As a psychiatrist who has dedicated his career to obsessive-compulsive disorder (OCD), related conditions, anxiety, and eating disorders, I am honored to serve as guest editor for this issue of Psychiatric Annals on eating disorders. Given the complexity, morbidity, and mortality associated with these conditions, the review articles presented here should have great clinical relevance.
I have the distinct privilege to work with specialist colleagues at Monte Nido and Affiliates who have dedicated their careers to eating disorders, and who have contributed articles to this issue. In the first article, “Medical Complications of Eating Disorders,” Dr. Joel Jahraus provides a much-needed review of the medical complications of eating disorders. He reviews the symptoms of eating disorders associated with medical complications, and discusses the physical impact of eating disorders by organ systems. He also discusses gluten enteropathy, food allergies, and laboratory studies. In the second article, “Neurobiology of Eating Disorders and the Use of Psychotropic Medications,” Drs. K. Molly McShane and Lauren Ozbolt discuss the neurobiology of eating disorders and the use of psychotropic medications. After an introduction, temperament traits are discussed. The authors then examine the neurobiology of anorexia nervosa, bulimia nervosa, and binge-eating disorder. Drs. McShane and Ozbolt then detail current medication options used in the treatment of these conditions and make the important point that further research is clearly needed to develop targeted pharmacological therapies. The issue then turns to the psychotherapeutic treatment of co-occurring eating disorders and posttraumatic stress disorder (PTSD). In “Psychotherapeutic Treatment of Co-Occurring Eating Disorders and Posttraumatic Stress Disorder,” Elizabeth H. Parks discusses issues that are pertinent to co-occurring eating disorders and examines the treatment of patients with eating disorders/PTSD. Cognitive-processing therapy is then explored, and directions for future research are considered. Finally, in the article, “Review of Avoidant/Restrictive Food Intake Disorder,” Diana Ushay and I review a newer eating disorder diagnosis that has been implemented in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5)1: avoidant/restrictive food intake disorder. Clinical features, DSM-5 criteria, and screening tools are discussed. We then discuss comorbidities and detail retrospective comparisons with patients who have anorexia nervosa. We also describe treatment strategies and conclude by discussing directions for future research. Please enjoy this issue that reviews clinically pertinent topics in eating disorders.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.