Young people with idiopathic intracranial hypertension (a condition that occurs when pressure inside the skull increases for no obvious reason) were more than four times more likely to report disordered eating behaviors and more than five times as likely to report depression, anxiety, and stress than those without the condition, according to a study in Pediatric Neurology.
“[Medical] caregivers should have increased awareness and implement active screening of [disordered eating behaviors] both at the time of the initial management and as part of the ongoing follow-up. This is of paramount importance to potentially prevent the consequential evolution into full-blown [eating disorders],” wrote Itay Tokatly Latzer, M.D., of the Pediatric Neurology Institute at Dana-Dwek Children’s Hospital at Tel Aviv Sourasky Medical Center and colleagues.
Disordered eating behaviors encompass a broad spectrum of eating pathologies—including strict or disinhibited eating, emotional eating, and weight or shape concerns—that do not meet the criteria for an eating disorder diagnosis, the researchers wrote. About 40% of individuals with disordered eating behaviors go on to develop an eating disorder.
The study included 53 patients aged 8 to 25 years who had been diagnosed with intracranial hypertension and received treatment at a medical center in Tel Aviv, Israel. They were compared with 106 age- and sex-matched healthy volunteers (control group). Latzer and colleagues reviewed the participants’ medical charts as well as their responses to two online self-rating questionnaires: the Eating Attitude Test-26 (EAT), which was adapted for participants younger than 18, and the Depression, Anxiety, and Stress Scale-21. Individuals with intracranial hypertension were treated with medication and surgery; those who were obese or overweight were also referred to a nutrition and lifestyle clinic and received a comprehensive nutritional assessment and diet plan. Participants with intracranial hypertension were assessed at different points in their treatment, with some in active treatment and others several years after recovery.
Participants with intracranial hypertension had a significantly higher body mass index (BMI), with significantly higher incidence of overweight/obesity than the control group (70% vs. 15%). Scores indicating disordered eating behaviors were found significantly more often in participants with intracranial hypertension than in the controls (26% vs. 6%), as was a near-threshold score for an eating disorder (19% vs. 1%), the researchers noted. Scores indicating a severe or extremely severe state of depression, anxiety, and stress were significantly more common among those with intracranial hypertension than those without this condition (15% vs. 3%).
In individuals with intracranial hypertension, disordered eating behaviors were associated with weight gain before disease presentation, a relatively long duration of treatment, and loss of significant weight during the course of treatment. Additionally, depression and anxiety were found to coexist in individuals with intracranial hypertension and disordered eating behaviors. The authors noted that they were unsure whether disordered eating behaviors were the cause of intracranial hypertension or a bidirectional association between the behaviors and disorder exists.
For more information, see the Psychiatric News article “Eating Disorders: Current Knowledge and Treatment Update.”
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