Objective
Our objective was to evaluate the psychopathological profile of obese women with binge eating disorder (BED) using the Symptom Checklist-90 (SCL-90).
Methods
Two hundred twelve obese women who seek for weight loss treatment were sequentially selected to participate in the study. Binge eating disorder was diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Binge eating disorder severity was assessed using Binge Eating Scale. Depressive symptoms were assessed using Beck Depression Inventory. The psychopathological profile was assessed using the SCL-90.
Results
Binge eating disorder was diagnosed in 54 patients (26.6%). Obese patients with BED presented significant higher scores in all domains of SCL-90 (P < .05 for all) in comparison with obese patients without BED. A significant relationship was found among Binge Eating Scale, Beck Depression Inventory, and all domains of the SCL-90 (P < .05 for all). After linear regression, obsessivity-compulsivity (P = .03), interpersonal sensitivity (P = .0064), paranoid ideas (P = .03), and psychoticism (P = .01) were independently related to the severity of BED.
Conclusion
Obese women with BED presented a more severe psychopathological profile than obese controls. Among all, obsessivity-compulsivity, interpersonal sensitivity, paranoid ideas, and psychoticism seem to be strongly linked to BED severi
The prevalence of obesity has increased substantially in the last 30 years. Recent data indicate that approximately 20% of Brazilian men and 25% of Brazilian women 20 to 59 years old are obese [1]. One possible explanation for this obesity epidemic includes several social changes that induce physical inactivity and increased feeding [2]. Some factors could ease weight gain, which defines obesity as a multifactorial disease: (1) genetic factors have permissive action on the environmental factors (susceptibility genes); (2) environmental factors, such as sedentarism and bad eating habits; (3) psychogenic, psychosocial, and cultural factors that define psychogenic obesity [3]. The presence of weight excess is associated with several medical comorbidities. Although clinical comorbidities (ie, diabetes mellitus, dyslipidemia, hypertension, among others) are well known, psychiatric comorbidities are still a matter of debate. Evidence can be found demonstrating that obesity and psychopathology are related, whereas a few articles also suggest that no correlation exists between them [4].
Binge eating disorder (BED) is a psychiatric disorder characterized by episodic uncontrolled consumption of large amounts of food in the absence of inappropriate compensatory methods that characterize bulimia nervosa. The provisional criteria for BED, which have been included in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Appendix B, state that the individual must experience significant distress related to binge eating and must endorse several behavioral indicators of loss of control [5].
Binge Eating Disorder is the most common eating disorder found in obese patients. The prevalence of BED ranges from approximately 0.3% to 7% in community samples to between 9% and 30% in obesity clinics, and from 9% to 47% among bariatric surgery patients [6], [7] and [8]. In the Brazilian population, obese patients with BED were significantly more likely to meet criteria for a lifetime diagnosis of any Axis I disorder, any mood disorder (including current or past major depressive disorder), and any anxiety disorder [9]. In addition, BED was already associated with an increased body mass index (BMI) [10]. For instance, Gruzca et al [8] confirmed the strong association between weight category and BED. Nearly 70% of binge eater subjects report BMI of 30 and above, whereas slightly fewer than 30% of non–binge eaters reported comparable BMI.
The Symptom Checklist-90 (SCL-90) is a self-report, multidimensional scale idealized by Derogatis et al [11]. The use of SCL-90 allows the assessment of a broad spectrum of psychological problems and psychopathological symptoms. According to Derogatis and Lazarus [12], SCL-90 could be used by psychologists and psychiatrists in mental health, medical and educational establishments, or research as a tool to evaluate symptoms intensity and its dimension. This scale is a self-report and multidimensional instrument with 90 items organized in 9 dimensions to assess primary psychopathologies and 3 global pathology indexes, which reflect psychopathological profile of the respondent [11] and [13].
The aim of this study is to investigate the psychopathological profile of obese patients with BED using the SCL-90.
