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Sample records for anorexia nerviosa concordancia

  1. Estudio del gasto energético en la anorexia nerviosa: concordancia entre calorimetría indirecta y diferentes ecuaciones Study of energy expenditure in anorexia nervosa: agreement between indirect calorimetry and several equations

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    M.ª C. Cuerda Compés; A. Ruiz Sancho; C. Moreno Rengel; M.ª T. Iriondo Martínez; C. Velasco Gimeno; I Bretón Lesmes; M Camblor Álvarez; P. García Peris

    2005-01-01

    El tratamiento nutricional es fundamental en la anorexia nerviosa (AN), si bien la reposición de nutrientes debe hacerse de forma progresiva para evitar la aparición del síndrome de realimentación. Objetivo: Comparar el gasto energético en reposo (GER) mediante calorimetría indirecta con el estimado con diferentes fórmulas en mujeres con AN. Material y Métodos: Estudiamos 21 mujeres ingresadas con AN (DSM-IV), edad 17 (DE 5,9) rango 12-34 años. El tiempo de ingreso fue 55,1 ± 20,7 días...

  2. Estudio del gasto energético en la anorexia nerviosa: concordancia entre calorimetría indirecta y diferentes ecuaciones Study of energy expenditure in anorexia nervosa: agreement between indirect calorimetry and several equations

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    M.ª C. Cuerda Compés

    2005-12-01

    Full Text Available El tratamiento nutricional es fundamental en la anorexia nerviosa (AN, si bien la reposición de nutrientes debe hacerse de forma progresiva para evitar la aparición del síndrome de realimentación. Objetivo: Comparar el gasto energético en reposo (GER mediante calorimetría indirecta con el estimado con diferentes fórmulas en mujeres con AN. Material y Métodos: Estudiamos 21 mujeres ingresadas con AN (DSM-IV, edad 17 (DE 5,9 rango 12-34 años. El tiempo de ingreso fue 55,1 ± 20,7 días (21-91. La valoración nutricional inicial incluyó antropometría (IMC, PTC, PSE, CMB,CMMB y bioimpedancia tetrapolar (HoltainBC. La calorimetría indirecta (CI se realizó tras ayuno nocturno (Deltatrac TM II MBM-200. En 9 pacientes se repitió el mismo estudio antes del alta. Comparamos el GER (kcal/24 h medido por CI con el obtenido por diferentes ecuaciones [Fleisch, Harris-Benedict (HB, FAO, Schofield-HW (SHW, Schebendach] mediante el coeficiente de correlación intraclase (CCI y el método de Bland y Altman. Resultados: El estado nutricional mejoró significativamente durante la hopitalización. El 50% del peso recuperado fue masa grasa. El GER aumentó significativamente durante el ingreso. Las fórmulas sobrestimaron el GER respecto al obtenido por CI (p Nutritional management is essential in anorexia nervosa (AN, although nutrient replenishment must be done progressively to prevent the occurrence of re-alimentation syndrome. Objective: to compare resting energy expenditure (REE by means of indirect calorimetry and by different equations in AN female patients. Material and methods: we studied 21 women admitted for AN (DSM-IV, mean age 17 years (SD 5.9, range 12-34 years. Admission stay was 55.1 ± 20.7 days (21-91. Initial nutritional assessment included anthropometrics (BMJ, TSF, SSE, MAC, MAMC and tetrapolar bioimpedance (HoltainBC. Indirect calorimetry (IC was done after overnight fasting (DeltatracTM II MBM-200. In 9 patients, the same study

  3. Nutrición y Anorexia Nerviosa

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    Alonso López, Andrea

    2016-01-01

    La anorexia nerviosa es un trastorno de la conducta alimentaria que afecta cada día a más tipos de población, aunque su principal nicho se encuentra en los adolescentes. A pesar de que su etiología es multifactorial, en este trabajo se ha pretendido hacer una revisión de los factores biológicos relacionados con dicha etiología por ser en ellos en los que se puede actuar mediante la alimentación permitiendo una pronta y adecuada rehabilitación del paciente anoréxico. La revisión bibliográf...

  4. Anorexia nerviosa: el cuerpo y los mandatos sociales-superyóicos

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    Sonia Patricia Murguía-Mier

    2015-01-01

    Full Text Available En este trabajo analítico y cualitativo presentamos los resultados de unainvestigación aplicada a cinco chicas con diagnóstico de anorexia nerviosa o trastorno alimentariono especificado. Utilizamos metodología de la sociología clínica en seis sesiones grupales y dosentrevistas individuales, para conocer las instancias psíquicas que se ponen en juego cuando lajoven con anorexia nerviosa es capaz de lastimar su cuerpo tan gravemente, y continuar con esadinámica a veces hasta la muerte. Encontramos que no las mueve un ideal de delgadez estético yque la enfermedad es regulada por el superyó, sostenida por lo que llamamos mandatos socialessuperyóicos,que son frases coaguladas -carentes de sentido-, que las instala en un fuera de control,como un regulador implacable, propiciando el dominio de la pulsión de muerte.

  5. La amenorrea como criterio diagnóstico de la anorexia nerviosa / Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

    OpenAIRE

    2013-01-01

    La amenorrea es un criterio para el diagnostico de la anorexia nerviosa (AN) según el DSM-IV-TR. Sin embargo, al comparar grupos de pacientes que cumplen todos los criterios de este manual para la AN con grupos de mujeres que los presentan todos salvo la amenorrea, algunos estudios no han encontrado diferencias significativas en la psicopatología típicamente asociadas con la AN. El propósito de nuestro estudio ha sido comparar variables demográficas, antropométricas, psicológicas y psicopatol...

  6. Trastornos de la alimentación y Terapia Ocupacional: Anorexia nerviosa

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    López Domínguez, Esther Mª

    2016-01-01

    [ES]Se realizó una revisión bibliográfica sobre la anorexia nerviosa y la terapia ocupacional, intentando analizar la evolución de este trastorno que actualmente está tan en apogeo, entre otros factores como los autores, las palabras de las cuales hacen más uso en sus títulos, el idioma y las revistas que más auge han tenido en dicho tema. Además, justificando la importancia que tiene la intervención desde la terapia ocupacional en los trastornos de la conducta alimentaria, esp...

  7. Valoración nutricional de niños y adolescentes ingresados por anorexia nerviosa

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    Caballero Sanz, Irene; Brito García Sousa Ferro, Inês de

    2016-01-01

    La anorexia nerviosa es el trastorno de la conducta alimentaria más prevalente en niños y adolecentes, y su tratamiento es largo y complejo, precisando de un equipo multidisciplinario. La rehabilitación nutricional y el restablecimiento del peso corporal saludable es uno de los objetivos más importantes en las primeras fases del tratamiento del paciente ingresado. Sin embargo, las recomendaciones actuales sobre las necesidades energéticas iniciales de los pacientes son inconsistentes, con una...

  8. Cardiomiopatía inducida por estrés (Takotsubo en una paciente con anorexia nerviosa

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    Sabrina Vadalá

    2014-06-01

    Full Text Available Presentamos el caso de una mujer con diagnóstico de anorexia nerviosa que desarrolló cardiomiopatía de takotsubo precipitada por estrés emocional y alteraciones del medio interno. Evolucionó favorablemente con manejo conservador. Los casos de cardiomiopatía inducida por estrés, descriptos en pacientes con trastornos de la conducta alimentaria, suelen alcanzar mayor gravedad y se asocian con la prolongación del intervalo QT por desequilibrios electrolíticos, arritmias ventriculares e hipoglucemia. Se realiza una revisión del compromiso cardiovascular en pacientes con anorexia nerviosa.

  9. Manifestaciones muco cutáneas en anorexia nerviosa: Mucous and cutaneous manifestations of the anorexia nervosa

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    MB Leroux

    Full Text Available La anorexia nerviosa es una enfermedad psiquiátrica, cuya incidencia está creciendo en las últimas décadas. Afecta sobre todo a las adolescentes y mujeres jóvenes. Los signos clínicos son consecuencia de las carencias nutricionales y de los mecanismos de compensación, que el organismo implementa para conservar la vida. Las manifestaciones cutáneas y bucales son consecuencia de la desnutrición: vómitos autoprovocados, consumo de drogas o medicamentos no recetados y de la enfermedad psiquiátrica en sí misma. Se presentan diez pacientes, ocho mujeres y dos varones con signos cutáneos compatibles con anorexia nerviosa. El rango de edad es de 17 a 32 años. En orden de frecuencia se hallaron: acrocianosis, alopecia, acné, xerosis, palidez, hirsutismo, cambios en las membranas bucales y lesiones autoprovocadas. Creemos que el reconocimiento de estos signos cutáneos acompañado de un exhaustivo interrogatorio, puede colaborar en el diagnóstico de este trastorno alimentario.Anorexia nervosa is a psychiatric disease with an increasing incidence in the last decade, which affects principally adolescents and young women. Clinical signs are a consequence of malnutrition and the compensating mechanisms implemented to preserve life. Skin and oral lesions are caused by malnutrition, self-provoked vomiting, illegal drug consumption or therapeutic drugs utilization, and the psychiatric disease so far. Case reports: ten patients (eight females and two males with possible skin alterations due to anorexia nervosa, aged 17 to 32 yr. The most frequent signs, in order of priority were: acrocyanosis, alopecia, acne, xerodermia, pallor, hirsutism, oral injuries and self provoked injuries. We propose that the finding of these skin lesions plus an exhaustive questionnaire could aid to diagnose this eating disorder.

  10. Anorexia nerviosa: el cuerpo y los mandatos sociales-superyóicos

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    Sonia Patricia Murguía-Mier, México

    2015-07-01

    Full Text Available (analítico En este trabajo analítico y cualitativo presentamos los resultados de una investigación aplicada a cinco chicas con diagnóstico de anorexia nerviosa o trastorno alimentario no especificado. Utilizamos metodología de la sociología clínica en seis sesiones grupales y dos entrevistas individuales, para conocer las instancias psíquicas que se ponen en juego cuando la joven con anorexia nerviosa es capaz de lastimar su cuerpo tan gravemente, y continuar con esa dinámica a veces hasta la muerte. Encontramos que no las mueve un ideal de delgadez estético y que la enfermedad es regulada por el superyó, sostenida por lo que llamamos mandatos socialessuperyóicos, que son frases coaguladas -carentes de sentido-, que las instala en un fuera de control, como un regulador implacable, propiciando el dominio de la pulsión de muerte.

  11. Conductas purgativas y estado nutricional en anorexia nerviosa y bulimia nerviosa Purging behaviours and nutritional status in anorexia nervosa and bulimia nervosa

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    F. J. Vaz

    2003-10-01

    Full Text Available Objetivos: La intención del estudio fue comprobar si el empleo de métodos purgativos en pacientes con trastornos alimentarios (anorexia nerviosa [AN], y bulimia nerviosa [BN] podía reflejarse en la existencia de un estado nutricional específico. Ámbito y pacientes: El grupo en estudio estuvo formado por 184 pacientes ambulatorios con diagnóstico confirmado de trastorno de la alimentación DSM-IV. Ciento dieciséis pacientes (63% padecían BN: 90 del subtipo purgativo y 26 del subtipo no-purgativo. Sesenta y ocho pacientes (37,0% cumplían los criterios diagnósticos del DSM-IV para la AN: 48 del subtipo restrictivo y 20 del subtipo compulsivo-purgativo. Intervenciones: El proceso de evaluación incluyó antropometría (perímetros corporales y pliegues cutáneos y análisis de la impedancia corporal. Resultados: Los dos subgrupos de pacientes AN presentaron diferencias significativas frente a cada uno de los subgrupos de pacientes BN. Desde el punto de vista nutricional, fueron encontradas diferencias entre pacientes con patrones purgativos y no purgativos dentro de la población anoréxica pero no entre los pacientes bulímicos. Conclusiones: La significación clínica de estos hallazgos es discutida y se propone la identificación alternativa de tres subgrupos de pacientes AN: 1 tipo restrictivo [pacientes que controlan la ingesta y no utilizan métodos de purga]; 2 tipo purgativo [pacientes con verdaderos atracones que utilizan métodos de purga], y 3 tipo pseudo-purgativo [pacientes con episodios subjetivos de descontrol alimentario que utilizan métodos de purga].Aims: The aim of the study was to investigate whether the use of purgative methods in patients with eating disorders (anorexia nervosa [AN] and bulimia nervosa [BN] could be capable of producing changes in the nutritional status of the patients. Setting and Patients: The group under study was composed of 184 female eating disordered outpatients. One hundred and sixteen

  12. La amenorrea como criterio diagnóstico de la anorexia nerviosa / Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

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    Santos Orejudo Hernández

    2013-06-01

    Full Text Available La amenorrea es un criterio para el diagnostico de la anorexia nerviosa (AN según el DSM-IV-TR. Sin embargo, al comparar grupos de pacientes que cumplen todos los criterios de este manual para la AN con grupos de mujeres que los presentan todos salvo la amenorrea, algunos estudios no han encontrado diferencias significativas en la psicopatología típicamente asociadas con la AN. El propósito de nuestro estudio ha sido comparar variables demográficas, antropométricas, psicológicas y psicopatológicas, en ambos grupos. No se observaron diferencias estadísticamente significativas entre ambos grupos en las variables evaluadas, pero el grupo con amenorrea tenía un índice de masa corporal significativamente más bajo. Nuestros datos apoyan la hipótesis de que la amenorrea podría no ser un criterio diagnóstico útil para la AN.

  13. Anorexia nerviosa en el embarazo: cuidados en la enfermería obstétrico-ginecológica

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    A. Herrera Gómez; Martínez Galiano, Juan Miguel; Fernández Valero, MJ.

    2011-01-01

    La anorexia nerviosa es un desorden alimentario psicosomático, complejo, que primariamente afecta a niñas y mujeres jóvenes. Los trastornos de la conducta alimentaria pueden ocurrir a cualquier edad y en determinadas situaciones (en particular, de cambio), pueden precipitar la aparición de síntomas. El embarazo y la maternidad son una de estas situaciones. Es una situación rara, pero la mujer anoréxica necesita unos cuidados especiales por parte de matronas y enfermeras implicadas en el embar...

  14. Processo de Enfermagem para pacientes com Anorexia Nervosa Proceso de Enfermería para pacientes con Anorexia Nerviosa Nursing Process to patients with Anorexia Nervosa

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    Vanessa Pellegrino Toledo

    2011-02-01

    Full Text Available Relato de experiência da aplicação do Processo de Enfermagem a uma paciente portadora de Anorexia Nervosa, utilizando histórico, diagnósticos, intervenções e resultados de enfermagem. As intervenções foram fundamentadas nos diagnósticos de enfermagem: distúrbio da imagem corporal, nutrição desequilibrada menos que as necessidades corporais, ansiedade, baixa autoestima crônica, intolerância a atividade, controle ineficaz do regime terapêutico, risco de infecção, volume de líquidos deficiente e isolamento social. A partir da aplicação do Processo de Enfermagem, os resultados planejados foram alcançados, proporcionando melhor qualidade de vida, no período em que permaneceu internada. Os fatores psíquicos, neurológicos, endócrinos e imunológicos, peculiares na anorexia nervosa, propiciaram a elaboração de um Processo de Enfermagem, que contribuiu de maneira positiva para a complementação da reabilitação da saúde da mesmaRelato de experiencia de la aplicación del proceso de enfermería (PE a una paciente portadora de Anorexia Nerviosa, utilizando histórico, diagnósticos, intervenciones y resultados de enfermería. Las intervenciones fueron basadas en los diagnósticos de enfermería: trastorno de la imagen corporal, nutrición alterada ingesta inferior a las necesidades corporales, ansiedad, autoestima baja crónica, intolerancia a la actividad, manejo ineficaz del régimen terapéutico, riesgo de infección, déficits de volumen de líquidos y aislamiento social. A partir de la aplicación del Proceso de Enfermería, los resultados planeados fueron alcanzados, proporcionando mejor calidad de vida en el período en que permaneció hospitalizada. Los factores psíquicos, neurológicos, endócrinos y inmunológicos, peculiares en la anorexia nerviosa, propiciaron la elaboración de un Proceso de Enfermería, que contribuyó de manera positiva para la complementación de la rehabilitación de su salud

  15. FACTORES DE RIESGO DE ANOREXIA Y BULIMIA NERVIOSA EN ESTUDIANTES DE PREPARATORIA: UN ANÁLISIS POR SEXO

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    Rosalinda Guadarrama Guadarrama

    2011-01-01

    Full Text Available Este estudio identifica los factores de riesgo de anorexia y bulimia nerviosa en estudiantes de preparatoria de acuerdo a su sexo. Se trabajó con 316 alumnos de ambos sexos de una escuela privada del nivel medio superior. Los instrumentos aplicados fueron el Test de Bulit y el Test de Actitudes Alimentarias, los cuales cuentan con propiedades psicométricas adecuadas a la población mexicana. Los resultados muestran que 17% de la muestra estudiada mostró síntomas de trastorno alimentario, predominando la anorexia y siendo mayor en las mujeres, siendo estas el grupo que estableció las diferencias estadísticamente significativas en ambas variables. Los resultados permiten concluir que los adolescentes de zonas externas a las grandes urbes pudieran ser propensos a desarrollar este tipo de trastornos, siendo las mujeres el grupo más afectado.

  16. Efecto de la realimentación en la composición corporal de mujeres con anorexia nerviosa restrictiva: antropometría frente a impedancia bioeléctrica

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    Beatriz de Mateo Silleras

    2013-10-01

    Full Text Available Objetivo: Evaluar la composición corporal en un grupo de pacientes desnutridas con anorexia nerviosa, respecto de controles sanas, antes y después del soporte nutricional, mediante antropometría y bioimpedancia. Métodos: Estudio observacional prospectivo. Se realizó una antropometría completa y un análisis de bioimpedancia a 12 mujeres con anorexia nerviosa restrictiva (24,5 años al ingreso hospitalario y semanalmente durante la realimentación. El grupo control estuvo formado por 24 mujeres sanas (21 años. Se aplicaron los test t-Student, U-Mann-Whitney, t-Student para medidas repetidas o Wilcoxon. La concordancia entre antropometría y BIA se analizó mediante el coeficiente de correlación intraclase y Bland-Altman. Resultados: Las pacientes mejoraron significativamente todos los índices de composición corporal a lo largo de la estancia hospitalaria, aunque sus valores al alta siguieron siendo menores que los de las controles. La media de peso ganado fue 5,22 kg (DE: 1,42, de los que el 51,4% fueron masa grasa, con distribución central preferentemente. En las controles la ecuación de BIA que mejor concuerda con antropometría es la de Sun (CCI = 0,896; en las pacientes la concordancia fue más débil, al ingreso y al alta. Conclusiones: La realimentación produce una ganancia ponderal, fundamentalmente a expensas de masa grasa, con distribución central; no se consigue restablecer el estado nutricional. La concordancia entre antropometría y bioimpedancia para el estudio de la composición corporal es aceptable, especialmente en sujetos sanos. Se recomienda emplear antropometría, si no se dispone de BIA vectorial o algún método gold estandard para el análisis de la composición corporal, en casos de alteraciones importantes en la composición corporal y/o el balance hídrico.

  17. Evaluación del autoconcepto, la satisfacción con el propio cuerpo y las habilidades sociales en la anorexia y bulimia nerviosas

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    ELENA GISMERO GONZALEZ

    2001-01-01

    Full Text Available De acuerdo con la observación clínica, y en algunos casos con la literatura experimental, los trastornos alimenticios van asociados a insatisfacción con la imagen corporal, así como a baja autoestima o un mal autoconcepto, y aislamiento social, alexitimia, etc. que conllevarían dificultades en las relaciones sociales. Pero ¿son estos aspectos característicos de las personas que padecen anorexia y bulimia nerviosa los que permiten diferenciarlos claramente de otros grupos?. El objetivo del presente estudio es pues, comparar pacientes con Anorexia y Bulimia Nerviosa con tres grupos: control, mujeres que hacen dieta y mujeres en psicoterapia, en medidas de autoconcepto-autoestima, satisfacción con el propio cuerpo y habilidades sociales. Los resultados apoyan la idea de que un mal autoconcepto y ciertos déficits en habilidades sociales son característicos de pacientes con anorexia y bulimia nerviosa, y que los diferencian no sólo de grupos controles normales, sino también de personas que hacen dieta para adelgazar. La insatisfacción con el propio cuerpo caracteriza al grupo de anorexia, diferenciandole tanto del grupo control, como del de psicoterapia y del de dieta.

  18. Revisión del tratamiento dietético-nutricional de la anorexia nerviosa

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    Jáuregui-Lobera, Ignacio; Bolaños-Ríos, Patricia

    2012-01-01

    While numerous studies have highlighted the need to approach anorexia nervosa from a multidisciplinary perspective, the dietary and nutritional aspects of the disorder are rarely considered in depth. Basic guidelines to monitor food intake of patients, are available. A literature review was performed in Medline, searching for articles related to the dietary and nutritional management of anorexia nervosa and published over the last five years. Thefinal analysis focused on 102 articles. This re...

  19. SECCIÓN ABIERTA - 2. INFLUENCIA DE LA ESPIRITUALIDAD EN LOS ESTILOS DE AFRONTAMIENTO DE PACIENTES CON BULIMIA Y ANOREXIA NERVIOSA // INFLUENCE OF SPIRITUALITY IN COPING STYLES OF PATIENTS WITH BULIMIA AND ANOREXIA NERVOSA

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    Marisa Edith Oviedo Romero

    2012-06-01

    Full Text Available Basándose en el supuesto de que la espiritualidad es un factor que podría influir sobre los estilos de afrontamiento de las personas ante situaciones problemáticas, se analizó la influencia de la espiritualidad en el estilo de afrontamiento de pacientes diagnosticadas de anorexia y/o bulimia nerviosa.39 mujeres de Buenos Aires, Entre Ríos, San Luis y Mendoza (Argentina, fueron evaluadas mediante el Cuestionario de Modos de Afrontamiento (WCCL y el Inventario de Sistema de Creencias (SBI–15R.Los resultados mostraron una influencia moderada de la dimensión soporte social religioso (F(1;24= 2,094; p=0,054 en el uso y/o desarrollo del estilo de afrontamiento centrado en la evaluación, no así en los demás estilos, por parte de pacientes diagnosticadas de bulimia y/o anorexia nerviosa.

  20. Respuesta electrofisiológica y conductual en pacientes con anorexia nerviosa a estímulos emocionales y estímulos relacionados con el alimento

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    Aguirre Vega, Elizabeth

    2016-01-01

    Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Psicología, Departamento de Psicología Básica y de la Salud. Fecha de lectura: 19 de febrero de 2016 La anorexia nerviosa (AN) es un trastorno de la conducta alimentaria que se caracteriza por una pérdida de peso corporal autoinducida, miedo intenso al aumento de peso y alteraciones en la percepción de la imagen y figura corporal. La investigación realizada en las últimas décadas ha arrojado numerosa evidencia e...

  1. Lipid profile and cardiovascular risk in anorexia nervosa: the effect of nutritional treatment Perfil lipídico y riesgo cardiovascular en anorexia nerviosa: efecto del tratamiento nutricional

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    B. Jáuregui-Garrido

    2012-06-01

    Full Text Available Objective: The aim of this study was to explore the lipid profile in patients with anorexia nervosa (AN, and the changes with refeeding. Methods: The sample comprised 102 AN outpatients (mean age 22.32 ± 3.17. Blood tests, after 12-hour overnight fast, were performed before refeeding (M0 and after weight restoration (M1. Total cholesterol (TC, high-density lipoproteins (HDL, low-density lipoproteins (LDL and triglycerides (TRG were determined and the following cardiovascular risk markers were calculated: LDL/HDL and TC/HDL ratios. These cut-off points were considered: TC 40 mg/dl; LDL Objetivo: El objetivo de este estudio fue explorar el perfil lipídico en pacientes con anorexia nerviosa (AN y los cambios con la realimentación. Métodos: Se estudiaron 102 pacientes ambulatorios con AN (edad media de 22,32 ± 3,17. Se determinaron en sangre, tras de 12 horas en ayunas, antes de la realimentación (M0 y después de la recuperación del peso (M1, colesterol total (CT, lipoproteínas de alta densidad (HDL, lipoproteínas de baja densidad (LDL y triglicéridos (TRG y se calcularon los siguientes marcadores de riesgo cardiovascular: LDL/HDL y CT/HDL ratios. Se consideraron los siguientes puntos de corte: CT 40 mg/dl, LDL <100 mg/dl y TRG < 150 mg/dl. Resultados: El tiempo para la recuperación del peso fue de 8,16 ± 7,35 meses. Teniendo en cuenta los pacientes con puntuaciones superiores e inferiores a los correspondientes puntos de corte, el test de Χ² reveló una diferencia significativa (M0-M1 en el caso de CT (p < 0,05, así como entre LDL/HDL0 y LDL/HDL1 (p < 0,05 y entre TC/HDL0 y TC/HDL1 (p < 0,01. Se encontraron diferencias significativas entre el HDL0 y HDL1 (p < 0,01 y entre TRG0 y TRG1 (p < 0,01. Se obtuvieron asociaciones significativas y negativas entre BMI0 y CT0 (r = -0,331, p < 0,05 y entre TRG0 y HDL0 (r = -0,387, p < 0,05 se encontraron. La asociación entre TRG1 y LDL1 fue significativa y positiva. Debate: La recuperación del

  2. Prevalencia y factores de riesgo para la bulimia y la anorexia nerviosa en una muestra de adolescentes en colegios de Medellín

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    Gina Posada

    2001-04-01

    Full Text Available

    Los trastornos más conocidos de la alimentación como la anorexia nerviosa y la bulimia son entidades de orden psíquico que no poseen un factor etiológico único; se destaca la constante carga publicitaria que ha transformado el concepto de imagen corporal y los patrones alimentarios.
    Se ha observado que representan un problema de salud; los
    grupos más vulnerables son las mujeres de 13-18 años (0.5-1% en anorexia, y 1-5% en bulimia. Ambas entidades generalmente son de curso crónico y traen consecuencias tanto físicas como sicológicas, que incluso pueden acarrear la muerte de quienes la padecen. Conociendo su potencial peligrosidad y el incremento de las imágenes visuales y las presiones socioculturales que inducen diariamente a estar delgado, a cambiar los hábitos alimentarios y a realizar ejercicio, consideramos que es de suma importancia realizar un estudio de uno de los principales síndromes psiquiátricos modernos, siguiendo de cerca los factores predisponentes y la prevalencia en el grupo de personas que están en mayor riesgo de presentarlos como son las mujeres adolescentes y en la adultez temprana.

