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.

Abstract Background Family functioning encompasses cultural values and behavioral patterns, with family dysfunction referring to pervasive and maladaptive interactions in the latter dimension. In Chinese culture, filial piety is a core familial value, comprising authoritarian filial piety (AFP), rooted in hierarchy and obedience, and reciprocal filial piety (RFP), based on mutual affection and care. This study examines the relationships between AFP, RFP, family dysfunction, and eating pathology among Chinese adults with anorexia nervosa (AN). Methods We employed a two-part design that included a cross-sectional analysis of 144 female adults with AN in Chinese mainland and, within the same cohort, a longitudinal follow-up of 75 patients to examine how filial piety and family dysfunction predict changes in eating pathology over time. Correlation, hierarchical multiple regression, and generalized least squares were used for data analysis. Results Cross-sectionally, AFP was associated with greater eating pathology (β = 0.161, p < .05). While RFP and family dysfunction were not significantly associated with eating pathology after controlling psychological and biological factors. Longitudinally, AFP did not independently predict symptom progression after controlling for baseline pathology, suggesting that AFP may act not as a primary driver of worsening symptoms. Conclusion AFP represents a stable cultural risk factor for eating pathology in Chinese adults with AN. These findings underscore the importance of integrating cultural values like AFP into therapeutic frameworks and developing culturally adapted interventions for Chinese populations.

Non-suicidal self-injury (NSSI) is a common behavior among adolescents, particularly within psychiatric populations. While neurobiological and psychosocial risk factors have been extensively studied, the mechanisms underlying NSSI’s heterogeneity remain unclear. This study investigated 304 hospitalized adolescents/young adults (16–25 years) with NSSI and comorbid psychiatric diagnoses (major depressive disorder [MDD], bipolar disorder [BD], eating disorders [ED]) using psychological assessments and resting-state fMRI data from 163 participants. Orthogonal projection non-negative matrix factorization of Ottawa Self-Injury Inventory responses identified two latent factors: self-related factor and social-related factor. The self-related factor correlated with amygdala-centered cortico-limbic emotional regulation networks and predominated in affective disorders (MDD/BD), while the social-related factor linked to frontoparietal cognitive control and frontotemporal social cognition networks, particularly in ED. Fuzzy C-means clustering revealed three NSSI functional subtypes, independent of diagnostic categories: self-subtype primarily driven by self-related functions, social-subtype influenced by both self-related and social-related functions with greater exposure to psychosocial risks, and non-specific subtype characterized by mixed motivations. No subtype was exclusively driven by social-related functions. The “self-social” dual-dimensional framework with distinct neural mechanisms demonstrated subtype-specific profiles in functional connectivity, psychosocial risk exposure, and clinical features. Self-related mechanisms primarily engaged emotional regulation circuits, whereas social-related mechanisms emphasize the role of psychosocial risk factors and cognitive-emotional circuits. These findings provide neural evidence for the functional heterogeneity of NSSI and highlight the need for personalized interventions. Treatments targeting emotion regulation may benefit all subtypes, individuals with prominent social-related motivations may additionally require interventions aimed at improving interpersonal functioning.

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.

