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Psychopathological and psychiatric evaluation of patients affected by lipodystrophy

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Abstract

Purpose

Lipodystrophy is a collection of rare disorders defined by complete or partial loss of adipose tissue, due to abnormal adipocyte production, function, or distribution; it shares the main metabolic complications with obesity. Aims of the present study were to investigate the psychopathological characteristics of non-HIV lipodystrophic patients in comparison with a group of obese patients, a group of patients affected by oncologic chronic illness, and a control group of healthy subjects.

Methods

All participants were female: 16 non-HIV lipodystrophic women (mean age 42 ± 12 years), 20 women with breast cancer (adenocarcinoma with a positive sentinel lymph node in outpatients awaiting chemotherapy, mean age 44 ± 5 years), 20 obese women (mean age 40 ± 3 years), and 20 healthy women (mean age 40 ± 2 years). Each lipodystrophic patient received a psychiatric assessment, following the diagnostic criteria for DSM-5. Patients and controls received a battery of self-report instruments measuring general psychopathology, body image concerns, eating habits and food craving, and pain concerns. The following psychopathological rating scales were used: SCL-90-R (Symptom Check List) for general psychopathology, BUT (Body Uneasiness Test) for body image, FCQ-T (Food Cravings Questionnaire Trait) for food craving, and WHYMPI (West Haven Yale Multidimensional Pain Inventory) for multidimensional pain inventory.

Results

The psychiatric assessment of the 16 lipodystrophic patients revealed: three lifetime mood disorder, six current mood disorder, six lifetime anxiety disorder, five current anxiety disorder, four current somatic symptom disorder with predominant pain, six current binge eating disorder, 11 eating disorder not otherwise specified, two borderline personality disorder, one obsessive–compulsive personality disorder, one avoidant personality disorder, and five personality disorder not otherwise specified. In SCL-90-R scale, the subscale sensitivity showed a significantly higher score in the lipodystrophic and oncologic groups compared to healthy subjects. The subscale paranoid ideation showed a significantly higher score in the lipodystrophic group vs all the other groups. The total score of BUT scale was significantly higher in the lipodystrophic compared to healthy subjects. In WHYMPI scale, the scores of pain interference and family support were significantly higher in the lipodystrophic group. The scores of negative responses were significantly higher in the lipodystrophic group vs healthy subjects. In FCQ-T scale, the score of Cues dimension in lipodystrophic patients was significantly lower as compared with all the other groups.

Conclusions

Our findings suggest that lipodystrophic patients have an increased prevalence of mood, anxiety, pain, and eating disorders.

Level of evidence

Level III. Evidence obtained from case-control analytic study.

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Funding

This study received no funding.

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Authors and Affiliations

  1. Endocrinology Unit, Department of Clinical and Experimental Medicine, Obesity and Lipodystrophy Research Center, University Hospital of Pisa, Pisa, Italy

    Pasquale Fabio Calabrò, Giovanni Ceccarini, Alba Calderone, Chita Lippi, Federica Ferrari, Silvia Magno & Ferruccio Santini

  2. PhD Program in Clinical Pathophysiology, Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy

    Pasquale Fabio Calabrò & Roberto Pedrinelli

  3. Phoenix Epidemiology and Clinical Research Branch National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Phoenix, AZ, USA

    Paolo Piaggi

Authors
  1. Pasquale Fabio Calabrò
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  2. Giovanni Ceccarini
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  3. Alba Calderone
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  4. Chita Lippi
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  5. Paolo Piaggi
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  6. Federica Ferrari
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  7. Silvia Magno
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  9. Ferruccio Santini
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Correspondence to Ferruccio Santini.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local ethical committee (Comitato Etico Area Vasta Nord Ovest, CEAVNO) approved the publication of this study.

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Calabrò, P.F., Ceccarini, G., Calderone, A. et al. Psychopathological and psychiatric evaluation of patients affected by lipodystrophy. Eat Weight Disord 25, 991–998 (2020). https://doi.org/10.1007/s40519-019-00716-6

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  • DOI: https://doi.org/10.1007/s40519-019-00716-6

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