     

  3. A propósito de un caso de malnutrición muy extrema en una paciente que presenta Anorexia Nerviosa Restrictiva de larga evolución y no recibía tratamiento

    Directory of Open Access Journals (Sweden)

    Beatriz Pelegrina Cortés

    Full Text Available La anorexia nerviosa es un trastorno de la conducta alimentaria que con frecuencia ocasiona malnutrición y asocia riesgo de mortalidad. Requiere la colaboración de un equipo multidisciplinar con amplia experiencia clínica para obtener óptimos resultados, una exitosa educación nutricional y evitar el síndrome de realimentación. El caso que se presenta constituye la malnutrición más severa secundaria a anorexia nerviosa que hemos tratado en nuestra unidad: una paciente de 33 años con IMC de 8.8 kg/m² y elevación de enzimas hepáticas, que, a pesar de la situación de extrema gravedad en la que se encontraba, no presentó complicaciones durante el proceso de realimentación, que se detalla.

  4. Desnutrición por ayuno prolongado en pacientes con anorexia nerviosa: mecanismos adaptativos y consecuencias. Revisión de la literatura - Puesta al día

    OpenAIRE

    Matellanes Palacios, Clara; Matellanes Palacios, María

    2016-01-01

    La anorexia nerviosa es la enfermedad psiquiátrica más frecuente entre las mujeres jóvenes, y se caracteriza por la realización de dietas con pérdida significativa de peso y un miedo desproporcionado a su ganancia. Aunque se ha descrito principalmente en el contexto psiquiátrico, esta enfermedad desde el punto de vista nutricional puede llevar a condiciones que ponen en peligro la vida del paciente, por lo que constituye una entidad difícil de manejar. El organismo humano dispone de mecani...

  5. La influencia de los medios de comunicación en el padecimiento y recuperación de la anorexia nerviosa. Una revisión bibliográfica.

    OpenAIRE

    Yeste Delgado, Gloria

    2016-01-01

    La anorexia nerviosa (AN) es un trastorno de la conducta alimentaria (TCA) que consiste en un intenso impulso por adelgazar o un fuerte temor a engordar. La incidencia de la AN está aumentando en los últimos años, se da principalmente en mujeres jóvenes y su etiología es multicausal. Esta revisión bibliográfica presenta tres objetivos: conocer la influencia de internet en el desarrollo y mantenimiento de la AN; conocer la influencia de internet en el tratamiento de la AN; valorar si los progr...

  6. La bulimia y la anorexia

    OpenAIRE

    Bersh, Sonia; Fundación Valle de Lili

    2001-01-01

    Trastornos de la conducta alimentaria / El auge de la anorexia y la bulimia / Complicaciones médicas de los trastornos de la alimentación / Otros problemas emocionales / Tratamiento / Complicaciones de la anorexia y la bulimia nerviosa.

  7. La bulimia nerviosa y sus subtipos

    OpenAIRE

    Myriam Sierra Puentes

    2005-01-01

    En este artículo se realiza una reseña sobre los trastornos de la alimentación, anorexia y bulimia, la relación que hacen los individuos con este comportamiento y la prevalencia, características y tratamientos más efectivos empleados en la bulimia nerviosa. Además, algunas aproximaciones para establecer subtipos de bulimia diferentes a los del DSM-IV e investigaciones sobre este trastorno del comportamiento alimentario, como la bulimia nerviosa.

  8. Anorexia

    Science.gov (United States)

    Eating disorder - anorexia nervosa ... The biggest challenge in treating anorexia nervosa is helping the person recognize that they have an illness. Most people with anorexia deny that they have an eating disorder. ...

  9. Impulsividad y búsqueda de sensaciones: factores asociados a síntomas de anorexia y bulimia nerviosas en estudiantes de secundaria (Impulsiveness and sensation seeking: Factors associated with symptoms of anorexia and bulimia nervosa in high school students

    Directory of Open Access Journals (Sweden)

    Serafina Castro-Zamudio

    2016-08-01

    Full Text Available This study investigated the potential association of impulsiveness and sensation seeking and the attitudes and behaviour characteristic of anorexia and bulimia nervosa in male and female students (between 12 and 20 years. The study had an observational case-control design, in which the case group comprised symptomatic subjects who had scores above the cutoff point designated by the authors for several assessment instruments, and the control group, which comprised asymptomatic participants who had scores below the cutoff point. The study included 300 participants (136 men [45.33%] and 164 women [(54.66%] from Malaga (Spain. All participants received parental authorization to take part in the study. The participants anonymously completed the following self-administered tests: Eating Disorder Inventory (EDI-II, Eating Attitudes Test (EAT-26, Bulimia Test Revised (BULIT-R, Barratt Impulsiveness Scale (BIS-11, and (SSS-V. The results suggest an association between impulsiveness and symptomatology associated with eating disorders, anorexia, and bulimia nervosa. In contrast, sensation seeking was only associated with bulimic symptoms. In summary, the variables impulsivity and sensation seeking appear to be closely associated with eating disorders. Thus, these aspects should be addressed in healthy lifestyle programs, because their inclusion may help to reduce or prevent the increase in eating disorders in the teenage population.

  10. [Effect of refeeding on the body composition of females with restrictive anorexia nervosa; anthropometry versus bioelectrical impedance].

    Science.gov (United States)

    de Mateo Silleras, Beatriz; Redondo del Río, Paz; Camina Martín, Alicia; Soto Célix, María; Alonso Torre, Sara R; Miján de la Torre, Alberto

    2013-01-01

    Objetivo: Evaluar la composición corporal en un grupo de pacientes desnutridas con anorexia nerviosa, respecto de controles sanas, antes y después del soporte nutricional, mediante antropometría y bioimpedancia. Métodos: Estudio observacional prospectivo. Se realizó una antropometría completa y un análisis de bioimpedancia a 12 mujeres con anorexia nerviosa restrictiva (24,5 años) al ingreso hospitalario y semanalmente durante la realimentación. El grupo control estuvo formado por 24 mujeres sanas (21 años). Se aplicaron los test t-Student, U-Mann-Whitney, t-Student para medidas repetidas o Wilcoxon. La concordancia entre antropometría y BIA se analizó mediante el coeficiente de correlación intraclase y Bland-Altman. Resultados: Las pacientes mejoraron significativamente todos los índices de composición corporal a lo largo de la estancia hospitalaria, aunque sus valores al alta siguieron siendo menores que los de las controles. La media de peso ganado fue 5,22 kg (DE: 1,42), de los que el 51,4% fueron masa grasa, con distribución central preferentemente. En las controles la ecuación de BIA que mejor concuerda con antropometría es la de Sun (CCI = 0,896); en las pacientes la concordancia fue más débil, al ingreso y al alta. Conclusiones: La realimentación produce una ganancia ponderal, fundamentalmente a expensas de masa grasa, con distribución central; no se consigue restablecer el estado nutricional. La concordancia entre antropometría y bioimpedancia para el estudio de la composición corporal es aceptable, especialmente en sujetos sanos. Se recomienda emplear antropometría, si no se dispone de BIA vectorial o algún método gold estandard para el análisis de la composición corporal, en casos de alteraciones importantes en la composición corporal y/o el balance hídrico.

  11. Anorexia nerviosa análisis de algunos aspectos cognitivos

    OpenAIRE

    Río Sánchez, Carmen del

    1995-01-01

    En el presente trabajo hemos comparado 50 chicas anoréxicas (an) (dsm-iii-r), con dos grupos de sujetos equivalentes en factores tales como sexo, edad y nivel académico, uno de ellos compuesto por chicas que puntuaron por encima de 21 (x=32.72) en el eat-40 (Garner y Garfinkel, 1979) y que, en consecuencia, presentan actitudes distorsionadas ante la alimentación, peso y figura ... (grupo subclínico) y el otro por chicas que puntuaron por debajo de 15 (x=8.84) en el eat-40 (grupo normal). A to...

  12. Anorexia y Bulimia: problemas de la sociedad desarrollada

    OpenAIRE

    Asensio Aller, Marta

    2014-01-01

    Según el Instituto Nacional de la Salud de Estados Unidos un trastorno de la alimentación es una enfermedad que causa graves perturbaciones en la dieta diaria, tales como comer cantidades muy pequeñas o comer en exceso. Los trastornos de la alimentación generalmente aparecen durante la adolescencia o adultez temprana, pero también se pueden dar durante la niñez o la adultez avanzada. Los trastornos de la alimentación más comunes son la anorexia nerviosa, bulimia nerviosa y e...

  13. Anorexia Nervosa

    Science.gov (United States)

    ... ePublications > Our ePublications > Anorexia nervosa fact sheet ePublications Anorexia nervosa fact sheet Print this fact sheet Anorexia nervosa fact sheet (PDF, 832 KB) Related information Binge ...

  14. Dysthymia in anorexia nervosa and bulimia nervosa

    Directory of Open Access Journals (Sweden)

    Mercedes Borda-Más

    2008-01-01

    Full Text Available Este estudio ex post facto analiza la presencia de distimia en 155 mujeres. Noventa y tres pacientes cumplían los criterios diagnósticos para un trastorno de la conducta alimentaria (TCA: 31 con anorexia nerviosa restrictiva (ANr, 31 con anorexia nerviosa purgativa/bulímica (ANp y 31 con bulimia nerviosa purgativa (BNp; y 62 mujeres constituían los dos grupos comparativos: 31 con alto riesgo de padecer un TCA (grupo comparativo sintomático: GC-S y 31 sin patología conocida (grupo comparativo no sintomático: GC-NS. Todas ellas cumplimentaron la versión española del MCMI-II. En los resultados encontramos diferencias significativas en las medias obtenidas por los grupos con TCA respecto a los dos grupos comparativos, y que presentaban el posible síndrome distímico [puntuaciones Tasa Base (TB > 74] el 50% de las pacientes con ANr, el 60% con ANp y el 63,30% de las pacientes con BNp. Sólo el 16,70% de las mujeres de alto riesgo y el 5,70% de las mujeres sin patología lo presentaban. Estos hallazgos indican que el síndrome distímico es frecuente en las mujeres con TCA, y en aquellas que presentan conductas purgativas aumenta levemente la severidad del mismo.

  15. Anorexia nervosa: un estudio de casos

    Directory of Open Access Journals (Sweden)

    Lillyana Zusman Tinman

    2013-09-01

    Full Text Available La Anorexia Nervosa es un trastorno de alimentación que se define (etimológicamente como una "pérdida nerviosa del apetito". Se caracteriza por la actitud consciente, voluntaria y rotunda de los sujetos  de tener un exceso de peso que intentan modificar por vía de la inanición. A partir del estudio de casos, se propone la distinción entre una Anorexia Nervosa Estructural -aquella en la que predomina el conflicto intrapsíquico primario y arcaico, y que manifiesta una conducta aislada y retraída- y una Anorexia Nervosa Reactiva, aquella en la que predomina un conflicto intrafamiliar algo más posterior y, por lo tanto, una personalidad más abierta y compatible con el medio. Anorexia Nervosa is an Eating Disorder defined (etimoligacally as a "nervouse loss of apetite". It is characterized by a conscious, voluntary and categoric attitude of the sick patient to refrain from eating. He/she has a firm conviction of having excess weight which they try to modify by starvation. Through a case study, a distinction between two types of Anorexia Nervosa is proposed: a Structural Anorexia Nervosa -in which an intrapsyhic, primary, arcaic conflic prevails, leading to an isolated, withdrawal conduct- and a Reactive Anorexia Nervosa, in which a later intrafamilial conflict prevails leading, therefore, to a more open personality, compatible with the enviroment.

  16. Anorexia nervosa: Divergent validity of a prototype narrative among anorexia relatives

    Directory of Open Access Journals (Sweden)

    Bárbara C. Machado

    2006-01-01

    Full Text Available El objetivo de este estudio ex post facto fue analizar la validez divergente (grado de discriminación de la narrativa prototipo de la anorexia nerviosa de acuerdo a los familiares significativos de los pacientes anoréxicos y explorar distintas características de los participantes que pueden estar asociadas con el grado de discriminación de la narrativa prototipo. Participaron 64 personas significativas de los individuos con anorexia nerviosa, a los que se les pidió que indicasen el grado de identificación, de acuerdo con su familiar, con cinco narrativas prototipo distintas (depresión, agorafobia, anorexia, alcoholismo y tóxico-dependencia. Los resultados no confirmaron la validez divergente de la narrativa prototipo de la anorexia. Los participantes mostraron tendencia a identificar en primer lugar a sus familiares con el prototipo de la agorafobia. Además, no se encontraron diferencias significativas entre la identificación con el prototipo de la anorexia y el de la depresión, de la agorafobia y del alcoholismo. La única diferencia significativa encontrada fue en la comparación entre el prototipo de la anorexia y el de la tóxico-dependencia. No obstante, las madres de las anoréxicas y la duración del trastorno se asocian al grado de identificación con la narrativa prototipo de la anorexia. Se discuten los resultados en términos de una aproximación sistémica versus prototipo de las perturbaciones del comportamiento alimentario.

  17. Executive functions in anorexia nervosa.

    Science.gov (United States)

    Jáuregui-Lobera, Ignacio

    2014-03-01

    Introducción: Los mecanismos fisiopatológicos que explican el desarrollo y la persistencia de la anorexia nerviosa (AN) siguen sin estar claros. Con respecto al funcionamiento neuropsicológico, se han señalado alteraciones en las funciones ejecutivas, especialmente en la flexibilidad cognitiva y en los procesos de toma de decisiones. Objetivos: El objetivo de este trabajo fue revisar el estado actual de los estudios neuropsicológicos sobre anorexia nerviosa, especialmente los centrados en las funciones ejecutivas. Métodos: Se realizó un proceso de búsqueda con tres relevantes bases de datos electrónicas, así como una búsqueda adicional con las referencias incluidas en los documentos analizados. Finalmente hay que mencionar otras revisiones ya publicadas y una búsqueda manual de otras fuentes. Resultados y discusión: Los datos de comparación de pacientes y controles sanos siguen siendo controvertidos, así como la comparación entre los diferentes trastornos de la alimentación con respecto a la disfunción neuropsicológica. El papel de variables como depresión, ansiedad y obsesividad necesita ser aclarado. Parece que hay alguna base para afirmar que existen algunos puntos en común entre los llamados trastornos de peso extremo (anorexia, obesidad). El vínculo entre la disfunción neuropsicológica en AN y biomarcadores aún no está claro. El papel de los déficits neuropsicológicos en la AN, como factores iniciales o simplemente como meras consecuencias, tampoco está aclarado. La relación entre los trastornos de imagen corporal y la disfunción neuropsicológica debe asimismo aclararse. Los datos sobre las similitudes, en cuanto a la disfunción neuropsicológica, entre AN y otros trastornos mentales pueden ser considerados, hasta la fecha, como una mera aproximación. Lo mismo ocurre con la relación entre el rendimiento neuropsicológico de los pacientes con AN y la personalidad o el género.

  18. Anorexia y bulimia y su relación con la depresión en adolescentes

    OpenAIRE

    2013-01-01

    El objetivo de la investigación fue determinar el cociente de correlación de anorexia nerviosa y bulimia nerviosa con respecto a la depresión, para lo cual se trabajó con una muestra no probabilística de tipo intencional constituida por 266 sujetos estudiantes de una preparatoria particular del sur del estado de México, 152 de ellos mujeres y 114 hombres. Los instrumentos aplicados fueron el Test de Actitudes Alimentarias, el Test de Bulit y el Inventario de Depresión de Beck, todos ellos val...

  19. Anorexia y estilos de afrontamiento en adolescentes de Lima Metropolitana

    OpenAIRE

    Giuliana Debbie, Caballero Salazar

    2014-01-01

    Compara las estrategias de afrontamiento en un grupo de 127 adolescentes con anorexia nerviosa de un Centro Terapéutico con un grupo de 300 adolescentes del quinto de secundaria de una institución educativa estatal que no sufren trastornos alimenticios. Se aplicó la encuesta de comportamiento alimentario y de modos de afrontamiento del estrés. La metodología es de tipo descriptiva comparativo correlacional y se concluye lo siguiente: Los instrumentos de recolección de datos: trastornos alimen...

  20. Tratamiento periodontal en un paciente con bulimia y anorexia

    OpenAIRE

    Dolonguevich, Evelyn Ruth; Boero López, Edgardo

    2009-01-01

    En el caso clínico se trató periodontalmente a la paciente C. J., con diagnóstico de bulimia y anorexia nerviosa purgativa. Se destacó el importante trabajo de motivación, que dio como resultado una respuesta excelente en su salud bucal. Se contó con la posibilidad de colocar implantes dentales con buen resultado postoperatorio, lo cual es promisorio en cuanto a lograr rehabilitarla con una solución fija, que no sufrirán de patología...

  1. Anorexia: comer nada. Una perspectiva psicoanalítica.

    Directory of Open Access Journals (Sweden)

    Luis Salvador López Herrero

    1999-01-01

    Full Text Available La anorexia, palabra que procede del griego y que significa falta de apetito, mantuvo un significado en el mundo antiguo que, en realidad, no se corresponde con el sentido actual de este término (rechazo al alimento. Podemos decir que la anorexia, también denominada «Síndrome de las tres A» (amenorrea, adelgazamiento y anorexia como actitud de rechazo al alimento, a la que más tarde se añadirían otros elementos clínicos, tales como la distorsión de la imagen corporal y el miedo a engordar, es, como entidad nosológica, un tipo de trastorno alimentario que adquiere su carácter clínico a partir de finales del siglo XIX con las descripciones de Gull en Inglaterra y de Lasègue en Francia, quienes hablaban de anorexia nerviosa y de anorexia histérica respectivamente (no en vano la histeria, bajo la mirada de Charcot en París, eclipsaba a la ciencia médica con su camaleónica sintomatología.

  2. Análisis de concordancia de atributos

    Directory of Open Access Journals (Sweden)

    Federico Picado Alvarado

    2008-04-01

    Full Text Available Se presenta la metodología del análisis de concordancia de atributos para la evaluación de las respuestas de los evaluadores, cuando se analizan características de calidad tipo atributo, donde la subjetividad puede afectar la efectividad del sistema de medición.El análisis de concordancia de atributos puede ser muy útil en sistemas de calidad donde se aplique métodos de inspección por atributos, tanto en organizaciones de manufactura como en servicios. Se desarrolla un ejemplo de aplicación con el uso del software estadístico Minitab 15.1.

  3. Repercusiones de la anorexia y la bulimia en la salud oral, prevención y tratamiento

    OpenAIRE

    Gomez Jiménez, Antonio; Casals Peidró, Elías; Boj Quesada, Juan Ramón

    2000-01-01

    El presente artículo trata de aportar una puesta al día de los problemas que presentan los pacientes afectados de anorexia y de bulimia nerviosa. Se expone la información que el odontólogo debe tener en cuenta respecto al conocimiento de la enfermedad, sus manifestaciones orales, los criterios diagnósticos y los enfoques preventivos y terapéuticos necesarios.

  4. [Anorexia nervosa].

    Science.gov (United States)

    Herzog, W; Friederich, H C; Wild, B; Löwe, B; Zipfel, S

    2006-08-01

    Anorexia nervosa differs distinctly from other psychogenic eating disorders. Well known for the past 300 years, anorexia occurs consistently and is one of the most serious illnesses to be found for a certain age group. Three-quarters of the patients are healed or improve their condition long-term; one-quarter has a chronic course frequently including somatic complications and death. Because of the long healing process as well as the extensive chronification and complication rate, an individual treatment plan should be set up at the beginning of therapy to allow for a long-term structure of the course of therapy. Depending on the severity, phase and co-morbidity, inpatient and ambulant therapies are indicated. Depending on the duration of therapy, adequate weight (BMI > 15 kg/m2), good motivation, and lack of complications, an ambulant therapy is justified. Inpatient treatment is multimodal corresponding to the multifactorial etiology of anorexia nervosa. Weight gain is an important primary goal of therapy and a prerequisite for a conflict oriented, ambulant psychotherapy to be carried on after inpatient treatment. Ambivalent psychotherapy motivation and the necessity of symptom orientation demand technical modification both for inpatient as well as ambulant psychotherapy.

  5. Anorexia nervosa and culture.

    Science.gov (United States)

    Simpson, K J

    2002-02-01

    Anorexia nervosa is currently considered a disorder confined to Western culture. Its recent identification in non-Western societies and different subcultures within the Western world has provoked a theory that Western cultural ideals of slimness and beauty have infiltrated these societies. The biomedical definition of anorexia nervosa emphasizes fat-phobia in the presentation of anorexia nervosa. However, evidence exists that suggests anorexia nevosa can exist without the Western fear of fatness and that this culturally biased view of anorexia nervosa may obscure health care professionals' understanding of a patient's own cultural reasons for self-starvation, and even hinder their recovery.

  6. Anorexia nervosa: a validação divergente de uma narrativa protótipo

    Directory of Open Access Journals (Sweden)

    Margarida Rangel Henriques

    2002-01-01

    Full Text Available Este estudio es la continuación de otro en el que se elaboró una narrativa prototipo de la anorexia y se analizó su validez convergente (grado de verosimilitud. Se plantean tres objetivos: analizar la validez divergente (grado de discriminación de la narrativa prototipo de la anorexia, explorar aspectos de la historia de los sujetos que puedan estar asociados a una diferencia de intensidad en la identificación con la narrativa de la anorexia y, por último, realizar un estudio exploratorio del poder predictivo de algunas de las variables descriptivas de la muestra en relación a la identificación con la narrativa prototipo de la anorexia. La muestra está formada por 38 sujetos con diagnóstico de anorexia nerviosa según los criterios del DSM-IV. Los resultados no confirman la validación divergente de la narrativa prototipo de la anorexia, poniendo en duda la hipótesis de su veracidad. No obstante, en los tres subgrupos de la muestra relacionados a la duración del trastorno superior a 2,5 años, la puntuación total del EDI y la subescala de Miedo a la Madurez encima del punto de corte, los sujetos se identifican más con la narrativa prototipo de la anorexia que con la de la toxicodependencia y la de la agorafobia. La duración de la perturbación de más de 2,5 años se revela como variable predictiva de la identificación con la narrativa prototipo de la anorexia.

  7. Anorexia of Aging.

    Science.gov (United States)

    Visvanathan, Renuka

    2015-08-01

    The anorexia of aging is common, leading to adverse health consequences. As populations age, the impacts from anorexia in the older population are set to increase. Only greater awareness will allow for prevention or early intervention. This article discusses the physiologic anorexia of aging, highlights contributing factors, and proposes management strategies, including screening, especially in primary care. Many neuroendocrine factors have been implicated in the pathophysiology; it is clear that further human research is necessary if there is to be a pharmacologic breakthrough. There are currently no approved pharmacologic treatment strategies to prevent or treat the anorexia of aging.

  8. Infection and anorexia.

    Science.gov (United States)

    Kanra, Güler Y; Ozen, Hasan; Kara, Ateş

    2006-01-01

    Whereas anorexia is a common behavioral response to infectious diseases, the reasons for and mechanisms behind this observation are still unknown. When it is considered on an evolutionary basis, the organism must have net benefits from anorexia. The first response to infection is the development of acute phase response (APR). The APR is triggered by microbial products and characterized by production of several cytokines known to induce anorexia. Several microbial products and cytokines reduce food intake after parenteral administration, suggesting a role of these substances in the anorexia during infection. Locally released cytokines may inhibit feeding by activating peripheral sensory fibers directly or indirectly, and without a concomitant increase in circulating cytokines. However, the final center for appetite or eating is the central nervous system (CNS). Thus, these peripheral signals must reach and interact with brain regions that control appetite. In addition, a direct action of cytokines and microbial products on the CNS is presumably involved in the anorexia during infection.

  9. Reconciliarse consigo misma: cuando la enfermera sufre anorexia

    Directory of Open Access Journals (Sweden)

    Inmaculada Tejada Morón

    Full Text Available Relato biográfico de Sonia, una enfermera que sufrió anorexia y bulimia nerviosa, cuando estaba cursando la carrera de enfermería. El objetivo ha sido conocer de las palabras de la propia informante, cómo se vive la anorexia desde la perspectiva de una enfermera con conocimientos amplios sobre el tema, y cómo desde su posición de profesional puede ayudar a otros. Para construir el relato he realizado una entrevista semiestructurada, con preguntas abiertas centradas en los temas esenciales. La informante relata su historia describiendo aspectos como la percepción de lucha interna con la que describe el factor desencadenante y el desarrollo de la enfermedad, las estrategias de afrontamiento que utiliza para recuperar la salud y la principal motivación que la llevó a tomar conciencia del problema y querer tomar el control de su vida. Este tipo de relatos puede servir de ayuda y aprendizaje a la sociedad y en especial a otros jóvenes que pueden verse reflejados en el mismo.

  10. Riesgo Cardiovascular en la Anorexia Nerviosa y en otras formas de Amenorrea Hipotalámica Funcional Relacionadas con la Desnutrición Cardiovascular risk in anorexia nerviosa and other forms of functional hypothalamic amenorrhea related to undernutrition

    Directory of Open Access Journals (Sweden)

    Leán Fiszlejder

    2012-03-01

    Full Text Available El disbalance entre el consumo/gasto energético observado en mujeres con amenorrea hipotalámica funcional (AHF mal nutridas o francamente desnutridas, desencadena una mayor actividad de las hormonas hipotalámicas y neuropéptidos periféricos, destinada a facilitar el aporte de metabolitos energéticos endágenos. La osteoporosis, la inmunodepresión, la amenorrea hipotalámica y el aumento del riesgo cardiovascular (RCV, pueden ser interpretados como efectos secundarios a las reacciones de adaptación homeostática ejercidas por las hormonas centrales y periféricas. El grado de insuficiencia del eje somatotráfico, el hipoestrogenismo y tiempo de evolución, condicionan el tenor de las alteraciones de la circulación coronaria y el compromiso estructural y funcional del miocardio. Un perfil lipídico aterogénico (relación LDL col normal/ HDL col bajo e hipertrigliceridemia y el ascenso de los marcadores periféricos de procesos inflamatorios y fibrinolíticos, instauran un medio proateroesclerático y protrombático. Frecuentemente es posible observar una prematura presencia de placas de ateroma en las paredes de las carátidas, engrosamiento de su íntima media y la consiguiente rigidez de estas arterias. Ello dificulta la circulación del flujo sanguíneo, induciendo así, la isquemia coronaria y una predisposición al accidente cerebrovascular. Estudios ecocardiográficos exhiben una reducción de la masa muscular de las paredes del ventrículo izquierdo y del septum interventricular. Estos cambios estructurales se correlacionan con una disminución del volumen sanguíneo de la fracción de eyección sistálica postesfuerzo, para presentarse luego en reposo. La alteración del volumen de llenado diastálico puede ser observada si el curso de la enfermedad es relativamente prolongado, evidenciando entonces, un grave compromiso de la performance cardíaca. Si bien, la incidencia de extrasístoles supraventriculares, fibrilación auricular y la bradicardia, no es estadísticamente significativa, la presencia de estas arritmias aumentan el RCV y la posibidad de una eventual muerte súbita.The imbalance between energy intake and energy expenditure observed in malnourished or frankly under-nourished women with functional hypothalamic amenorrhea triggers an increased activity of hypothalamic hormones and peripheral neuropeptides, at facilitating the availability of endogenous energy metabolites. Osteoporosis, immune depression, hypothalamic amenorrhea and increased cardiovascular risk can be interpreted as secondary effects of the homeosthatic adaptation reactions by central and peripheral hormones. The extent of somatotropic axis deficiency, hypoestrogenism and time of evolution condition the nature of coronary circulation alterations and myocardial structural and functional involvement. An unfavorable lipid profile (normal LDL/ low HDL and hypertriglyceridemia, the rise in peripheral markers of fibrinolytic and inflammatory processes, results in a proatherosclerotic and prothrombotic environment. A premature presence of atheroma plaques in carotid walls, intima media thickness and subsequent artery stiffness may be frequently observed. This makes blood flow difficult, leading to coronary ischemia and predisposition to stroke. Echocardiographic studies show a decrease in the muscle mass of the left ventricle walls and the interventricular septum. These structural changes correlate with a volume reduction in the post-stress systolic ejection fraction, which subsequently occurs at rest at rest.The reduction in diastolic filling volume can be observed if the course of the disease is relatively long, showing, a serious compromise of cardiac performance. Even if the incidence of supraventricular extrasystoles, atrial fibrillation and bradycardia is not statistically significant, the presence of such arrhythmias increases CVR and the possibility of potential sudden death.

