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BACKGROUND: There is hardly any empirical evidence on emotion processing by controlled studies in obesity. MATERIAL AND METHODS: Participants rated their emotions in response to visual emotional stimuli from the International Affective Picture System. Study 1 compared obese women with normal-weight controls and women with eating disorders. Study 2 compared obese men with normal-weight controls. RESULTS: Obese women had reduced emotional intensity scores for all basic emotions and the mixed emotion sadness-fear. Obese men had reduced scores for all emotions except happiness and disgust; anger showed a trend towards significance. The results were mainly based on ratings from non-depressed obese individuals. DISCUSSION: Obese men and women scored significantly lower on most basic and mixed emotions. Non-depressed obese subjects seem particularly affected. These new findings must be validated by further study, and longitudinal evaluation after weight loss, e.g. by bariatric surgery, will be of interest. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

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OBJECTIVE: Emotion regulation is a key issue for many psychiatric and psychosomatic disorders, including eating disorders. Eating disordered patients (EDP) show high levels of depressive comorbidity, and there is much uncertainty about disorder-specific deficits. This study is aimed at delineating disorder-specific disturbances of emotional perception in EDP. METHOD: Fifty-two EDP were compared with 35 depressed patients (DP) and 25 healthy controls. They rated their emotional experience when viewing visual emotional stimuli. Emphasis was placed on the patients' perception of their own emotions and not on the recognition of emotions in others. Severity of depression was assessed by the Beck Depression Inventory. RESULTS: Eating disordered patients and DP reported less anger than healthy controls-independent of the severity of depression. In addition, DP showed increased levels of disgust when confronted with anger stimuli. Happiness was rated less in EDP and DP, which was associated with severity of depression. There were no differences between the EDP subgroups bulimia nervosa and anorexia nervosa. CONCLUSION: Eating disordered patients and DP showed alterations of emotional perception of anger, an emotion which is closely linked to interpersonal difficulties. Alterations in emotional perception of EDP and DP might be due to more general emotion regulation disturbances. In order to detect more subtle differences between psychiatric subgroups, more sophisticated investigation tools are needed. Increased disgust ratings in DP merit further investigation.

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BACKGROUND: Patients with psychosocial problems often present somatic symptoms in primary care. OBJECTIVE: The authors compare interventions and outcomes of emotionally-distressed patients by presenting physical disease, somatoform symptoms, or psychological symptoms. METHOD: General practitioners (N=191) documented data from 1,286 patients with psychosocial problems. Experts rated the presented reasons for encounter. RESULTS: Somatoform symptoms, as well as physical disease, result in patients' receiving physical treatments. Psychologically-oriented treatment is more likely with psychological presentation, but not significantly related to somatoform symptoms. CONCLUSION: These findings underline the importance of a specific treatment approach for patients with somatoform symptoms, so as to avoid inappropriate treatment.

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BACKGROUND: In bulimia nervosa, more intense treatments are recommended if outpatient treatment fails. This is the first randomized controlled trial comparing the options of inpatient versus day clinic treatment. METHOD: Patients with severe bulimia nervosa were randomly assigned to inpatient or day clinic treatment of similar length and intensity. Specific and general psychopathology was assessed at the end of treatment and a 3-month follow-up. RESULTS: Fifty-five patients were randomized; 22 day clinic patients and 21 inpatients started the program. At the end of treatment, a significant reduction of general and specific pathology was found in both settings. Following discharge, there was more deterioration in bulimic symptoms after inpatient treatment, but overall, results were comparable. CONCLUSIONS: Inpatient and day clinic programs are effective treatments for severely disturbed bulimic patients with similar results at the 3-month follow-up. Further follow-up will show if a higher instability of results after inpatient treatment is of importance in the long term.

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The acceptance of a treatment depends on what patients experience as helpful or not. In the treatment of anorexia nervosa, the patient's perspective is of special importance as patients are typically highly ambivalent concerning a change in their dysfunctional attitudes and behaviour. 102 patients with anorexia nervosa (ICD-10) evaluated the components of a complex, multimodal treatment programme (inpatient and day clinic) at the end of therapy or follow-up. Overall, psychodynamic as well as symptom-oriented treatment components were experienced as "helpful". Psychodynamic individual sessions received the best assessments. Individual sessions got higher ratings than group sessions. Patients with less successful outcomes described symptom oriented elements like weight goals and work on eating behaviour as significantly less helpful. Lower rankings of some symptom oriented components were associated with more overall symptom severity and bulimic pathology and may point to a feeling of being overtaxed with the programme or a lack of motivation to change.

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OBJECTIVES: Explorative comparison of short term outcomes of day clinic and inpatient treatment for anorexia nervosa. METHODS: N = 13 consecutively admitted day clinic patients (anorexia nervosa; DSM IV) were matched with N = 13 inpatients (variables: age, duration of illness, gender, admission weight, subtype of anorexia nervosa). Results at discharge were compared using defined outcome criteria as well as scores of the SCL-90-R and EDI-2. RESULTS: After inpatient treatment significantly more patients showed a good outcome (predefined criteria). Effect sizes also pointed to a superiority of inpatient treatment. CONCLUSIONS: In the initial phase of therapy the structured and holding environment of an inpatient unit may be favourable for severely underweight anorexic patients. The interpretation of these results is limited due to the small sample size.

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