Eating disorders (EDs) are severe mental illnesses with significant morbidity and mortality. Adverse childhood experiences (ACEs) are recognized risk factors, but their specific impact across ED subtypes and the mediating psychological mechanisms require further elucidation. In this cross-sectional study (2008–2015), 970 outpatients with eating disorders (919 female) were assessed for adverse childhood experiences and clinical behaviors with the Eating Disorder Questionnaire, and for psychological traits with the Eating Disorder Inventory-1. This study used factorial ANOVA, Lasso regression, and mediation analysis to clarify the effects of ACEs and diagnostic subtypes, identify specific influencing factors, and explore the mediating role of psychological traits. ACEs were nominally associated with most clinical behaviors except dieting; after correction, the most robust associations were observed for binge eating, laxative use, and several onset-age variables. Childhood emotional abuse most profoundly impacted psychological traits. The cumulative number of ACEs was associated with increased severity of psychological traits and a higher likelihood of clinical behaviors. Mediation analyses revealed that psychological traits significantly mediated the relationship between ACEs and clinical behaviors. For instance, ineffectiveness mediated the link from cumulative ACE count (mediation proportion = 0.481), “criticism and blame” (mediation proportion = 0.629), and “abandonment threats” (mediation proportion = 0.601) to binge eating. Childhood emotional abuse and cumulative ACEs significantly correlated with worsened psychological traits and clinical ED behaviors, with notable implications for binge-eating/purging symptoms. Several psychological traits showed substantial indirect associations between ACE exposure and clinical ED behaviors. These findings highlight the necessity of routine ACE assessment and trauma-informed interventions targeting these psychological vulnerabilities in ED treatment. Eating disorders are serious mental illnesses, and adverse childhood experiences may shape how these illnesses develop and appear in clinical care. This study examined 970 Chinese outpatients with eating disorders to understand how adverse childhood experiences, such as emotional abuse, physical abuse, and sexual abuse, were related to eating-disorder symptoms and psychological difficulties. Patients who reported adverse childhood experiences tended to show more severe psychological traits, including feelings of ineffectiveness, perfectionism, difficulties sensing internal body states, body dissatisfaction, and bulimia-related concerns. Emotional abuse, especially repeated criticism, blame, and threats of abandonment, showed particularly strong links with these psychological traits. Having more types of childhood adversity was also associated with a greater likelihood of behaviors such as binge eating, purging, laxative use, and diet pill use. The analyses suggested that psychological traits may help explain the statistical association between childhood adversity and later eating-disorder behaviors. These findings support routine assessment of childhood adversity in eating-disorder services and highlight the importance of trauma-informed treatment that addresses self-worth, emotion regulation, and body-related psychological difficulties.

Background: To investigate the incidence of childhood sexual abuse (CSA) and its association on the clinical and psychological characteristics of patients with eating disorders (EDs). Methods: In total, 970 patients, including 51males and 919 females, were included in this study during 2008-2015. A cross-sectional survey was conducted using the Eating Disorder Questionnaire (CSA was assessed with two brief yes/no questions) and Eating Disorder Inventory. The patients were divided into two groups based on their CSA experience and into four groups based on the Diagnostic and Statistical Manual of Mental Disorders IV. Demographic, clinical, and psychological characteristics were compared between the two groups. A general linear model was used to explore interactions between ED subtypes and CSA and moderator effect models were used to assess how CSA influenced the relationship between psychological features and binge eating in bulimia nervosa (BN) and EDs not otherwise specified. Results: The prevalence of CSA among patients with eating disorders was 8.4%, aligning with the general population in China. Those with a history of CSA exhibited significantly higher scores on psychological measures, with the exception of fear of maturity. Anorexia nervosa of the restricting type, had a lower rate of 4.9%, showing minimal association on this subtype. BN had the highest incidence of abuse of 12.6%. CSA history was significantly associated with higher ineffectiveness scores in both BN and EDNOS groups. CSA significantly moderated the associations between psychological traits (drive for thinness, bulimia, and interoceptive awareness) and binge eating frequency, with stronger associations observed in individuals without a history of CSA. Conclusion: This study showed a nuanced interaction between CSA history and ED psychopathology. This emphasizes the need for clinicians to consider a history of CSA when assessing and treating individuals with EDs, especially BN and EDs not otherwise specified, as it may influence the severity and presentation of the disorder.

