Theme 2 | E- & M-health in mental health care and research

Experiences in daily life in individuals with eating disorders: an experience sampling study.

Ankie Roedelof

Ankie Roedelof1,2, Danielle Jacobs1, Nicole van Bezouw1, Martine DeMilliano1, Claudia Simon1,2, Machteld Marcelis1,2

1 GGzE Eindhoven
2 Department of Psychiatry and Neuropsychology, MHENS, Maastricht University

psychotic experiences, eating disorders, experience sampling method. 

Body image disturbance and inner anorexic voices occur in anorexia nervosa as well as in bulimia nervosa. There is some evidence that in a subgroup of patients these experiences are respectively (subclinical) delusional and hallucinatory in nature. This study examines the transdiagnostic role of psychotic features in patients with eating disorder.

We examined i) whether patients with eating disorders have increased levels of ‘general’ (not eating disorder related) (sub)clinical psychotic experiences compared to controls, ii) whether body image disturbance and anorexic voice reach psychotic levels, and ii) whether ‘general’ (sub)clinical psychotic experiences or (sub)clinical body image delusion / hallucinatory anorexic voice are associated with negative affect (NA) and sleeping behavior? 

A cross-sectional observational experience sampling study (ESM) with 50 female individuals with eating disorders (anorexia nervosa & bulimia nervosa, age 15-25) and 50 healthy controls was conducted. Data were analysed with multilevel-regression analyses.

The preliminary results (on N=14 patients, N=16 controls; data collection is still ongoing) show that patients with eating disorders have significant more ‘general’ psychotic experiences than controls. In patients, (sub)clinical body image delusional (but not (sub)clinical hallucinatory voice) experiences, were more frequently observed than in controls. NA in patients was positively associated with ‘general’ delusional and hallucinatory experiences (the latter not significant). In patients, quality of sleep and awakening during the night were significantly worse than in controls and associated with ‘general’ (sub)clinical delusional (but not hallucinatory) experiences. No associations were present between the (sub)clinical psychotic core-symptoms of eating disorder and NA or sleep.

Patients with eating disorders may have higher than average vulnerability for (subclinical) psychosis associated with affect and sleep, suggesting that a transdiagnostic approach in eating disorder may benefit from further research.

Konstantakopoulos, G., et al. (2012), Espeset, J.E.M.S., et al. (2011). Pugh, M., et al. (2016). Abdou, t.a., et al. (2018). 

The School for Mental Health and Neuroscience (MHeNs) strives to advance our understanding of brain-behaviour relationships by using an approach integrating various disciplines in neuro- and behavioural science, medicine, and the life sciences more widely. MHeNs performs high-impact mental health and neuroscience research and educates master's students and PhD researchers. MHeNs performs translational research, meaning practical collaboration between researchers in the lab and in the hospital. MHeNs is one of six graduate schools of the Faculty of Health, Medicine and Life Sciences (FHML) aligned to the Maastricht University Medical Centre+ (MUMC+).