  11. La óptica sistémica en el tratamiento de la anorexia nerviosa y la bulimia.

    Directory of Open Access Journals (Sweden)

    Beatriz Rodríguez Vega

    1996-01-01

    Full Text Available «En un período de nuestra vida nos encontramos frente a un muro. Durante la terapia descubrimos una puerta. Junto con ustedes hemos construido una llave». Un padre de una paciente anoréxica (Onnis et al, 1994.

  12. [Anorexia and malnutrition].

    Science.gov (United States)

    Bertrand, Pauline Coti; Roulet, Michel

    2003-02-01

    Anorexia is a frequent and complex symptom occurring physiologically in older persons and during acute or chronic pathology. It's an adaptable physiological response to stress. It must be respected as such, as long as it's quickly reversible. The study of anorexia requires evaluation of oral intakes, causal aetiology and nutritional repercussion on body composition, different systems function and quality of life. Early artificial nutrition is recommended for adult patient who severely diminished oral intakes for 7 to 10 days after the beginning of acute pathology. Artificial nutrition is also indicated with chronic pathology associated with a significant weight loss. Faced to the impossibility of treating anorexia and its all causes, we have to treat at least anorexia repercussions and prevent undernutrition with an adequate artificial nutrition.

  13. Medical complications of anorexia nervosa.

    Science.gov (United States)

    Shuttleworth, E; Sharma, S; Lal, S; Allan, P J

    2016-05-01

    Anorexia nervosa is a psychiatric disorder with potential life-threatening medical sequelae. This article reviews the principal medical complications associated with anorexia nervosa, highlights associated diagnostic pitfalls and emphasizes the importance of a multidisciplinary approach to management.

  14. The occupational roles of women with anorexia nervosa Los papeles ocupacionales de mujeres con anorexia nervosa Os papéis ocupacionais de mulheres com anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Leila Maria Quiles-Cestari

    2012-04-01

    Full Text Available This study’s objective was to understand how occupational roles of individuals with anorexia nervosa are configured. The sample was composed of a control group and 11 adult women with anorexia nervosa being cared for by the Eating Disorders Care Group in a hospital in Ribeirão Preto, SP, Brazil. Socio-demographic and anthropometric data were collected and the Role Checklist was applied. The results revealed a significant loss of roles for women with anorexia nervosa in relation to the performance of the roles worker, friend, and amateur/hobbyist, supporting the idea that psychosocial harm may arise from this eating disorder. The evaluation of occupational roles in the treatment of eating disorders is an important strategy for planning Occupational Therapy activities and supporting the creation of healthier spaces to enable individuals to resume occupational roles, and acquire independence and autonomy.El objetivo es entender como figuran los papeles ocupacionales de las personas con anorexia nervosa. La casuística fue compuesta por 11 personas diagnosticadas en tratamiento en el Grupo de Asistencia en Trastornos Alimentares de un Hospital de Ribeirão Preto-Brasil y un grupo control. Se recogieron variables sociodemográficas, antropométricas y por la “Lista de Identificación de Papeles Ocupacionales”. Los resultados muestran hubo cambio, con pérdida de papeles debido a la anorexia nerviosa, con pérdida de los papeles de trabajador, voluntario, amigo y pasatiempo amador, corroborando los perjuicios psicosociales derivados de este trastorno. La evaluación de los papeles ocupacionales en el tratamiento de los trastornos alimentares es una estrategia importante para la planificación de la terapia ocupacional por la concesión de subvenciones para crear ambientes más saludables, donde las posibilidades de crear el rescate de los papeles ocupacionales, la independencia y autonomía.O objetivo desta pesquisa foi compreender como se

  15. CONCORDANCIA ENTRE CINCO DEFINICIONES DE SÍNDROME METABÓLICO. CARTAGENA, COLOMBIA

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    Gustavo Mora García

    2012-01-01

    Full Text Available Fundamentos: Durante la última década el síndrome metabólico fue definido en cinco diferentes guías. Con cada definición se modifica la capacidad predictiva del síndrome sobre la enfermedad cardiovascular. El objetivo del presente estudio fue determinar el grado de concordancia entre estas cinco guías en Cartagena (Colombia. Métodos: Se realizó un estudio de corte transversal en adultos. El tamaño mínimo de muestra se estimó con información del censo DANE 2005. Se realizó un muestreo por conglomerados bietápico que incluyó 670 individuos. Para estimar la prevalencia del síndrome se aplicaron las guías OMS (Organización Mundial de la Salud, AHA/NHBLI (Asociación Americana del Corazón, ATPIII (Panel de Tratamiento de Adultos, IDF (Federación Internacional de Diabetes y JIS (Declaración Provisional Conjunta. La concordancia fue calculada con el índice Kappa de Cohen. Resultados: Según las guías JIS, IDF, ATPIII, AHA/NHBLI y OMS, la prevalencia de síndrome metabólico fue del 36,3%, 35,1%, 30,3%, 24,2% y 4,9% respectivamente. La concordancia entre JIS e IDF fue de 0,893 mientras que el índice entre estas guías y AHA/NHBLI fue de 0,778 y 0,750 respectivamente. El ATP III tuvo una concordancia más baja con JIS e IDF (0,711 y 0,645, respectivamente pero con AHA/NHLBI la concordancia fue de 0,863. La OMS presentó un acuerdo con las demás guías de entre 0,14 y 0,16. Conclusiones: Existe concordancia significativa entre las cuatro guías más recientes. Los puntos de corte para obesidad abdominal podrían justificar las diferencias encontradas.

  16. Reconfiguring Relatedness in Anorexia.

    Science.gov (United States)

    Warin, Megan J

    2006-04-01

    Anthropological concepts of relatedness have not been addressed in any of the writings on anorexia, despite the literature being replete with negative connotations of sociality such as withdrawal, regression, and toxic families (in the form of 'obsessive mothers' or 'absent fathers'). As a departure to the vast literature on this topic, this multi-sited ethnographic project draws on the recent critiques and broadening of the concept of kinship to examine the ways in which a group of people with a diagnosis of anorexia understood and experienced relatedness in their everyday lives, that is, how they continually transformed connections by truncating, creating, sustaining and abandoning them. Those practices that are taken for granted as creating and sustaining relatedness-from the everyday practices of commensality to the capacity to have children-were consistently negated. Negating consensual avenues of relatedness did not leave these people in a void. On the contrary, new and productive meanings and experiences of being related were created and people entered into a relationship with anorexia that, in turn, tempered their relationships with their everyday worlds. In examining the 'relational matrix' of anorexia, new spaces of agency, ambiguity and power are illuminated.

  17. Anorexia nervosa en adolescenten

    NARCIS (Netherlands)

    van Elburg, A A; Danner, U N

    2015-01-01

    BACKGROUND: Anorexia nervosa (AN), which is the most serious of the eating disorders, starts earlier in life and often continues into adulthood. AIM: To discuss the typical features of AN in adolescents. METHOD: We present an overview based on the literature about AN in adolescents and on analysis p

  18. Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Csapo, Marg

    1987-01-01

    The article reviews the literature on anorexia nervosa, with or without bulimia, and presents a comprehensive picture of this eating disorder, focusing on terminology, historical references, prevalence, prognosis, classification, diagnostic criteria, physical and psychological characteristics, evolution of the disability, etiology, treatment, and…

  19. Case 39: Anorexia nervosa

    Science.gov (United States)

    Anorexia nervosa is a disease affecting primarily young women who have distorted body images. Although their weight is less than 30 percent under ideal body weight, they see themselves as overweight. Anorectics often use diuretic and laxative agents to accomplish their weight loss. Patients with bul...

  20. Tumores malignos de la vaina nerviosa periférica como origen de dolor orofacial

    Directory of Open Access Journals (Sweden)

    Jorge Chaurand-Lara

    2016-07-01

    Full Text Available Los tumores malignos de la vaina nerviosa periférica (TMVNP, también llamados neurofribrosarcomas o schwannomas malignos, representan el 10% de todos los sarcomas de tejidos blandos. El tumor usualmente se encuentra en las extremidades inferiores, y solo del 10 al 20% de las lesiones ocurren en la región de cabeza y cuello, convirtiéndolas en una entidad rara. Los neurofibromas son tumores de la vaina nerviosa que aparecen comúnmente en la neurofibromatosis 1 o enfermedad de Von Recklinghausen. Se ha reportado que los individuos con antecedentes familiares de neurofibromatosis 1 tienen un riesgo incrementado de desarrollar TMVNP en el transcurso de sus vidas, sin embargo, esta asociación no se ha confirmado en TMVNP a nivel de los nervios craneales. En este artículo los autores analizaron la literatura actual con respecto a los TMVNP del nervio trigémino, así como la inclusión de un caso inusual que involucra las 3 ramas de dicho nervio.

  1. Anorexia e melancolia

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    Mônica Assunção Costa Lima

    2012-06-01

    Full Text Available O texto desenvolve a proposição freudiana, que se encontra no Rascunho G, de que a anorexia é a neurose paralela à melancolia. Propõe que o elo entre melancolia e anorexia deve ser buscado no campo do narcisismo. Explora quatro aspectos da melancolia que permitem a aproximação destas duas afecções, entre elas, a inibição, a perspectiva de uma instância crítica que se diferencia do eu e se volta contra ele, o sadismo com que essa instância crítica trata o eu, e a identificação do eu ao objeto.

  2. Psychobiology of anorexia nervosa.

    Science.gov (United States)

    Ploog, D W; Pirke, K M

    1987-11-01

    The psychobiology of anorexia nervosa is described and explained under four headings; (1) the psychopathology as related to the motivation for fasting; (2) metabolic and somatic consequences of starvation, including brain morphology; (3) endocrine abnormalities in the hypothalamic-pituitary-adrenal and gonadal axis; and (4) the hunger drive and its possible perversions in terms of aspects of neuroethology and the reward system in the brain.

  3. Dopamine and anorexia nervosa.

    Science.gov (United States)

    Södersten, P; Bergh, C; Leon, M; Zandian, M

    2016-01-01

    We have suggested that reduced food intake increases the risk for anorexia nervosa by engaging mesolimbic dopamine neurons, thereby initially rewarding dieting. Recent fMRI studies have confirmed that dopamine neurons are activated in anorexia nervosa, but it is not clear whether this response is due to the disorder or to its resulting nutritional deficit. When the body senses the shortage of nutrients, it rapidly shifts behavior toward foraging for food as a normal physiological response and the mesolimbic dopamine neurons may be involved in that process. On the other hand, the altered dopamine status of anorexics has been suggested to result from a brain abnormality that underlies their complex emotional disorder. We suggest that the outcomes of the treatments that emerge from that perspective remain poor because they target the mental symptoms that are actually the consequences of the food deprivation that accompanies anorexia. On the other hand, a method that normalizes the disordered eating behavior of anorexics results in much better physiological, behavioral, and emotional outcomes.

  4. Embodiment, experiencia vivida y anorexia: La contribución de la fenomenología a un enfoque terapéutico crítico

    Directory of Open Access Journals (Sweden)

    Jordi Sanz Porras

    2001-04-01

    Full Text Available En este artículo nos proponemos recuperar el trabajo de Merlau-Ponty como un instrumento válido para la elaboración de una psicología crítica ya sea en como referente teórico o en sus aplicaciones prácticas. En concreto, nos vamos a centrar en los conceptos de percepción y corporalidad y como Merleau-Ponty los define de forma radicalmente distinta a la psicología convencional. Complementariamente, reflejamos el carácter crítico de las perspectivas fenomenológicas mediante la aplicación de los conceptos de percepción y corporalidad a la concepción clínico-teórica de la anorexia nerviosa. Este artículo constituye un punto de partida que nos permita repensar la naturaleza encarnada de la anorexia nerviosa, tanto a partir de una crítica fenomenológica al concepto de corporalidad en la concepción de los desórdenes alimentarios de la psicología clínico-conductual como la ausencia de la noción de cuerpo encarnado en algunas perspectivas feministas.

  5. Adolescent Eating Disorder: Anorexia Nervosa.

    Science.gov (United States)

    Muuss, Rolf E.

    1985-01-01

    Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…

  6. Diseño y Validación de una Tarea Computarizada Tipo Stroop para Evaluar Sesgos de la Atención en Bulimia Nerviosa

    OpenAIRE

    Esteban Jaime Camacho-Ruíz; Juan Manuel Mancilla-Díaz; María Del Consuelo Escoto-Ponce De León; María Guillermina Yáñez-Tellez

    2009-01-01

    Objetivo: Desarrollar una tarea computarizada tipo Stroop para evaluar sesgos en la atención hacia palabras relacionadas con la comida y la figura, en pacientes con bulimia nerviosa. Se desarrollaron cuatro listas de palabras con valencia positiva y negativa, relacionadas con la comida y la figura corporal. Método: treinta y dos mujeres con bulimia nerviosa emparejadas con 32 mujeres sin trastorno, respondieron la versión original y una modificada de la Prueba de Stroop computarizada. Resulta...

  7. Anorexia Nervosa: Sociocultural Factors and Treatment.

    Science.gov (United States)

    Williams, Jennifer

    This paper examines how the epidemiological findings of anorexia nervosa lead theorists to speculate a correlation between sociocultural factors and the development of anorexia nervosa. A section on the essential features of anorexia nervosa identifies five primary characteristics of anorexia: (1) severe weight loss; (2) a disturbance of body…

  8. Anorexia nervosa during pregnancy.

    OpenAIRE

    Goldman, Ran D.; Koren, Gideon

    2003-01-01

    QUESTION: A 22-year-old patient in my clinic was diagnosed with anorexia nervosa (AN) 7 years ago. She is now married and planning her first pregnancy. She is still underweight. What should she expect during pregnancy, and are there any implications for her unborn baby? ANSWER: Women with AN are at higher risk of complications during pregnancy, mainly because of low body weight. Apgar scores and birth weights of infants born to mothers with AN have been found to be significantly lower than th...

  9. [Franz Kafka's anorexia nervosa].

    Science.gov (United States)

    Fichter, M M

    1988-07-01

    The evidence for the hypothesis that the poet Franz Kafka had suffered from an atypical anorexia nervosa is presented. Kafka was slim and underweight throughout his life and showed an ascetic attitude and abjuration of physical enjoyment and pleasure (fasting, vegetarianism, sexual abstinence, emphasis on physical fitness). The analysis is mainly based on Kafka's own descriptions in his letters, diaries, and literary work. Kafka was achievement oriented, reported many sadomasochistic fantasies, and had an anancastic (obsessive-compulsive) depressive personality. In addition there is evidence for a disturbed psychosexual and gender identity development. Our results concerning Kafka's psychopathology do not question his genius as a poet.

  10. Verbo de concordancia en la lengua de señas chilena

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    Dora Adamo Quintela

    1999-09-01

    Full Text Available El presente trabajo trata sobre una clase verbo de la lengua de señas chilena, el verbo de concordancia. A través de su descripción se da cuenta de los diversos mecanismos utilizados por el sistema de la lengua de señas para establecer la concordancia entre el sujeto y el objeto, que funcionan en la oración mediante el proceso de inflexión gramatical. Una característica relevante de la LSCh consiste en la utilización del espacio para producir modificaciones gramaticales regulares, entendidas como procesos de inflexión, a través de la co-ocurrencia de parámetros gestual-visuales, que permiten una comunicación eficiente entre sus usuarios. (This article focuses on a particular type of verb used in Chilean Sign Language: the verb of agreement. Through its description, different mechanisms used to show subject-object accord operating through inflection are presented. A relevant feature of Chilean Sign Language (LSCh, is to use space to mark regular grammatical modifications, understood as processes of inflection through the co-occurrence of visual-kinetic parameters that allow its user an efficient communication.

  11. Concordancia copulative, pronombres sujeto y adquisición de sistemas no nativos

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    Yolanda Ruiz de Zarobe

    2000-12-01

    Full Text Available El presente articulo investiga la actuación de distintos pronombres sujeto en la adquisición de un sistema no nativo. Por un lado, estudiamos la evolución en el proceso adquisitivo de los sujetos referenciales. Por otro, analizamos algunas construcciones con sujetos pleonásticos, que incluyen oraciones existenciales y construcciones de concordancia copulativa. Tras realizar varias pruebas a estudiantes españoles de inglés, pudimos determinar cómo el proceso adquisitivo dijiere con respec­ to a los distintos sujetos. Los pronombres pleonásticos fueron los últimos en adquirirse, sobre todo en aquellos contextos que resultan semánticamente complejos para los hablantes nativos de español, como es el caso de las construcciones de concordancia copulativa. Estos resultados harán que debamos replantearnos algunas teorias sobre el valor de los sujetos pleonasticos en la reestructuración del parametro de Sujeto Nulo.

  12. Homeostasis in anorexia nervosa

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    Per eSodersten

    2014-08-01

    Full Text Available Brainstem and hypothalamic orexigenic/anorexigenic networks are thought to maintain body weight homeostasis in response to hormonal and metabolic feedback from peripheral sites. This approach has not been successful in managing over- and underweight patients. It is suggested that concept of homeostasis has been misinterpreted; rather than exerting control, the brain permits eating in proportion to the amount of physical activity necessary to obtain food. In support, animal experiments have shown that while a hypothalamic orexigen excites eating when food is abundant, it inhibits eating and stimulates foraging when food is in short supply. As the physical price of food approaches zero, eating and body weight increase without constraints. Conversely, in anorexia nervosa body weight is homeostatically regulated, the high level of physical activity in anorexia is displaced hoarding for food that keeps body weight constantly low. A treatment based on this point of view, providing patients with computerized mealtime support to re-establish normal eating behavior, has brought 75% of patients with eating disorders into remission, reduced the rate of relapse to 10%, and eliminated mortality.

  13. CONCORDANCIA EN LATALLA PARA LA EDAD ENTRE DIFERENTES REFERENCIAS DE CRECIMIENTO. CALDAS, COLOMBIA. 2006-2009

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    María Victoria Benjumea Rincón

    2012-01-01

    Full Text Available Fundamentos: en Colombia se han propuesto diversas referencias antropométricas para su uso en salud pública sin contar con un consenso sobre el ideal y han sido adoptadas sin estudios previos de validación. El objetivo de este estudio fue medir la concordancia en la clasificación de la talla para la edad entre tres referencias antropométricas para menores de 17 años asistentes al programa de nutrición de CONFAMILIARES, Caldas, Colombia. Métodos: estudio descriptivo de 31.961 menores de 17 años asistentes al programa de nutrición de CONFAMILIARES, Caldas, Colombia, entre 2006 y 2009. Las variables fueron la talla para la edad y el sexo. La clasificación antropométrica con las referencias del CentroNacional de Estadísticas en Salud de Estados Unidos (NCHS y de la Organización Mundial de la Salud (OMS se llevó a cabo con Anthro y la del Centro para el Control de Enfermedades (CDC con EpiInfo 6.04d. Se calculó el puntaje Z diferenciado por sexo. Se estimó el coeficiente kappa para evaluar la concordancia entre las categorías antropométricas y se clasificó ésta con los puntos de corte de Altman DG. Resultados: la concordancia más alta se encontró entre las referencias del NCHS y de la OMS (niñas: 0,854; niños: 0,899, p=0,000, seguida de las del NCHS frente al CDC (niñas: 0,787; niños: 0,860, p=0,000 y de la del CDC comparada con la OMS (niñas: 0,754; niños: 0,829, p=0,000. Conclusiones: de acuerdo con los resultados podría usarse cualquiera de las tres referencias para evaluar la talla en este grupo de edad.

  14. Study Links Celiac Disease, Anorexia

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_164453.html Study Links Celiac Disease, Anorexia Chances of being diagnosed with eating ... April 4, 2017 (HealthDay News) -- Young women with celiac disease may face a heightened risk of being ...

  15. Concordancia de tres definiciones de síndrome metabólico en pacientes hipertensos

    OpenAIRE

    Paternina-Caicedo, Ángel J.

    2009-01-01

    Objetivo Determinar la concordancia entre tres definiciones de síndrome metabólico (SMet) en pacientes hipertensos colombianos.Materiales y Métodos Se diseñó un estudio descriptivo en 323 pacientes hipertensos de Cartagena de Indias. Se realizó historia clínica, medición de tensión arterial, perímetro abdominal, lípidos séricos y glucosa sérica en ayunas. Se comparó la prevalencia deSMet según la definición del Adult Treatment Panel III (ATP III), la American Heart Association (AHA), la Inter...

  16. Baja concordancia entre la información clínica de atención primaria y hospital

    Directory of Open Access Journals (Sweden)

    Concha Revilla-López

    2016-04-01

    Conclusiones: La baja concordancia de la información diagnóstica contenida en AP y hospital obliga a adoptar medidas que permitan a los profesionales sanitarios a conocer el conjunto de problemas de salud que presenta un paciente.

  17. Update on anorexia and cachexia.

    Science.gov (United States)

    Strasser, Florian; Bruera, Eduardo D

    2002-06-01

    Declining physical, emotional, and social function as a result of anorexia and cachexia are considerable contributors to discomfort for cancer patients and their families, and they impair the patient's ability to express optimal physical and psychosocial potential as long as possible. This decline no longer has to be accepted as an indispensable sequel to advanced cancer, just as pain is no longer considered to be unavoidable. A routine screening for anorexia and cachexia and associated symptoms is necessary, as is a careful, comprehensive assessment, because the condition is not always obvious. Decisions about anorexia and cachexia treatment are guided by prioritizing the different, concurrent physical, psychosocial, and existential problems and by considering the natural course of the cancer and the effects of antineoplastic therapies. Reversible causes for anorexia and cachexia need to be identified and treated, if appropriate. Nutritional interventions are often indicated; patients with a predominant starvation component and without inflammation may profit the most. New pharmacologic therapies for primary anorexia and cachexia syndrome are expected to enter clinical practice soon; however, until then, treatment with corticosteroids, progestins, or prokinetics may be indicated for some patients. To understand a multicausal syndrome, multimodal and interdisciplinary therapy is required. Specialist palliative care services can be helpful to provide, hand-in-hand with the disease specialists [172], assessment and management of psychophysical symptoms and sociospiritual needs of patients during the course of the illness and at the end of life [173]. Research efforts aim to better characterize subgroups of patients suffering from secondary causes of anorexia and cachexia and to elucidate the mechanisms involved in the primary anorexia and cachexia syndrome. Increasingly individualized treatments are expected with combination treatments that involve different

  18. ["Pro Ana": Psychodynamic References for Anorexia Nervosa].

    Science.gov (United States)

    Siefert, Linda

    2017-02-01

    "Pro Ana": Psychodynamic References for Anorexia Nervosa The internet-based phenomenon "Pro Ana" refers to the eating disorder anorexia nervosa in a positive way. To understand what the phenomenon "Pro Ana" represents, the websites are used as a starting point of the current analysis. Based on these results, similarities and differences between "Pro Ana" and the eating disorder anorexia nervosa are discussed. Furthermore psychodynamic references for anorexia nervosa are derived and finally their importance for treatment motivation will be considered.

  19. The incidence of anorexia nervosa on Curacao

    NARCIS (Netherlands)

    Hoek, HW; van Harten, PN; Hermans, KME; Katzman, MA; Matroos, GE; Susser, ES

    2005-01-01

    Objective: Although anorexia nervosa was once thought to occur only in affluent societies, cases have now been documented across the globe. To examine whether anorexia nervosa emerges in societies undergoing socioeconomic transition, the authors studied the incidence of anorexia nervosa on the Carib

  20. Comorbilidad entre bulimia nerviosa purgativa y trastornos de la personalidad según el Inventario Clínico Multiaxial de Millon (MCMI-II)

    OpenAIRE

    2002-01-01

    La comorbilidad entre trastornos de la personalidad y trastornos de la conducta alimentaria ha sido destacada en numerosas investigaciones, encontrándose frecuencias desde un 22% hasta un 95%, según los estudios. El objetivo de este trabajo ha sido analizar este tópico en la bulimia nerviosa. Un total de 33 mujeres que cumplían los criterios diagnósticos DSM-IV para la bulimia nerviosa subtipo purgativo cumplimentaron la versión española del MCMI-II. Los resultados mostraron al...

  1. Impacto de una solución para el estudio de vías de conducción nerviosa en Morfofisiología III

    OpenAIRE

    José Manuel Ruiz Medina; Alicia Ríos Carbonell; Gisela Trevín Fernández; Elnis Quiala Ballester; Vivian Santoya Varela

    2013-01-01

    Fundamento: las condiciones actuales en que se imparte la asignatura Morfofisiología III y el conocimiento de las dificultades históricas que existen para que los estudiantes logren la comprensión de las características morfofuncionales de las vías de conducción nerviosa hacen necesario buscar una solución. Objetivo: confeccionar un conjunto de medios que proporcione un recurso práctico para el estudio de las características morfofuncionales de las vías de conducción nerviosa y evaluar el imp...

  2. Taking control of anorexia together.

    Science.gov (United States)

    Cole, Elaine

    2015-02-27

    Many people with anorexia receive inadequate treatment for what is a debilitating, relentless and life-threatening illness. In Lincolnshire an innovative nurse-led day programme is helping people stay out of hospital and take back control from the illness. Peer support is crucial to the programme's success.

  3. [Caring for teenagers with anorexia].

    Science.gov (United States)

    Lapp, Aymeric

    2015-04-01

    Anorexia mainly affects young girls, although more and more boys and adults are also concerned. The consequences of eating disorders have a significant impact on young people's health. Nurses play a key role in the therapeutic contract set up during the hospital treatment.

