Perfectionism is considered a risk factor and is very close related to Eating Disorders (EDs). It estimates heritability of 29-42%. However, it has also been related to psychosocial factors such as the insecure attachment style.

To study the relationship of perfectionism with personality dimensions, its likelihood of improvement and its treatment.

To analyze if Perfectionism is associated with dimensions of Temperament or dimensions of Character and therefore more psychosocial.

Participants were 151 female outpatients who consecutively started treatment at the Eating Disorders Unit (Ciudad Real University General Hospital). Personality was assessed by using the Temperament and Character Inventory (TCI). Perfectionism was assessed by using the Edinburg Investigatory Test (EDI-2) subscale (t0). One year later, patients were re-assessed with the EDI-2 (t1).

The scores on Perfectionism significantly improved from t0 to t1, (repeated measures ANOVA, F = 6.6, P < 0.01). At baseline, Perfectionism was related to any of the Temperament dimensions, but the Character variable Purposefulness (SD2) (β = .25 95% CI .17, 98), 2.7% of variance). Responsibility (SD1) and Self-Aceptance (SD4) were inversely associated with Perfectionism. At t1, Responsibility still was a protective factor for Perfectionism, regardless the effect of Perfectionism at t0.

Perfectionism is also related to psychosocial and developmental factors. People with an internal locus of control tend to take responsibility for their own actions and are resourceful in solving problems. Thus, Self-directedness, mainly Responsibility for their own actions, is a protective factor for Perfectionism in EDs.

The authors have not supplied their declaration of competing interest.

Perfectionism is considered a multidimensional key risk factor for Eating Disorders (EDs). There are discrepancies regarding if it is mainly associated to Anorexia nervosa (AN) but not to other EDs.

To study if Perfectionism is not only related with AN, but it is present in all EDs and associated with more transdiagnostic attitudes and behaviors.

To see if there were significant differences among EDs subgroups concerning Perfectionism and to study which abnormal eating attitudes were more associated with this trait.

Participants were 151 outpatients with EDs. DSM-IVTR diagnoses were: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders not Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2) subscale; general psychopathology with the Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self-Esteem Questionnaire (RSE). Eating psychopathology was measured with the Bulimic Investigatory Test (BITE), Eating Attitude Test (EAT-40), EDI-2 and the Body Shape Questionnaire (BSQ).

No significant differences were found regarding Perfectionism among the three groups. Body dissatisfaction was the variable most associated with Perfectionism (β = 0.330, F = 14.2, P < 0.001, 10.9% of the variance) adjusting for general and eating psychopathology. Ascetism and Interoceptive awareness were the EDI-2 subscales most associated with Perfectionism.

The findings confirm that Perfectionism is present in all EDs and there is a relationship between body dissatisfaction and Perfectionism. Interplay has been suggested between these two factors for the development of EDs.

The authors have not supplied their declaration of competing interest.

Referrals to psychiatry from primary care has increased in recent years. This can be the result of the global economic situation and represents a problem for specialized care, because patients can’t usually be correctly attended to. On the other hand, patients who don’t come to visits make up other important issues that we must analyze.

To analyze the differences between patients who did not come for their first visit and those who did in order to try to describe variables that could be affecting them.

This is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data, (4) attendance to appointment, (5) diagnosis impression and (6) destination of referral. The SPSS 19.0 was used to analyze the data.

We studied a total of 1.048 patients for 15 months, of which 20.6% did not come to their first visit. A statistically significant relationship between attendance and gender, year of the appointment, adequate demand or not, previous follow-up and diagnosis was found (Chi2). However, if a logistic regression was carried out, only the adequacy of the demand was included in the model.

Coordination with general practitioners is essential to improve referrals and, most importantly, the attention to patients. If we can agree on the referral criteria, a better-personalized assistance can be offered to patients who have more difficulties in coming (because of characteristics of illness, place of residence, and other variables).

The authors have not supplied their declaration of competing interest.

Body dissatisfaction is one of the core psychopathological components in Eating Disorders (EDs) and it tends to persist over time regardless treatment interventions. Perfectionism is considered as a mediator and moderator between body dissatisfaction and disordered eating.

To study the influence of Perfectionism in EDs outcome.

To analyze changes in body dissatisfaction at one year follow-up in patients with eating disorders and the effect of perfectionism over these changes.

Participants were 151 patients with eating disorders. DSM-IVTR diagnoses were as follows: 44 (29.1%) Anorexia Nervosa (AN), 55 (36.4%) Bulimia Nervosa (BN) and 52 (34.4%) Eating Disorders no Otherwise Specified (EDNOS). Perfectionism was assessed with the Edinburg Investigatory Test (EDI-2). The Body Shape Questionnaire (BSQ) was also distributed. One year after the beginning of their treatment, patients were reassessed.