BACKGROUND:Eating concerns are core symptoms of eating disorders (EDs). Attachment theory assists in understanding the underlying psychological mechanisms behind eating concerns and suggests that the relationship between eating concerns and parenting styles may be connected through patients' self-compassion. Consequently, the present study aims to investigate the relationship between parenting styles and eating concerns, along with the mediating role of self-compassion. METHODS:This cross-sectional study enrolled 177 female patients diagnosed with EDs. Eating concerns were assessed via the Eating Concerns subscale of the Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0). Parenting styles were evaluated via the short-form Egna Minnen av Barndoms Uppfostran for Chinese (s-EMBU-C). Self-compassion was measured via the Self-Compassion Scale (SCS). Spearman correlation analysis explored relationships among the dimensions of maternal and paternal parenting styles (i.e., emotional warmth, rejection, overprotection), self-compassion, and eating concerns. Based on these results, mediation analysis was conducted, with self-compassion as mediator. RESULTS:Correlation analysis indicated eating concerns positively correlated with paternal overprotection. For maternal parenting styles, eating concerns positively correlated with rejection and overprotection, but negatively with emotional warmth. Eating concerns negatively correlated with self-compassion. Mediation analysis revealed that self-compassion fully mediated the relationships between eating concerns and four specific parenting styles: paternal overprotection, maternal rejection, maternal overprotection, and maternal emotional warmth. CONCLUSION:Our results indicate distinct associations between maternal and paternal parenting styles and eating concerns, with self-compassion functioning as a full mediator. These findings may expand understanding of links between early attachment-related experiences and EDs by clarifying parental roles and identifying self-compassion as a explanatory factor, highlighting value in addressing these via family-based therapy and fostering self-compassion in ED interventions.

BACKGROUND:Interventions targeting core characteristics of eating disorders (EDs) can effectively alleviate symptoms. However, it remains unclear whether these characteristics exhibit cultural specificity within the Chinese population. This study combines exploratory graph analysis (EGA) and network analysis to identify key psychological characteristics in Chinese patients with EDs. METHODS:The psychological characteristics of 1,001 patients with EDs were assessed using the Eating Disorder Inventory-1 (EDI-1). Nineteen representative items were selected and categorized into different dimensions through EGA. Network analysis was then performed to identify key psychological characteristics by determining central and bridge nodes. RESULTS:In addition to the "ED-specific" and "Non-specific" categories, an unexpected category, "Perfectionism," was identified. Across these three categories, four key psychological characteristics were highlighted: "terrified of gaining weight," "guilty after overeating," "worry that feelings will get out of control," and "must do things perfectly." CONCLUSION:Beyond drive for thinness, perfectionism and emotional regulation difficulties may represent key psychological characteristics among Chinese individuals with EDs. These findings could help inform the development of culturally tailored treatment strategies for EDs in China.

Binge-eating disorder(BED)is a type of eating disorder characterized by recurrent episodes of binge eating.Patients with BED have recurrent impulsive and out-of-controlled binge eating behavior,which can lead to gastrointestinal disorders,obesity,and the resulting metabolic and functional disorders of various systems and other physical problems;and it is also often co-morbid with affective disorder,anxiety disorders,substance use disorders,and other mental disorders,which need to be taken seriously.However,the recognition of BED in China was late,and it is difficult to achieve early identification and diagnosis,resulting in a prolonged course of disease.Therefore,under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association,together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association,an expert group composed of 15 psychiatrists and evidence-based medicine experts,and 2 internal medicine experts,formulated this expert consensus based on evidence-based medical evidence,domestic and foreign guidelines and expert consensus,and expert experiences.The aim of this study is to improve the recognition,diagnosis and treatment of BED by psychiatrists,internists and general practitioners in China.