  4. Medical Complications of Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Westmoreland, Patricia; Krantz, Mori J; Mehler, Philip S

    2016-01-01

    Anorexia nervosa and bulimia nervosa are serious psychiatric illnesses related to disordered eating and distorted body images. They both have significant medical complications associated with the weight loss and malnutrition of anorexia nervosa, as well as from the purging behaviors that characterize bulimia nervosa. No body system is spared from the adverse sequelae of these illnesses, especially as anorexia nervosa and bulimia nervosa become more severe and chronic. We review the medical complications that are associated with anorexia nervosa and bulimia nervosa, as well as the treatment for the complications. We also discuss the epidemiology and psychiatric comorbidities of these eating disorders.

  5. Bulimia nerviosa y trastornos de la personalidad. Una revisión teórica de la literatura

    Directory of Open Access Journals (Sweden)

    Maite Gargallo Masjuán

    2003-01-01

    Full Text Available En la bulimia nerviosa, como en el caso de otros trastornos mentales, suele describirse con frecuencia una alta comorbilidad con otras patologías y/o trastornos psiquiátricos, y especialmente con trastornos de la personalidad. A pesar de que numerosos estudios analizan la relación existente entre trastornos de personalidad y trastornos de la alimentación, la importancia de ésta será contemplada de forma diversa y contradictoria en la literatura, donde la co-ocurrencia entre bulimia nerviosa y trastornos de personalidad oscila entre el 27-84% de los casos, siendo los trastornos de personalidad del cluster B, y especialmente el límite, los más frecuentemente descritos. A grandes rasgos, cabe señalar que en la literatura sobre los trastornos de la alimentación, trastornos de la personalidad comórbidos han sido generalmente asociados a diversos factores, tales como diagnóstico, mayor impulsividad y auto-agresiones, mayor abuso de sustancias tóxicas, intentos de suicidio, mayor frecuencia de conductas de purga, trastornos afectivos, abuso sexual, mayor comorbilidad y severidad del trastorno. Asimismo, los trastornos de la personalidad han sido identificados como predictores de peor pronóstico y asociados a una mayor frecuencia de abandonos del tratamiento. En el presente estudio teórico, se analizan de forma crítica los estudios aparecidos en la literatura, durante las últimas dos décadas, sobre este tema.

  6. Concordancia endoscópico-histológica de la gastritis crónica en Cali

    OpenAIRE

    Gustavo Mariño; Eduardo Lima; Fernado Tuffi García; Carlos Cuello; Harold Cuello; Alberto Alzate

    2009-01-01

    Se realizó un estudio prospectivo con el fin de evaluar la concordancia entre signos endoscópicos y diagnóstico histológico en 216 pacientes con gastritis y metaplasia intestinal. Se estableció un registro codificado de los signos sugestivos de gastritis, que se correlacionaron con los diagnósticos histológicos de las biopsias gástricas. Se seleccionaron aquellas asociaciones que tuvieran una correlación mayor que la esperada por azar. Estas fueron: gastritis atrófica y aumento de visibilidad...

  7. Concordancia entre histología pre, intra y postoperatoria en cáncer de endometrio

    OpenAIRE

    Serman V.,Felipe; Sánchez A,María Elena; Barrientos F,Bárbara; Saldaña G,Bárbara; Trullen S,Javier; Burky A,Daniela; Calvo S,Paula; Matus I,Maritza; Walton L,Roderick

    2012-01-01

    Antecedentes: En pacientes con cáncer de endometrio se discute la concordancia entre biopsia pre e intraoperatoria versus la definitiva, en grado de diferenciación, tipo histológico y profundidad de mioinvasión. Método: Se determinó sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN) de: grado de diferenciación bien diferenciado y tipo histológico sólo endometrioide en biopsia preoperatoria; y grado de diferenciación bien diferenciado, tipo h...

  8. Action monitoring and perfectionism in anorexia nervosa

    NARCIS (Netherlands)

    Pieters, G.L.M.; Bruijn, E.R.A. de; Maas, Y.J.; Hulstijn, W.; Eycken, W. van der; Peuskens, J.; Sabbe, B.G.C.C.

    2006-01-01

    To study action monitoring in anorexia nervosa, behavioral and EEG measures were obtained in underweight anorexia nervosa patients (n = 17) and matched healthy controls (n = 19) while performing a speeded choice-reaction task. Our main measures of interest were questionnaire outcomes, reaction times

  9. Leptin treatment in activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; Koeners, Maarten P; de Rijke, Corine E; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    BACKGROUND: Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa (AN). In ABA, scheduled feeding together with voluntary access to a running wheel results in increased running wheel activity (RWA), hypophagia, and body weight loss. Previously it was shown that leptin treat

  10. Anorexia Nervosa/Bulimia: The Teenager's Dilemma.

    Science.gov (United States)

    Thompson, G. Sue

    Anorexia nervosa and bulimia are currently being studied with great intensity by the medical profession. Anorexia nervosa was first described in the medical literature in 1868, but was considered a rarity until the late 1930's. Bulimia was not identified in the medical literature until 1979. Recent studies suggest that approximately five percent…

  11. Anorexia Nervosa: Treatment in the Family Context.

    Science.gov (United States)

    Levitt, Dana Heller

    2001-01-01

    One form of treatment for anorexia nervosa that continues to be developed is family therapy. In the following article, anorexia nervosa and its prevalence are defined, theories of its development are discussed, and family therapy interventions that have been applied to the treatment of the disorder are outlined. (Contains 15 references.) (GCP)

  12. Action Monitoring and Perfectionism in Anorexia Nervosa

    Science.gov (United States)

    Pieters, Guido L. M.; de Bruijn, Ellen R. A.; Maas, Yvonne; Hulstijn, Wouter; Vandereycken, Walter; Peuskens, Joseph; Sabbe, Bernard G.

    2007-01-01

    To study action monitoring in anorexia nervosa, behavioral and EEG measures were obtained in underweight anorexia nervosa patients (n=17) and matched healthy controls (n=19) while performing a speeded choice-reaction task. Our main measures of interest were questionnaire outcomes, reaction times, error rates, and the error-related negativity ERP…

  13. Concordancia endoscópico-histológica de la gastritis crónica en Cali

    Directory of Open Access Journals (Sweden)

    Gustavo Mariño

    2009-10-01

    Full Text Available Se realizó un estudio prospectivo con el fin de evaluar la concordancia entre signos endoscópicos y diagnóstico histológico en 216 pacientes con gastritis y metaplasia intestinal. Se estableció un registro codificado de los signos sugestivos de gastritis, que se correlacionaron con los diagnósticos histológicos de las biopsias gástricas. Se seleccionaron aquellas asociaciones que tuvieran una correlación mayor que la esperada por azar. Estas fueron: gastritis atrófica y aumento de visibilidad de vasos en antro, Kappa 0.208 (0.041-0.376; gastritis atrófica y aumento de visibilidad de vasos en cuerpo gástrico, Kappa 0.195 (0.002-0.388; gastritis atrófica y superficie en empedrado en antro, Kappa 0.213 (0.044-0.381; inflamación aguda y pliegues engrosados en antro, Kappa 0.094 (0.018-0.16. Hubo una concordancia pobre entre la mayoría de los signos endoscópicos y los diagnósticos histológicos. El diagnóstico definitivo de la gastritis sólo se debe hacer con base en los estudios histológicos de las biopsias.

  14. Executive functions in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Ignacio Jauregui-Lobera

    2014-03-01

    Full Text Available Introduction: The pathophysiologic mechanisms that account for the development and persistence of anorexia nervosa (AN remain unclear. With respect to the neuropsychological functioning, the executive functions have been reported to be altered, especially cognitive flexibility and decision-making processes. Objectives: The aim of this study was to review the current state of the neuropsychological studies focused on anorexia nervosa, especially those highlighting the executive functions. Methods: This was done by means of a searching process covering three relevant electronic databases, as well as an additional search on references included in the analysed papers. Eventually we have to mention other published reviews and a hand-search. Results and discussion: Comparing AN patients and healthy controls the results remain controversial and so remains the comparison of different eating disorders with respect to the neuropsychological dysfunction. The role of variables such as depression, anxiety and obsessionality needs to be clarified. There seems to be some base to state that some commonalities exist in the so-called extreme weight conditions (anorexia, obesity. The link between neuropsychological dysfunction in AN and biomarkers remains unclear. The role of neuropsychological deficits in AN, as initial factors or simply as mere consequences, remains unclear too. The link between the body image disturbances and the neuropsychological dysfunction needs to be clarified. The similarities between the AN neuropsychological dysfunction and that found in other mental disorders may be considered up to date as a mere approach. The same applies to the relationship between the AN patients´ neuropsychological performance and personality or gender.

  15. ANOREXIA FOLLOWING TERMINATION OF PREGNANCY AND LAPROSCOPIC STERILIZATION

    OpenAIRE

    Velayudhan, Ajay; Raghu, T.M.; Sudarshan, B.; Chandra, Prabha S.

    2001-01-01

    Presentations of Anorexia Nervosa in India are usually atypical and anorexia is more commonly a symptom rather than a syndrome. This report highlights a case of anorexia following medical termination of pregnancy and laproscopic sterilisation, its association with conflicts regarding childbirth and motherhood in a 34 year old woman and the impact of anorexia on child rearing.

  16. Concordancia entre capacidad vital lenta y capacidad vital forzada en pacientes con enfermedad pulmonar obstructiva crónica o con sospecha de ella

    OpenAIRE

    Hidalgo Martínez, Patricia

    2010-01-01

    Objetivo. Determinar la concordancia en términos de consistencia entre la capacidad vital lenta y la capacidad vital forzada en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) o remitidos por sospecha de EPOC. Diseño. Estudio de concordancia en términos de consistencia entre la capacidad vital lenta (CVL) y la capacidad vital forzada (CVF) en pacientes con EPOC o remitidos por sospecha de EPOC. Lugar. Se llevó a cabo en el Laboratorio de Función Pulmonar del Hospital Universitari...

  17. Case report on anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Preeti Srinivasa

    2015-01-01

    Full Text Available Anorexia nervosa is an eating disorder characterized by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception. It is clinically diagnosed more frequently in females, with type and severity varying with each case. The current report is a case of a 25-year-old female, married for 5 years, educated up to 10 th standard, a homemaker, hailing from an upper social class Hindu (Marvadi family, living with husband′s family in Urban Bangalore; presented to our tertiary care centre with complaints of gradual loss of weight, recurrent episodes of vomiting, from a period of two years, menstrual irregularities from 1 year and amenorrhea since 6 months, with a probable precipitating factor being husband′s critical comment on her weight. Diagnosis of atypical anorexia nervosa was made, with the body mass index (BMI being 15.6. A multidisciplinary therapeutic approach was employed to facilitate remission. Through this case report the authors call for the attention of general practitioners and other medical practitioners to be aware of the symptomatology of eating disorders as most patients would overtly express somatic conditions similar to the reported case so as to facilitate early psychiatric intervention.

  18. Young Women With Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Elisabeth Dahlborg Lyckhage

    2015-03-01

    Full Text Available The aim of this study was to describe how young women living with self-identified anorexia narrate about their lives by blogging. Thirteen Swedish blogs were chosen and analyzed by means of qualitative content analysis. The results described falling ill, the illness itself, and the path to recovery. Low self-esteem, depressed state of mind, and self-destructive behavior were typical signs at the start of the illness. The women’s lives were characterized by a need for controlling their body by tormenting it and by the illness demanding all their concentration and energy. The women suffered from the feeling of being a disappointment to their family members. The illness was like an enemy that had to be defeated with the help of family members, health care professionals, and by means of therapy. A turning point occurred when the women felt at their worst or had tired of the illness and could concentrate on something other than their body and the eating disorder. Suffering from self-identified anorexia was described as experiencing low self-esteem. The illness took all of the women’s time and energy. For a turning point to be reached, the women needed support from family, friends, and health care professionals, including the use of distractions.

  19. Comorbilidad entre bulimia nerviosa purgativa y trastornos de la personalidad según el Inventario Clínico Multiaxial de Millon (MCMI-II

    Directory of Open Access Journals (Sweden)

    Carmen del Río Sánchez

    2002-01-01

    Full Text Available La comorbilidad entre trastornos de la personalidad y trastornos de la conducta alimentaria ha sido destacada en numerosas investigaciones, encontrándose frecuencias desde un 22% hasta un 95%, según los estudios. El objetivo de este trabajo ha sido analizar este tópico en la bulimia nerviosa. Un total de 33 mujeres que cumplían los criterios diagnósticos DSM-IV para la bulimia nerviosa subtipo purgativo cumplimentaron la versión española del MCMI-II. Los resultados mostraron altas puntuaciones en la escala Esquizoide (TB=76,97, seguida por la Autodestructiva (TB=68,64, Pasivo-Agresiva (TB=68,15 y Evitativa (TB=67,12. Un 81% de las pacientes presentaba niveles clínicamente significativos de comorbilidad en alguna de las escalas (TB>75: un 45% presentaba elevaciones en una, dos o tres escalas (15% respectivamente y el 36% restante, las presentaba en cuatro o más escalas. Nuestros resultados son relativamente consistentes con el único estudio que utiliza el MCMI-II con grupos diferenciados de trastornos de conductas alimentarias, entre ellos de bulimia nerviosa subtipo purgativo; no obstante, no es posible establecer un patrón típico de rasgos de personalidad para estas pacientes

  20. Intracranial germ cell tumor mimicking anorexia nervosa.

    Science.gov (United States)

    Andreu Martínez, F J; Martínez Mateu, J M

    2006-12-01

    We report on a case of a 23 year-old female diagnosed as having a germ-cell tumour located in the sellar region. The patient referred anorexia, psychic disorders, weight loss of 15 kilograms and secondary amenorrhea during the previous three years. This is the reason why the patient was diagnosed as having anorexia nervosa. Subsequently, the patient presented some endocrine dysfunction. MRI revealed the existence of a lesion located in suprasellar and hypothalamic regions. This case shows that the presence of intracranial tumours next to the hypothalamus must be borne in mind as a rare but real possibility in cases of anorexia nervosa, specially in those non-typical cases.

  1. Anorexia nervosa and family relationships: Perceived family functioning, coping strategies, beliefs, and attachment to parents and peers

    Directory of Open Access Journals (Sweden)

    Ana Isabel Cunha

    2009-01-01

    Full Text Available Este estudio ex post facto ha explorado las diferencias entre la percepción de características familiares de 34 mujeres jóvenes con anorexia nerviosa y 34 mujeres jóvenes sin patología alimentaria. Todas las participantes completaron los siguientes instrumentos de auto-respuesta: FACES II, F-COPES, IPPA y el Cuestionario de Creencias Familiares. Los resultados demostraron que, en comparación con el grupo de mujeres sin patología alimentaria, las pacientes consideran a sus familias menos unidas y menos capaces de redefinir de una forma más aceptable las experiencias y situaciones de estrés. Sin embargo, consideran a sus familias más capaces de buscar y aceptar ayuda, y presentan más creencias familiares relacionadas con la responsabilidad individual/ auto-censura. En comparación con el grupo sin patología alimentaria, las pacientes parecen confiar menos en sus madres y amigos, parecen comunicarse menos con los amigos, y tienden a demostrar una mayor alienación en relación a la madre, al padre y a los amigos. De todas las variables en estudio, la alienación en relación a los amigos y a la madre, así como la mayor capacidad para buscar y aceptar ayuda fueron las variables más importantes para discriminar los grupos.

  2. Anorexia Nervosa and Bulimia: A Research Review.

    Science.gov (United States)

    Sweeten, Mary K.

    1985-01-01

    The eating disorders called anorexia nervosa and bulimia are examined in terms of their symptomatology, etiology, and treatment, and in terms of how the extension home economist or teacher can help. Resources for additional information or help are listed. (CT)

  3. Anorexia Nervosa: Adolescent Starvation by Choice.

    Science.gov (United States)

    Gilbert, Evelyn H.; DeBlassie, Richard R.

    1984-01-01

    Discusses anorexia nervosa in terms of symptoms, characteristics of patients, family relationship, and modes of treatment. Suggests that a combination of psychological and medical treatment is more effective than behavior modification. (JAC)

  4. Jane: A Case Study in Anorexia Nervosa.

    Science.gov (United States)

    Willingham, Barbara

    1988-01-01

    The article reports the case history of a 15-year-old Australian girl with anorexia nervosa. Information is also given on prevalence, causes, definitions, and treatments including hospitalization, co-therapy, psychotherapy, behavior modification, family therapy, and counseling. (DB)

  5. Treatment of Adolescents with Anorexia Nervosa.

    Science.gov (United States)

    Patel, Dilip R.; Pratt, Helen D.; Greydanus, Donald E.

    2003-01-01

    Reviews research on the treatment of adolescents with anorexia nervosa, including the general approach, treatment setting, treatment of medical complications, nutritional management, psychopharmacotherapy, psychotherapy, treatment efficacy and outcome studies, comparison studies, and prevention programs. (EV)

  6. Anorexia: a taste of things to come?

    Science.gov (United States)

    Wilcock, Andrew

    2006-01-01

    Anorexia, the loss of the desire to eat, is common in patients with cancer. Studies report a prevalence of up to 66% and clinical practice suggests that it is an almost universal experience as the cancer progresses. It generally leads to a reduction in food intake that contributes to the development of malnutrition and cachexia, impairing quality of life and increasing morbidity and mortality. Successful curative or palliative treatment of the underlying cancer is an effective approach. When this is not possible, there are limited treatment options, which generally have not been shown to be practicable, tolerable, effective or safe in the long-term management of the cachexia-anorexia syndrome. Recent increases in the understanding of the physiology of energy intake and of the pathophysiology of anorexia are helping to guide the development of rational approaches. This journal club provides an outline of the pathophysiology of anorexia and highlights a paper that may provide an exciting glimpse of the future.

  7. New Insights in Anorexia Nervosa

    Science.gov (United States)

    Gorwood, Philip; Blanchet-Collet, Corinne; Chartrel, Nicolas; Duclos, Jeanne; Dechelotte, Pierre; Hanachi, Mouna; Fetissov, Serguei; Godart, Nathalie; Melchior, Jean-Claude; Ramoz, Nicolas; Rovere-Jovene, Carole; Tolle, Virginie; Viltart, Odile; Epelbaum, Jacques

    2016-01-01

    Anorexia nervosa (AN) is classically defined as a condition in which an abnormally low body weight is associated with an intense fear of gaining weight and distorted cognitions regarding weight, shape, and drive for thinness. This article reviews recent evidences from physiology, genetics, epigenetics, and brain imaging which allow to consider AN as an abnormality of reward pathways or an attempt to preserve mental homeostasis. Special emphasis is put on ghrelino-resistance and the importance of orexigenic peptides of the lateral hypothalamus, the gut microbiota and a dysimmune disorder of neuropeptide signaling. Physiological processes, secondary to underlying, and premorbid vulnerability factors—the “pondero-nutritional-feeding basements”- are also discussed. PMID:27445651

  8. Update on endocrine disturbances in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Hangaard, J; Hagen, C

    2001-01-01

    The marked endocrine changes that occur in anorexia nervosa have aroused a great deal of interest, and over the last decade much research has been conducted in this field. The endocrine disturbances are not specific to this disorder, as they also occur in starvation states secondary to other causes...... of the large body of literature concerning endocrine aspects of anorexia nervosa with the main focus on the latest results, which provide leads for potential etiological theories....

  9. Concordancia en el diagnóstico entre pediatría y salud mental Diagnostic concordance between paediatric and mental health

    Directory of Open Access Journals (Sweden)

    N. Landa

    2009-08-01

    Full Text Available Objetivo. Analizar el grado de concordancia en el diagnóstico entre los profesionales de los servicios de pediatría y de salud mental. Pacientes y métodos. El trabajo se ha realizado con 207 pacientes de 0 a 16 años, derivados desde pediatría al centro de Salud Mental (CSM de Estella durante los años 2006 y 2007. Se calcula el índice de concordancia Kappa global y específico para los diferentes diagnósticos mediante Epidat 3.1. Resultados. El índice Kappa global de concordancia en el diagnóstico entre ambos niveles asistenciales es de 0,58. Existe una importante variabilidad en la concordancia obtenida para los diferentes diagnósticos. La concordancia es débil (0,2-0,4 para el trastorno específico del desarrollo, los trastornos depresivos y los adaptativos. Se obtiene una concordancia moderada (0,41-0,6 para el retraso mental, el trastorno generalizado del desarrollo, los códigos Z y el trastorno de rivalidad entre hermanos (celos. La concordancia es buena (0,61-0,8 para el trastorno por déficit de atención e hiperactividad, el trastorno de ansiedad y el trastorno disocial. Por último, la concordancia diagnóstica es muy buena (> 0,8 para el trastorno del control de esfínteres y para el trastorno de la conducta alimentaria. Conclusiones. La concordancia en el diagnóstico alcanzado entre los servicios de pediatría y el centro de salud mental es moderada. Existe una importante variabilidad en la concordancia obtenida para los diferentes diagnósticos.Background. To analyse the diagnostic concordance between the paediatric and mental health (MH services. Materials and methods. Two hundred and seven patients from 0 to 16 years referred from paediatrics to the Estella Mental Health Centre during 2006 and 2007. Concordance between global Kappa Index and specific diagnosis was calculated with Epidat 3.1. An analysis was made for each diagnostic category of the percentage of cases where the diagnosis made in paediatrics was

  10. Understanding the 'Anorexic Voice' in Anorexia Nervosa.

    Science.gov (United States)

    Pugh, Matthew; Waller, Glenn

    2016-07-20

    In common with individuals experiencing a number of disorders, people with anorexia nervosa report experiencing an internal 'voice'. The anorexic voice comments on the individual's eating, weight and shape and instructs the individual to restrict or compensate. However, the core characteristics of the anorexic voice are not known. This study aimed to develop a parsimonious model of the voice characteristics that are related to key features of eating disorder pathology and to determine whether patients with anorexia nervosa fall into groups with different voice experiences. The participants were 49 women with full diagnoses of anorexia nervosa. Each completed validated measures of the power and nature of their voice experience and of their responses to the voice. Different voice characteristics were associated with current body mass index, duration of disorder and eating cognitions. Two subgroups emerged, with 'weaker' and 'stronger' voice experiences. Those with stronger voices were characterized by having more negative eating attitudes, more severe compensatory behaviours, a longer duration of illness and a greater likelihood of having the binge-purge subtype of anorexia nervosa. The findings indicate that the anorexic voice is an important element of the psychopathology of anorexia nervosa. Addressing the anorexic voice might be helpful in enhancing outcomes of treatments for anorexia nervosa, but that conclusion might apply only to patients with more severe eating psychopathology. Copyright © 2016 John Wiley & Sons, Ltd.

  11. [Infantile anorexia: from birth to childhood].

    Science.gov (United States)

    Poinso, F; Viellard, M; Dafonseca, D; Sarles, J

    2006-05-01

    Young child's anorexia (0-4 years) may have organic or psychological origin, when parents-child relationships are concerned. The most complex and earliest forms often have unspecified aetiology. Psychopathological classifications, which emphasize the mother-child relationships, are essential reference marks. But there is now a consensus in the definitions: the diagnosis of infantile anorexia requires criteria of acute or chronic malnutrition. We mainly distinguish anorexia by early disorder of homeostasis, anorexia resulting from serious disorder of attachment, anorexia by disorder of mother-child interactions, and finally early and complex anorexia, mixing an organic vulnerability and a bonding trouble, which can be secondary. Treatments differ according to the selected aetiology. Even if the origin is not mainly the fact of a relational mother-child dysfunction, parents-child's relations require a support to avoid aggravation by interactive vicious circles (force feeding). More than other diseases of early childhood, feeding disorders require a good knowledge of the working hypotheses both in the field of the paediatrics and the child psychiatry.

  12. [Masculine anorexia nervosa: realities and perspectives].

    Science.gov (United States)

    Chambry, Jean; Corcos, Maurice; Guilbaud, Olivier; Jeammet, Phillipe

    2002-05-01

    Since its description by Morton in 1694, masculine anorexia nervosa has been the subject of much debate. For many, two questions remain unanswered: does anorexia nervosa, as described in girls, exist in boys? - if so, is it the same disease? We analyzed the data in the literature which demonstrate a lower incidence than in the female population, although estimates are probable low due to underdiagnosis. The behavioral aspects suggest a similarity between masculine and feminine anorexia nervosa although the pure restrictive forms of anorexia are more rare in boys. There are however a few differences. Affected boys, according to Crips and Burns (1990), are heavier than girls at onset of the disorder but present a lower body weight during certain periods of the disease. Excessive physical activity is more frequent as is excessive intellectual involvement (Margo, 1987). The problem of amenorrhea, on/off periods, is not present in the male form. Testosterone and sexual function decline gradually, in parallel with the state of malnutrition (Anersen, 1990). The patient does not have particular difficulty discussing sexual relations but does exhibit a poor level of experience and mental representations. Contact with the opposite sex is rare and the fantastic life is generally very limited. The frequency of homosexual behavior would lie between 25% (Herzog, 1984) and 58% (Schneider and Agras, 1987), which is higher than in the female anorexia population (Herzog, 1984). This observation raises the question concerning the relationship between masculine mental anorexia nervosa and fragile sexual identity.

  13. Understanding anorexia: an hermeneutic approach as a methodological alternative for the field of contemporary anorexia research

    Directory of Open Access Journals (Sweden)

    Anne Puuronen

    1999-01-01

    Full Text Available Theories of anorexia nervosa have mainly been dominated by psychiatry and concentrate upon its physiological aspects, both in diagnosis and treatment. This has led to a search for organic causes behind anorectic conditions, instead of seeing it as molded and shaped both by the individual and the socio-cultural context. This "medicalisation" has been an impediment to a more complete conceptualisation of the experience of discipline and of the ascetic modes of action in anorexia. The intension is to approach anorexia as lived process. The focus is not in explaining what cause anorexia, but is centered on the contents of living experience as such. Thus, the author proposes a phenomenological approach to anorexia as a methodological alternative compared to the dominant medico-psychological approaches to anorexia of today. If we consider the body of an anorectic person as an intersection in which the subject's relationship to social reality will be materialized and verified, we are able to see first how accurate a picture of the dual meanings, double bindings and paradoxical commitments of our present culture and its relation to a woman's body anorexia will draw up. Also, because the fact is that anorexia is a predominantly "women's" illness we have to take in account that the construction of subjectivity and in this context the construction of a lived anorectic experience of discipline, is not a gender-neutral process.

