Psychiatric inpatient care is a high-resource component of mental health systems. Understanding the diagnoses driving inpatient care is essential for evidence-based service planning. This study describes psychiatric inpatient bed use in Ireland from 2013 to 2023 by diagnosis, sex, and age group.

National descriptive analyses using aggregated data from the National Psychiatric Inpatient Reporting System, covering acute inpatient admissions in Ireland. The outcome was total number of inpatient bed days, categorised by ICD-10 diagnostic group. Primary analyses focused on public services, with private services reported separately. We additionally report on child and adolescent mental health services (CAMHS), adult services, and sex-stratified results.

Between 2013 and 2023, there were k=3,993,628 public and k=1,879,877 private inpatient bed days. In public services, schizophrenia spectrum disorders accounted for 41.9% of bed days (k=1,673,529), more than twice as many as the next most prevalent diagnosis. Men accounted for 51.2% of acute public bed days. In private adult services, depressive disorders accounted for the largest proportion of bed days (28.5%, k=513,166). In public and private CAMHS, eating disorders accounted for the largest proportion of bed days (25.6%, k=46,850 and 24.4%, k=18,775), respectively.

This national analysis demonstrates that schizophrenia spectrum disorders represent, by far, the largest diagnostic group, accounting for 42% of public acute psychiatric inpatient beds days, highlighting the sustained, intensive service demands associated with these disorders. These data provide a clear empirical basis for future service planning, highlighting where targeted enhancements to community-based care could most effectively reduce the need for hospitalisation.

Cognitive Behavioural Therapy-Ten (CBT-T) offers a briefer manualised approach to treatment of non-underweight eating disorders (EDs) compared with traditional therapy models, and has the potential to help services deliver timely access to care. This study evaluated CBT-T outcomes in a naturalistic setting, with a focus on session-by-session change patterns.

A total of 151 young adults received CBT-T in a no-threshold-to-access community ED service. Symptom trajectories were assessed using the ED-15 global scale and subscales (eating concern, weight/shape concern). Using intent-to-treat principle, linear mixed-effect models evaluated treatment effectiveness, and chi-squared and receiver operating characteristic (ROC) analyses explored associations between early symptom change and end-of-treatment remission.

Treatment led to significant reductions in ED symptoms and psychosocial impairment, with large effect sizes. Reliable improvement in Weight/Shape Concern – but not Eating Concern – on ED-15 at session 4 significantly predicted ED symptom scores below the clinical cut-off at the last session.

CBT-T is effective in reducing ED symptoms in young adults with non-underweight EDs. While engagement and progress prior to session 4 have been used to guide treatment planning, as stated in the treatment manual, only the change in weight/shape concern at session 4 appeared to be strongly predictive of outcome in this sample, whereas change in eating concern did not. Early changes in weight and shape concerns at initial sessions may be informative in predicting treatment outcome. The findings can support the future development of CBT-T and other brief ED interventions.

To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.

A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12th, 2020, and December 20th, 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.

Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.

Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.

The link between problematic usage of the internet (PUI) and eating disorder symptoms is well-established. However, less is known about this association in the context of orthorexia nervosa (ON), an excessive preoccupation with healthy eating. This study aimed to investigate the relationship between PUI, including various problematic online behaviors, and ON tendency in a sample of US adults.

Three hundred adults completed an online survey via prolific (mean age = 37.40, 54.6% female). The survey included demographic questions, the ORTO-R to measure ON symptoms, and the Internet Severity and Activities Addiction Questionnaire (ISAAQ-10) to assess PUI and the extent of engagement in several online activities, such as gaming, shopping, social networking, cyberchondria, pornography, and cyberbullying.

Women had higher ORTO-R scores than men (p < .05). ISAAQ-10 scores predicted ORTO-R scores in a regression model (β = .375, p < .001) even after controlling for age, gender, and an eating disorder diagnosis. ON risk was associated with a high engagement in cyberchondria, researching healthy food choices on the internet, cyberbullying perpetration, and online shopping.

