Impact of Body Schema Distortion on Remission and Weight Regain in Anorexia Nervosa
- Conditions
- Anorexia Nervosa
- Interventions
- Other: PAQ questionnaireOther: F-DFlex questionnaireOther: BSQ questionnaireOther: Silhouette testingOther: Eating Disorder Inventory - 2Other: EDEQ questionnaireOther: STAI questionnaireOther: BECK questionnaire
- Registration Number
- NCT05682417
- Lead Sponsor
- Hospices Civils de Lyon
- Brief Summary
Anorexia nervosa is a predominantly female eating disorder that most often appears in adolescence. The latter leads to strict and voluntary food deprivation for several months or even years. The lifetime prevalence of anorexia is 1.4% in women and 0.2% in men.
Ultimately, only half of people treated for anorexia nervosa in adolescence recover, 30% simply improve, 21% suffer from chronic disorders and 5 to 6% die. At the same time, between a quarter and half of patients abandon their current treatment, including during hospitalization. Relapses occur during the evolution of anorexia nervosa. Even more worrying, mortality is highest the year following the patient's discharge from hospital. This appears to be due to somatic complications in more than half of cases (most often cardiac arrest), to suicide in 27% of cases.
Researchers are still trying to clarify the mechanisms involved in the emergence and persistence of this disorder. The objective is to obtain more verified and faster cures. However, the obstacles to successful treatment are mainly due to the denial of disorders and thinness.
From a neurocognitive perspective, the representation one has of one's body is underpinned by two types of representations, i.e. body image and body schema.
It has long been shown that body image is altered in anorexia nervosa. More recently, authors have shown that the distortion of the body representation was however more extensive and also affected the body schema. Patients find themselves too fat despite obvious thinness and move through space as if this were really the case.
Worryingly, these distortions in bodyschema seem to persist after therapeutic management. Despite the potential role of body-scheme distortions in maintaining the disorder, as well as the risk of relapse, the difficulties in assessing body-scheme are significant. Indeed, recovery in these pathologies is often determined according to the Body Mass Index, self-declaration and questionnaires evaluating body image, again limiting the verification of the resorption of distortions in the body schema.
Investigators have therefore developed the systematic, ergonomic and simplified evaluation of the body schema in patients suffering from anorexia nervosa at the time of diagnosis in an expert center, but also during follow-up evaluations thanks to the use of an evaluation platform of the body schema, i.e. the body in brain platform, developed by the LIP/PC2S laboratory and the SATT Linksium which allows the evaluation of the body schema.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- Female
- Target Recruitment
- 42
- Patient over 15 years old
- Women
- Patient with a BMI <18.5
- Patient suffering from anorexia nervosa (DSM V, 2013)
- Patient agreeing to participate in the study with signed informed consent (Or whose parents/holder of parental authority have signed the informed consent)
- Patient affiliated to a Social Security plan or beneficiary of such a plan
- Adult patients protected by a legal protection measure (guardianship, curatorship, etc.)
- Patients participating in another research that may interfere with this research
- Patients with acute and co-occurring psychiatric comorbidities (suicidal crisis, delusions)
- Patients not fluent in French
- Pregnant, parturient or breastfeeding women (on questioning of the patient)
- Persons deprived of their liberty by a judicial or administrative decision
- Persons admitted to a health or social establishment for purposes other than research
- Patients with any current pathology or history of psychotic disorders, migraine, epilepsy, balance disorders, vertigo, visual disorders, proprioceptive disorders and/or neuromuscular disorders.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Patients with anorexia nervosa according to DSM-5 BSQ questionnaire Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 PAQ questionnaire Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 F-DFlex questionnaire Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 Silhouette testing Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 EDEQ questionnaire Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 STAI questionnaire Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 BECK questionnaire Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities Patients with anorexia nervosa according to DSM-5 Eating Disorder Inventory - 2 Patients over 15 years old, suffering from anorexia nervosa according to DSM-V with a BMI\<18.5 and without psychiatric comorbidities
- Primary Outcome Measures
Name Time Method Overestimation of the body schema Baseline (T0); 6 months after baseline (T+6); 12 months after baseline (T+12) Overestimation of the body schema (in percentage) assessed by the body schema assessment platform (MOVE tool, motion assessment in virtual reality).
Overestimation of the body schema (percentage of distortion) will be compared to normal values, and then compared with the percentages at T+6 and T+12.
- Secondary Outcome Measures
Name Time Method Cognitive rigidity score Baseline T0; 6 months; 12 months The cognitive rigidity score is measured with the D-Flex questionnaire comprising 20 questions. The patient must then respond to the proposed statements using a 6-point scale (Strongly disagree (1), Somewhat disagree (2), Somewhat disagree (3), Somewhat agree (4) , Somewhat agree (5, Strongly agree (6).
Body dissatisfaction score Baseline T0; 6 months; 12 months Body dissatisfaction is measured with the BSQ questionnaire comprising 34 questions rated from 1 (never) to 6 (Always)
Weight/height ratio, expressed by body mass index (BMI) Baseline T0; 6 months; 12 months This weight(kg)/height(m)2 ratio is measured using a mathematical formula. It will be analyzed using the DSM-V reference table to measure the severity of the disorder.
Lightweight: BMI \> or = 17 kg/m2 Moderate: BMI 16-16.99 kg/m2 Severe: BMI: 15-15.99 kg/m2 Extreme: BMI \< 17 kg/m2Body overstatement Baseline T0; 6 months; 12 months Body overestimation is assessed using the computerized silhouette test. This test presents 27 figures with BMIs ranging from 11 to 40. The patient answers whether or not the figure presented corresponds to his current figure.
Alexithymia score Baseline T0; 6 months; 12 months Alexithymia is assessed with the PAQ questionnaire consisting of 24 questions with 7 degrees of response. (1 strongly disagree - 2 - 3 - 4 Neither agree nor disagree -5 - 6 - 7 strongly agree)
Eating behavior assessed by the EDI-2 questionnaire Baseline T0; 6 months; 12 months The eating behavior will be assessed by the EDI-2 questionnaire
Eating behavior assessed by the EDE-Q questionnaire Baseline T0; 6 months; 12 months The eating behavior will be assessed by the EDE-Q
Level of anxiety Baseline T0; 6 months; 12 months Anxiety is measured by STAI questionnaire.
Level of Depression Baseline T0; 6 months; 12 months Depression is measured by BECK questionnaire
Trial Locations
- Locations (1)
Referral Center for Eating Disorders. Neurological Hospital-GH East / Hôpital Neurologique Pierre Wertheimer GHE HCL
🇫🇷Bron, France