Bipolar Bozuklukta Duygusal Yemenin Anlaşılması: Öz-Bildirimler ve Objektif Değerlendirmeler

Yıl 2025, Sayı: 26, 597 - 610, 31.08.2025

Pınar Hamurcu

https://doi.org/10.38079/igusabder.1505802

Öz

Amaç: Bipolar Bozukluk'ta (BB) duygusal yeme davranışlarının incelenmesi, ruh sağlığı ve beslenme ihtiyaçlarını etkili bir şekilde yönetmek için hedefe yönelik müdahaleler geliştirmek açısından önemlidir. Bu çalışma, BB ile duygusal yeme davranışı arasındaki ilişkiyi ve öz-bildirim ile nesnel ölçümler arasındaki farklılıkları araştırmayı amaçlamaktadır.
Yöntem: Kesitsel ve tanımlayıcı nitelikteki bu çalışma, BB tanısı almış 43 hasta ile gerçekleştirilmiştir. Bilgi Formu, Bipolar Depresyon Derecelendirme Ölçeği (BDDÖ), Bipolar Bozukluk İşlevsellik Ölçeği (BBİÖ) ve Duygusal Yeme Ölçeği (DYÖ) yüz yüze görüşme yöntemiyle uygulanmıştır.
Bulgular: Çalışmaya katılan 43 BB hastasının %58,1'i erkek olup, yaş ortalaması 26,93±10,29 yıl ve Beden Kütle İndeksi (BKİ) ortalaması 25,01±6,06 kg/m²'dir. Cinsiyet, yaş, BKİ, fiziksel aktivite veya uyku süresi, BB hastalarında DYÖ ve alt boyutları için ayırt edici faktörlerden değildir (p>0,05). BB hastaları, kaygı ve depresyon gibi olumsuz duygular esnasında daha az yeme eğiliminde olduklarını ve mutluluk gibi olumlu duygular esnasında ise daha fazla yeme eğiliminde olduklarını beyan etmişlerdir. Ancak bu öz-bildirimlerin aksine, BDDÖ'ye göre karma belirtiler (manik dönemler) "Uyaran Karşısında Kontrol" ile pozitif korelasyon göstermiştir (p=0,003) ve "Gerginlik Durumlarında Yeme" hem somatik depresif belirtiler (p=0,002) hem de psikolojik depresif belirtiler (p=0,005) ile pozitif korelasyon göstermiştir.
Sonuç: Bu çalışma, BB hastalarında yeme davranışlarının öz-bildirim değerlendirmeleri ile objektif değerlendirmeler arasındaki farklılıkları vurgulamaktadır. BB hastaları olumsuz duygular sırasında yeme eğilimlerinin azaldığını ve olumlu duygular sırasında yeme eğilimlerinin arttığını beyan etmiş olsalar da, nesnel ölçümler bu öz-bildirimlerin aksini göstermiştir. Bu bulgular, bipolar bozukluğu olan bireylerde duygusal durumlarla ilişkili yeme davranışlarını değerlendirmek için objektif yöntemlerin kullanılmasının önemini vurgulamaktadır.

Anahtar Kelimeler

Bipolar bozukluk , duygusal yeme , beslenme davranışı , beslenme ve yeme bozuklukları , obezite yönetimi

Understanding Emotional Eating in Bipolar Disorder: Self-Reports vs. Objective Assessments

Öz

Aim: Understanding emotional eating nuances in Bipolar Disorder (BD) is crucial for developing targeted interventions to effectively manage mental health and nutritional needs. This study aims to explore the relationship between BD with emotional eating behavior, as well as the disparities between self-reported appetite tendencies and objective measurements.
Method: This cross-sectional, descriptive study was conducted with 43 patients diagnosed with BD. The Information Form, Bipolar Depression Rating Scale (BDRS), Bipolar Disorder Functioning Questionnaire (BDFQ) and Emotional Eating Scale (EES) were administered through face-to-face interviews.
Results: Of the 43 BD patients, 58.1% were male, with a mean age of 26.93±10.29 years and a mean body mass index (BMI) of 25.01±6.06 kg/m2. Gender, age, BMI, physical activity, or sleep duration were not significant factors for EES sub-dimensions in BD patients (p>0.05). BD patients self-reported less eating tendency during negative emotions such as anxiety and depression and a higher tendency to eat during positive emotions like happiness. However, contrary to these self-reports, according to the BDRS, mixed symptoms (manic episodes) were positively correlated with "Control Against Stimuli" (p=0.003) and "Eating when Nervous" was positively correlated with both somatic (p=0.002) and psychological depression (p=0.005).
Conclusion: This study highlights differences between self-reported and objective assessments of eating behaviors in BD patients. While patients reported reduced food intake during negative emotions and increased intake during positive ones, objective measures showed contrasting results. These findings emphasize the importance of using objective methods to assess eating behaviors linked to emotional states in individuals with bipolar disorder.

Anahtar Kelimeler

Bipolar disorder , emotional eating , feeding behavior , feeding and eating disorders , obesity management

Etik Beyan

Numbered 61351342/2020-115 and dated 29.02.2020 was obtained from XXX Non- Interventional Research Ethics Committee as well as from XXX Brain Hospital under protocol number 2020/602 and approval date of 05.03.2020. This research was conducted in accordance with the "Helsinki Declaration Principles" and "Research and Publication Ethics".

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Teşekkür

The author would like to thank Mr. A.Ç. for performing the statistical analyses of the study, HB for support during the data collection phase and all patients who participated in this study.