Results indicate that PUI is associated with ON symptoms even after considering other predictors. Maladaptive use of nutrition and medical-related resources may play a significant role in this association. However, it remains unclear whether exposure to this content increases ON risk or if people with ON symptoms seek this information online. The directionality of this relationship is an important area for future research.

It is well established that there is a substantial genetic component to eating disorders (EDs). Polygenic risk scores (PRSs) can be used to quantify cumulative genetic risk for a trait at an individual level. Recent studies suggest PRSs for anorexia nervosa (AN) may also predict risk for other disordered eating behaviors, but no study has examined if PRS for AN can predict disordered eating as a global continuous measure. This study aimed to investigate whether PRS for AN predicted overall levels of disordered eating, or specific lifetime disordered eating behaviors, in an Australian adolescent female population.

PRSs were calculated based on summary statistics from the largest Psychiatric Genomics Consortium AN genome-wide association study to date. Analyses were performed using genome-wide complex trait analysis to test the associations between AN PRS and disordered eating global scores, avoidance of eating, objective bulimic episodes, self-induced vomiting, and driven exercise in a sample of Australian adolescent female twins recruited from the Australian Twin Registry (N = 383).

After applying the false-discovery rate correction, the AN PRS was significantly associated with all disordered eating outcomes.

Findings suggest shared genetic etiology across disordered eating presentations and provide insight into the utility of AN PRS for predicting disordered eating behaviors in the general population. In the future, PRSs for EDs may have clinical utility in early disordered eating risk identification, prevention, and intervention.

Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs).

We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons.

Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction).

Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.

This study tested whether the dissonance-based Body Project eating disorder prevention program reduced onset of subthreshold/threshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD) over long-term follow-up.

Data were combined from three prevention trials that targeted young women at high-risk for eating disorders (N = 1092; M age = 19.3). Participants were randomized to Body Project groups led by peer educators or expressive writing/educational controls and completed masked diagnostic interviews over 2- to 4-year follow-ups. Logistic regressions tested whether onset of each eating disorder over follow-up differed between Body Project and control participants.

Peer-led Body Project groups produced a 46% reduction in onset of subthreshold/threshold BN and a 62% reduction in onset of PD relative to controls over follow-up. Rates of onset of subthreshold/threshold AN and BED did not significantly differ between peer-led Body Project participants and control participants.

Results support the dissemination of the peer-led Body Project for reducing future onset of BN and PD. This study and recent research suggest that thin-ideal internalization, the risk factor for eating disorders targeted in the Body Project, may be more relevant for predicting onset of BN and PD compared to AN and BED. Findings support the development of a version of the Body Project aimed to reduce risk factors that have predicted future onset of all four types of eating disorders (e.g. overvaluation of weight/shape, fear of weight gain), which may more effectively prevent all eating disorder types.

The quantification of suicidal risk in specific populations is important for the adoption of prevention and risk reduction measures. This risk remains very high in patients with eating disorders compared to the general population.

The present study evaluates the prevalence of suicide among patients with eating disorders all seeking different suicidal risk factors in these patients.

A retrospective study of medical records of all patients with eating disorders, diagnosed according to DSM 5 criteria, at Arrazi hospital of Salé for the past 14 years, by assessing the prevalence of suicide attempts and care.

In our work, all patients are female, 17 years old on average, 18 patients out of 20 have anorexia nervosa, 4 of them have had bouts of bulimia, and only one patient was admitted for management of bulimia nervosa alone. The mean age of onset was 15 years with addictive comorbidity in 5 patients.

Thirteen patients had comorbid depressive disorder, one patient was schizophrenic and six patients had borderline personality disorder.

12 patients have made suicide attempts, planned especially in a depressive environment.

Preventive management of suicidal risk must be taken in order to improve the prognosis in this category of patients.

No significant relationships.