  14. Krank durch Sport: Anorexia athletica

    Directory of Open Access Journals (Sweden)

    Friedmann-Bette B

    2012-01-01

    Full Text Available Sportler aus Sportarten, in denen ein geringes Körpergewicht vorteilhaft für die Leistungsfähigkeit ist, gehen oft durch Reduktion der Kalorienzufuhr bei gleichzeitig hohem Energieverbrauch ein erhebliches Energiedefizit ein. Dabei kommt es häufig zu Essstörungen, für die in besonders gefährdeten Sportarten eine Prävalenz von bis zu 80 % berichtet wird und die sich zur Anorexia nervosa oder Bulimia nervosa entwickeln können. Als Folge des Energiedefizits können Konzentrationsänderungen von Stoffwechselhormonen, Störungen der Hypothalamus- Hypophysen-Gonaden-Achse und des Knochenstoffwechsels mit Abnahme der Knochendichte bis hin zur Osteoporose und einem erhöhten Risiko für Stressfrakturen beobachtet werden. Der Symptomkomplex aus Essstörung, sekundärer Amenorrhö und verminderter Knochendichte wird auch als „Female Athlete Triad“ bezeichnet, wobei in den vergangenen Jahren als viertes Symptom eine endotheliale Dysfunktion beschrieben wurde. Die effektivste Therapie ist das Herstellen eines dauerhaften Energiegleichgewichts, wofür eine tägliche Energieverfügbarkeit von mindestens 30 kcal/kg Magergewicht erforderlich ist. Eine hierdurch bedingte Gewichtszunahme kann den Sportlern nicht immer vermittelt werden, weshalb durch eine sorgfältig zusammengestellte Ernährung zumindest auf eine ausreichende Zufuhr von Kalzium, Vitamin D und Eiweiß geachtet werden muss. Oftmals ist die zusätzliche Verabreichung von Kalzium- und Vitamin-D-Präparaten angezeigt sowie eine Östrogensubstitution. Allerdings ist ein orales Kontrazeptivum als einzige Therapie – anders als früher angenommen – nicht ausreichend zur Behandlung oder Vermeidung einer Knochendichteminderung. Zur Prävention der Anorexia athletica sind die Aufklärung der Sportler, Trainer und Betreuer und ein Screening im Rahmen von Sporttauglichkeitsuntersuchungen, vor allem aber auch strukturelle Maßnahmen durch die Sportfachverbände erforderlich (wie zum Beispiel im

  15. Understanding Eating Disorders, Anorexia, Bulimia, and Binge-Eating

    Science.gov (United States)

    ... Javascript on. Photo: iStock Eating disorders, such as anorexia nervosa, bulimia nervosa, and binge eating , are among ... There are three main types of eating disorders: anorexia nervosa, bulimia nervosa, and binge-eating disorder. People ...

  16. Impacto de una solución para el estudio de vías de conducción nerviosa en Morfofisiología III

    Directory of Open Access Journals (Sweden)

    José Manuel Ruiz Medina

    2013-07-01

    Full Text Available Fundamento: las condiciones actuales en que se imparte la asignatura Morfofisiología III y el conocimiento de las dificultades históricas que existen para que los estudiantes logren la comprensión de las características morfofuncionales de las vías de conducción nerviosa hacen necesario buscar una solución. Objetivo: confeccionar un conjunto de medios que proporcione un recurso práctico para el estudio de las características morfofuncionales de las vías de conducción nerviosa y evaluar el impacto de su aplicación al impartir la Morfofisiología III. Métodos: se utilizaron los modelos prácticos creados en una primera etapa de la investigación y que se encuentran en generalización. Se utilizó un conjunto de modelos tridimensionales que simulan estructuras del sistema nervioso central a gran escala con la mayor cantidad de detalles anatómicos que pudieron representarse. En cada modelo se representan las vías de conducción nerviosa siguientes: térmico-dolorosa, propioceptiva consciente, táctil discriminativa, tactil no discriminativa y piramidal. Se evaluó la adquisición de conocimientos en las diferentes formas organizativas de la docencia, en los grupos de estudiantes seleccionados: el grupo control y el experimental. Resultados: en los grupos experimentales se obtuvo una promoción de 81 % y una calidad de 85,7 % en comparación con los grupos control donde la promoción fue de 29 % y la calidad de 45 %. Conclusiones: se demostró que el modelo práctico presentado como solución al estudio de las vías de conducción nerviosa es eficaz, pues tras su aplicación se obtiene un mayor grado de comprensión del contenido por parte de los alumnos.

  17. The role of socialization in male anorexia nervosa: two cases.

    Science.gov (United States)

    Halperin, E N

    1996-01-01

    Social isolation, competitiveness and self-defeating masochism are the major themes in male and female Anorexia Nervosa. A relationship is seen between Anorexia Nervosa and Perversions, where there is a preconscious reenactment of traumatic situations. This dynamic of competition and masochism is described in two cases of male anorexia and seen as part of many other cases.

  18. Anorexia Nervosa in Chinese Adolescents: Does Culture Make a Difference?

    Science.gov (United States)

    Lai, Kelly Y. C.

    2000-01-01

    Reports on clinical and psychosocial characteristics of 16 Chinese adolescents from Hong Kong with anorexia nervosa. Over 80% of these patients expressed a fear of fatness. Against the background of increasing Westernization of Hong Kong society, anorexia is taking on a Western pattern, in congruence with the notion that anorexia nervosa is a…

  19. Anorexia nervosa--diagnosis, aetiology, and treatment.

    Science.gov (United States)

    Hartman, D

    1995-12-01

    The aetiology, assessment and treatment of anorexia nervosa are reviewed in the light of the classical accounts of Morton, Lasègue and Gull. The core symptoms are deliberate weight loss, disturbed body image and amenorrhoea, and complications may include cardiac failure, electrolyte disturbances, hypothermia and osteoporosis. Common clinical findings are described. Disturbed brain serotonin activity is implicated in the aetiology of anorexia nervosa, but there is little support for the use of pharmacological treatments. Psychological theories of aetiology are discussed with reference to Bruch, Crisp, Palazzoli and Minuchin: the common theme is the reaction of the patient and her family to the physical and social changes of puberty. Individual and/or family psychotherapy is seen as central to the treatment of anorexia nervosa, and the relevant clinical research is reviewed. The roles of general practitioners, general psychiatrists and eating disorder specialists are discussed in the light of recent consensus treatment guidelines.

  20. [Pharmacotherapy for anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Greetfeld, M; Cuntz, U; Voderholzer, U

    2012-01-01

    Psychotherapy is the treatment of choice for both anorexia nervosa and for bulimia nervosa. However, many patients are also treated by pharmaceutical drugs. For the clinician it is difficult to choose pharmacotherapy, because the drugs may not be licensed, because of pharmacodynamic problems due to underweight or purging behaviour, or because of comorbidity. The present review summarises the current knowledge on pharmacotherapy for anorexia nervosa and bulimia nervosa considering the available guidelines. In general, the knowledge based on studies is insufficient for anorexia nervosa. Up to now, there is no proof of efficacy for any antidepressant or atypical antipsychotic with respect to weight gain; atypical antipsychotics may be helpful for ruminating or excessive motor hyperactivity. For bulimia nervosa antidepressants are the pharmacotherapy of first choice. Long-term effects, however, are still unknown.

  1. Rodent model of activity-based anorexia.

    Science.gov (United States)

    Carrera, Olaia; Fraga, Ángela; Pellón, Ricardo; Gutiérrez, Emilio

    2014-04-10

    Activity-based anorexia (ABA) consists of a procedure that involves the simultaneous exposure of animals to a restricted feeding schedule, while free access is allowed to an activity wheel. Under these conditions, animals show a progressive increase in wheel running, a reduced efficiency in food intake to compensate for their increased activity, and a severe progression of weight loss. Due to the parallelism with the clinical manifestations of anorexia nervosa including increased activity, reduced food intake and severe weight loss, the ABA procedure has been proposed as the best analog of human anorexia nervosa (AN). Thus, ABA research could both allow a better understanding of the mechanisms underlying AN and generate useful leads for treatment development in AN.

  2. Satiety and the anorexia of ageing.

    Science.gov (United States)

    Benelam, Bridget

    2009-08-01

    The 'anorexia of aging' refers to reduced appetite and energy intakes observed in some older adults. Satiation (the process that leads to the termination of eating, which may be accompanied by a feeling of satisfaction) and satiety (the feeling of fullness that persists after eating, potentially suppressing further energy intake until hunger returns) are important factors in the control of appetite and energy intake, and there is evidence that some aspects of satiation and satiety are altered in older adults. Factors affected include gastric emptying, which could affect satiation, and levels of gut hormones which could affect satiety. Sensory specific satiety also appears to be reduced in older subjects. This might be important in the anorexia of aging and dietary strategies could be used to reduce satiety and encourage an increased energy intake. However, many other factors may affect the anorexia of aging and it is important to understand these in order to help those at risk of malnutrition.

  3. Neurobiology of inflammation-associated anorexia

    Directory of Open Access Journals (Sweden)

    Laurent Gautron

    2010-01-01

    Full Text Available Compelling data demonstrate that inflammation-associated anorexia directly results from the action of pro-inflammatory factors, primarily cytokines and prostaglandins E2, on the nervous system. For instance, the aforementioned pro-inflammatory factors can stimulate the activity of peripheral sensory neurons, and induce their own de novo synthesis and release into the brain parenchyma and cerebrospinal fluid. Ultimately, it results in the mobilization of a specific neural circuit that shuts down appetite. The present article describes the different cell groups and neurotransmitters involved in inflammation-associated anorexia and examines how they interact with neural systems regulating feeding such as the melanocortin system. A better understanding of the neurobiological mechanisms underlying inflammation-associated anorexia will help to develop appetite stimulants for cancer and AIDS patients.

  4. [Impaired theory of mind in anorexia nervosa].

    Science.gov (United States)

    Gál, Zita; Egyed, Katalin; Pászthy, Bea; Németh, Dezsö

    2011-01-01

    Anorexia nervosa (AN) is a severe mental illness, which is characterized by a continuously growing occurrence in the population and by the shift of the onset for earlier ages. The understanding of factors playing role in AN and the importance of effective prevention is an essential issue in science as well as in the society. AN also affects the social domain of life, patients with AN may exhibit impaired social interaction, social isolation, difficulties in emotion recognition and egocentric thinking in cognitive processing. Therefore, the aim of present study was to investigate the theory of mind (ToM) deficits is anorexia nervosa. Although previous studies have reported ToM deficits in autism and in schizophrenia, the number of studies investigating ToM functioning in eating disorders are particularly low. Even though ToM difficulties, such as the affective ToM impairments were found in AN, however, the evidence of cognitive ToM deficits in anorexia patients is still lacking. Twenty anorexia nervosa patients and 20 healthy control adolescent girls participated in the experiment. EDI, BAT, Fallon-Rozin Test and Anamoprhic Micro Body Image Assesment Programme questionnaires and body-image tests were applied to discriminate anorexia nervosa group from healthy control group. The Hungarian version of Faux Pas Recognition Test was applied to evaluate ToM functioning. Compared to healthy control group, impairment in ToM functioning was found in AN group, especially in affective mental state attribution. Our results can raise new aspects for research, therapy and prevention of anorexia nervosa.

  5. Psychosomatic syndromes and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Abbate-Daga Giovanni

    2013-01-01

    Full Text Available Abstract Background In spite of the role of some psychosomatic factors as alexithymia, mood intolerance, and somatization in both pathogenesis and maintenance of anorexia nervosa (AN, few studies have investigated the prevalence of psychosomatic syndromes in AN. The aim of this study was to use the Diagnostic Criteria for Psychosomatic Research (DCPR to assess psychosomatic syndromes in AN and to evaluate if psychosomatic syndromes could identify subgroups of AN patients. Methods 108 AN inpatients (76 AN restricting subtype, AN-R, and 32 AN binge-purging subtype, AN-BP were consecutively recruited and psychosomatic syndromes were diagnosed with the Structured Interview for DCPR. Participants were asked to complete psychometric tests: Body Shape Questionnaire, Beck Depression Inventory, Eating Disorder Inventory–2, and Temperament and Character Inventory. Data were submitted to cluster analysis. Results Illness denial (63% and alexithymia (54.6% resulted to be the most common syndromes in our sample. Cluster analysis identified three groups: moderate psychosomatic group (49%, somatization group (26%, and severe psychosomatic group (25%. The first group was mainly represented by AN-R patients reporting often only illness denial and alexithymia as DCPR syndromes. The second group showed more severe eating and depressive symptomatology and frequently DCPR syndromes of the somatization cluster. Thanatophobia DCPR syndrome was also represented in this group. The third group reported longer duration of illness and DCPR syndromes were highly represented; in particular, all patients were found to show the alexithymia DCPR syndrome. Conclusions These results highlight the need of a deep assessment of psychosomatic syndromes in AN. Psychosomatic syndromes correlated differently with both severity of eating symptomatology and duration of illness: therefore, DCPR could be effective to achieve tailored treatments.

  6. Concordancia entre las escalas de riesgo cardiovascular Procam y Framingham en varones que reciben tratamiento antirretroviral en un Hospital Nacional de Lima, Perú 2013

    Directory of Open Access Journals (Sweden)

    Patricia Lister-Del Pino

    Full Text Available Objetivos. Determinar la concordancia entre las escalas PROCAM (Prospective Cardiovascular Münster y Framingham en pacientes receptores de tratamiento antirretroviral. Materiales y métodos. Estudio transversal analítico en población masculina VIH positiva que recibe tratamiento antirretroviral en un hospital de referencia nacional en Lima, Perú. Para evaluar la concordancia entre ambas escalas se empleó el método gráfico de Bland y Altman, correlación con el coeficiente de Pearson y acuerdo entre pruebas mediante el coeficiente de Kappa. Resultados. Enrolamos 111 personas, con edad promedio de 47,0 años. La distribución de pacientes en riesgo cardiovascular bajo, moderado y alto fue de 81,2%, 13,6% y 5,4%, según PROCAM y de 71,2%, 25,2% y 3,6% según Framingham, respectivamente. Según el método de Bland y Altman, la concordancia fue adecuada en valores bajos y se fue perdiendo en riesgos altos. El coeficiente de Pearson mostró fuerte correlación (r=0,87 y p<0,05 y el coeficiente de Kappa fue de 0,56 (p<0,001. Conclusiones. La concordancia existente a riesgos bajos se va perdiendo a medida que el riesgo se va incrementando. Existe fuerte correlación entre ambas escalas. Se recomienda realizar más estudios que permitan conocer qué escala es la más óptima para ser utilizada en población adulta VIH positiva que recibe tratamiento antirretroviral

  7. Anorexia nervosa: Divergent validity of a prototype narrative among anorexia relatives

    OpenAIRE

    Bárbara C. Machado; Gonçalves, Óscar F.; Machado, Paulo P. P.; Margarida R. Henriques; António Roma-Torres; Isabel Brandão

    2006-01-01

    The objective of this ex post facto study was to test the divergent validity (degree of discrimination) of anorexia prototype narrative according to anorectic close confidents (relatives), as well as explore different characteristics of the participants which may be associated with the degree of prototype discrimination. Sixty-four relatives of individuals with anorexia nervosa participated in the study and were asked to indicate their degree of identification, according to their rel...

  8. Osteoporosis in women with anorexia nervosa.

    Science.gov (United States)

    Rigotti, N A; Nussbaum, S R; Herzog, D B; Neer, R M

    1984-12-20

    Because estrogen deficiency predisposes to osteoporosis, we assessed the skeletal mass of women with anorexia nervosa, using direct photon absorptiometry to measure radial bone density in 18 anorectic women and 28 normal controls. The patients with anorexia had significantly reduced mean bone density as compared with the controls (0.64 +/- 0.06 vs. 0.72 +/- 0.04 g per square centimeter, P less than 0.001). Vertebral compression fractures developed in two patients, and bone biopsy in one of them demonstrated osteoporosis. Bone density in the patients was not related to the estradiol level (r = 0.02). Levels of parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal despite low calcium intakes. The patients with anorexia who reported a high physical activity level had a greater bone density than the patients who were less active (P less than 0.001); this difference could not be accounted for by differences in age, relative weight, duration of illness, or serum estradiol levels. The bone density of physically active patients did not differ from that of active or sedentary controls. We conclude that women with anorexia nervosa have a reduced bone mass due to osteoporosis, but that a high level of physical activity may protect their skeletons.

  9. Anorexia Nervosa: Its Symptoms and Possible Cures.

    Science.gov (United States)

    Bingaman, David E.

    This document presents a definition and description of anorexia nervosa as a disorder that occurs predominantly in girls and that can affect 1 out of every 250 girls between the ages of 12 and 18 years. The existence of a distorted mental body image among anorexics is discussed and symptoms of the disorder are described, including amenorrhea…

  10. Cisplatin-induced anorexia and ghrelin.

    Science.gov (United States)

    Hattori, Tomohisa; Yakabi, Koji; Takeda, Hiroshi

    2013-01-01

    Cisplatin, a formidable anticancer treatment, is used for several varieties of cancer. There are, however, many cases in which treatment must be abandoned due to a decrease in the patient's quality of life from loss of appetite associated with vomiting and nausea. There is a moderate degree of improvement in prevention of cisplatin-induced nausea and vomiting when serotonin (5-HT) 3 receptor antagonists, neurokinin 1 receptor antagonists, and steroids-either alone or in combination-are administered. The mechanism of action for anorexia, which continues during or after treatment, is, however, still unclear. This anorexia is, similar to the onset of vomiting and nausea, caused by the action of large amounts of 5-HT released as a result of cisplatin administration on tissue 5-HT receptors. Among the 5-HT receptors, the activation of 5-HT2b and 5-HT2c receptors, in particular, seems to play a major role in cisplatin-induced anorexia. Following activation of these two receptors, there is reduced gastric and hypothalamic secretion of the appetite-stimulating hormone ghrelin. There is ample evidence of the usefulness of exogenous ghrelin, synthetic ghrelin agonists, and the endogenous ghrelin signal-enhancer rikkunshito, which are expected to play significant roles in the clinical treatment and prevention of anorexia in future.

  11. Body representation disturbances in anorexia nervosa

    NARCIS (Netherlands)

    Keizer, A.

    2014-01-01

    One of the main symptoms of anorexia nervosa (AN) is a disturbed experience of body size and shape. Although patients are underweight, they experience their body as bigger than it in reality is. Previous studies were mainly conducted by (clinical) psychologists and psychiatrists, and almost exclusiv

  12. Compulsory Treatment in Anorexia Nervosa : A Review

    NARCIS (Netherlands)

    Elzakkers, Isis F. F. M.; Danner, Unna N.; Hoek, Hans W.; Schmidt, Ulrike; van Elburg, Annemarie A.

    2014-01-01

    ObjectiveCompulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN.

  13. Male Anorexia Nervosa: A New Focus.

    Science.gov (United States)

    Crosscope-Happel, Cindy; Hutchins, David E.; Getz, Hildy G.; Hayes, Gerald L.

    2000-01-01

    Although anorexia nervosa affects over one million males yearly, it is often misdiagnosed or overlooked by mental health and medical practitioners. This article brings the problem to the forefront and outlines features that are unique to these males. Greater recognition of the disorder can lead to more accurate diagnoses and, subsequently, better…

  14. Anorexia in hemodialysis patients: an update.

    Science.gov (United States)

    Bossola, M; Tazza, L; Giungi, S; Luciani, G

    2006-08-01

    Anorexia, defined as the loss of the desire to eat, is relatively common in hemodialysis (HD) patients, occurring in one-third of cases. The pathogenesis is essentially unknown. It has been proposed that uremic toxins as middle molecules, inflammation, altered amino-acid pattern, leptin, ghrelin, and neuropeptide Y are involved. Anorexia reduces oral energy and protein intakes, thus contributing to the development of malnutrition and cachexia. Unquestionably, it contributes to poor quality of life. The clinical relevance of anorexia as an independent prognostic factor in HD patients is a matter of debated issue. The treatment of this debilitating condition is based on a therapeutic strategy which may include daily dialysis sessions and nutritional counseling. Normalization of plasma branched-chain amino acids through branched-chain amino acids supplementation may decrease anorexia and improve energy and protein intake. The role of megestrol acetate as appetite stimulant needs to be validated through adequate randomized trials. Subcutaneous ghrelin administration and melanocortin-receptor antagonists appear promising therapeutic interventions.

  15. Juvenile Anorexia Nervosa: Family Therapy's Natural Niche

    Science.gov (United States)

    Fishman, H. Charles

    2006-01-01

    Juvenile Anorexia Nervosa (AN) is a severe problem both in terms of presenting symptomatology and its tendency toward chronicity. Researchers have consistently shown that family-based approaches are superior to individual approaches for the treatment of juvenile AN. This article addresses the capacity deficit of trained family therapists to treat…

  16. [Pharmacological therapy of cancer anorexia-cachexia].

    Science.gov (United States)

    Cardona, D

    2006-05-01

    Anorexia is one of the most common symptoms of patients with advanced cancer and it presents as loss of appetite due to satiety. On the other hand, cachexia is described in those patients with unwanted weight loss. Cancerous processes produce an energy unbalance by decreased food intake and increased catabolism, resulting in a clearly negative balance. Several factors determining cachexia are observed, from metabolic unbalances produced by tumoral products and endocrine impairments or the inflammatory response produced by cytokines, all of them leading to higher lipolysis, loss of muscle protein, and anorexia. Besides, causes of anorexia are multiple, from chemotherapy agents, radiotherapy, or immunotherapy, which may produce different degrees of nausea, vomiting, diarrhea, and also leading to impairments of taste and smell, to obstruction of the digestive tract, pain, depression, constipation, etc. From the knowledge of the different mechanisms producing the anorexia-cachexia syndrome, hypercaloric diets for artificial nutrition have been studied with varying success, and different drugs with a positive effect on appetite gain such as progestogens, steroids, and with lesser clinical evidence cannabinoids, cyproheptadine, mirtazapine (antidepressant), and olanzapine (antipsychotic). Other drugs have been studied because of their anti-inflammatory properties, anti-cytokine, such as melatonin, polyunsaturated omega-3 fatty acids, pentoxifylline, and thalidomide; with the exception of the latter, clinical data are still scant for daily usage. Similarly happens with testosterone-derived anabolic drugs or with metabolism inhibitors such as hydrazine sulfate. With no doubt, progestogens, especially megestrol, and corticosteroids will be first-line therapies for anorexia-cachexia syndrome to stimulate the appetite and increase weight (megestrol), and have an effect on quality of life improvement and comfort in patients with advanced cancer.

  17. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  18. [Change of peripheral blood appetite regulation factor of anorexia children and infect of child anorexia granule].

    Science.gov (United States)

    Hu, Ai-Hua; Xu, Hui-Min; Hu, Guo-Hua; Jin, Fang; Li, Zhong; Fang, Guo-Xing

    2014-12-01

    Study the infect of child anorexia granule on serum ghrelin and leptin of anorexia children and its clinical efficacy. Selected 81 cases of anorexia children aged 1-6 years old into treatment group (42 cases) and control group (39 cases), in addition, 30 case healthy children as healthy control group. The control group children were treated with domperidone suspension 0.3 mg x kg(-1) x d(-1), tid, orally 30 minutes before meals. Treatment group were treated with child anorexia granule, 1-3 years 1 package, bid; 4-6 years 1 package, tid; po, 4 weeks as a course of treatment. Study the change of serum ghrelin and leptin before and after therapy. The study demonstrates that before treatment, the serum ghrelin level of disease group was lower than healthy group (P anorexia granule can facilitate secretion of ghrelin, and inhibit secretion of leptin, so as to work up an appetite. And the molecular mechanism is its infect on serum ghrelin, leptin.

  19. [Anorexia nervosa as differential diagnosis in underweight patients].

    Science.gov (United States)

    Rapps, Nora; Skoda, Eva; Zipfel, Stephan

    2016-02-01

    Anorexia nervosa is a differential diagnosis in underweight patients, especially in young underweight women. Diagnostic criteria for anorexia nervosa are self-induced weight loss due to restrictive eating or purging behaviour, intense fear of gaining weight and disturbance in the way in which one`s shape is experienced, undue influence of body weight on self-evaluation and persistent lack of recognition of the seriousness of the current low body weight. Anorexia nervosa is associated with numerous medical complications.

  20. Pituitary apoplexy presenting with anorexia and hyponatraemia.

    Science.gov (United States)

    Sasaki, Yosuke; Nakata, Kenji; Suzuki, Kenichi; Ando, Yasuyo

    2015-04-09

    Pituitary apoplexy, a syndrome caused by haemorrhage into the pituitary gland, typically manifests as sudden severe headache, visual symptoms and hypopituitarism, including adrenal insufficiency. We report a case of a 65-year-old man with adrenal insufficiency due to pituitary apoplexy presenting with anorexia following temporal headache and diagnosed through evaluation for hyponatraemia. MRI focusing on the pituitary gland helped to confirm the diagnosis. Our experience serves as a useful reminder of this atypical presentation of pituitary apoplexy, also known as 'subclinical pituitary apoplexy,' and underscores the importance of careful evaluation for hyponatraemia using serial urine osmolality, which is useful to distinguish hypovolaemic hyponatraemia from euvolaemic hyponatraemia. Clinicians should consider pituitary apoplexy as a differential diagnosis in cases of anorexia, loss of energy or hyponatraemia, following headache even when the patient is lacking classical symptoms such as severe headache or visual symptoms.

  1. Leptin in Anorexia and Cachexia Syndrome

    Directory of Open Access Journals (Sweden)

    Diana R. Engineer

    2012-01-01

    Full Text Available Leptin is a product of the obese (OB gene secreted by adipocytes in proportion to fat mass. It decreases food intake and increases energy expenditure by affecting the balance between orexigenic and anorexigenic hypothalamic pathways. Low leptin levels are responsible for the compensatory increase in appetite and body weight and decreased energy expenditure (EE following caloric deprivation. The anorexia-cachexia syndrome is a complication of many chronic conditions including cancer, chronic obstructive pulmonary disease, congestive heart failure, chronic kidney disease, and aging, where the decrease in body weight and food intake is not followed by a compensatory increase in appetite or decreased EE. Crosstalk between leptin and inflammatory signaling known to be activated in these conditions may be responsible for this paradox. This manuscript will review the evidence and potential mechanisms mediating changes in the leptin pathway in the setting of anorexia and cachexia associated with chronic diseases.

  2. Anorexia: "uma neurose paralela à melancolia"

    Directory of Open Access Journals (Sweden)

    Flávia Coutinho Campos Cunha

    2013-06-01

    Full Text Available Investiga-se a assertiva freudiana de que "a neurose nutricional paralela à melancolia é a anorexia". Percorreremos a obra freudiana para construir o paralelo entre essas duas afecções. O conceito de narcisismo e o mecanismo de identificação fundamentarão essa aproximação desdobrada nos seguintes pontos: a anestesia sexual, a autodepreciação e o sadismo.

  3. Narrative art inquiry and anorexia nervosa.

    Science.gov (United States)

    Craig, Jennifer

    Narrative art inquiry is a new qualitative research methodology. It is different from the narrative approaches used by some nurse investigators because the study's findings are presented in the form of creative writing. In this article the author describes narrative art inquiry using material from research that used this approach to study anorexia nervosa. The author believes that narrative art inquiry has a wider application and could be used to study other types of psychological illness and physiological distress.