Anorexia nervosa(AN)is a type of eating disorders characterized by self-starvation,significant loss of body mass,and malnutrition.AN has the highest mortality rate among all psychiatric disorders,leading to severe psychopathologic symptoms and life-threatening medical complications.However,AN cannot be recognized and diagnosed early in China,resulting in a prolonged course of the disease.Therefore,under the organization of the Eating Disorders Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association,together with the Eating Disorders Research Collaboration Group of the Psychiatric Medicine Society of the Chinese Medical Association,this expert consensus was formulated by 16 medical experts based on evidence-based medical evidence,domestic and international guidelines and expert consensus,expert experience,etc.,in order to improve the recognition,diagnosis and treatment of AN among domestic professionals.

Central pontine myelinolysis (CPM) is a rare neurologic disorder characterized by symmetric demyelination in the central region of pons. Until recently its prognosis was considered poor if not fatal. CPM may manifest as a severe complication of eating disorders, especially anorexia nervosa (AN), primarily due to a rapid correction of hyponatremia. In this report, we presented the case of a 13-year-old girl with a five-month history of AN who exhibited typical CPM brain lesions, confirmed by magnetic resonance imaging (MRI) examination without the context of severe electrolyte imbalances. Surprisingly, despite the patient’s critical clinical manifestations in the initial stages, her prognoses of both AN and CPM were relatively optimistic. We discussed these observations in the light of recent reports on CPM and AN comorbidity. Although the clinical implications of MRI-detected lesions remain uncertain, psychiatrists should be cautious about CPM when refeeding patients with AN. Further studies about the relationship between CPM and AN are imperative.

进食障碍是一类易复发、疾病负担重的慢性疾病.进食障碍患者存在与执行功能相关的神经认知缺陷,其中最主要的表现是注意偏向及抑制控制的异常.随着事件相关电位研究的发展,进食障碍患者认知异常背后的神经机制得以被探究.本文回顾了近年来进食障碍患者注意偏向以及抑制控制两方面相关的事件相关电位研究,为基于神经认知机制诊疗方案的发展提供了参考.

OBJECTIVE:Bulimia nervosa (BN) is an eating disorder associated with the dysfunction of intrinsic brain networks. However, whether the network disruptions in BN patients manifest as dysconnectivity or imbalances of network modular segregation remains unclear.METHOD:We collected data from 41 women with BN and 41 matched healthy control (HC) women. We performed graph theory analysis based on resting-state functional magnetic resonance imaging (RS-fMRI) data; then, we computed the participation coefficient (PC) among brain modules to characterize the modular segregation for the BN and HC groups. The number of intra- and inter-modular connections was calculated to explain the PC changes. Additionally, we examined the potential associations of the measures mentioned above with clinical variables within the BN group.RESULTS:Compared with the HC group, the BN group showed significantly decreased PC in the fronto-parietal network (FPN), cingulo-opercular network (CON), and cerebellum (Cere). Additionally, the number of intra-modular connections of the default mode network (DMN) and the number of the inter-modular connections between the DMN and CON, FPN and Cere, and CON and Cere in the BN group were lower than those in the HC group. The nodal level analysis showed that the BN group had a decreased PC of the anterior prefrontal cortex (aPFC), dorsal frontal cortex (dFC), inferior parietal lobule (IPL), thalamus, and angular gyrus. Further, these metrics were significantly correlated with clinical variables in the BN group.DISCUSSION:These findings may provide novel insights to capture atypical topologies associated with pathophysiology mechanisms and clinical symptoms underlying BN.

•Xiaoyaosan effectively regulates metabolic disorders in patients with mild to moderate depression.•Xiaoyaosan demonstrates the ability to regulate metabolic disorders in depressed rats.•The administration of Xiaoyaosan results in the up-regulation of XDH and GRIA2 expression in CUMS rats.