Individuals with anorexia nervosa (AN) often face significant challenges in maintaining motivation for recovery. Understanding the perceived pros and cons associated with the disorder is crucial for promoting recovery. This study aimed to translate, adapt, and validate the Pros and Cons of Anorexia Nervosa Scale (P-CAN) for use with Chinese adults with AN, thereby facilitating a clearer understanding of the motivations and barriers encountered by these patients. This study employed a cross-sectional survey design to collect data from 207 Chinese adults with AN (Mage25.58 and SD 6.011). Content validity was assessed by a panel of professionals. Reliability testing included internal consistency, test-retest reliability, item-total correlation, and correlation analysis between subscales. Principal Component Analysis (PCA) assessed the factor structure, focusing on two components (Pro and Con-AN) and ten subscales—Safe/Structured, Appearance, Fertility/Sexuality, Special, Fitness, Communicate Emotions/Distress for Pro-AN and Trapped, Guilt, Hatred, Stifled for Con-AN as per the original scale. Criterion validity was evaluated using the eating pathology tested by Eating Disorder Examination Questionnaire (EDE-Q) and Body Mass Index (BMI). The content validity of the overall scale was 0.86. The Pro-AN and Con-AN subscales exhibited strong internal consistency (α = 0.84 and 0.82) and test-retest reliability (r = 0.912 and 0.704, p < 0.001). Item-Total Correlations exceeded 0.3 for all items except item 2, and there was no significant correlation between the Pro-AN and Con-AN subscales. The PCA results indicated that the Chinese P-CAN retained two components, which are consistent with the original scale. Differences emerged in more granular dimensions that may not be appropriate within the Chinese context. Significant correlations were found between the Pro-AN (r = 0.279, p < 0.001) and Con-AN (r = 0.240, p < 0.001) subscales and eating pathology and Con-AN was significantly correlated with BMI (r = -0.214, p < 0.01). The P-CAN has shown promising psychometric properties among Chinese patients with AN. In terms of dimensionality, the Chinese context aligns closely with the original scale’s binary division into Pro-AN and Con-AN. However, the further differentiation into ten dimensions, may not be culturally appropriate for the Chinese context. This study aimed to translate and culturally adapt the Pros and Cons of Anorexia Nervosa Scale (P-CAN) for Chinese adults with anorexia nervosa (AN). The adapted scale is designed to assess motivations and barriers among Chinese individuals with AN in the recovery process, providing insights for clinical practice. The study involved 207 Chinese adults with AN, who completed the translated scale. The scale was tested for accuracy (content validity), consistency (reliability), and its ability to measure what it’s supposed to measure (validity). The results showed that the Chinese version of the P-CAN is reliable and valid for use with Chinese adults with AN. The scale divides into two main parts: Pro-AN (reasons patients might see benefits in their disorder) and Con-AN (reasons they might see drawbacks). These two parts showed strong consistency and reliability. However, while the overall structure of the scale matched the original version, some of the more detailed subcategories (like “Safe/Structured” or “Trapped”) might not fit as well in the Chinese cultural context. The study also found that both the Pro-AN and Con-AN parts of the scale were linked to eating disorder symptoms, and the Con-AN part was also linked to body weight (BMI). In conclusion, the Chinese version of the P-CAN is a useful tool for understanding the motivations and challenges of Chinese adults with AN. While the overall structure works well, some of the finer details might need adjustment to better fit the Chinese cultural context. This tool can help clinicians and researchers better support patients in their recovery.

Background: Non-suicidal self-injury (NSSI) is common in adolescents and young adults, especially among psychiatric disorders. It arises from neurobiological and psychosocial factors, yet its underlying mechanisms remain unclear. Methods: A total of 304 inpatients (aged 16-25 years) with NSSI and psychiatric diagnoses (major depressive disorder [MDD], bipolar disorder [BD], and eating disorders [ED]) were assessed using the Ottawa Self-Injury Inventory. Resting-state functional magnetic resonance imaging were collected from 163 of them. Functional factors, representing motivations of NSSI, were identified using orthogonal projection non-negative matrix factorization. These factors were then linked to brain functional connections (FC) via canonical correlation analysis and used to classify patients into subtypes through fuzzy C-means clustering. Differences in FC and psychosocial characteristics were analyzed across subtypes. Results: Two NSSI functional factors were identified: self-related and social-related. Self-related factor was associated with an amygdala-centered cortico-limbic network and prevalent in affective disorders (MDD and BD). Social-related factor correlated with frontoparietal and frontotemporal networks, prominent in ED. Clustering identified three NSSI functional subtypes. Subtype 1 was primarily driven by self-related functions. Subtype 2 was influenced by both self- and social-related functions with greater exposure to psychosocial risks. Subtype 3 remained undifferentiated. No subtype exclusively driven by social-related function was observed. Conclusion: This study establishes the neural correlates of a "self-social" functional model of NSSI. Self-related functions are underpinned by emotional regulation networks, while social-related functions synergize with psychosocial risks via cognitive-emotional regulation pathways. These findings highlight the need for tailored psychological and neuromodulatory interventions targeting specific functional subtypes. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was supported by the National Natural Science Foundation of China (82071505, 81771443). HY was partly supported by Clinical Medicine Plus X-Young Scholars Project, Peking University the Fundamental Research Funds for the Central Universities (PKU2024LCXQ046) and Capital's Funds for Health Improvement and Research (2024-2-4115). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of Ethics Committee of Peking University Sixth Hospital gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.

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.