Patients with BN showed significantly higher scores on BSQ than those with AN. There was a significant improvement in BSQ after one year of treatment regardless the diagnostic (repeated measures ANOVA: F 8.4, P<.01). Perfectionism was a co-variable that influenced in those changes.

The results confirm the interaction between perfectionism and body dissatisfaction in the treatment outcome of EDs. It has been described an interplay between Perfectionism, body dissatisfaction and disordered eating attitudes and behaviours, being Perfectionism a moderator factor. The results highlight the need of dealing not only with the core symptoms of EDs, but also with the moderator factors such as Perfectionism to enhance the outcome.

The authors have not supplied their declaration of competing interest.

The first visit is crucial, since it is where a treatment plan is selected and the decision to refer or not the patient to a specialized unit is made. Mental care could be improved through the centralization of demand and the identification of patients’ and psychiatrists’ expectations.

Analyzing patients’ and psychiatrists’ demands and expectations in the first visit to use them as a starting point for the planning and coordination of treatment actions.

To design a record system of the Minimum Basic Data Set of the Centralized Department of our Unit.

This is an epidemiological, observational, prospective study of patients referred to our department. Following variables were collected:

– referral origin;

– reason;

– demographic data;

– diagnosis impression;

– destination of referral.

The Statistical Package for Social Science version 19.0 was used to analyze the data.

Table 1.

The data obtained are consistent with those reported in the literature for this population. The high rate of wrong referrals reveals the necessity of improving coordination and establishing specific referral criteria. Some initiatives have been designed and will be prospectively evaluated in the future.

Table 1

The authors have not supplied their declaration of competing interest.

Dissociation has been related to emotional dysregulation and eating psychopathology. Dissociation may interfere with the learning process, affecting at the therapy negatively. The aim of the study is to analyse if at the eating disorders (ED), dissociation is linked to temperamental traits or also to character traits, which are susceptible to be modulated during the therapeutic process.

We studied 119 females that started an outpatient program for their ED. We used the Dissociative Experience Scale (DES), Temperament and Character Inventory (TCI), Eating Attitudes Test (EAT-40), and the State Trait Anxiety Inventory (STAI). We used multiple regression analysis.

Dissociation was associated with high scores on the EAT-40, even controlling the effect of anxiety traits, which also was related to dissociation. The temperament dimension “searching for novelty”, has been related in an opposite way to the DES. Also, the “dimension of transcendence “character and “self determination” influenced on the DES.

This study confirms the importance of improving Self Determination levels at ED therapy, which influence on a lot of prognostic aspects, such as protecting from dissociation, which is related to anxiety and alimentary psychopathology and can interfere with the therapeutic progress.

The authors have not supplied their declaration of competing interest.

The first time when people attempt suicide first contact is critical. Psychiatrists must decide to hospitalize them or follow-up in mental health units and the bases of a doctor-patient relationship are formed.

An analysis of referrals to psychiatry from the emergency room (ER) was developed. Our objective was to discover if there was a statistical correlation between gender and other variables, especially repeated visits and admissions.

Our sample was composed of patients who visited the ER for suicidal tendencies for 20 months. We carried out an observational retrospective study. The variables collected were: age, gender, cause, repeated visit (visit to the ER in the following two months), previous attempts, previous follow-up, method used, use of toxic substances during the attempt, intentionality, referral from the ER, later follow-up and diagnostic impression at the ER.

A total of 620 patients were sampled. The relationship between gender and repeated visit, previous attempts, dysfunctional personality traits, use of substances and later follow-up was found (Chi2). Although the relationship between admissions and gender were not statistically significant, influence by gender (over all in males) can be observed in logistic regression models. As well as, in patients who visited the ER several times, dysfunctional personality traits seem to be the most common but gender marks significant differences between groups.

The data obtained is consistent with those reported in previous studies. To know who the riskier groups are can allow professionals to plan protocols and unify admission criteria.

The authors have not supplied their declaration of competing interest.

The subgenual anterior cingulate cortex (sgACC) is considered to be an important site of abnormality in major depressive disorder. However, structural alterations in this region have not been a consistent finding and functional imaging studies have also implicated additional areas.

A total of 32 patients with major depressive disorder, currently depressed, and 64 controls underwent structural imaging with MRI. Also, 26 patients and 52 controls were examined using functional magnetic resonance imaging (fMRI) during performance of the n-back working memory task. Structural and functional changes were evaluated using whole-brain, voxel-based methods.

The depressed patients showed volume reductions in the sgACC and orbitofrontal cortex bilaterally, plus in both temporal poles and the hippocampus/parahippocampal gyrus on the left. Functional imaging revealed task-related hypoactivation in the left lateral prefrontal cortex and other regions, as well as failure of deactivation in a subcallosal medial frontal cortical area which included the sgACC.

Whole-brain, voxel-based analysis finds evidence of both structural and functional abnormality in the sgACC in major depressive disorder. The fact that the functional changes in this area took the form of failure of deactivation adds to previous findings of default mode network dysfunction in the disorder.