Insight and depressive symptoms in eating disorders : the mediating role of disorder-specific psychopathology
Gawron, Leonor Patricia (Institut de Recerca Sant Pau)
Portella Moll, Maria J., 1975- (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Pousa Tomàs, Esther (Institut de Recerca Sant Pau)
Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut

Fecha:	2026
Resumen:	Objective: To study whether the insight described in psychosis also occurs in eating disorders (EDs), whether it differs between anorexia nervosa (AN) and bulimia nervosa (BN), and whether diagnosis-specific ED psychopathology mediates this relationship. Methods: Cross-sectional baseline data from a prospective cohort of 103 day-hospital patients with AN or BN were analyzed. Standardized measures of insight, depressive symptoms, and ED psychopathology were administered. Exploratory factor analysis was conducted on depressive symptoms, followed by diagnosis-stratified correlation analyses between insight dimensions and depressive symptom factors. Mediation models were then applied to examine whether diagnosis-specific ED psychopathology accounted for significant associations. Results: Three depressive dimensions were identified: emotional, apathetic, and self-critical, explaining 56. 26% of the variance. In AN, affective distress was associated with poorer insight into hypothetical contradiction and treatment engagement, whereas negative self-cognitions where associated with better recognition and relabeling of ED pathology. In BN, depressive symptoms were associated with reduced insight into body weight concerns and treatment engagement. ED-specific psychopathology significantly mediated the relationship between depressive symptoms and insight in both AN and BN. Conclusion: These findings reveal that depressive symptoms and insight are associated in distinct patterns in anorexia and bulimia, and appear to be linked through different ED-specific psychopathological pathways. Highlighting these diagnosis-specific associations contributes to a more nuanced understanding of insight in EDs and underscores the need for tailored clinical approaches.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Eating disorders ; Anorexia nervosa ; Bulimia nervosa ; Insight ; Illness awareness ; Depression ; Mediation analysis
Publicado en:	Psychiatry research, Vol. 358 (April 2026) , art. 116965, ISSN 1872-7123

DOI: 10.1016/j.psychres.2026.116965

7 p, 789.1 KB

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