Impact of Neuropsychological Alteration of Decision-making Abilities on the Functioning of Patients With Eating Disorders

Study Overview
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Brief Summary
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Eating disorders are multifactorial disorders currently conceptualized in a biopsychosocial model, but pathophysiology remains relatively unknown, and robust etiological models to guide treatment are therefore lacking. Different endophenotypes and neurocognitive vulnerability factors have been found in eating disorders including decision making abnormalities. The investigators hypothesize that decision making abnormalities are associated with a lower level of functioning and quality of life which could lead to social and interpersonal difficulties. The investigators also hypothesize that these anomalies are associated with a particular clinical profile (more restrictive profile, more hyperactivity, less insight on the disease and desire for care ...).

Detailed Description
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The investigators will recruit a total of 340 patients with an eating disorder in the university hospital of Montpellier. Participation consists of a one-day visit with a multidisciplinary assessment. No action is specific to research. This is the usual management of patients with eating disorders addressed to our department. An ancillary study will be proposed, if the patient is addressed by his general practitioner for an annual evaluation. This second visit will be exactly the same as the initial visit.

Official Title
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Impact of Neuropsychological Alteration of Decision-making Abilities on the Functioning of Patients With Eating Disorders

Conditions
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Eating Disorder

Intervention / Treatment
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* Behavioral: Ambulatory cares in a day-hospital (University Hospital of Montpellier) specialized in the evaluation of eating disorders


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient with an eating disorder according to Diagnostic and Statistical Manuel of Mental disorders-V (DSM-V) criteria Patient aged from 15 to 65 years Patient who performs the day-hospital evaluation Patient affiliated to a French social security system Patient able to understand the nature, the aim and the methodology of the study For minor one of the legal guardians gave his consent Exclusion Criteria: Patient in an unstable somatic state (eg severe metabolic disorder making impossible or unreliable neuropsychological assessments) Patient's refusal to participate Patient on protective measures (guardianship or trusteeship) Pregnant or nursing women. A dosage of beta human chorionic gonadotropin (βHCG) will be performed to ensure the absence of pregnancy.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Participants<br>All participants performed the same evaluation: clinical and neuropsychological assessment. All of them are patients with an eating disorder. | Behavioral: Ambulatory cares in a day-hospital (University Hospital of Montpellier) specialized in the evaluation of eating disorders<br>* All patients assessed in the day-hospital will performed the same evaluation : Blood sampling Calorimetry Osteodensitometry Psychiatric assessment Endocrinologic assessment Dietetic assessment Neuropsychological assessment Self-questionnaires With the patient agreement, a biological collection will be constituted. The objective is the subsequent study of biological factors involved in eating disorders (in particular genetic factors)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of functional impairment assessed by the Work and Social Adjustment Scale (WSAS) | We aim to investigate the link between decision-making and daily functioning of patients with eating disorder. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life assessed by the Eating disorder quality of life (EDQOL) scale. | We aim to investigate the link between quality of life and alteration of cognitive flexibility of patients with eating disorder. | Baseline | 
| Level of functional impairment assessed by the clinician with the Functional Assessment Staging Test (FAST) scale | We aim to investigate the link between global functioning and alteration of cognitive flexibility of patients with eating disorder. | Baseline | 
| Quality of life assessed by the Eating disorder quality of life (EDQOL) scale. | We aim to investigate the link between quality of life and alteration central coherence of patients with eating disorder. | Baseline | 
| Level of functional impairment assessed by the clinician with the FAST scale | We aim to investigate the link between global functioning and alteration central coherence of patients with eating disorder. | Baseline | 
| Score to decision making test (Iowa gambling task) | We aim to investigate the prognostic value of decision making abnormalities on the rates of recovery | At 12 months if patient is included in the ancillary study | 
| Score to decision making test (Iowa gambling task) | We aim to investigate the prognostic value of decision making abnormalities on weight recovery (for anorexic patients) | At 12 months if patient is included in the ancillary study | 
| Score to decision making test (Iowa gambling task) | We aim to investigate the prognostic value of decision making abnormalities on daily functioning | At 12 months if patient is included in the ancillary study | 
| Score to decision making test (Iowa gambling task) | We aim to investigate the prognostic value of decision making abnormalities on switch to another subtype of eating disorder | At 12 months if patient is included in the ancillary study | 
| Score to decision making test (Iowa gambling task) | We aim to investigate the impact of weight recovery on decision making abilities | At 12 months if patient is included in the ancillary study | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anorexia nervosa, Bulimia, Binge eating disorders, Neuropsychology, Neurocognition, Daily functioning