Kaynakça

• 1. Bauer M, Andreassen OA, Geddes JR, et al. Areas of uncertainties and unmet needs in bipolar disorders: Clinical and research perspectives. Lancet Psychiatry. 2018;5:930-939. doi: 10.1016/S2215-0366(18)30253-0.
• 2. Işık E, Işık U, eds. Depressive and Bipolar Disorders in Children, Adolescents, Adults and the Elderly, 1th ed. Ankara: Rota Tıp; 2013.
• 3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association Publishing; 2013.
• 4. Merikangas KR, Jin R, He JP, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2011;68(3):241-251. doi: 10.1001/archgenpsychiatry.2011.12.
• 5. Grande I, Berk M, Birmaher B, et al. Bipolar disorder. Lancet. 2016;387(10027):1561-1572. doi: 10.1016/S0140-6736(15)00241-X.
• 6. Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-2223. doi: 10.1016/S0140-6736(12)61689-4.
• 7. Schaffer A, Isometsä ET, Tondo L, et al. Epidemiology, neurobiology and pharmacological interventions related to suicide deaths and suicide attempts in bipolar disorder: Part I of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder. Aust N Z J Psychiatry. 2015;49(9):785-802. doi: 10.1177/0004867415594427.
• 8. Macht M. How emotions affect eating: A five-way model. Appetite. 2008;50(1):1-11. doi: 10.1016/j.appet.2007.07.002.
• 9. Levitan RD, Davis C. Emotions and eating behavior: Implications for the current obesity epidemic. University of Toronto Quarterly. 2010;79(2):783-99. doi: 10.3138/utq.79.2.783.
• 10. Economy AM. Exploring the association between emotions and eating behavior. Capstone Project, Winona State University, 2013.
• 11. Desmet P, Schifferstein H. Sources of positive and negative emotions in food experience. Appetite. 2008;50(2-3):290-301. doi: 10.1016/j.appet.2007.08.003.
• 12. Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220-229. doi: 10.1001/archgenpsychiatry.2010.2.
• 13. Cecchetto C, Aiello M, Gentili C, et al. Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress. Appetite. 2021;160:105122. doi: 10.1016/j.appet.2021.105122.
• 14. Al-Musharaf S. Prevalence and predictors of emotional eating among healthy young Saudi women during the COVID-19 pandemic. Nutrients. 2020;12(2923):1-17. doi: 10.3390/nu12102923.
• 15. Kornacka M, Czepczor-Bernat K, Napieralski P, et al. Rumination, mood, and maladaptive eating behaviors in overweight and healthy populations. Eating and Weight Disorders: EWD. 2021;26(1):273–285. doi: 10.1007/s40519-020-00857-z.
• 16. Alalwan TA, Hilal SJ, Mahdi AM, et al. Emotional eating behavior among University of Bahrain students: A cross-sectional study. Arab Journal of Basic and Applied Sciences. 2019;26(1):424-432. doi: 10.1080/25765299.2019.1655836.
• 17. Hamurcu P, Arslan M. The relationship between mood, life satisfaction and emotional appetite: A study on university students. Gevher Nesibe Journal of Medical and Health Sciences. 2022;7(17):119-130. doi: 10.46648/gnj.367.
• 18. Romo-Nava F, Blom T, Guerdjikova A, et al. Evening chronotype, disordered eating behavior, and poor dietary habits in bipolar disorder. Acta Psychiatrica Scandinavica. 2020;142(1):58–65. doi: 10.1111/acps.13179.
• 19. Zhao Z, Okusaga OO, Quevedo J, et al. The potential association between obesity and bipolar disorder: A meta-analysis. J Affect Disord. 2016;202:120-123. doi: 10.1016/j.jad.2016.05.059.
• 20. Berk M, Malhi GS, Cahill C, et al. The Bipolar Depression Rating Scale (BDRS): Its development, validation and utility. Bipolar Disorders. 2007;9(6):571-579. doi: 10.1111/j.1399-5618.2007.00536.x.
• 21. Batmaz S, Ozdel K, Kocbiyik S, et al. The validity and reliability of the Turkish version of the Bipolar Depression Rating Scale. Comprehensive Psychiatry. 2014;55(6):1448-1454. doi: 10.1016/j.comppsych.2014.04.020.
• 22. Aydemir Ö, Eren İ, Savaş H, et al. Development of a questionnaire to assess inter-episode functioning in bipolar disorder: bipolar disorder functioning questionnaire. Turkish Journal of Psychiatry. 2007;18:344-352.
• 23. Bilgen SŞ. Development, Validity and Reliability Study Of Turkish Emotional Eating Scale [master's thesis]. İstanbul, Türkiye: Üsküdar University Institute of Social Sciences; 2018.
• 24. Martin K, Woo J, Timmins V, et al. Binge eating and emotional eating behaviors among adolescents and young adults with bipolar disorder. J Affect Disord. 2016;195:88–95. doi: 10.1016/j.jad.2016.02.030.
• 25. Tuncer GZ, Duman ZÇ. An examination of emotional eating behavior in individuals with a severe mental disorder. Archives of Psychiatric Nursing. 2020;34(6):531-536. doi: 10.1016/j.apnu.2020.10.002.
• 26. Koning E, Vorstman J, McIntyre RS, Brietzke E. Characterizing eating behavioral phenotypes in mood disorders: a narrative review. Psychological Medicine. 2022;52, 2885–2898. doi: 10.1017/S0033291722002446.
• 27. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: A review of empirical studies. Clin Psychol Rev. 2011;31(6):1041-1056. doi: 10.1016/j.cpr.2011.04.006.
• 28. Sevinçer GM, Konuk N. Emotional eating. Journal of Mood Disorders. 2013;3(4):171- 178. doi: 10.5455/jmood.20130926052526.