Anorexia nervosa (AN) is a severe psychiatric disorder associated with extreme malnutrition and multi-organ complications, including cutaneous manifestations. We report an 11-year-old girl with restrictive-type AN who presented with a critically low BMI (7.7–9.0 kg/m2), who presented with striking cutaneous findings. These included widespread striae distensae with a translucent, “cellophane-like” appearance, desquamative lesions reminiscent of the “flaky paint” dermatosis seen in kwashiorkor, and sacral pressure ulcers. Laboratory findings revealed severe protein-energy deficiency, anemia, electrolyte imbalance, and endocrine alterations. A structured refeeding program with close monitoring led to substantial clinical improvement. Over 8 weeks, her weight increased by 6 kg, and the skin gradually regained thickness, elasticity, and integrity. This case highlights the interplay of nutritional deficiency, catabolism, cortisol elevation, and mechanical stress in producing rare dermatoses in anorexia nervosa. The co-occurrence of glassy striae and flaky desquamation suggests a marasmic–kwashiorkor phenotype of malnutrition. The reversibility of these lesions further underscores the remarkable regenerative capacity of the skin under restored nutritional conditions.

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.

BACKGROUND: Nonsuicidal self-injury (NSSI) behavior is significantly prevalent in both adolescents and psychiatric populations, particularly in individuals with major depressive disorder. NSSI can be considered a result of risky decision making in response to negative emotions, where individuals choose self-harm over other less harmful alternatives, suggesting a potential decision-making deficit in those engaging in NSSI. This study delves into the complex relationship between NSSI and depression severity in decision making and its cognitive underpinnings. METHODS: We assessed decision behaviors in 57 patients with major depressive disorder and NSSI, 42 patients with major depressive disorder without NSSI, and 142 healthy control participants using the Balloon Analog Risk Task, which involves risk taking, learning, and exploration in uncertain scenarios. Using computational modeling, we dissected the nuanced cognitive dimensions influencing decision behaviors. A novel statistical method was developed to elucidate interaction effects between NSSI and depression severity. RESULTS: Contrary to common perceptions, we found that individuals with NSSI behaviors were typically more risk averse. There was also a complex interaction between NSSI and depression severity in shaping risk-taking behaviors. As depressive symptoms intensified, the individuals with NSSI began to perceive less risk and behave more randomly. CONCLUSIONS: This research provides new insights into the cognitive aspects of NSSI and depression, highlighting the importance of considering the influence of comorbid mental disorders when investigating the cognitive underpinnings of such behaviors, especially in the context of prevalent cross-diagnostic phenomena such as NSSI behaviors.

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.

IntroductionNon-suicidal self-injury (NSSI) is highly prevalent in depression, and is associated with psychosocial factors, emotion dysregulation, and strategies of cognitive emotion regulation. However, the internal combination and interactions of these risk factors in depression remain unclear.MethodsData from 122 patients with depression, including 56 with NSSI and 66 without NSSI, were analyzed. Self-rating scales were used to assess psychosocial factors, emotion dysregulation, and cognitive regulation strategies. Sparse partial least squares discriminant analysis (sPLS-DA) was employed to explore internal combinations in each profile. A moderated mediation model was applied to examine their interactional relationship.ResultsThe results identified an NSSI-related psychosocial profile characterized by high neuroticism, childhood trauma, poor family functioning, and low psychological resilience. Emotion dysregulation, including high levels of alexithymia, anhedonia, and emotion regulation difficulties, mediated the association between this psychosocial profile and NSSI. The mediated effect was further moderated by maladaptive cognitive regulation strategies.LimitationsLack of sufficient information on NSSI frequency and severity. Relatively small sample size for discussing the impact of gender and age of depressive patients with NSSI.ConclusionThese findings hold important implications for the prevention, treatment, and rehabilitation of NSSI.

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.

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.

神经性厌食(AN)是一种可危及生命的严重进食障碍，为病死率最高的精神疾病。传统心理治疗和辅助药物治疗在成人AN患者中的效果并不确切。约20%的AN患者发展为慢性难治性AN。研究表明，神经外科手术，特别是脑深部电刺激术(DBS)和立体定向毁损手术是难治性AN潜在的有效治疗方式。本文对手术治疗慢性难治性AN的研究进展做一综述。

