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Trastornos psicopatológicos depresivos y experiencias infantiles adversas en los trastornos de la conducta alimentaria

Published online by Cambridge University Press:  12 May 2020

Mario Speranza
Affiliation:
“Centro Hospitalario de Versalles, Servicio de Paidopsiquiatría, Le Chesnay, Francia Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia
Frederic Atger
Affiliation:
Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia
Maurice Corcos
Affiliation:
Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia
Gwenolé Loas
Affiliation:
Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia Servicio Hospitalario Universitario de Psiquiatría, Hospital Pinel, Amiens, Francia
Olivier Guilbaud
Affiliation:
Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia
Phillipe Stéphan
Affiliation:
Servicio de Psiquiatría del Niño y del Adolescente, Lausana, Suiza
Fernando Pérez-Díaz
Affiliation:
CNRS, UMR 7593, Hospital de la Salpétriére, París, Francia
Olivier Halfon
Affiliation:
Servicio de Psiquiatría del Niño y del Adolescente, Lausana, Suiza
Jean Luc Venisse
Affiliation:
Unidad de Adicciones, Hospital Saint-Jacques, Nantes, Francia
Paul Bizouard
Affiliation:
Servicio de Psiquiatría, CHU de Besançon, Besançon, Francia
François Lang
Affiliation:
Servicio de Psiquiatría, CHU de Saint-Etienne, Saint-Etienne, Francia
Martine Flament
Affiliation:
Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia CNRS, UMR 7593, Hospital de la Salpétriére, París, Francia
Philippe Jeammet
Affiliation:
Departamento de Psiquiatría del Adolescente, Instituto Mutualista Montsouris, París, Francia
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Resumen

Propósito.

El propósito de este artículo era investigar la especificidad diagnóstica de las experiencias depresivas de autocrítica y dependencia en una muestra clínica de pacientes con trastorno de la conducta alimentaria y explorar el impacto de las experiencias infantiles adversas en estas dimensiones de la personalidad.

Método.

Se evaluó a una muestra de 94 pacientes anoréxicas y 61 bulímicas que cumplían los criterios del DSM-IV y 236 controles emparejados con el Cuestionario de Experiencias Depresivas (DEQ), la versión abreviada del Inventario de Depresión de Beck (BDI) y el Inventario de Acontecimientos Vitales de la AMDP. Se excluyó de la muestra a los sujetos que presentaban depresión mayor o trastorno adictivo comórbido utilizando la Mini Entrevista Neuropsiquiátrica Internacional (MINI).

Resultados.

Las pacientes anoréxicas y bulímicas mostraron puntuaciones más altas que los controles en las subescalas tanto de autocrítica como de dependencia del DEQ. Las pacientes bulímicas puntuaron significativamente más alto que las anoréxicas en autocrítica y comunicaron más experiencias infantiles adversas. Por último, los acontecimientos vitales negativos correlacionaban sólo con la autocrítica en la muestra entera.

Discusión.

Las diferencias en Autocrítica del DEQ entre anoréxicas y bulímicas no se podían explicar por la depresión, ya que las pacientes bulímicas no mostraron niveles más altos en el BDI comparado con las anoréxicas, y no se encontró que los síntomas depresivos medidos con el BDI fueran predictores significativos del agrupamiento diagnóstic en una regresión múltiple logística.

Conclusión.

Este estudio apoya la especificidad diagnóstica de las dimensiones depresivas de dependencia y autocrítica en los trastornos de la conducta alimentaria y refuerza investigaciones previas sobre el papel de las experiencias tempranas en el desarrollo de estos trastornos.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2004