  4. Concordancia entre la predicción e índices de intubación difícil en pacientes con trauma maxilofacial

    OpenAIRE

    Iván Manotas Arévalo; Martha Rebolledo Cobos; Heidy Pinzón Ramírez; Tatiana Vélez Mercado

    2013-01-01

    ResumenObjetivo: Determinar la concordancia entre la predicción de intubación difícil medida por los índices de Mallampati modificado (Ma), distancia tiromentoniana (DT) y apertura bucal (AB), en pacientes con fractura maxilar y/o mandibular que requirieron manejo del trauma bajo anestesia general con intubación endotraqueal. Metodología: estudio descriptivo prospectivo con una muestra 61 pacientes, se diligenció una historia clínica donde se recolectó información como: diagnóstico, edad, sex...

  5. Concordancia entre el diagnóstico clínico y el patológico por necropsias Clinico-pathological concordance at autopsies

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    EDITH VALDEZ-MARTÍNEZ

    1998-01-01

    Full Text Available Objetivo. Determinar la concordancia entre diagnósticos clínicos y patológicos con base en los resultados de necropsias. Material y métodos. Se revisaron 67 protocolos de necropsia y expedientes clínicos de niños y adultos del servicio de patología del Centro de Especialidades Médicas del Estado de Veracruz Doctor Rafael Lucio, durante 1995 y 1996. Se obtuvieron las frecuencias simples de las variables de estudio, y la concordancia se calculó con el estadístico kappa simple. Resultados. En general la cifra de necropsias fue de 10.5%. Correspondió a la población infantil la mayor frecuencia (17.5%. El 59% de diagnósticos clínicos en niños y el 57% en adultos presentaron algún tipo de error La concordancia del diagnóstico principal ante y postmortem fue de 26% (infantes y 41% (adultos. Conclusiones. La alta cifra de errores diagnósticos y la consecuente baja concordancia clínicopatológica apoyan el hecho de que, a pesar del avance tecnológico en los procedimientos diagnósticos, es necesario realizar necropsias con el fin de documentar de manera más definitiva el control de calidad del ejercicio de la medicina.Objective. To determine the degree of concordance between clinical and autopsy diagnosis. Material and methods. The records of 67 autopsies and clinical files of children and adults, comprising the years 1995 to 1996, from a third level hospital in the State of Veracruz, Mexico, were revised. The concordance score was calculated with the statistical kappa. Results. In general, the rate of autopsy was 10.5%, with higher frequency for children (17.5%. In children, 59% of clinical diagnoses revealed mistakes and in adults, 57%. The degree of agreement in the underlying cause ante and postmortem was 6% in children and 41% in adults. Conclusions The high rate of diagnostic error and low concordance score between clinical and autopsy diagnosis strongly suggests that, in spite of increased availability of modern diagnostic

  6. Anorexia and eating patterns in the elderly.

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    Lorenzo Maria Donini

    Full Text Available OBJECTIVES: To evaluate the change in eating habits occurring in community-dwelling and institutionalized elderly subjects with senile anorexia. DESIGN: Cross-sectional, observational. SETTING: Community, nursing homes and rehabilitation or acute care facilities in four Italian regions. PARTICIPANTS: A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards. MEASUREMENTS: All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables. RESULTS: In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups ("meat, eggs and fish" and "fruit and vegetables" whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety. CONCLUSION: Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients.

  7. Involuntary admission: the case of anorexia nervosa.

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    Douzenis, Athanasios; Michopoulos, Ioannis

    2015-01-01

    Involuntary treatment of psychiatric disorders has always been controversial; this is especially true for eating disorders. Patients with anorexia nervosa of life threatening severity frequently refuse psychiatric hospitalization. Ambivalence toward treatment is characteristic of eating disorders and patients are often admitted to inpatient programs under pressure from family and doctors. In this article, we report research on the positive or negative impact of involuntary admission in the treatment of eating disorders, its application and effectiveness as well as the adverse consequences of coercive treatment in eating disorders. A literature review was done. From a total of 134 publications which were retrieved from the literature search, 50 studies were directly relevant to the scope of this review and fulfilled all inclusion criteria. There are trends and arguments for both sides; for and against involuntary treatment in anorexia nervosa. The scientific literature so far is inconclusive, although in the short term, involuntary hospitalization has benefits. This review has also shown that involuntary hospitalization can have adverse long-term consequences for the patient-therapist allegiance. We conclude that in some cases, involuntary treatment can save lives of young patients with anorexia nervosa; however, in other cases, it can break the psychotherapeutic relationship and make the patient abandon treatment. It is the clinician who has to decide for whom and when to approve involuntary treatment or not.

  8. Physical activity in patients with anorexia nervosa.

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    Achamrah, Najate; Coëffier, Moïse; Déchelotte, Pierre

    2016-05-01

    Anorexia nervosa (AN) is often associated with physical hyperactivity. Recent studies have established links between anorexia and hyperactivity, suggesting the existence of commonalities in neural pathways. How physical activity should be managed during the clinical care of patients with anorexia remains controversial. This review first focuses on the implication of hyperactivity in the pathophysiology of AN. Hyperactivity during refeeding of patients with AN has been associated with increased energy needs to achieve weight gain, poorer clinical outcome, longer hospitalization, and increased psychiatric comorbidity. This typically leads to the prescription of bed rest. However, current knowledge suggests that preserving some kind of physical activity during refeeding of patients with AN should be safe and beneficial for the restoration of body composition, the preservation of bone mineral density, and the management of mood and anxiety. In the absence of standardized guidelines, it is suggested here that physical activity during refeeding of patients with AN should be personalized according to the physical and mental status of each patient. More research is needed to assess whether programmed physical activity may be a beneficial part of the treatment of AN.

  9. Hematological abnormalities in severe anorexia nervosa.

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    Sabel, Allison L; Gaudiani, Jennifer L; Statland, Barbara; Mehler, Philip S

    2013-05-01

    Little is known about the prevalence of hematologic abnormalities in adults with severe anorexia nervosa. We report the first major analysis of hematologic dysfunction in such patients. We retrospectively analyzed the charts of 53 men and women with severe anorexia nervosa, admitted between October 2008 and December 2010 for medical stabilization to our center, which has a national referral base. Patients were predominantly female (89 %), with a median age of 28 years (range 17-65), and were hospitalized for a median duration of 15 days (I.Q.R. 9-29). Nadir body mass index during hospitalization was markedly low at 12.4 kg/m(2) (range 8.4-15.7), and the mean discharge BMI was 13.8 kg/m(2) (range 10.2-16.8). 83 % of patients were anemic (hematocrit  400 k/μL) during their hospitalization. Eighty-nine percent of patients had resolved their neutropenia by discharge. Marked hematologic deficiencies are often present in patients with severe anorexia nervosa, generally attributed to starvation-mediated gelatinous marrow transformation which resolves with proper nutritional rehabilitation. Improved provider awareness of this association may reduce unnecessary testing and costly treatment interventions.

  10. Refeeding Hypophosphatemia in Adolescents With Anorexia Nervosa

    Science.gov (United States)

    Nicholls, Dasha

    2013-01-01

    The rate of adolescents presenting with anorexia nervosa (AN) is increasing. Medically unstable adolescents are admitted to the hospital for nutrition restoration. A lack of global consensus on appropriate refeeding practices of malnourished patients has resulted in inconsistent refeeding practices. Refeeding hypophosphatemia (RH) is the most common complication associated with refeeding the malnourished patient. This review sought to identify the range of refeeding rates adopted globally and the implication that total energy intake and malnutrition may have on RH while refeeding adolescents with anorexia nervosa. Studies were identified by a systematic electronic search of medical databases from 1980 to September 2012. Seventeen publications were identified, including 6 chart reviews, 1 observational study, and 10 case reports, with a total of 1039 subjects. The average refeeding energy intake was 1186 kcal/d, ranging from 125–1900 kcal/d, with a mean percentage median body mass index (% mBMI) of 78%. The average incidence rate of RH was 14%. A significant correlation between malnutrition (% mBMI) and post-refeeding phosphate was identified (R 2 = 0.6, P = .01). This review highlights the disparity in refeeding rates adopted internationally in treating malnourished adolescents with anorexia nervosa. Based on this review, the severity of malnutrition seems to be a marker for the development of RH more so than total energy intake. PMID:23459608

  11. Anorexia nervosa: uma revisão

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    Eder Schmidt

    2008-12-01

    Full Text Available Os autores apresentam uma revisão de alguns pontos de vista com relação à anorexia nervosa. Alinham-se aspectos classificatórios, históricos, clínicos e terapêuticos. Reconhecida como a base para ocorrências místicas na Idade Média, foi entendida como uma apresentação histérica no século XVII, para tornar-se, logo em seguida, objeto das indagações freudianas. Discute-se a anorexia como uma apresentação da estrutura histérica, aqui abordada a partir dos conceitos freudianos sobre histeria, Édipo e feminino, e considerando-se o corpo físico como um mero suporte para articulações simbólicas. Para Freud, a anorexia nervosa seria um quadro pelo qual a histérica exprime sua aversão à sexualidade.

  12. Adolescent Eating Disorders: Anorexia and Bulimia. Publication 352-004.

    Science.gov (United States)

    Bayer, Alan E.; Baker, Daniel H.

    This document presents an overview of anorexia nervosa and bulimia in adolescents. A brief review of the historical background of these eating disorders is included. Causes of anorexia and bulimia are discussed and physical, behavioral, emotional, and perceptual characteristics of the disorders are listed in a section on symptoms. The need for a…

  13. alpha-MSH enhances activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa (AN). In ABA, scheduled feeding in combination with voluntary access to running wheels, results in hyperactivity, hypophagia, body weight loss and activation of the HPA axis. Since stimulation of the melanocortin (MC) sy

  14. The paradoxical nature of sexuality in anorexia nervosa

    NARCIS (Netherlands)

    Tuiten, A; Panhuysen, G; Everaerd, W; Koppeschaar, H; Krabbe, P; Zelissen, P

    1993-01-01

    Psychosexual dysfunctioning is often put forward as an etiological factor in anorexia nervosa. In contrast, we hypothesize that anorexia nervosa patients were in general psychosexually normal before their illness, and that the problems in their sexual life arise only after the emergence of hypogonad

  15. [Anorexia and refusal to eat in the elderly].

    Science.gov (United States)

    Hazif-Thomas, Cyril; Thomas, Philippe

    2016-01-01

    The question of the links between anorexia and the refusal to eat in the elderly is often the cause of major difficulties with regard to therapeutic strategies within caregiving teams. Likewise, few studies have been carried out into the diachronic links between teenage anorexia and that of the elderly. The role of the multi-disciplinary team is essential.

  16. Multimodal Therapy for Anorexia Nervosa: An Holistic Approach to Treatment.

    Science.gov (United States)

    O'Keefe, Edward J.; Castaldo, Christine

    1985-01-01

    Anorexia nervosa has received considerable attention lately because of its increased incidence, potential danger, and resistance to treatment. A review of the literature on anorexia nervosa suggests that, although it is characterized by complex interrelated psychological and physiological processes, it is often conceptualized and treated in…

  17. Current perspectives on behavioural and cellular mechanisms of illness anorexia.

    Science.gov (United States)

    Asarian, Lori; Langhans, Wolfgang

    2005-12-01

    Here we review our current understanding of the integration of immune, neural, metabolic and endocrine signals involved in the generation of anorexia during acute infection, with the focus on anorexia elicited by peripheral administration of bacterial lipopolysaccharide (LPS). We chose to limit this review to peripheral LPS-anorexia because the mechanisms underlying this response may also be valid for anorexia during other types of acute or chronic infections, with slight differences in the duration of anorexia, levels of circulating concentrations of pro-inflammatory cytokines and hypermetabolism. Evidence so far indicates that LPS-anorexia is a complex response beneficial to host defence that involves both peripheral and central action of pro-inflammatory cytokines, other immune factors, such as prostanoids, and neurotransmitters, such as serotonin. One interesting characteristic of LPS-anorexia is its sexual differentiation, an aspect mainly mediated by the gonadal hormone estradiol. Understanding the behavioural and molecular mechanisms of LPS-anorexia may even provide useful leads for identifying mechanisms of eating disorders in humans.

  18. Physiological Regulation and Infantile Anorexia: A Pilot Study

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    Chatoor, Irene; Ganiban, Jody; Surles, Jaclyn; Doussard-Roosevelt, Jane

    2004-01-01

    Objective: To examine whether infantile anorexia is associated with physiological dysregulation. Method: This study included eight toddlers with infantile anorexia and eight healthy eaters matched for age, race, socioeconomic status, and gender. Physiological measures of heart period and respiratory sinus arrhythmia were assessed across three…

  19. Anorexia nervosa e gravidez: relato de caso Anorexia nervosa and pregnancy: a case report

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    Fabiano Gonçalves Nery

    2002-02-01

    Full Text Available Relata-se o caso de uma adolescente de 18 anos que desenvolveu quadro de hiperemese gravídica seguida de anorexia nervosa durante sua primeira gravidez, chegando a índice de massa corporal (IMC de 14,3 Kg/m². Os sintomas apresentados remitiram após o término prematuro da gestação. Apesar de a anorexia nervosa ser incomum na gravidez, seu diagnóstico é importante em virtude dos riscos para a saúde materna e fetal.The authors describe a case of an eighteen years-old adolescent who developed hyperemesis gravidarum followed by anorexia nervosa during her first pregnancy. Her body mass index (BMI achieved 14.3 Kg/m². The symptoms remitted after the premature delivery of the newborn. Although anorexia nervosa is uncommon in pregnancy, its diagnosis is important in view of the risks for the health of mother and fetus.

  20. Altered social reward and attention in anorexia nervosa

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    Karli K Watson

    2010-09-01

    Full Text Available Dysfunctional social reward and social orienting attend a variety of neuropsychiatric disorders including autism, schizophrenia, social anxiety, and psychopathy. Here we show that similar social reward and attention dysfunction attend anorexia nervosa, a disorder defined by avoidance of food and extreme weight loss. We measured the implicit reward value of social stimuli for female participants with (n=11 and without (n=11 anorexia nervosa using an econometric choice task and also tracked gaze patterns during free viewing of images of female faces and bodies. As predicted, the reward value of viewing bodies varied inversely with observed body weight for women with anorexia but not neurotypical women, in contrast with their explicit ratings of attractiveness. Surprisingly, women with anorexia nervosa, unlike neurotypical women, did not find female faces rewarding and avoided looking at both the face and eyes—independent of observed body weight. These findings demonstrate comorbid dysfunction in the neural circuits mediating gustatory and social reward in anorexia nervosa.

  1. Concordancia en la determinación de la longitud radicular en dientes temporales entre radiografía convencional y localizador electrónico de ápice

    OpenAIRE

    Fortich Mesa, Natalia

    2013-01-01

    Objetivo: establecer el grado de concordancia existente entre radiografía convencional y localizador electrónico de ápice in vivo para determinar la longitud de trabajo en dientes temporales. Materiales y métodos: se realizó un estudio de pruebas diagnósticas, concordancia consistencia, se seleccionaron pacientes pediátricos diagnosticados con caries dental con cavidad extensa, y que requerían tratamiento de pulpectomía, a quienes se les determinó la longitud de trabajo, utilizando inicia...

  2. Olanzapine reduces physical activity in rats exposed to activity-based anorexia : possible implications for treatment of anorexia nervosa?

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; van Elburg, Annemarie A; Kas, Martien J H; van Engeland, Herman; Adan, Roger A H

    2005-01-01

    BACKGROUND: Anorexia nervosa (AN) patients often show extreme hypophagia and excessive physical activity. Activity-based anorexia (ABA) is considered an animal model of AN and mimics food restriction and hyperactivity in rats. This study investigated whether treatment with olanzapine (Zyprexa) reduc

  3. Cuerpo y subjetividad: acerca de la anorexia

    OpenAIRE

    Francisco Pereña García

    2007-01-01

    Desde el comienzo, la descripción clínica de la anorexia, muestra su dificultad no sólo etiológica (si es un trastorno endocrino o neurológico o psíquico) sino también diagnóstica (si es un trastorno histérico o no, si es una enfermedad propiamente dicha o no) y terapéutica (la tozudez del síntoma). El criterio diferencial que pronto aparece es el rechazo. La dificultad del sujeto con el alimento ha de situarse en el marco de la dependencia radical que tiene el organismo ...

  4. Neuromodulation for eating disorders: obesity and anorexia.

    Science.gov (United States)

    Gorgulho, Alessandra A; Pereira, Julio L B; Krahl, Scott; Lemaire, Jean-Jacques; De Salles, Antonio

    2014-01-01

    Extremes of eating disorders (ED) have become prevalent in both developed and developing countries. Available therapies, though largely effective, fail in a substantial number of patients and carry considerable side effects. Morbid obesity and anorexia nervosa (AN) represent important causes of morbidity and mortality among young adults. Morbid obesity affects disproportionate numbers of children. AN is also important for its high mortality in young adults. The challenges of effectively treating AN are well recognized. In this article, important aspects of ED are reviewed in detail and novel approaches to the treatment of ED are proposed.

  5. [Anorexia nervosa: study method and sleep analysis].

    Science.gov (United States)

    Cervera, S; Zapata, R; Gual, P; Quintanilla, B

    1989-01-01

    By studying anorexia nervosa with an Integrated Inventory and the quality and the quantity of sleep applying Hauri's scale for the analysis of dream contents, the sleeping habits of 50 anorexic patients who were under treatment have been studied. The results show that sleep in these patients is similar and sometimes better in quantity and quality than those in the control group. Their dreams are characterized by an almost total absence of sexual, aggressive and alimentary contents, and that reality, active participation, unpleasant feelings and sensory-perceptive elements are predominant.

  6. Medical management of acute severe anorexia nervosa.

    Science.gov (United States)

    Norrington, Amy; Stanley, Ruth; Tremlett, Michael; Birrell, Ginny

    2012-04-01

    Anorexia nervosa (AN) is a common condition affecting young people. The medical management of AN on a general paediatric ward is challenging. It is important to identify young people who are at risk of medical complications, so early intervention can be instigated. This article aims to review the clinical practice and evidence supporting the current medical management of young people with AN. It provides a system-based approach to potential complications of the disease, guidance on feeding and the management of re-feeding syndrome. Approaches to legal and ethical challenges are also considered. While the importance of psychiatric treatment is recognised, the same is not discussed within this article.

  7. Anorexia in the Adolescence - case study

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    Almeida de Paiva, Maria O

    2010-07-01

    Full Text Available Eating disorders lead to special biological and psychological states. The result of the total lack of food is treated in a distinct way by anorexia. Nutritionists have thus had difficulty in coming to an agreement on the best therapy to prevent such disorders. First it is essential to understand which treatment aims are and then to attempt to know how the several treatment models used nowadays can reach those aims. Someone who suffers from eating disorders, together with an inner deformation, suffers from too much sensitiveness. In order to solve these problems, one needs a change in the relationship with oneself, with the others and with the world. This study presents a teenager’s case study – Anorexia. Is, in fact, a problem that society faces and can’t ignore. Many youngsters have already died and others are following their steps. But there are also those ones that succeeded in overcoming the problem and now are reporting their stories.

  8. Autoimmune Polyglandular Syndrome Type 3 with Anorexia

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    Toshio Kahara

    2012-01-01

    Full Text Available A 71-year-old man with diabetes mellitus visited our hospital with complaints of anorexia and weight loss (12 kg/3 months. He had megaloblastic anemia, cobalamin level was low, and autoantibody to intrinsic factor was positive. He was treated with intramuscular cyanocobalamin, and he was able to consume meals. GAD autoantibody and ICA were positive, and he was diagnosed with slowly progressive type 1 diabetes mellitus (SPIDDM. Thyroid autoantibodies were positive. According to these findings, he was diagnosed with autoimmune polyglandular syndrome type 3 with SPIDDM, pernicious anemia, and Hashimoto's thyroiditis. Extended periods of cobalamin deficiency can cause serious complications such as ataxia and dementia, and these complications may not be reversible if replacement therapy with cobalamin is delayed. Although type 1 diabetes mellitus with coexisting pernicious anemia is very rare in Japan, physicians should consider the possibility of pernicious anemia when patients with diabetes mellitus have cryptogenic anorexia with the finding of significant macrocytosis (MCV > 100 fL.

  9. Self-focused Attention in Anorexia Nervosa

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    Zucker, Nancy; Wagner, H. Ryan; Merwin, Rhonda; Bulik, Cynthia M.; Moskovich, Ashley; Keeling, Lori; Hoyle, Rick

    2015-01-01

    Objective The clinical presentation of anorexia nervosa (AN) is characterized by preoccupation with body experience, intrusive concerns regarding shape, and pathological fears of weight gain. These symptoms are suggestive of unrelenting self-focused attention. No research to date has characterized self-focused attention (SFA) in AN nor examined neurocognitive features that may facilitate an excessive, rigid, or sustained focus on one’s appearance. Method This study examined SFA, body image disturbance, and executive functioning in women with current anorexia nervosa (AN-C; n = 24), a history of AN who were weight-restored at the time of the study weight-restored (WR; n = 19), and healthy controls (n = 24). Results Private and public SFA were highest among WR and lowest among AN-C. Shape concerns were negatively correlated with SFA, especially among AN-C, after controlling for depression and social anxiety symptoms. Discussion Lower levels of SFA among AN-C were unexpected and suggest the acute state of AN may lessen pathological self-focus, negatively reinforcing symptoms. In addition, body image concerns may distract from general SFA. Deficits in executive attention may explain these findings, as each one unit increase in perseverative errors among AN-C participants was associated with an almost one-half unit decrease in public SFA. PMID:24899215

  10. Nutritional approach of inpatients with anorexia nervosa

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    José Manuel Marugán de Miguelsanz

    Full Text Available Anorexia nervosa (AN is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientific evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN. Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way.

  11. Perioperative management of severe anorexia nervosa.

    Science.gov (United States)

    Hirose, K; Hirose, M; Tanaka, K; Kawahito, S; Tamaki, T; Oshita, S

    2014-02-01

    As the prevalence of anorexia nervosa (AN) increased, surgery in severe AN patients also increased in the 2000s. We experienced a surgical case of a patient with severe AN, showing an extremely low BMI of 8.6 kg m(-2). We investigated the problems associated with this case and propose criteria to manage severe AN. We endeavour to report on the perioperative management of rare and severe symptoms and surgical indications of severely malnourished patients. All published reports were identified through comprehensive searches using PubMed, BioMedLib, and the Japan Medical Abstracts Society with the following terms and keywords: 'anorexia nervosa', 'eating disorder', 'hypoglycaemia', 'leucocytopaenia', 'gelatinous bone marrow', 'surgery', and 'operation'. In cases of AN with a BMI under 13 kg m(-2), marked hypoglycaemia, leucocytopaenia feeding syndrome until surgery. During the course of anaesthesia, careless loading of glucose or catecholamine may lead to disturbance of electrolytes or fatal arrhythmia. Intensive care and early feeding as soon as possible after surgery are important to prevent surgical site infection. Although not many perioperative cases of AN have been reported, clinicians must be aware of the danger and the causes of mortality in critical cases. Thus, the decision to undertake surgery must be taken carefully and close perioperative coordination among physicians, surgeons, psychiatrists, anaesthesiologists, and intensivists is essential.

  12. Anorexia athletica in pre-professional ballet dancers.

    Science.gov (United States)

    Herbrich, Laura; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Schneider, Nora

    2011-08-01

    Competitive sport has been under increasing discussion as a possible favourable factor in the development of eating disorders among children and adolescents. The aim of this study was to determine the frequency of sport-specific eating disorders, in line with the concept of anorexia athletica. This prospective field study included one experimental group and two control groups (disease and healthy). Fifty-two pre-professional ballet dancers aged 13-20 years were tested for clinical eating disorders, anorexia athletica criteria, eating disorder related psychopathology and self-concept, and were compared with 52 patients with anorexia nervosa and 44 non-athletic controls of the same age. The study was conducted using semi-structured interviews as well as self-report questionnaires. A clinical eating disorder diagnosis was made in 1.9% of the ballet dancers versus 0% of the high school students; anorexia athletica was diagnosed in 5.8% of the dancers versus 2.3% of the students. Ballet dancers scored lower than patients with anorexia nervosa with regard to eating disorder related psychopathology and higher than the patients with regard to self-concept. We conclude that more sensitive tools to differentiate between sport-specific (eating) patterns, anorexia athletica and clinically relevant eating disorders are needed, especially for aesthetic sports such as ballet. It remains an important goal to identify athletes with symptoms of anorexia athletica irrespective of their physique and/or sport.

  13. Anorexia of aging: a modifiable risk factor for frailty.

    Science.gov (United States)

    Martone, Anna Maria; Onder, Graziano; Vetrano, Davide Liborio; Ortolani, Elena; Tosato, Matteo; Marzetti, Emanuele; Landi, Francesco

    2013-10-14

    Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail individuals. Anorexia recognizes a multifactorial origin characterized by various combinations of medical, environmental and social factors. Given the interconnection between weight loss, sarcopenia and frailty, anorexia is a powerful, independent predictor of poor quality of life, morbidity and mortality in older persons. One of the most important goals in the management of older, frail people is to optimize their nutritional status. To achieve this objective it is important to identify subjects at risk of anorexia and to provide multi-stimulus interventions that ensure an adequate amount of food to limit and/or reverse weight loss and functional decline. Here, we provide a brief overview on the relevance of anorexia in the context of sarcopenia and frailty. Major pathways supposedly involved in the pathogenesis of anorexia are also illustrated. Finally, the importance of treating anorexia to achieve health benefits in frail elders is highlighted.

  14. Resting tachycardia, a warning sign in anorexia nervosa: case report

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    Krantz Mori J

    2004-07-01

    Full Text Available Abstract Background Among psychiatric disorders, anorexia nervosa has the highest mortality rate. During an exacerbation of this illness, patients frequently present with nonspecific symptoms. Upon hospitalization, anorexia nervosa patients are often markedly bradycardic, which may be an adaptive response to progressive weight loss and negative energy balance. When anorexia nervosa patients manifest tachycardia, even heart rates in the 80–90 bpm range, a supervening acute illness should be suspected. Case presentation A 52-year old woman with longstanding anorexia nervosa was hospitalized due to progressive leg pain, weakness, and fatigue accompanied by marked weight loss. On physical examination she was cachectic but in no apparent distress. She had fine lanugo-type hair over her face and arms with an erythematous rash noted on her palms and left lower extremity. Her blood pressure was 96/50 mm Hg and resting heart rate was 106 bpm though she appeared euvolemic. Laboratory tests revealed anemia, mild leukocytosis, and hypoalbuminemia. She was initially treated with enteral feedings for an exacerbation of anorexia nervosa, but increasing leukocytosis without fever and worsening left leg pain prompted the diagnosis of an indolent left lower extremity cellulitis. With antibiotic therapy her heart rate decreased to 45 bpm despite minimal restoration of body weight. Conclusions Bradycardia is a characteristic feature of anorexia nervosa particularly with significant weight loss. When anorexia nervosa patients present with nonspecific symptoms, resting tachycardia should prompt a search for potentially life-threatening conditions.