Objective:To explore the characteristic of cognitive flexibility in young female patients with eating disorders（EDs）,including anorexia nervosa（AN） and bulimia nervosa（BN）,and its relationship with the clinical features of ED.Methods:Ninety-two young female patients with EDs, including 28 patients with AN and 64 patients with BN,and 38 normal controls were enrolled.Cognitive flexibility was assessed with percentage of persistent errors（PPE） and percentage of persistent responses（PPR） of the Wisconsin Card Sorting Test（WCST）,and clinical features of ED by using the Eating Disorder Inventory-1（EDI-1）.Results:The PPE[（5.0±4.7）% vs.（2.8±2.8）%,P＜0.01]and PPR[（11.7±7.8）% vs.（6.4±5.9）%,P＜0.001]were higher in ED group than in normal control group, but the differences on PPE[（5.5±5.4）% vs.（5.0±4.5）%,P＞0.05]and PPR[（11.2±7.8）% vs.（11.1±7.3）%,P＞0.05]between AN and BN groups were not statistically significant.The PPE（r=0.21,P＜0.05） and PPR（r=0.27,P＜0.01） were positively correlated with the EDI-1 total scores.PPR was positively correlated with the frequency of appetite suppressant use（r=0.28,P＜0.05） and skipping several meals（r=0.30,P＜0.01） in the ED group.Conclusion:The presence of cognitive flexibility deficits in young female patients with eating disorders, and their correlation with clinical features of eating disorders further support the possibility of being an endophenotype of eating disorders.

Billions of people play Internet games and some of them may develop Internet gaming disorder (IGD), yet the differences between IGD and non-disordered but heavy Internet gaming use behavior remain unclear. We used multiple behaviors and multimodal functional magnetic resonance imaging (fMRI) to examine the specificity of impulse control to differentiate IGD from non-disordered but heavy Internet gaming use. One hundred sixty subjects, including patients with IGD (PIGD), non-disordered but heavy Internet gaming participants (NIGP), and healthy controls rated Barratt Impulsiveness Scale, and 141 out of them completed delay-discounting task and resting-state during fMRI. The PIGD but not the NIGP showed altered impulsiveness and delay discounting behavior as compared to healthy controls. Moreover, the PIGD but not the NIGP showed altered activity pattern in the frontoparietal network as compared to healthy controls. The PIGD but not the NIGP showed altered functional connectivity in the frontoparietal network during delay discounting and resting-state as compared to healthy controls. Furthermore, impulse control-related behavioral and fMRI measures significantly classified PIGD from NIGP. This study provides consistent evidence supporting the specificity of impulse control for distinguishing IGD from non-disordered but heavy Internet gaming use.

目的:评估进食障碍照料者技能量表(CASK)中文版在神经性厌食和神经性贪食患者的照料者中应用的效度和信度.方法:选取符合DSM-5诊断标准的神经性厌食和神经性贪食患者的照料者151名,进行CASK测评;选取其中37名照料者进行照料者技能培训,比较培训前后CASK得分以检验实证效度.结果:探索性因子分析抽取大局观、自我照料、闭嘴、理解接纳、情商、挫折耐受6个因子;验证性因子分析显示6因子模型拟合良好(x2/df=2.47,CFI=0.84,TLI=0.82,RMSEA=0.09);照料者在参与照料技能培训后的CASK各维度得分及总分均高于培训前(均P＜0.001).总量表的Cronbach α系数为0.96,各维度的α系数为0.81～0.92;总量表的重测信度为0.85,各维度的重测信度为0.63～0.87.结论:进食障碍照料者技能量表中文版具有良好的效度和信度,可用于评估国内进食障碍患者照料者的照料技能水平.

目的:采用机器学习模型,探讨预测哌甲酯控释片(OROSMPH)与托莫西汀(ATX)治疗注意缺陷多动障碍(ADHD)疗效的临床和认知特征指标.方法:纳入符合DSM-Ⅳ诊断标准的6～16岁ADHD患者237例,1∶1随机接受OROS MPH或ATX治疗,以缓解作为结局指标.以基线ADHD评定量表、临床总体印象量表、中国韦氏儿童智力量表、执行功能测查结果为特征,分别构建两种药物的疗效预测模型.结果:临床症状较轻、C因子智商较高、执行功能计划和抑制受损较轻的患者,OROSMPH疗效更好,疗效预测模型准确率81.3％;而对于ATX,B因子智商较高、执行功能启动和抑制受损较轻的患者,疗效更好,预测模型准确率80.7％.结论:患者基线智商水平、执行功能受损程度是OROS MPH与ATX疗效的重要预测指标,同时,临床症状严重程度也是OROSMPH疗效的预测指标.