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References

Bibliografía

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.Washington, DC: APA; 1994.Google Scholar
Armstrong, JG, Roth, DM.Attachment and separation diffculties in eating disorders: a preliminary investigation. Int J Eat Disord 1989;8:141–55.3.0.CO;2-E>CrossRefGoogle Scholar
Atger, G, Frasson, G, Coreos, M, Guiborgé, S, Speranza, M, Perez Diaz, F, et al.Etude de validation du Depressive Experience Questionnaire. Encéphale 2003 [in press].Google Scholar
Bach, M, de Zwaan, M, Ackard, D, Nutzinger, DO, Mitchell, JE.Ale-xithymia: relationship to personality disorders. Compr Psychiatry 1994;35(3):239–43.CrossRefGoogle Scholar
Bagby, MR, Cox, BJ, Schuller, DR, Levitt, AJ, Swinson, RP, Joffe, RT.Diagnostic specificity of the dependent and self-critical personality dimensions in major depression. J Affect Disord 1992;26:5964.CrossRefGoogle ScholarPubMed
Bagby, MR, Schuller, DR, Parker, JDA, Levitt, AJ, Joffe, RT, Shafir, MS.Major depression and the Self-Criticism and Dependency personality dimensions. Am J Psychiatry 1994;151:597–9.Google ScholarPubMed
Bagby, RM, Parker, JDA, Joffe, RT, Buis, T.Reconstruction and validation of the Depressive Experiences Questionnaire. Assessment 1994;1(1):5968.CrossRefGoogle ScholarPubMed
Beck, AT.Cognitive therapy of depression: new perspectives. In: Clayton, PJ, Barrett, JE, editors. Treatment of depression: oíd controversies and new approaches. New York: Raven; 1983.Google Scholar
Beck, AT, Rial, WY, Rickels, K.Short form of depression inventory: cross validation. Psychol Rep 1974;34:1184–6.Google ScholarPubMed
Blatt, SJ, Zuroff, DC.Interpersonal relatedness and self-definition: two prototypes for depression. Clin Psychol Rev 1992;12:527–62.CrossRefGoogle Scholar
Blatt, SJ, D’Afflitti, JP, Quinlan, DM.Depressive experiences questionnaire. New Haven, CT: Yale University Press; 1976.Google Scholar
Blatt, SJ, Quinlan, DM, Pilkonis, PA, Shea, MT.Impact of perfectionism and need for approval on the brief treatment of depression: the National Institute of Mental Health Treatment of Depression Collaborative Research Program revisited. J Consult Clin Psychol 1995;63(1):125–32.CrossRefGoogle ScholarPubMed
Bobon, DP, Sanchez-Blanque, A, Von Franckell, D.Comparison between the short form of the Beck Depression Inventory and the combined Beck Pichot Inventory. J Psychiatr Biol Ther 1981;1(1):211–8.Google Scholar
Bruch, H.Eating disorders: obesity, anorexia nervosa and the person within. New York: Basic Books; 1973.Google Scholar
Cox, BJ, Rector, NA, Bagby, RM, Swinson, RP, Levitt, AJ, Joffe, RT.Is self-criticism unique for depression? A comparison with social phobia. J Affect Disord 2000;57:223–8.CrossRefGoogle ScholarPubMed
Crittenden, PM.Peering into the black box: an exploratory treatise on the development of self in young children. In: Cicchetti, D, Toth, SL, editors. Rochester Symposium on Developmental Psychopathology, vol 5 Disorder and dysfunction of the self. Rochester: University of Rochester Press; 1994. p. 79148.Google Scholar
Dube, SR, Anda, RF, Felitti, VJ, Edwards, VJ, Croft, JB.Adverse childhood experiences and personal alcohol abuse as an adult. Addict Behav 2002;27(5):713–25.CrossRefGoogle ScholarPubMed
Fonagy, P, Target, M.The place of psychodynamic theory in developmental psychopathology. Dev Psychopathol 2002;12:407–25.CrossRefGoogle Scholar
Goodsitt, A.Eating disorders a self psychological perspective. In: Garner, DM, Garfinkel, PE, editors. Handbook of treatment for eating disorders. New York: Guilford; 1997. p. 205–28.Google Scholar
Greenberg, RP, Bornstein, RE.The dependent personality: II. Risk for psychological disorders. J Pers Assess 1988;2:136–43.Google Scholar
Grotstein, JS.The psychology of powerlessness: disorder of selfregu-lation and interactional regulation as a newer paradigm for psychopathology. Psychoanal Inquiry 1986;6:93118.CrossRefGoogle Scholar
Heatherton, TF, Baumeister, RF.Binge-eating as escape from self-awareness. Psychol Bull 1991;110:86108.CrossRefGoogle ScholarPubMed
Hermann, U.AMDP anamnestic data: foundations, structure and functions. In: Bobon, D, et al., editors. The AMDP-system in pharmacopsychiatry. Basel: Kaiger; 1983.Google Scholar
Herzog, DB, Keller, MB, Sacks, NR, Yeh, CJ, Lavori, PW.Psychiatric morbidity in treatment-seeking anorexics and bulimics. J Am Acad Child Adolesc Psychiatry 1992;31:810–8.CrossRefGoogle ScholarPubMed
Klump, KL, Wonderlich, S, Lehoux, P, Lilenfeld, LR, Bulik, CM.Does environment matter? A review of nonshared environment and eating disorders. Int J Eat Disord 2002;31(2):118–35.CrossRefGoogle Scholar
Kraemer, S, Loader, R.Passing through life: alexithymia and attachment disorders. J Psychosom Res 1995;39(8):937–41.CrossRefGoogle ScholarPubMed
Lynskey, MT.The comorbidity of alcohol dependence and affective disorders: treatment implications. Drug Alcohol Depend 1998;52(3):201–9.CrossRefGoogle ScholarPubMed
Schmidt, U, Tiller, J, Blanchard, M, Andrews, B, Treasure, J.Is there a specific trauma precipitating anorexia nervosa? Psychol Med 1997;27(3):523–30.CrossRefGoogle Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, et al.The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(20):2233.Google ScholarPubMed
Steinberg, BE, Shaw, RJ.Bulimia as a disturbance of narcissism: self-esteem and the capacity to self-soothe. Addict Behav 1997;22(5):699710.CrossRefGoogle ScholarPubMed
Suess, GJ, Grossmann, K, Sroufe, LA.Effects of infant attachment to mother and father on quality of adaptation in preschool: from dyadic to individual organisation of self. Int J Behav Dev 1992;15:4365.CrossRefGoogle Scholar
Taylor, GJ, Bagby, RM, Parker, JDA.Disorders of affect regulation: alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press; 1997.CrossRefGoogle Scholar
Westen, D, Moses, MJ, Silk, KR, Lohr, NE, Cohén, R, Segal, H.Quality of depressive experience in borderline personality disorder and major depression. When depression is not just depression. J Pers Disord 1992;6:383–92.CrossRefGoogle Scholar
Yehuda, R, Kahana, B, Southwick, SM, Giller, EL.Depressive features in Holocaust survivors with post-traumatic stress disorder. J Trauma Stress 1994;7(4):699704.CrossRefGoogle ScholarPubMed
Zanarini, MC, Frankenburg, ER, Dubo, ED, Sickel, AK, Trikha, A, Levin, A, et al.Axis I comorbidity of borderline personality disorder. Am J Psychiatry 1998;155(12):1733–9.CrossRefGoogle ScholarPubMed
Zuroff, DC, Quinland, DM, Blatt, SJ.Psychometric properties of the depressive experience questionnaire in a college population. J Pers Assess 1990;55:6572.CrossRefGoogle Scholar