A Bell Jar of Emotions: Exploring the Impact of Depressive Symptoms on the Severity of Eating Symptomatology and Psychological Adjustment in Patients with Eating Disorders.

Introduction: Previous findings have shown that comorbid depressive symptoms play a central role in determining clinical manifestations and symptom severity in patients with eating disorders (EDs) (Garcia et al. 2020; Martin et al. 2019). However, there is a lack of studies investigating how depressive symptoms may influence treatment outcomes, especially in residential settings. The main aim of this study was to evaluate if there would be significant differences between ED patients with or without comorbid depressive symptoms in terms of change in ED symptoms and overall psychopathology. Materials and methods: A national sample of N=100 ED patients [N=60 with anorexia nervosa (AN) and N=40 with bulimia nervosa (BN)] treated in a multidisciplinary residential treatment setting completed the Beck Depression Inventory (BDI) to evaluate depressive symptoms, the Eating Attitudes Test (EAT) to evaluate eating symptoms, and the Outcome Questionnaire-45.2 (OQ-45.2) to assess overall psy- chopathology at both intake and discharge. Results: A total of 50 patients exhibited clinical levels of depression above the cutoff (BDI > 30). Patients with comorbid depressive symptoms at intake showed more severe ED and psychopathological symptoms at discharge. Moreover, comorbid depression at intake have been found to predict the degree of change in overall psychopathological severity. Notably, no significant effects were detected for DSM-5 categories of AN and BN. Discussion and conclusions: These results suggest the pivotal role of comorbid depression when treating individuals with EDs. Then, there is an increasing need to consider both the presence and the severity of comorbid depression as a facet of a comprehensive ED treatment. Exploring the influence of depressive symptoms on eating disorder’s severity and treatment outcomes could be a be a key aspect in promoting more accurate and clinically useful treatment and "tailored" multidisciplinary therapeutic interventions focused on the specific characteristics of ED individuals. Declaration of conflict of interest: None.