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EV0500

A transdiagnostic case of behavioral dysregulation: from an eating disorder to mood instability

A TRANSDIAGNOSTIC CASE OF BEHAVIORAL DYSREGULATION: FROM EATING DISORDER TO AFFECTIVE INSTABILITY

In a patient with an eating disorder characterized by bulimic and restrictive features, the interaction of impulsivity, maladaptive coping, and biological factors led to cyclical affective instability; multimodal treatment achieved clinical stabilization.

The aim was to describe the longitudinal course of behavioral and affective dysregulation in a patient with an eating disorder characterized by bulimic and restrictive features within a transdiagnostic framework, examine the contributions of impulsivity, maladaptive coping, and neuroendocrine factors to affective instability, and demonstrate the role of the HDRS and YMRS in capturing cyclical symptom patterns. A retrospective descriptive case analysis was conducted using clinical records, structured psychiatric assessment, and longitudinal follow-up. Symptom severity was measured using the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS), and biological variables, such as subclinical hypothyroidism, were evaluated in relation to mood regulation. The clinical focus was on cross-domain features such as impulsivity, self-harm behaviors, and substance use. The patient was a 34-year-old woman with a history of an eating disorder characterized by bulimic and restrictive features since adolescence; over time, she developed progressive mood instability with alternating hypomanic episodes (increased energy, decreased need for sleep, impulsivity, and hypersexuality) and depressive episodes (anhedonia, hopelessness, psychomotor retardation, and insomnia). Recurrent self-induced vomiting and daily cannabis use were identified, and HDRS and YMRS scores supported cyclical affective dysregulation. Multimodal treatment comprising quetiapine, psychotherapy, and nutritional support achieved clinical stabilization. The poster introduction states that up to 60% of patients with eating disorders have a lifetime comorbid mood disorder. In conclusion, the case illustrates a transdiagnostic model in which early vulnerability, maladaptive coping, and biological factors interact to produce recurrent instability across domains; it emphasizes that objective psychometric assessment improves diagnostic certainty and that early screening and multidisciplinary interventions are necessary to prevent chronicity and functional impairment.

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