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Illness perception in patients with eating disorders: clinical, personality, and food addiction correlates

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Abstract

Purpose

Although the role of illness perception in the clinical course of many physical diseases and certain mental disorders has been well described, little is known about illness perception in eating disorders (ED) so far. Therefore, the purpose of this study was to extend our understanding of illness perception in different ED diagnostic types and to explore its association between clinical, psychopathological, motivational, personality, and food addiction (FA) features.

Methods

The sample consisted of 104 patients with ED [(23 anorexia nervosa (AN), 39 bulimia nervosa (BN), 19 binge eating disorder (BED), and 23 other specified feeding and eating disorders (OSFED)]. Illness perception was assessed by means of the revised version of the Illness Perception Questionnaire (IPQ-R).

Results

The results supported the association between illness perception and clinical, psychopathological, and personality factors. Patients with BN and BED showed greater illness perception than the other types. Improved illness perception was positively associated with a longer duration of the disorder and FA. Furthermore, a relevant finding suggests that at least half of the patients with ED did not achieve a good level of illness perception until after having the disorder for 20 years on average.

Conclusion

Our findings suggest that higher levels of FA and longer duration of the ED are positively and directly associated with increased illness perception. This may explain the low levels of initial motivation in these patients and their high dropout rates in the early stages of treatment.

Level of evidence III

Case-control analytic study.

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Funding

We thank CERCA Programme/Generalitat de Catalunya for institutional support. This research was supported by Instituto de Salud Carlos III (ISCIII; grant number: PI17/01167), by Ministerio de Economía y Competitividad (grant number: PSI2015‐68701‐R), by Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067), by Ministerio de Sanidad, Servicios Sociales e Igualdad (grant number: PR338/17), by PERIS (Generalitat de Catalunya, SLT006/17/00246), and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBERobn is an initiative of ISCIII.

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Authors and Affiliations

  1. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain

    Zaida Agüera, Nadine Riesco, Roser Granero, Isabel Sánchez, Susana Jiménez-Murcia & Fernando Fernández-Aranda

  2. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain

    Zaida Agüera, Nadine Riesco, Eduardo Valenciano-Mendoza, Isabel Sánchez, Susana Jiménez-Murcia & Fernando Fernández-Aranda

  3. Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain

    Zaida Agüera

  4. Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain

    Roser Granero

  5. Department of Endocrinology and Nutrition, Obesity Unit, Hospital Clinic de Barcelona, Barcelona, Spain

    Alba Andreu

  6. Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain

    Susana Jiménez-Murcia & Fernando Fernández-Aranda

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  1. Zaida Agüera
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  2. Nadine Riesco
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  4. Roser Granero
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  8. Fernando Fernández-Aranda
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Correspondence to Zaida Agüera.

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In accordance with the Declaration of Helsinki, the present study was approved by the Ethics Committee of our institution [The Clinical Research Ethics Committee (CEIC) of Bellvitge University Hospital].

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Agüera, Z., Riesco, N., Valenciano-Mendoza, E. et al. Illness perception in patients with eating disorders: clinical, personality, and food addiction correlates. Eat Weight Disord 26, 2287–2300 (2021). https://doi.org/10.1007/s40519-020-01083-3

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  • DOI: https://doi.org/10.1007/s40519-020-01083-3

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