[Pilot study on nutritional and eating disorders in children and mood disorders: comorbidity or prodromal traits?]

INTRODUCTION: Both children affected by nutritional and eating disorders (ED) and adults with bipolar disorder (BD) display symptoms of deficient emotional self-regulation, which can present in different forms. If we observe the clinical and developmental histories of individuals affected by EDs and BD, based on a cognitive systemic post-rationalist approach, we can hypothesise a continuum between the two disorders. The aim of this pilot study is to support the hypothesis - from an explanatory rather than a non-descriptive approach - that EDs and BD are the possible result of issues tied to biological and psychological self-regulation. When such an issue manifests during an individual's early stages through an eating disorder, it is more likely to result in an actual affective disorder, such as BD, during an individual's adult years.

MATERIALS AND METHODS: The study examined a total of 51 patients affected by an ED between the ages of 8 and 18. At least one of the parents had been diagnosed with a mental disorder. All of the subjects completed the Child Behavior Checklist (CBCL) and the Eating Disorders Inventory (EDI) II. Each of the patients underwent a pediatric assessment using their BMI to establish the type of ED. The parents were divided into two groups: subjects with BD and subjects affected by other psychopathologies.

RESULTS: Although the comparison between patients with EDs and parents with or without BD did not demonstrate a significant difference in any scale, it highlighted specific common characteristics between the disorder presented by the parent and the cognitive-emotional expressions of his or her child. In fact, the results indicate that the CBCL "problems of thought" scale explains much of the Impulsivity variance obtained by the EDI and that the CBCL "high withdrawal/depression" dependent factor highlighted a statistical significance for the EDI's "low interoceptive awareness" scale.

CONCLUSIONS: The study presented limitations, especially with respect to the sample size examined, but it suggests a field that can be further explored to understand the reasons for a significance in the aspects related to contrasting emotional adjustments, impulsivity and depression/withdrawal, highlighting a connection with the parents' distinctive relational model.