROM AUTHOR]

Background and Objectives: The NUCB2 gene and its polymorphisms were identified as novel players in the regulation of food intake, potentially leading to obesity (OBE) and altered eating behaviors. Naltrexone/bupropion SR (NB) showed good efficacy and tolerability for treating OBE and altered eating behaviors associated with binge eating disorder (BED). This prospective study investigates the influence of NUCB2 gene polymorphism on NB treatment response in OBE and BED. Materials and Methods: Body mass index (BMI), eating (EDE-Q, BES, NEQ, GQ, Y-FAS 2.0) and general psychopathology (BDI, STAI-S) were evaluated at baseline (t0) and after 16 weeks (t1) of NB treatment in patients with OBE and BED (Group 1; N = 22) vs. patients with OBE without BED (Group 2; N = 20). Differences were evaluated according to the rs757081 NUCB2 gene polymorphism. Results: NUCB2 polymorphism was equally distributed between groups. Although weight at t0 was higher in Group 1, weight loss was similar at t1 in both groups. BMI was not influenced by NUCB2 polymorphism. In Group 1, the CG-genotype reported significant improvement in eating psychopathology while the GG-genotype reported improvement only for FA. No differences were observed in Group 2. Conclusions: Patients diagnosed with BED and treated with NB exhibited a more favorable treatment response within the CG-genotype of the NUCB2 polymorphism. [ABSTRACT FROM AUTHOR]