Eating Disorder and Depression

Eating Disorder and Depression

Annotated Bibliography: What is the Association between Depression and Eating Disorders?

Costa, J., Maroco, J., Gouveia, J., & Ferreira, C. (2016). Shame, self-criticism, perfectionistic self-presentation and depression in eating disorders. International Journal of Psychology and Psychological Therapy, 16(3), 315-328.

This article focuses on the connection between external shame and depression in individuals with eating disorders and the moderating role of self-criticism and perfectionistic self-presentation. Following a cross-sectional survey of 121 women with eating disorder, it was found that shame and perfectionistic self-presentation interact to cause self-criticism, which in turn results in depression. The implication thereto is that, when an individual internalises an ideal self, they gain a standard that as per their comparison with the actual self, results in negative feelings and self-evaluations; the individual perceives their real self as flawed or inferior. Consequently, the individual resorts to perfectionist self-representation so as to create to a positive image on other people's mind. Though this strategy can prevent shame and self-criticism, it potentially leads to eating disorder-related depression. The fairly large sample used is a major strength of the study. Nonetheless, the cross-sectional nature of the study design hinders the derivation of causality conclusions. Additionally, the study only included women. Overall, the study has significant implications for practice in the sense that therapeutic interventions aimed at treating eating disorder-related depression should pay greater attention to helping patients minimise the tendency of perfectionistic self-presentation.

Mustelin, L., Raevuori, A., Kaprio, J., & Keski-Rahkonen, A. (2014). Association between eating disorders and migraine may be explained by major depression. International Journal of Eating Disorders, 47, 884-887.

This longitudinal study sought to examine the relationship between eating disorders and migraine and the moderating effect of depression. The study, which included 2,825 twin women diagnosed with eating disorder, found that subjects with eating disorder were more likely to have migraine compared to those without eating disorder, with the correlation being mediated by major depressive disorder. In essence, the occurrence of migraine was found to be significantly higher in subjects with both eating disorder and depression. In addition to its large sample, the study finds a formerly ignored link between eating disorder, depression, and migraine. This is a valuable addition to the field of psychopathology. Nonetheless, there are important weaknesses. First, the study focused only on women. Also, the target subjects were twins, meaning familial transmission could have been a causal factor. Another limitation appears in the longitudinal nature of the study, which hinders the determination of temporal and causality relationships. From a practice perspective, it is imperative for interventions aimed at treating eating disorder-related depression to focus on migraine as well.

Herpertz-Dahlmann, B., Dempfle, A., Konrad, K., Klasen, F., & Ravens-Sieberer, U. (2015). Eating disorder symptoms do not just disappear: the implications of adolescent eating-disordered behaviour for body weight and mental health in young adulthood. European Child & Adolescent Psychiatry, 24, 675-684.

The aim of this prospective, population-based study was to examine the relationship between body weight, eating disorder, and mental health in children and adolescents. The study involved 771 subjects, 351 males and 420 females. Scores for body weight, eating disorder, and mental health were recorded at baseline and after 6 years. It was established that subjects with eating disorder were more likely to develop overweight and depressive signs. The study particularly found a high prevalence of unhealthy weight management techniques, uncontrollable eating, and dissatisfaction with body weight, which negatively affected mental health. The study has two major strengths: a large sample and the inclusion of both males and females. Nonetheless, the study relied on self-report data, which may often be characterised by bias or subjectivity. There was also a high attrition rate. Despite its weaknesses, the study makes valuable contributions to knowledge by demonstrating the connection between eating disorders during adolescence and depression risk. In practice, therefore, it is important to monitor adolescents with depressive symptoms for eating disorder. This is particularly true because adolescence is a major risk factor for the occurrence of eating disorder.

Allen, K., Mori, T., Bellin, L., Byrne, S., Hickling, S., & Oddy, W. (2013). Dietary intake in population-based adolescents: support for a relationship between eating disorder symptoms, low fatty acid intake and depressive symptoms. Journal of Human Nutrition and Dietetics, 26, 459-469.

This article focuses on the relationship between dietary intake, eating disorder signs, and depressive symptoms in adolescents. The relationship was tested using a population-based cohort of 429 female adolescents. It was found that adolescents diagnosed with an eating disorder had a substantially lower consumption of fat, starch, fatty acid, as well as vitamins A and E. compared to their counterparts without an eating disorder. Further, for participants with an eating disorder, fatty acid intake was found to be significantly and negatively correlated with eating disorder and depressive signs. A major strength of the study is the large sample used, which reinforces the representativeness of the findings. In addition, the study compared specific dietary ingredients' intake and depressive symptoms in subjects with and without an eating disorder. Major weaknesses of the study include use of self-report data and exclusion of male subjects. Even so, the study further demonstrates the impact of eating disorder on psychological wellbeing. In the event an eating disorder is discovered, proper monitoring and management should be undertaken, specifically focusing on nutritional deficiencies and depressive symptoms.