Abstract Background: Anorexia nervosa (AN) is a psychological disorder, which is characterized by the misunderstanding of body image, food restriction, and low body weight. An increasing number of studies have reported that the pathophysiological mechanism of AN might be associated with the dysbiosis of gut microbiota. The purpose of our study was to explore the features of gut microbiota in patients with AN, hoping to provide valuable information on its pathogenesis and treatment. Methods: In this cross-sectional study, from August 2020 to June 2021, patients with AN who were admitted into Peking University Third Hospital and Peking University Sixth Hospital (n = 30) were recruited as the AN group, and healthy controls (HC) were recruited from a middle school and a university in Beijing (n = 30). Demographic data, Hamilton Depression Scale (HAMD) scores of the two groups, and length of stay of the AN group were recorded. Microbial diversity analysis of gut microbiota in stool samples from the two groups was analyzed by 16S ribosomal RNA (rRNA) gene sequencing. Results: The weight (AN vs. HC, [39.31 ± 7.90] kg vs. [56.47 ± 8.88] kg, P < 0.001) and body mass index (BMI, AN vs. HC, [14.92 ± 2.54] kg/m2vs. [20.89 ± 2.14] kg/m2, P < 0.001) of patients with AN were statistically significantly lower than those of HC, and HAMD scores in AN group were statistically significantly higher than those of HC. For alpha diversity, there were no statistically significant differences between the two groups; for beta diversity, the two groups differed obviously regarding community composition. Compared to HC, the proportion of Lachnospiraceae in patients with AN was statistically significantly higher (AN vs. HC, 40.50% vs. 31.21%, Z = −1.981, P = 0.048), while that of Ruminococcaceae was lower (AN vs. HC, 12.17% vs. 19.15%, Z = −2.728, P = 0.007); the proportion of Faecalibacterium (AN vs. HC, 3.97% vs. 9.40%, Z = −3.638, P < 0.001) and Subdoligranulum (AN vs. HC, 4.60% vs. 7.02%, Z = −2.369, P = 0.018) were statistically significantly lower, while that of Eubacterium_hallii_group was significantly higher (AN vs. HC, 7.63% vs. 3.43%, Z = −2.115, P = 0.035). Linear discriminant effect (LEfSe) analysis (LDA score >3.5) showed that o_Lachnospirales, f_Lachnospiraceae, and g_Eubacterium_hallii_group (o, f and g represents order, family and genus respectively) were enriched in patients with AN. Microbial function of nutrient transport and metabolism in AN group were more abundant (P > 0.05). In AN group, weight and BMI were significantly negatively correlated with the abundance of Bacteroidota and Bacteroides, while positively correlated with Subdoligranulum. BMI was significantly positively correlated with Firmicutes; HAMD scores were significantly negatively correlated with Faecalibacterium. Conclusions: The composition of gut microbiota in patients with AN was different from that of healthy people. Clinical indicators have correlations with the abundance of gut microbiota in patients with AN.

We examined the care burden and related factors of 192 parents of a family member being treated for an eating disorder in China. Participants completed a survey designed to measure demographic variables, caregiver burden, social support, and coping style. Results show that a greater care burden was associated with longer duration of the disorder, low family income, and longer interaction time between the parent and the family member. The use of a positive (vs. negative) coping style and good social support were associated with a lesser (vs. greater) care burden. Thus, we propose that parents be provided with support and that their coping style be improved as part of a comprehensive eating disorder intervention process.

目的:评估进食障碍症状影响量表简体中文版(EDSIS-C)在神经性厌食和神经性贪食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206名,进行EDSIS-C和照料者负担量表(CBI)测评,随机选取其中31名照料者在2周内进行重测.结果:各条目内容效度(CVI)为0.86～1.00,量表平均CVI值为0.87.验证性因子分析显示拟合良好(x2/df=600.80,CFI=0.63,TLI=0.60,RMSEA=0.08).EDSIS-C与CBI两个量表的组内相关系数ICC为0.58(P＜0.01).总量表的Cronbach α系数为0.83,营养、行为失控、内疚、社会孤立4个分量表的α系数分别为0.67、0.64、0.68和0.73;总量表的重测信度为0.69,4个分量表的重测信度分别为0.61、0.70、0.44、0.36.结论:进食障碍症状影响量表简体中文版具有良好的效度和信度,能够评估进食障碍症状对照料者的影响程度.

目的:探索进食障碍照料者线上技能培训在中国的可行性和可接受性.方法:选取符合美国精神障碍诊断与统计手册第5版(DSM-5)诊断标准的进食障碍患者的照料者84例,进行为期6周的线上照料技能讲座与小组讨论干预;在基线、干预结束时及干预后3个月用进食障碍症状影响量表(EDSIS)、一般健康问卷(GHQ-12)进行评估,在干预结束时填写培训满意度调查问卷.结果:与基线相比,干预结束时、干预后3个月EDSIS内疚分量表得分和行为失控分量表得分降低,营养分量表得分升高;GHQ-12得分降低(均P＜0.05).本次培训的照料者来自全国各地,其中92.8％的照料者参与＞75％的培训,89.3％的照料者对技能培训的有效性满意度为10分.结论:进食障碍照料者线上技能培训在中国有良好的可行性与可接受性.