  15. Complications of pre-operative anorexia nervosa in bariatric surgery.

    Science.gov (United States)

    Shear, Matthew; DeFilippis, Ersilia M

    2015-01-01

    It is important to recognise that patients who seek weight loss surgery may have a history of restrictive eating or anorexia nervosa. The following case report describes a woman with a history of anorexia nervosa who underwent Roux-en-Y gastric bypass surgery. Her eating disorder symptoms subsequently reappeared and were largely resistant to treatment. To the best of our knowledge, this is the first case report of a bariatric surgery patient with a prior history of anorexia nervosa. Further research is required to determine how best to select patients for weight loss surgery.

  16. Appetite and cancer-associated anorexia: a review.

    Science.gov (United States)

    Davis, Mellar P; Dreicer, Robert; Walsh, Declan; Lagman, Ruth; LeGrand, Susan B

    2004-04-15

    Appetite is governed by peripheral hormones and central neurotransmitters that act on the arcuate nucleus of the hypothalamus and nucleus tactus solitarius of the brainstem. Cancer anorexia appears to be the result of an imbalance between neuropeptide-Y and pro-opiomelanocortin signals favoring pro-opiomelanocortin. Many of the appetite stimulants redress this imbalance. Most of our understanding of appetite neurophysiology and tumor-associated anorexia is derived from animals and has not been verified in humans. There have been few clinical trials and very little translational research on anorexia despite its prevalence in cancer.

  17. Carbohydrate metabolism and its regulatory hormones in anorexia nervosa.

    Science.gov (United States)

    Casper, R C

    1996-04-16

    Findings of studies of carbohydrate metabolism in anorexia nervosa are reviewed. Topics covered included fasting blood sugar concentrations; serum insulin concentrations, insulin receptor binding activity, insulin sensitivity, and insulin resistance; plasma ketone bodies and free fatty acids; glucose tolerance tests; growth hormone, cortisol, intestinal hormones, and norepinephrine. Metabolic changes reported in anorexia nervosa are similar to those found in human and animal studies of states of caloric and carbohydrate restriction. Restoration of normal body weight is associated with normalization of virtually all measures. It is concluded that published studies offer no conclusive evidence for a syndrome-specific impairment in carbohydrate metabolism in anorexia nervosa.

  18. Feeding size 0: the challenges of anorexia nervosa. Managing anorexia from a dietitian's perspective.

    Science.gov (United States)

    Cockfield, Annette; Philpot, Ursula

    2009-08-01

    Anorexia nervosa has the highest mortality rate of any psychiatric condition and its management is complex and multi-faceted, requiring a multidisciplinary team approach. Dietitians are an important part of the multidisciplinary team, offering objective nutritional advice with the aim of helping the patient to develop an improved relationship with food. Refeeding patients with a low body weight requires careful management; nonetheless, refeeding the low-weight patient with anorexia presents many additional complications, largely of a psychological nature. Treatment plans need to consider psychological, physical, behavioural and psycho-social factors relating to anorexia nervosa. Currently, there is no consistent approach and a paucity of evidence to support best practice for weight restoration in this group of patients. Tube feeding is utilised at varying BMI in anorexia nervosa, mainly in an inpatient setting. However, its use should be seen as a last resort and limited to a life-saving intervention. Weight restoration is best managed by an experienced dietitian within a specialist eating disorders team, using normal foods. This approach is ideal for nutrition rehabilitation, promoting skills for eating and normal behaviour and providing a longer-term solution by challenging unhelpful coping strategies from the onset. Dietitians have a unique mix of skills and knowledge in numerous areas including nutrition, physiology, psychology, sociology and behaviour change, which can be applied to support patients with thoughts and behaviours around food, weight and appetite. Further research is required into the effectiveness of dietetic interventions in eating disorders in order to establish an evidence base for best practice.

  19. An Adolescent Case of Citrin Deficiency With Severe Anorexia Mimicking Anorexia Nervosa.

    Science.gov (United States)

    Takeuchi, Satsuki; Yazaki, Masahide; Yamada, Shinji; Fukuyama, Tetsuhiro; Inui, Akio; Iwasaki, Yasushi; Ikeda, Shu-ichi

    2015-08-01

    We report a 12-year-old female citrin-deficient patient presenting with severe anorexia and body weight loss, mimicking the restricting type of anorexia nervosa (AN). She showed normal development until age 10 years when she started to play volleyball at school. She then became gradually anorexic, and her growth was stunted. At age 12, she was admitted to hospital because of severe anorexia and thinness. She was first thought to have AN, and drip infusion of glucose solution and high-calorie drinks were given, but her condition deteriorated further. She had a history of neonatal hepatitis and was therefore suspected to have citrin deficiency (CD). Genetic analysis of SLC25A13 revealed that she was compound heterozygous for 851del4 and IVS16ins3kb, and a diagnosis of CD was made. A low-carbohydrate diet with oral intake of arginine and ursodeoxycholic acid was started, and her condition gradually improved. The clinical features in our patient were similar to those of AN, and therefore AN may also be an important clinical sign in adolescent patients with CD.

  20. Cancer anorexia: a model for the understanding and treatment of secondary anorexia.

    Science.gov (United States)

    Rossi Fanelli, Filippo; Laviano, Alessandro

    2002-09-01

    Under normal conditions, food intake is controlled in the hypothalamus by: (i) transducing metabolic/sensorial inputs arising from the periphery into neuronal response; (ii) integrating the information originating from different tissues; and (iii) triggering the appropriate feeding responses. Thus, the anorexia associated with a number of chronic diseases, including cancer, may result from an abnormal input of information to the hypothalamus, or in its defective transduction and integration, or in the induction of exaggerated and inappropriate feeding responses. Currently available data suggest that the pathogenesis of secondary anorexia is multifactorial, and involves most of the neuronal signalling pathways modulating energy intake, including hormones (e.g. leptin), neuropeptides (e.g. NPY), cytokines (e.g. IL-1, IL-6, TNF) and neurotransmitters (e.g. serotonin and dopamine). However, it is unlikely that they represent separate and distinct pathogenic mechanisms, rather it appears that close interrelationships may exist among them. In line with this reasoning, consistent experimental and human data suggest that the hypothalamic serotonergic neurotransmission may represent a major target on which different anorexia-related factors converge. Thus, interfering pharmacologically with hypothalamic serotonin synthesis and activity may represent an effective therapeutic strategy in anorectic patients, as suggested by recent preliminary clinical data.

  1. Cuerpo y subjetividad: acerca de la anorexia

    Directory of Open Access Journals (Sweden)

    Francisco Pereña García

    2007-01-01

    Full Text Available Desde el comienzo, la descripción clínica de la anorexia, muestra su dificultad no sólo etiológica (si es un trastorno endocrino o neurológico o psíquico sino también diagnóstica (si es un trastorno histérico o no, si es una enfermedad propiamente dicha o no y terapéutica (la tozudez del síntoma. El criterio diferencial que pronto aparece es el rechazo. La dificultad del sujeto con el alimento ha de situarse en el marco de la dependencia radical que tiene el organismo humano respecto al cuerpo de la madre, quebrando así la articulación entre necesidad y demanda, lo que desregula la vida instintiva. La pulsión es el nombre de esa desregulación. La vida pulsional ha de regularse por el deseo. La transmisión de la vida es transmisión del deseo íntimo de vivir. Sin él, el cuerpo desfallece o se produce una separación entre vida y cuerpo. El rechazo, que es componente de la subjetividad, pasa a convertirse en la anorexia en rechazo del cuerpo y en sumisión a ideales confusos, con los que el sujeto anoréxico pretende orientarse. La bulimia señala el aspecto más adictivo de la desregulación pulsional. La pregunta sobre por qué se da más en mujeres que en hombres no tiene fácil respuesta. A ello contribuye la sexualidad femenina (la relación con el deseo y la reproducción y también el modo como en una sociedad de la “abundancia”, la mujer simboliza el objeto de adorno, una figura virtual inerte. Se puede tomar la anorexia como denuncia de una vida familiar automatizada, desvitalizada, y de una sociedad caracterizada por el fetichismo de la mercancía y el canibalismo.

  2. Percepção de familiares sobre a anorexia e bulimia: revisão sistemática Percepción de familiares sobre la anorexia y bulimia: revisión sistemática Family perception of anorexia and bulimia: a systematic review

    Directory of Open Access Journals (Sweden)

    Cybele Ribeiro Espíndola

    2009-08-01

    Full Text Available Realizou-se revisão sistemática da literatura publicada entre 1990 e 2006 com metodologia qualitativa sobre a perspectiva de familiares de pessoas com anorexia e bulimia nervosa. Após revisão crítica dos artigos e metassíntese, utilizou-se a abordagem meta-etnográfica para analisar e sintetizar os dados. O processo de interpretação empregado foi a reciprocal translation. Dentre 3.415 estudos, nove atenderam aos critérios de inclusão e exclusão. Dois conceitos emergiram: reconhecimento da doença e repercussões da doença. Na reorganização familiar, o sentimento de impotência foi predominante. Os resultados indicam a presença de distorções sobre os conceitos da doença associadas a um comprometimento familiar, que modifica a comunicação, atitudes e comportamentos dentro de um contexto de impotência.Se realizó revisión sistemática de la literatura publicada entre 1990 y 2006 con metodología cualitativa sobre la perspectiva de familiares de personas con anorexia y bulimia nerviosa. Posterior a la revisión crítica de los artículos y metasíntesis, se utilizó el abordaje meta-etnográfico para analizar y sintetizar los datos. El proceso de interpretación empleado fue el reciprocal translation. Entre 3.415 estudios, nueve atendieron a los criterios de inclusión y exclusión. Dos conceptos emergieron: reconocimiento de la enfermedad y repercusiones de la enfermedad. En la reorganización familiar, el sentimiento de impotencia fue predominante. Los resultados indican la presencia de distorsiones sobre los conceptos de la enfermedad asociados a un compromiso familiar, que modifica la comunicación, actitudes y comportamientos dentro de un contexto de impotencia.A systematic literature review published between 1990 and 2006 using a qualitative approach was conducted to explore family members' perception of anorexia and bulimia nervosa patients. Articles were critically reviewed and a meta-synthesis analysis was carried out

  3. Diagnosed Anxiety Disorders and the Risk of Subsequent Anorexia Nervosa: A Danish Population Register Study.

    Science.gov (United States)

    Meier, Sandra M; Bulik, Cynthia M; Thornton, Laura M; Mattheisen, Manuel; Mortensen, Preben B; Petersen, Liselotte

    2015-11-01

    Anxiety disorders and anorexia nervosa are frequently acknowledged to be highly comorbid conditions, but still, little is known about the clinical and aetiological cohesion of specific anxiety diagnoses and anorexia nervosa. Using the comprehensive Danish population registers, we aimed to determine the risk of anorexia nervosa in patients with register-detected severe anxiety disorders. We also explored whether parental psychopathology was associated with offspring's anorexia nervosa. Anxiety disorders increased the risk of subsequent anorexia nervosa, with the highest risk observed in obsessive-compulsive disorder. Especially, male anxiety patients were at an increased risk for anorexia nervosa. Furthermore, an increased risk was observed in offspring of fathers with panic disorder. A diagnosis of an anxiety disorder, specifically obsessive-compulsive disorder, constitutes a risk factor for subsequent diagnosis of anorexia nervosa. These observations support the notion that anxiety disorders and anorexia nervosa share etiological mechanisms and/or that anxiety represents one developmental pathway to anorexia nervosa.

  4. Indirect evidence for decreased hypothalamic somatostatinergic tone in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Andersen, M; Flyvbjerg, A

    2002-01-01

    in the central feeding mechanism in anorexia nervosa (AN). Peripheral administration of pyridostigmine (PD) minimizes the release of hypothalamic SRIH. DESIGN: To study the influence of hypothalamic somatostatinergic inhibition on the exaggerated somatotroph responsiveness to GHRH in patients with severe AN, two...... indirectly to greater SRIH withdrawal and greater GHRH release in anorexia nervosa. Moreover, hypothalamic SRIH activity seems to be inversely related to cortisol levels, indirectly supporting the hypothesis that SRIH and CRH neuronal activity are inversely related in anorexia nervosa. Leptin, which...... is believed to act on hypothalamic feeding mechanisms, seems to be positively related to SRIH activity. Finally, the present data demonstrate that the potentiating effect of pyridostigmine in anorexia nervosa is related to body mass index and increases upon weight gain, suggesting that the low...

  5. Neuroendokrine forstyrrelser ved anorexia nervosa - primoere eller sekundoere?

    DEFF Research Database (Denmark)

    Støving, R K; Hansen-Nord, M; Hangaard, J

    1996-01-01

    Anorexia nervosa is associated with multiple endocrine abnormalities. Hypothalamic neuropeptides and monoamines are involved in the regulation of human appetite, and they are changed in several ways in anorexia nervosa. But it remains to be clarified whether these alterations are secondary...... or etiologic. Feeding behaviour in anorexia nervosa is characterised by a strong ambivalence and not by loss of appetite. Hypothalamic amenorrhea is a diagnostic criterion, and is not only secondary as it often precedes the weight loss and persists for a long time after weight and motor activity have returned...... to normal. Hypersecretion of corticotropin releasing hormone seems to be secondary to starvation, but at the same time it may keep up and intensify the anorexia, physical hyperactivity and amenorrhea. Low production of insulinlike growth factor-I and high growth hormone secretion reflects the nutritional...

  6. A review of endocrine changes in anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Hangaard, J; Hansen-Nord, M

    1999-01-01

    Anorexia nervosa is a syndrome of unknown etiology. It is associated with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of human appetite, and in several ways...... they are changed in anorexia nervosa. However, it remains to be clarified whether the altered appetite regulation is secondary or etiologic. Increased secretion of corticotropin-releasing hormone and proopiomelanocortin seems to be secondary to starvation, however, there is evidence that it may maintain...... and intensify anorexia, excessive physical activity and amenorrhea. Hypothalamic amenorrhea, which is a diagnostic criterion in anorexia nervosa, is not solely related to the low body weight and exercise. Growth hormone resistance with low production of insulin-like growth factor I and high growth hormone...

  7. What People with Anorexia Nervosa Need to Know about Osteoporosis

    Science.gov (United States)

    ... People With Anorexia Nervosa Need to Know About Osteoporosis Publication available in: PDF (86 KB) Related Resources ... Management Strategies Resources For Your Information What Is Osteoporosis? Osteoporosis is a condition in which the bones ...

  8. [ANOREXIA AND BULIMIA: IMPACT ON NETWORK SOCIETY].

    Science.gov (United States)

    Alex Sánchez, María Dolores

    2015-01-01

    The Information and Communication Technologies (ICT) have an increasing influence on the way we relate and in shaping personal identity. The phenomenon of online social networking emerges strongly and contributes to the development of new spaces breaking with the official discourse that marks the scientific evidence on health. This paper analyzes the impact of ICT in relation to the identity of the digital natives and eating disorders (ED). Particular attention to how the network society determines the response of young people in situations of social tension is dedicated. To do this, provides a perspective on the concept of interaction from the analysis of the discourse on anorexia and bulimia in the network, and how to care nurses should consider these factors to improve efficiency and quality in clinical care and patient care.

  9. Emotion recognition and regulation in anorexia nervosa.

    Science.gov (United States)

    Harrison, Amy; Sullivan, Sarah; Tchanturia, Kate; Treasure, Janet

    2009-01-01

    It is recognized that emotional problems lie at the core of eating disorders (EDs) but scant attention has been paid to specific aspects such as emotional recognition, regulation and expression. This study aimed to investigate emotion recognition using the Reading the Mind in the Eyes (RME) task and emotion regulation using the Difficulties in Emotion Regulation Scale (DERS) in 20 women with anorexia nervosa (AN) and 20 female healthy controls (HCs). Women with AN had significantly lower scores on RME and reported significantly more difficulties with emotion regulation than HCs. There was a significant negative correlation between total DERS score and correct answers from the RME. These results suggest that women with AN have difficulties with emotional recognition and regulation. It is uncertain whether these deficits result from starvation and to what extent they might be reversed by weight gain alone. These deficits may need to be targeted in treatment.

  10. The body in anorexia and bulimia

    Directory of Open Access Journals (Sweden)

    Maria Helena Fernandes

    2012-09-01

    Full Text Available The psychoanalytic clinic for anorexia and bulimia puts us into immediate contact with the question of the body, as well as with aspects typical of adolescence. These aspects especially include difficulties in early relationships with the mother regarding the management of the drives, and relationships with primary identification. Consequently, we are dealing with ideals, differentiation, autonomy, time and death. Here hypotheses that were drawn up on the basis of metapsychology are discussed, with the objective of contributing to a broader understanding of the construction of the bodily image. This process includes the perception, representation and internal experience of the patients' own bodies. The impasses experienced in the analytic situation also indicate particularities in managing the transference in these cases.

  11. Extreme Achalasia Presenting as Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    P. J. Goldsmith

    2012-01-01

    Full Text Available Background. Achalasia may lead to cachexia if not diagnosed in an early stage. Surgery in cachectic patients is hazardous and complications may result in a protracted recovery or even death. Different treatment options have been described. In this paper, we report a stepwise surgical laparoscopic approach which appears to be safe and effective. Methods. Over a one-year period, a patient with a body mass index (BMI below 17 being treated for anorexia nervosa was referred with dysphagia. Because of the extreme cachexia, a laparoscopic feeding jejunostomy (LFJ was fashioned to enable long-term home enteral feeding. The patient underwent a laparoscopic Heller myotomy (LHM when the BMI was normal. Results. The patient recovered well following this stepwise approach. Conclusion. Patients with advanced achalasia usually present with extreme weight loss. In this small group of patients, a period of home enteral nutrition (HEN via a laparoscopically placed feeding jejunostomy allows weight gain prior to safe definitive surgery.

  12. Management of anorexia in dogs and cats.

    Science.gov (United States)

    Delaney, Sean J

    2006-11-01

    The management of anorexia should center first on the urgent and emergent medical management of the patient and be followed by feeding of a highly palatable food in a low-stress environment and manner. Diet palatability can potentially be improved by increasing dietary moisture, fat, or protein, and, in the dog, by adding sugar or salt as well as by using a variety of fresh, pleasantly aromatic, and uncommon foods. Caution should be used when increasing or adding nutrients that may be harmful to patients with specific diseases. Concurrent drug therapy that may reduce appetite should be minimized, and physical barriers to eating should be removed. Patients that consume less than resting energy requirement of longer than 3 to 5 days with no trend toward improving should receive parenteral or enteral nutrition.

  13. The syndrome of anorexia-cachexia.

    Science.gov (United States)

    Body, J J

    1999-07-01

    Cancer anorexia/cachexia is a major clinical problem, especially in advanced cancer patients. Its pathogenesis is quite complex. Anorexia plays a central role, but cancer cachexia is more complex than pure chronic starvation. One of the key differences is the preferential mobilization of fat and the sparing of skeletal muscle in simple starvation compared with an equal mobilization of fat and skeletal muscle in cancer patients. An increase in basal energy expenditures seems to play a contributory role in many patients. Cytokines, essentially but not exclusively tumor necrosis factor alpha, play an essential role, and the syndrome can be compared with a low-grade chronic inflammatory state. As it is in most fields in medicine, prevention is more efficacious than treatment, and, to avoid the final and dramatic stages of cancer cachexia, adequate nutritional advice and support must be provided sufficiently early. Parenteral nutrition could facilitate the administration of complete doses of chemotherapy or radiotherapy, but no significant survival benefit or decrease in treatment-induced toxicity have ever been demonstrated in prospective randomized trials. The gut should always be used if at all possible. Percutaneous endoscopic gastrostomy is used increasingly in patients who cannot eat but who have functionally intact gastrointestinal tracts, especially in patients with head and neck cancer. Eight randomized, double-blind, placebo-controlled studies have demonstrated that progestational drugs can somewhat stimulate appetite, food intake, and energy level; increase weight in many patients; and often decrease nausea and vomiting severity; however, pharmacologic treatment of cancer cachexia remains disappointing, and more trials with anticytokine drugs should be conducted.

  14. Diminished creatinine clearance in anorexia nervosa: reversal with weight gain.

    OpenAIRE

    Boag, F; Weerakoon, J; Ginsburg, J.; Havard, C W; Dandona, P

    1985-01-01

    To assess whether patients with anorexia nervosa have abnormalities in creatinine clearance, we measured plasma creatinine concentration, urinary creatinine excretion, and creatinine clearance in 10 patients with anorexia nervosa before and during treatment. Urinary creatinine excretion and creatinine clearance were diminished in all patients. Nine patients had significant decreases in their plasma creatinine and creatinine clearance was increased even when corrected for body weight and body ...

  15. Increased hypothalamic serotonin turnover in inflammation-induced anorexia

    OpenAIRE

    Dwarkasing, J.T.; Witkamp, R F; Boekschoten, M.V.; Laak, ter, H.J.; Heins, M.S.; Norren, van, K.

    2016-01-01

    Background Anorexia can occur as a serious complication of disease. Increasing evidence suggests that inflammation plays a major role, along with a hypothalamic dysregulation characterized by locally elevated serotonin levels. The present study was undertaken to further explore the connections between peripheral inflammation, anorexia and hypothalamic serotonin metabolism and signaling pathways. First, we investigated the response of two hypothalamic neuronal cell lines to TNFα, IL-6 and LPS....

  16. Treatments of medical complications of anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Mehler, Philip S; Krantz, Mori J; Sachs, Katherine V

    2015-01-01

    Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging. Yet, the encouraging fact is that most of these medical complications are treatable and reversible with definitive care and cessation of the eating-disordered behaviours. Herein, these treatments are described for both the medical complications of anorexia nervosa and those which are a result of bulimia nervosa.

  17. Could dopamine agonists aid in drug development for anorexia nervosa?

    Science.gov (United States)

    Frank, Guido K W

    2014-01-01

    Anorexia nervosa is a severe psychiatric disorder most commonly starting during the teenage-years and associated with food refusal and low body weight. Typically there is a loss of menses, intense fear of gaining weight, and an often delusional quality of altered body perception. Anorexia nervosa is also associated with a pattern of high cognitive rigidity, which may contribute to treatment resistance and relapse. The complex interplay of state and trait biological, psychological, and social factors has complicated identifying neurobiological mechanisms that contribute to the illness. The dopamine D1 and D2 neurotransmitter receptors are involved in motivational aspects of food approach, fear extinction, and cognitive flexibility. They could therefore be important targets to improve core and associated behaviors in anorexia nervosa. Treatment with dopamine antagonists has shown little benefit, and it is possible that antagonists over time increase an already hypersensitive dopamine pathway activity in anorexia nervosa. On the contrary, application of dopamine receptor agonists could reduce circuit responsiveness, facilitate fear extinction, and improve cognitive flexibility in anorexia nervosa, as they may be particularly effective during underweight and low gonadal hormone states. This article provides evidence that the dopamine receptor system could be a key factor in the pathophysiology of anorexia nervosa and dopamine agonists could be helpful in reducing core symptoms of the disorder. This review is a theoretical approach that primarily focuses on dopamine receptor function as this system has been mechanistically better described than other neurotransmitters that are altered in anorexia nervosa. However, those proposed dopamine mechanisms in anorexia nervosa also warrant further study with respect to their interaction with other neurotransmitter systems, such as serotonin pathways.

  18. Anorexia of infection as a mechanism of host defense.

    Science.gov (United States)

    Murray, M J; Murray, A B

    1979-03-01

    The role of anorexia of infection as a mechanism of host defense was studied by force-feeding infected mice to a normal energy intake. Their mortality and survival times were then compared with those of infected mice feeding ad libitum. Mortality was increased and survival time shortened in force fed animals. Our observations suggest that anorexia, by reducing energy intake, has a significant role in the early defense of the host.

  19. Anorexia nervosa - fenomen ponowoczesnej kultury i choroba systemu rodzinnego

    OpenAIRE

    2005-01-01

    The aim of this article is to present anorexia nervosa as a complex phenomenon which ought to be analyzed in macro-, mezzo- and microstructural context. Anorexia is defined in terms of “self destructive adaptation strategy” which is considered to be a reaction to specific configuration of cultural patterns and family system. The most significant factors affecting the process of forming the identity based on being an anorectic are: perfectionism and contemporary standards of bea...

  20. The Disjointed Historical Trajectory of Anorexia Nervosa Before 1970

    OpenAIRE

    2016-01-01

    Responses in pre-modern eras to anorexia nervosa (as now understood) varied widely, from religious piety and sanctity through fear and superstition. While noting briefly the limited conceptualizations from pre-modern history this article is primarily focused from the late 19th century, commencing with helpful but tentative formulations of anorexia nervosa for early-modern medicine that were laid out, consistently between themselves, by Lesègue, Gull and Osler. Yet that promising biomedical ad...

  1. Severe anorexia nervosa in males: clinical presentations and medical treatment.

    Science.gov (United States)

    Sabel, Allison L; Rosen, Elissa; Mehler, Philip S

    2014-01-01

    The clinical presentation and medical complications of severe anorexia nervosa among males were examined to further the understanding of this increasingly prevalent condition. Fourteen males were admitted to a medical stabilization unit over the study period. Males with severe anorexia nervosa were found to have a multitude of significant medical and laboratory abnormalities, which are in need of treatment via judicious, nutritional rehabilitation and weight restoration to prevent additional morbidity and to facilitate transfer and admission to traditional eating disorder programs.

  2. [Psychodiagnostic findings in anorexia nervosa and post-pill amenorrhea].

    Science.gov (United States)

    Ehle, G; Wahlstab, A; Ott, J

    1982-11-01

    Anorexia nervosa is originated from disturbances at various points of the cortico-hypothalamo-hypophyseal axis. 65 patients suffering from anorexia nervosa or post-pill-amenorrhea were classified by cluster-analysis with 174 marks of the social, psychodynamic and biological levels. The different psychodiagnostic characteristics (470-F-Test, Hamilton-Depression-Scale, Beck-Depression-Scale, Giessen-test) are discussed according to the 3 clusters.

  3. Could Dopamine Agonists Aid in Drug Development for Anorexia Nervosa?

    Directory of Open Access Journals (Sweden)

    Guido eFrank

    2014-11-01

    Full Text Available Anorexia nervosa is a severe psychiatric disorder most commonly starting during the teenage years and associated with food refusal and low body weight. Typically there is a loss of menses, intense fear of gaining weight and an often delusional quality of altered body perception. Anorexia nervosa is also associated with a pattern of high cognitive rigidity, which may contribute to treatment resistance and relapse. The complex interplay of state and trait biological, psychological and social factors has complicated identifying neurobiological mechanisms that contribute to the illness. The dopamine D1 and D2 neurotransmitter receptors are involved in motivational aspects of food approach, fear extinction and cognitive flexibility. They could therefore be important targets to improve core and associated behaviors in anorexia nervosa. Treatment with dopamine antagonists has shown little benefit, and it is possible that antagonists over time increase an already hypersensitive dopamine pathway activity in anorexia nervosa. On the contrary, application of dopamine receptor agonists could reduce circuit responsiveness, facilitate fear extinction and improve cognitive flexibility in anorexia nervosa, as they may be particularly effective during underweight and low gonadal hormone states. This article provides evidence that the dopamine receptor system could be a key factor in the pathophysiology of anorexia nervosa and dopamine agonists could be helpful in reducing core symptoms of the disorder. This review is a theoretical approach that primarily focuses on dopamine receptor function as this system has been mechanistically better described than other neurotransmitters that are altered in anorexia nervosa. However, those proposed dopamine mechanisms in anorexia nervosa also warrant further study with respect to their interaction with other neurotransmitter systems, such as serotonin pathways.