In the clinical work, a patient with bipolar disorder who took lithium carbonate was found to have sporadic skin rash with itching and was diagnosed as lichen planus pigmentosum. After discontinuing lithium carbonate, the skin rash was improved. A variety of affective stabilizers including lithium carbonate have adverse reactions of skin rash, but there are few reports of lichen planus pigmentosum within China and abroad. Sharing this case could help to attract the attention on this adverse reaction in clinicians.

As a novel antipsychotic drug, lumateperone acts synergistically via serotonergic, dopaminergic, and glutamatergic systems to generate efficacy in positive, negative and depressive symptoms as well. Common adverse reactions are sedation, headache, diarrhea, and dry mouth. Lumateperone has been approved by the U.S. Food and Drug Administration for treatment in adult schizophrenic patients. The pharmacodynamic and the pharmacokinetic profiles, evidence of clinical researches, safety and tolerability of Lumateperone are reviewed in this article.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的:评估身份和进食障碍问卷简体中文版（IDEA）的效度和信度。方法:选取187例符合DSM-IV诊断标准的进食障碍患者和60例正常对照进行IDEA和进食障碍调查问卷（EDI-1）量表测评,选择30例患者在2周内进行重测。结果:探索性因素分析得到4个因子,4个因子的累积贡献率为63.3%,有3个条目发生移动,考虑到可能与中英文表达差异有关,在后续统计中,删除了这3个条目。IDEA与EDI-1两个量表的组内相关系数为0.86;患者组IDEA总分、分量表得分均高于正常对照组（均P&lt;0.001）。IDEA量表的Cronbach α系数为0.95、分半信度为0.93、重测信度为0.86。结论:IDEA简体中文版测评进食障碍患者的身体感受和自我认知紊乱程度具有良好的效度和信度。</span>

Background: Disturbed self-regulation, taste reward, as well as somatosensory and visuospatial processes were thought to drive binge eating and purging behaviors that characterize bulimia nervosa. Although studies have implicated a central role of the striatum in these dysfunctions, there have been no direct investigations on striatal functional connectivity in bulimia nervosa from a network perspective. Methods: We calculated the functional connectivity of striatal subregions based on the resting-state functional Magnetic Resonance Imaging data of 51 bulimia nervosa patients and 53 healthy women. Results: Compared with the healthy women, bulimia nervosa patients showed increased positive functional connectivity in bilateral striatal nuclei and thalamus for nearly all of the striatal subregions, and increased negative functional connectivity in bilateral primary sensorimotor cortex and occipital areas for both ventral striatum and putamen subregions. Only for the putamen subregions, we observed reduced negative functional connectivity in the prefrontal (bilateral superior and middle frontal gyri) and parietal (right inferior parietal lobe and precuneus) areas. Several striatal connectivities with occipital and primary sensorimotor cortex significantly correlated with the severity of bulimia. Conclusions: The findings indicate bulimia nervosa-related alterations in striatal functional connectivity with the dorsolateral prefrontal cortex supporting self-regulation, the subcortical striatum and thalamus involved in taste reward, as well as the visual occipital and sensorimotor regions mediating body image, which contribute to our understanding of neural circuitry of bulimia nervosa and encourage future therapeutic developments for bulimia nervosa by modulating striatal pathway.

目的 了解北京市学习困难学生心理健康状况,为改善学习困难学生心理健康水平提供依据.方法 采用随机整群抽样的方法,选取北京市11所公立普通初中初一、初二年级全体在籍学生共5787名作为调查对象.采用自行设计的调查问卷对调查对象进行匿名自填式问卷调查,了解学生学习困难和心理健康状况.结果 有11.6％的学生自我报告有学习困难,其中数学推理困难和数学计算困难的学生占比较高,分别为44.1％和40.7％.学生心理健康问题的报告率为38.3％.10个因子平均分排名前4位的分别是强迫症状(2.19±0.77)分、学习压力(2.17±0.99)分、情绪不稳定(2.09±0.90)分、焦虑(2.07±1.08)分.多因素Logistic回归分析结果表明,与非学习困难学生相比,自我报告学习困难学生的心理健康状况较差(OR=1.47),且学习困难与心理健康大多数因子相关,不同的学习困难类型与不同的心理健康因子相关.结论 与非学习困难学生相比,学习困难学生的心理健康状况较差.应大力加强学习困难学生的心理健康帮扶工作,提高心理健康水平.