title: Mood spectrum comorbidity in patients with anorexia and bulimia nervosa.
abstract: OBJECTIVE
  To investigate the presence of mood spectrum signs and symptoms in patients with anorexia nervosa, restricting subtype (AN-R) or bulimia nervosa (BN).
  
  
  METHODS
  55 consecutive female patients meeting DSM-IV criteria for eating disorders (EDs) not satisfying DSM-IV criteria for Axis I mood disorders were evaluated with the Lifetime Mood Spectrum Self-Report (MOODS-SR) and the Mini-International Neuropsychiatric Interview (MINI). The MOODS-SR explored the subthreshold comorbidity for mood spectrum symptoms in patients not reaching the threshold for a mood disorder Axis I diagnosis. MOODS-SR included 161 items. Separate factor analyses of MOODS-SR identified 6 'depressive factors' and 9 'manic-hypomanic factors'.
  
  
  RESULTS
  The mean total score of MOODS-SR was significantly higher in BN than in AN-R patients (97.5 ± 25.4 vs 61.1 ± 38.5, respectively; p = 0.0001). 63.6 % of the sample (n = 35) endorsed the threshold of ≥61 items, with a statistically significant difference between AN-R and BN (39.3 % vs 88.9 %; χ2= 14.6; df = 1; p = 0.0001). Patients with BN scored significantly higher than AN-R patients on several MOODS-SR factors: (a) MOODS-SR depressive component: 'depressive mood' (11.2 ± 7.4 vs 16.0 ± 5.8; p < 0.05), 'psychomotor retardation' (5.4 ± 5.6 vs 8.9 ± 3.8; p = 0.003), 'psychotic features' (2.0 ± 1.8 vs 4.1 ± 1.6; p = 0.001), 'neurovegetative symptoms' (5.0 ± 2.6 vs 7.7 ± 1.7; p = 0.001); (b) MOODS-SR manic/hypomanic component: 'psychomotor activation' (4.3 ± 3.6 vs 7.4 ± 3.1; p = 0.002), 'mixed instability' (1.0 ± 1.5 vs 2.0 ± 1.6; p < 0.05), 'mixed irritability' (2.5 ± 1.8 vs 3.7 ± 1.6; p < 0.05), 'inflated self-esteem' (1.1 ± 1.4 vs 2.1 ± 1.6; p < 0.05), and 'wastefulness/recklessness' (1.0 ± 1.4 vs 2.0 ± 1.2; p = 0.009).
  
  
  CONCLUSIONS
  MOODS-SR identifies subthreshold mood signs/symptoms among patients with AN-R, and BN and with no Axis I comorbidity for mood disorders, and provides a better definition of clinical phenotypes.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy. mario.miniati@med.unipi.it.
authors.forename: Mario
authors.identifier: http://orcid.org/0000-0001-7536-9927
authors.initials: M
authors.lastname: Miniati
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Benvenuti
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bologna
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Maglio
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Cotugno
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Massimetti
authors.affiliation: Alma Mater Studiorum, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Calugi
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Mauri
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000523:psychology; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology; D052018:Bulimia Nervosa / Q000150:complications* / Q000523:psychology; D003863:Depression / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
keywords: Anorexia; Bulimia; Eating disorders; Mood spectrum and comorbidity