Exploring Maladaptive Eating Behaviors in Mood Disorders: From Phenotypic Characterization and Digital Monitoring to Psilocybin-Assisted Psychotherapy

Abstract

Mood disorders, including depressive and bipolar disorders, represent a complex and prevalent group of psychiatric conditions characterized by significant heterogeneity in symptomatic domains of, not only mood, but also eating behavior. The latter is a far less recognized aspect in clinical care, despite the well-documented and bi-directional neurobiological relationship with mood. The objective of this thesis is to stimulate advancement in mood disorder research and clinical care by expanding knowledge of the characterization, assessment, and treatment of maladaptive eating behaviors in mood disorders. First, we characterized eating behavioral phenotypes using both knowledge synthesis and survey-based exploratory analysis. Building on these findings, we investigated how maladaptive eating behaviors can be assessed, specifically by demonstrating the feasibility of AI-powered ecological momentary assessment and a multidimensional analytical approach to capture circadian desynchronized eating behaviors in bipolar disorders. From a therapeutic perspective, we reviewed the potential of psilocybin-assisted psychotherapy and designed a clinical trial to evaluate its potential as a personalized approach for both mood symptoms and maladaptive eating behaviors. Together, the work presented in this thesis contributes knowledge about maladaptive eating behaviors in mood disorders to researchers, clinicians, and the general public via knowledge mobilization. These findings provide a base for larger investigations to confirm the phenotypic characterizations, refine the digital assessment of maladaptive eating behaviors in psychiatry, and progress toward comprehensive, personalized therapeutic approaches that address the multifaceted nature of mood disorders.