Alexithymia is a construct which has been described in persons under the autistic spectrum. Besides Autistic Spectrum Disorders, alexithymia nowadays is highly correlated with several psychiatric disorders, among them being Eating Disorders. Several studies suggested a “cognitive-affective” division in the inner experience of patients with Anorexia Nervosa, because of their difficulty in describing, identifying and recognising their own emotions as well as others

This study aims to identify how many adolescents diagnosed with Anorexia Nervosa meet the characteristics of alexithymic personality traits and in which domain of these traits they had the most struggles with.

The study lot includes 34 adolescents diagnosed with Anorexia Nervosa evaluated by a self report survey: Online Alexithymia Questionnaire-G2 (OAQ-G2). The cut-off scores are: 113 and above - correlated with alexithymia, 95-112 - correlated with possible alexithymia and under 94 - insignificant clinical score. We analyzed the result of every subcategory of the questionnaire in order to determine whether there is an area affected more than others.

The sample included 34 patients, female to male ratio 31:3, evaluated in the Department of Child and Adolescent Psychiatry, “Prof. Dr. Alexandru Obregia” Psychiatry Hospital. 29,41% had clinically semnificative scores for alexithymic traits, while 52,94% scored for possibile alexithymia according to the OAQ-G2.

In 82,35% of patients from the lot we identified alexithymic personality traits. The F1 subcategory (difficulty identifying feelings) and F5a (problematic interpersonal process) were the ones that distinguished the alexithymic group from the possible alexithymic one.

No significant relationships.

During the last 30 years, many studies have shown a high prevalence of substance use among patients diagnosed with an Eating Disorder (ED). Almost 50% of the patients with ED have a history of substance use, and 35% of the patients that seek help for an addiction disorder also meet criteria for ED. Nevertheless, both substance abuse specialists and pratictioners with expertise in ED have difficulties in treating these dually diagnosed patients.

The aim of this study is to emphasize the importance of assessing substance use in patients with ED and disturbed eating behaviors in patients with Substance Use Disorders (SUD), as well as the need for evidence-based treatment guidelines for this comorbid condition.

A literature search of published articles on substance use patterns in ED and on the therapeutic approach for this comorbid condition was performed on PubMed database.

A diagnosis of Bulimia Nervosa and the presence of binging/ purging behaviors are strongly associated with substance use. Most frequently used substances are represented by nicotine, caffeine and alcohol, followed by cannabis and amphetamines. Reasons why patients with ED use substances are emotional regulation and appetite suppression. Detailed and systematic evaluation of the substances used and for other psychiatric comorbidities is mandatory. Management plan involves simultaneously treating ED and SUD.

The comorbidity of Substance Use Disorders and Eating Disorders is a complex entity, but nonetheless treatable. Further studies are needed to specify the patterns of substance use in Eating Disorders and their implications for treatment.

No significant relationships.

Current studies indicate a strong relationship between Eating Disorders and obesity, while studies on Bipolar Disorder (BPD) show that patients with BPD form an important risk group in terms of obesity.

The aim of this study is to investigate the frequency of Binge Eating Disorder (BED) in patients diagnosed with euthymic Bipolar Disorder 1 (BPD 1), and the relationship between their clinical features

This study included 150 patients between 18-65 years of age, diagnosed with euthymic BPD 1 according to DSM 5 criteria. Structured Clinical Interview for DSM-5 Disorders, Structured Sociodemographic Form, Young Mania Scale, Beck Depression Scale, Eating Disorders Assessment Scale (EDAS) , Eating Attitude Test (EAT) were applied to participants.

A diagnosis of BED was detected in 19.3% of the patients. Body weight, highest weight and BMI values were significantly higher in those who were diagnosed with BED compared to those who were not diagnosed with BED. Most of the diagnosed with BED are women; gender was found to be determinant for BED. The total and subscale scores of EAT and EDAS of those with a diagnosis of BED were statistically significantly higher than those who did not. The rate of attacks with psychotic symptoms, rapid cycling and presence of suicide attempt were significantly higher in those with a diagnosis of BED compared to those who did not.

BED may be frequent in BPD 1 patients. Noticing BED in BPD1 patients might help both the more effective treatment of BPD and the prevention of obesity.

No significant relationships.

Binge-eating disorder (BED), is one of the most common eating disorder. Treatment aims to reduce binge-eating frequency and disordered eating–related cognitions, improve metabolic health and weight, and regulate mood (in patients with coexisting depression or anxiety)

The aim of this study was to examine the efficacy of lisdexamfetamine dimesylate in a simple of 50 women with a binge eating disorder diagnosis compare with selective serotonin reuptake inhibitor

Two groups were made, one with lisdexamfetamine and the other with selective serotonin reuptake inhibitor (fluoxetine). 20 women were in each group (total n=40). The doses depend of the binge symptoms and rates were from 30 to 70md/day for lisdexamfetamine and for fluoxetine the doses were from 20 to 60mg/day.

Binge behaviors decreased with a 50mg/day dose of lisdexamfetamine. The 70mg/day doses present also less binge behaviors but also more adverse events. The 30mg/day doses did not decrease binge-eating behaviors.

Lisdexamfetamine is the first pharmacological agent to receive FDA approval for use in adults with moderate to severe binge eating disorder. This study supports further assessment of lisdexamfetamine as a treatment option for decreasing binge eating behavior and also symptoms associated such as anxiety and obsessive and compulsive features in adults.Increased efficacy with increasing dosages of lisdexamfetamine suggests a dose-response relationship until 50mg/day. Women with a dose of 50mg/day of lisdexamfetamine report less adverse event, more adherence to treatment and improve their eating behaviors.

No significant relationships.

15-year-old female referred to outpatient unit after COVID lockdown for binge eating and purging with depressive symptoms and anxiety.

To show the importance of a correct diagnosis in an impulsive patient with eating disorder

case report and literature review

The patient presents emotional instability with interpersonal difficulties with high fear of rejection. She suffered from fear of gaining weight and desires to lose weight with rejection of her body image. Fluoxetine and lorazepam are started together with low doses of olanzapine. During the follow up she presented a worsening of mood, onset of self-injuries and an episode of suicidal attempt. A biographical examination was performed, expressing a feeling of academic failure with difficulty concentrating and performing simple tasks. As a child she is described as impulsive, with frequent arguments with classmates. CPT III was performed with a high probability of ADHD. Treatment was started with lisdexamfetamine up to 50 mg with good tolerance. From the beginning of the treatment the patient expressed a feeling of improvement in the control of emotions as well as in the management of her impulsivity. There was an improvement in her academic performance with a decrease in self-injury episodes. The patient was able to express improvement in the sense of incapacity she felt.

This case shows how marked emotional dysregulation and impulsive symptoms improves after diagnosis and subsequent treatment of ADHD, also improving eating symptoms. ADHD is present in eating disorders, especially in those with impulse dyscontrol such as binge eating disorder or bulimia nervosa.

No significant relationships.

Adolescence, when physical body image changes occur, is highly vulnerable to the development of eating disorders. At this age, there is an acute task of accepting oneself as another - an adult who has changed.

To study the features of the image of an adult in young people with eating disorders.

The study involved 58 girls (from 17 to 22 years old). The main group included 31 people with a high risk of eating disorders, the control group - 27 people with an average and low risk. Respondents filled in: Taylor Manifest Anxiety Scale, Eating behavior rating scale, projective drawing of an adult and child, association test about words «adult» and «child»

1. A high level of personal anxiety was revealed in the main group; 2. The visualized image of an adult in the main group has more distortions and fewer signs of gender identification than in the normal group; 3. Semantic ideas about adulthood in the main group are negatively emotionally colored and include categories related to eating behavior; 4. Semantic ideas about childhood in the main group are more negatively emotionally colored, and ideas about the present are more connected with appearance than in the control group. Semantic ideas about the future in this group are often negatively colored.

Figurative and semantic ideas about childhood, adulthood and about oneself in the present and in the future in girls with eating disorders have qualitative characteristics in comparison with the control group.

No significant relationships.