  4. Mechanisms of the anorexia of aging-a review.

    Science.gov (United States)

    Wysokiński, Adam; Sobów, Tomasz; Kłoszewska, Iwona; Kostka, Tomasz

    2015-08-01

    Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.

  5. Female-biased anorexia and anxiety in the Syrian hamster.

    Science.gov (United States)

    Shannonhouse, John L; Fong, Li An; Clossen, Bryan L; Hairgrove, Ross E; York, Daniel C; Walker, Benjamin B; Hercules, Gregory W; Mertesdorf, Lauren M; Patel, Margi; Morgan, Caurnel

    2014-06-22

    Anorexia and anxiety cause significant mortality and disability with female biases and frequent comorbidity after puberty, but the scarcity of suitable animal models impedes understanding of their biological underpinnings. It is reported here that in adult or weanling Syrian hamsters, relative to social housing (SH), social separation (SS) induced anorexia characterized as hypophagia, weight loss, reduced adiposity, and hypermetabolism. Following anorexia, SS increased reluctance to feed, and thigmotaxis, in anxiogenic environments. Importantly, anorexia and anxiety were induced post-puberty with female biases. SS also reduced hypothalamic corticotrophin-releasing factor mRNA and serum corticosteroid levels assessed by RT-PCR and RIA, respectively. Consistent with the view that sex differences in adrenal suppression contributed to female biases in anorexia and anxiety by disinhibiting neuroimmune activity, SS elevated hypothalamic interleukin-6 and toll-like receptor 4 mRNA levels. Although corticosteroids were highest during SH, they were within the physiological range and associated with juvenile-like growth of white adipose, bone, and skeletal muscle. These results suggest that hamsters exhibit plasticity in bioenergetic and emotional phenotypes across puberty without an increase in stress responsiveness. Thus, social separation of hamsters provides a model of sex differences in anorexia and anxiety during adulthood and their pathogeneses during adolescence.

  6. Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus

    Directory of Open Access Journals (Sweden)

    Daniel Reyes-Haro

    2016-01-01

    Full Text Available Anorexia nervosa is an eating disorder observed primarily in young women. The neurobiology of the disorder is unknown but recently magnetic resonance imaging showed a volume reduction of the hippocampus in anorexic patients. Dehydration-induced anorexia (DIA is a murine model that mimics core features of this disorder, including severe weight loss due to voluntary reduction in food intake. The energy supply to the brain is mediated by astrocytes, but whether their density is compromised by anorexia is unknown. Thus, the aim of this study was to estimate GFAP+ cell density in the main regions of the hippocampus (CA1, CA2, CA3, and dentate gyrus in the DIA model. Our results showed that GFAP+ cell density was significantly reduced (~20% in all regions of the hippocampus, except in CA1. Interestingly, DIA significantly reduced the GFAP+ cells/nuclei ratio in CA2 (−23% and dentate gyrus (−48%. The reduction of GFAP+ cell density was in agreement with a lower expression of GFAP protein. Additionally, anorexia increased the expression of the intermediate filaments vimentin and nestin. Accordingly, anorexia increased the number of reactive astrocytes in CA2 and dentate gyrus more than twofold. We conclude that anorexia reduces the hippocampal GFAP+ cell density and increases vimentin and nestin expression.

  7. Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus

    Science.gov (United States)

    Labrada-Moncada, Francisco Emmanuel; Varman, Durairaj Ragu; Krüger, Janina; Morales, Teresa; Miledi, Ricardo; Martínez-Torres, Ataúlfo

    2016-01-01

    Anorexia nervosa is an eating disorder observed primarily in young women. The neurobiology of the disorder is unknown but recently magnetic resonance imaging showed a volume reduction of the hippocampus in anorexic patients. Dehydration-induced anorexia (DIA) is a murine model that mimics core features of this disorder, including severe weight loss due to voluntary reduction in food intake. The energy supply to the brain is mediated by astrocytes, but whether their density is compromised by anorexia is unknown. Thus, the aim of this study was to estimate GFAP+ cell density in the main regions of the hippocampus (CA1, CA2, CA3, and dentate gyrus) in the DIA model. Our results showed that GFAP+ cell density was significantly reduced (~20%) in all regions of the hippocampus, except in CA1. Interestingly, DIA significantly reduced the GFAP+ cells/nuclei ratio in CA2 (−23%) and dentate gyrus (−48%). The reduction of GFAP+ cell density was in agreement with a lower expression of GFAP protein. Additionally, anorexia increased the expression of the intermediate filaments vimentin and nestin. Accordingly, anorexia increased the number of reactive astrocytes in CA2 and dentate gyrus more than twofold. We conclude that anorexia reduces the hippocampal GFAP+ cell density and increases vimentin and nestin expression. PMID:27579183

  8. Social Cognition in Child and Adolescents with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    ipek Percinel

    2015-06-01

    Full Text Available Social cognition represents the mental processes of social interaction between oneself and others. In recent years, the interest in social cognition skills has increased in cases with eating disorders. Anorexia nervosa is an eating disorder that is associated with the multiple factors in etiology. Treatment of anorexia nervosa is still controversial. The youths diagnosed with anorexia nervosa are known to be as the most difficult group in eating disorders for building therapeutic relations. Studies, mostly suggests that there are difficulties in social cognitive functions in patients with anorexia nervosa. However, there are studies that reported different results. It seems that, the majority of studies which evaluate the social cognitive functions in patients with anorexia nervosa, are carried out with the adult age group. There are limited number of studies in child and adolescent age group. The purpose of this paper was to examinate the studies of social cognitive skills in children and adolescents diagnosed with anorexia nervosa and present the general characteristics. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 178-189

  9. Anorexia in human and experimental animal models: physiological aspects related to neuropeptides.

    Science.gov (United States)

    Yoshimura, Mitsuhiro; Uezono, Yasuhito; Ueta, Yoichi

    2015-09-01

    Anorexia, a loss of appetite for food, can be caused by various physiological and pathophysiological conditions. In this review, firstly, clinical aspects of anorexia nervosa are summarized in brief. Secondly, hypothalamic neuropeptides responsible for feeding regulation in each hypothalamic nucleus are discussed. Finally, three different types of anorexigenic animal models; dehydration-induced anorexia, cisplatin-induced anorexia and cancer anorexia-cachexia, are introduced. In conclusion, hypothalamic neuropeptides may give us novel insight to understand and find effective therapeutics strategy essential for various kinds of anorexia.

  10. Concordancia entre la predicción e índices de intubación difícil en pacientes con trauma maxilofacial

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    Iván Manotas Arévalo

    2013-10-01

    Full Text Available ResumenObjetivo: Determinar la concordancia entre la predicción de intubación difícil medida por los índices de Mallampati modificado (Ma, distancia tiromentoniana (DT y apertura bucal (AB, en pacientes con fractura maxilar y/o mandibular que requirieron manejo del trauma bajo anestesia general con intubación endotraqueal. Metodología: estudio descriptivo prospectivo con una muestra 61 pacientes, se diligenció una historia clínica donde se recolectó información como: diagnóstico, edad, sexo, valores de los índices predictivos, predicción según índices, tipo de intubación, dificultad de intubación y porcentaje de concordancia. Los datos fueron procesados mediante tabulación mecánica utilizando una hoja de cálculo del programa Excel. Resultados: se evidenció baja concordancia entre la predicción del índice y la intubación real lograda, obteniéndose 32,8% de predicción de intubación difícil, en cuanto a la dificultad en la intubación durante el procedimiento se encontró que el 83,6% se logró sin dificultad, el 16,4% presentó dificultad media y en el 100% de los casos se logró intubar. Conclusión: ninguna de estas clasificaciones e índices predictivos individualmente ofrece una certeza del 100% y presencia de trauma maxilofacial en pacientes adultos intervenidos quirúrgicamente con intubación endotraqueal no limitó el compromiso de la vía aérea, al igual que en la predicción de una intubación difícil. (DUAZARY 2011 No. 2, 237 - 242AbstractObjective: To determine the correlation between the prediction of difficult intubation as measured by modified Mallampati index (Ma, thyromental distance (DT and mouth opening (AB in patients with a fractured jaw and / or mandibular trauma management requiring anesthesia general endotracheal intubation. Methods: prospective study with a sample 61 patients filled out a medical history is where information was collected as diagnosis, age, sex, values of the predictive index

  11. Reflexiones sobre la anorexia Reflexões sobre a anorexia Reflections about anorexy

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    Andrea Ferrero

    2009-03-01

    Full Text Available El propósito de este artículo es presentar algunas reflexiones sobre el trastorno anoréxico, algunas posibles explicaciones sobre el mismo, y proponer una respuesta posible desde la perspectiva psicoanalítica. Este estudio plantea el sufrimiento del sujeto como la manifestación de una relación inconsciente entre las ecuaciones afectivas y el entramado social de la persona. Se discute la particular relación que se establece entre la necesidad, la demanda y el deseo en este tipo de trastornos, y cómo el síntoma anoréxico se plantea como estrategia enferma de defensa del deseo. Se puede considerar el impacto que la presión de la cultura tiene en la manutención del síntoma anoréxico, dada la importancia del ideal de delgadez y belleza, también asociados con la obtención de mayor éxito y felicidad. Finalmente, se plantea el valor del análisis de la personalidad en relación a aspectos sociales para la consideración del trastorno anoréxico, el cual debe ser comprendido singularmente, más allá de sus manifestaciones y de la posible limitación a la estructura de la histeria.O objetivo deste artigo é apresentar algumas reflexões sobre o processo de adoecimento da anorexia e algumas possíveis explicações sobre esse processo, bem como propor uma possível resposta a partir da perspectiva psicanalítica. Este estudo estabelece o sofrimento do sujeito como a manifestação da relação inconsciente entre as equações afetivas e a trama social da pessoa. Procura-se discutir a peculiar relação entre necessidade, demanda e desejo neste tipo de transtorno, e como a anorexia é uma estratégia patológica de defesa do desejo. Pôde-se observar a influência da pressão da cultura na manutenção da anorexia, justificada pelo ideal de magreza e de beleza, que também são associadas com a possibilidade de obter maior êxito e felicidade. Por último, considera-se o valor da análise da personalidade em relação aos aspectos sociais

  12. Concordancia entre observadores en la detección por palpación de bocio en población escolar de 6 a 14 años

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    Begoña Peris Roig

    2009-01-01

    Full Text Available Fundamento: Estimar la concordancia entre observadores en la detección de bocio por palpación manual en la población escolar. Métodos. Durante un periodo de 5 meses durante el curso escolar 2001/2002 se estudió la presencia de bocio en una muestra representativa de 845 escolares de 6 a 14 años de 18 colegios de una Área de Salud de la Comunidad Valenciana. La exploración fue realizada de forma enmascarada por dos observadores (siempre los mismos. El tamaño tiroideo se estableció en seis grados (OA, OB, I, II, III y IV. Se consideró bocio a partir del grado OB inclusive. La concordancia se valoró en relación a variables como edad, sexo, masa corporal, y día de exploración. Se utilizó el índice kappa ponderado como medida de concordancia. Resultados. La prevalencia global de bocio fue del 40,4% según el observador 1º y de 36,8% para el 2º. La concordancia entre observadores tuvo un índice kappa de 0,83 (IC95% 0,78 -0,88 y fue similar en relación al sexo, la masa corporal y el día de exploración. Según la edad de los niños: de 6 a 7 años (kappa 0,80; IC95% 0,69-0,91 de 12 a 14 años (kappa 0,85; IC95% 0,72 - 0,97. Conclusiones. Los observadores consiguieron una concordancia muy alta en la detección de bocio por palpación manual. La edad del niño influyó en el grado de concordancia con mayor dificultad en los más pequeños.

  13. Using the Activity-based Anorexia Rodent Model to Study the Neurobiological Basis of Anorexia Nervosa.

    Science.gov (United States)

    Chowdhury, Tara Gunkali; Chen, Yi-Wen; Aoki, Chiye

    2015-10-22

    Anorexia nervosa (AN) is a psychiatric illness characterized by excessively restricted caloric intake and abnormally high levels of physical activity. A challenging illness to treat, due to the lack of understanding of the underlying neurobiology, AN has the highest mortality rate among psychiatric illnesses. To address this need, neuroscientists are using an animal model to study how neural circuits may contribute toward vulnerability to AN and may be affected by AN. Activity-based anorexia (ABA) is a bio-behavioral phenomenon described in rodents that models the key symptoms of anorexia nervosa. When rodents with free access to voluntary exercise on a running wheel experience food restriction, they become hyperactive - running more than animals with free access to food. Here, we describe the procedures by which ABA is induced in adolescent female C57BL/6 mice. On postnatal day 36 (P36), the animal is housed with access to voluntary exercise on a running wheel. After 4 days of acclimation to the running wheel, on P40, all food is removed from the cage. For the next 3 days, food is returned to the cage (allowing animals free food access) for 2 hr daily. After the fourth day of food restriction, free access to food is returned and the running wheel is removed from the cage to allow the animals to recover. Continuous multi-day analysis of running wheel activity shows that mice become hyperactive within 24 hr following the onset of food restriction. The mice run even during the limited time during which they have access to food. Additionally, the circadian pattern of wheel running becomes disrupted by the experience of food restriction. We have been able to correlate neurobiological changes with various aspects of the animals' wheel running behavior to implicate particular brain regions and neurochemical changes with resilience and vulnerability to food-restriction induced hyperactivity.

  14. Rikkunshito, a ghrelin potentiator, ameliorates anorexia-cachexia syndrome

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    Naoki eFujitsuka

    2014-12-01

    Full Text Available Anorexia-cachexia syndrome develops during the advanced stages of various chronic diseases in which patients exhibit a decreased food intake, weight loss, and muscle tissue wasting. For these patients, this syndrome is a critical problem leading to an increased rate of morbidity and mortality. The present pharmacological therapies for treating anorexia-cachexia have limited effectiveness. The Japanese herbal medicine rikkunshito is often prescribed for the treatment of anorexia and upper gastrointestinal disorders. Thus, rikkunshito is expected to be beneficial for the treatment of patients with anorexia-cachexia syndrome. In this review, we summarize the effects of rikkunshito and its mechanisms of action on anorexia-cachexia.Persistent loss of appetite leads to a progressive depletion of body energy stores, which is frequently associated with cachexia. Consequently, regulating appetite and energy homeostasis is critically important for treating cachexia. Ghrelin is mainly secreted from the stomach, and it plays an important role in initiating feeding, controlling gastrointestinal motility, and regulating energy expenditure. Recent clinical and basic science studies have demonstrated that the critical mechanism of rikkunshito underlies endogenous ghrelin activity. Interestingly, several components of rikkunshito target multiple gastric and central sites, and regulate the secretion, receptor sensitization, and degradation of ghrelin. Rikkunshito is effective for the treatment of anorexia, body weight loss, muscle wasting, and anxiety-related behavior. Furthermore, treatment with rikkunshito was observed to prolong survival in an animal model of cachexia. The use of a potentiator of ghrelin signaling, such as rikkunshito, may represent a novel approach for the treatment of anorexia-cachexia syndrome.

  15. Anorexia Nervosa: Analysis of Trabecular Texture with CT.

    Science.gov (United States)

    Tabari, Azadeh; Torriani, Martin; Miller, Karen K; Klibanski, Anne; Kalra, Mannudeep K; Bredella, Miriam A

    2016-10-31

    Purpose To determine indexes of skeletal integrity by using computed tomographic (CT) trabecular texture analysis of the lumbar spine in patients with anorexia nervosa and normal-weight control subjects and to determine body composition predictors of trabecular texture. Materials and Methods This cross-sectional study was approved by the institutional review board and compliant with HIPAA. Written informed consent was obtained. The study included 30 women with anorexia nervosa (mean age ± standard deviation, 26 years ± 6) and 30 normal-weight age-matched women (control group). All participants underwent low-dose single-section quantitative CT of the L4 vertebral body with use of a calibration phantom. Trabecular texture analysis was performed by using software. Skewness (asymmetry of gray-level pixel distribution), kurtosis (pointiness of pixel distribution), entropy (inhomogeneity of pixel distribution), and mean value of positive pixels (MPP) were assessed. Bone mineral density and abdominal fat and paraspinal muscle areas were quantified with quantitative CT. Women with anorexia nervosa and normal-weight control subjects were compared by using the Student t test. Linear regression analyses were performed to determine associations between trabecular texture and body composition. Results Women with anorexia nervosa had higher skewness and kurtosis, lower MPP (P anorexia nervosa. Conclusion Patients with anorexia nervosa had increased skewness and kurtosis and decreased entropy and MPP compared with normal-weight control subjects. These parameters were associated with lowest lifetime weight and duration of amenorrhea, but there were no such associations with bone mineral density. These findings suggest that trabecular texture analysis might contribute information about bone health in anorexia nervosa that is independent of that provided with bone mineral density. (©) RSNA, 2016.

  16. Valor del grosor de la capa de fibras nerviosas de la retina medido mediante tomografía de coherencia óptica como marcador de daño neuroaxonal en la esclerosis múltiple

    OpenAIRE

    López Lizcano, Ruth María

    2012-01-01

    Estudio del valor del grosor de la Capa de Fibras Nerviosas de la Retina (CFNR) a lo largo de un año como marcador de daño neuroaxonal en pacientes con distintos estadios de Esclerosis Múltiple (EM): pacientes con síndrome clínico aislado (CIS) que es el estadio más inicial de enfermedad desmielinizante, pacientes con esclerosis múltiple remitente-recurrente (EMRR) y pacientes con esclerosis múltiple primaria-progresiva (EMPP) frente a sujetos sanos. Estudio de las posibles correlaciones exis...

  17. Valor diagnóstico y pronóstico de la evaluación de la capa de fibras nerviosas de la retina en la esclerosis múltiple

    OpenAIRE

    Herrero Latorre, Raquel; Polo Llorens, Vicente; Frezzotti, Pablo; García Martín, Elena

    2013-01-01

    Introducción: El tema principal de las cuatro publicaciones internacionales que componen esta tesis doctoral se centra en el estudio de la capa de fibras nerviosas de la retina en pacientes con esclerosis múltiple como método para mejorar y acelerar el proceso diagnóstico así como el seguimiento y la monitorización de esta enfermedad. Material y Métodos: Se realizó un estudio observacional y prospectivo donde se incluyeron 150 sujetos con esclerosis múltiple y 150 sujetos sanos. El protoc...

  18. Evaluación del efecto de la administración intravítrea de ranibizumab sobre el grosor de la capa de fibras nerviosas de la retina

    OpenAIRE

    Ruiz Calvo, Aurora

    2013-01-01

    El glaucoma y la degeneración macular asociada a la edad son las dos causas más frecuentes de ceguera irreversible en los países desarrollados. En el glaucoma, se produce una pérdida progresiva en la capa de fibras nerviosas de la retina que se traduce en una pérdida progresiva de campo visual y que en fases avanzadas puede conducir a la ceguera. En la degeneración macular asociada a la edad de tipo exudativo, la proliferación de neovasos en el área macular y la consiguiente exudación y sangr...

  19. Osteopenia and bone fractures in a man with anorexia nervosa and hypogonadism

    Energy Technology Data Exchange (ETDEWEB)

    Rigotti, N.A.; Neer, R.M.; Jameson, L.

    1986-07-18

    Women with anorexia nervosa have reduced skeletal mass. Both anorexia and osteopenia are less common in men. We describe a 22-year-old man with anorexia nervosa and severe osteopenia involving both cortical and trabecular bone who developed a pelvic fracture and multiple vertebral compression fractures. He was found to have secondary hypogonadotropic hypogonadism that was reversible with weight gain. This case illustrates the need to consider osteopenia as a potential complication of anorexia nervosa in males as well as females.

  20. Compulsivity in anorexia nervosa: a transdiagnostic concept.

    Science.gov (United States)

    Godier, Lauren R; Park, Rebecca J

    2014-01-01

    The compulsive nature of weight loss behaviors central to anorexia nervosa (AN), such as relentless self-starvation and over-exercise, has led to the suggestion of parallels between AN and other compulsive disorders such as obsessive-compulsive disorder (OCD) and addictions. There is a huge unmet need for effective treatments in AN, which has high rates of morbidity and the highest mortality rate of any psychiatric disorder, yet a grave paucity of effective treatments. Viewing compulsivity as a transdiagnostic concept, seen in various manifestations across disorders, may help delineate the mechanisms responsible for the persistence of AN, and aid treatment development. We explore models of compulsivity that suggest dysfunction in cortico-striatal circuitry underpins compulsive behavior, and consider evidence of aberrancies in this circuitry across disorders. Excessive habit formation is considered as a mechanism by which initially rewarding weight loss behavior in AN may become compulsive over time, and the complex balance between positive and negative reinforcement in this process is considered. The physiological effects of starvation in promoting compulsivity, positive reinforcement, and habit formation are also discussed. Further research in AN may benefit from a focus on processes potentially underlying the development of compulsivity, such as aberrant reward processing and habit formation. We discuss the implications of a transdiagnostic perspective on compulsivity, and how it may contribute to the development of novel treatments for AN.

  1. Genetic findings in anorexia and bulimia nervosa.

    Science.gov (United States)

    Hinney, Anke; Scherag, Susann; Hebebrand, Johannes

    2010-01-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are complex disorders associated with disordered eating behavior. Heritability estimates derived from twin and family studies are high, so that substantial genetic influences on the etiology can be assumed for both. As the monoaminergic neurotransmitter systems are involved in eating disorders (EDs), candidate gene studies have centered on related genes; additionally, genes relevant for body weight regulation have been considered as candidates. Unfortunately, this approach has yielded very few positive results; confirmed associations or findings substantiated in meta-analyses are scant. None of these associations can be considered unequivocally validated. Systematic genome-wide approaches have been performed to identify genes with no a priori evidence for their relevance in EDs. Family-based scans revealed linkage peaks in single chromosomal regions for AN and BN. Analyses of candidate genes in one of these regions led to the identification of genetic variants associated with AN. Currently, an international consortium is conducting a genome-wide association study for AN, which will hopefully lead to the identification of the first genome-wide significant markers.

  2. Compulsivity in Anorexia Nervosa: a transdiagnostic concept

    Directory of Open Access Journals (Sweden)

    Lauren Rose Godier

    2014-07-01

    Full Text Available The compulsive nature of weight loss behaviours central to Anorexia Nervosa (AN, such as relentless self-starvation and over-exercise, has led to the suggestion of parallels between AN and other compulsive disorders such as Obsessive-Compulsive Disorder (OCD and addictions. There is a huge unmet need for effective treatments in AN, which has high rates of morbidity and the highest mortality rate of any psychiatric disorder, yet a grave paucity of effective treatments. Viewing compulsivity as a transdiagnostic concept, seen in various manifestations across disorders, may help delineate the mechanisms responsible for the persistence of AN, and aid treatment development. We explore models of compulsivity that suggest dysfunction in cortico-striatal circuitry underpins compulsive behaviour, and consider evidence of aberrances in this circuitry across disorders. Excessive habit formation is considered as a mechanism by which initially rewarding weight loss behaviour in AN may become compulsive over time, and the complex balance between positive and negative reinforcement in this process is considered. The physiological effects of starvation in promoting compulsivity, positive reinforcement and habit formation are also discussed. Further research in AN may benefit from a focus on processes potentially underlying the development of compulsivity, such as aberrant reward processing and habit formation. We discuss the implications of a transdiagnostic perspective on compulsivity, and how it may contribute to the development of novel treatments for AN.

  3. [Anorexia nervosa - from a neuroscience perspective].

    Science.gov (United States)

    Kappel, Viola; van Noort, Betteke; Ritschel, Franziska; Seidel, Maria; Ehrlich, Stefan

    2014-01-01

    Anorexia nervosa is a frequent disorder especially among adolescent girls and young women, with high morbidity, mortality, and relapse rates. To date, no single therapeutic approach has proved to be superior to others (Herpertz et al., 2011). It remains unclear how its etiology and pathology are encoded within cognitive, neural, and endocrinological processes that modulate important mechanisms in appetitive processing and weight regulation. Yet, several trait characteristics have been identified in AN which might reflect predisposing factors. Further, altered levels of neuropeptides and hormones that regulate appetite and feeding behavior have been found during both the acute and the recovered state, pointing to dysfunctional mechanisms in AN that persist even after malnutrition has ceased. Researchers are also hoping that brain imaging techniques will allow for a more detailed investigation of the neural basis of reward and punishment sensitivity that appears to be altered in AN. The integration and extension of recent findings in these areas will hopefully provide a more comprehensive understanding of the disorder and hence enable the development of more effective treatments.

  4. Set Shifting Among Adolescents with Anorexia Nervosa

    Science.gov (United States)

    Fitzpatrick, Kathleen Kara; Darcy, Alison; Colborn, Danielle; Gudorf, Caroline; Lock, James

    2012-01-01

    Objective Set shifting difficulties are documented for adults with anorexia nervosa (AN). However, AN typically onsets in adolescents and it is unclear if set-shifting difficulties are a result of chronic AN or present earlier in its course. This study examined whether adolescents with short duration AN demonstrated set shifting difficulties compared to healthy controls (HC). Method Data on set shifting collected from the Delis-Kaplan Executive Functioning System (DKEFS) and Wisconsin Card Sort Task (WCST) as well as eating psychopathology were collected from 32 adolescent inpatients with AN and compared to those from 22 HCs. Results There were no differences in set-shifting in adolescents with AN compared to HCs on most measures. Conclusion The findings suggest that set-shifting difficulties in AN may be a consequence of AN. Future studies should explore set-shifting difficulties in a larger sample of adolescents with the AN to determine if there is sub-set of adolescents with these difficulties and determine any relationship of set-shifting to the development of a chronic from of AN. PMID:22692985

  5. The endocrine manifestations of anorexia nervosa: mechanisms and management.

    Science.gov (United States)

    Schorr, Melanie; Miller, Karen K

    2017-03-01

    Anorexia nervosa is a psychiatric disorder characterized by altered body image, persistent food restriction and low body weight, and is associated with global endocrine dysregulation in both adolescent girls and women. Dysfunction of the hypothalamic-pituitary axis includes hypogonadotropic hypogonadism with relative oestrogen and androgen deficiency, growth hormone resistance, hypercortisolaemia, non-thyroidal illness syndrome, hyponatraemia and hypooxytocinaemia. Serum levels of leptin, an anorexigenic adipokine, are suppressed and levels of ghrelin, an orexigenic gut peptide, are elevated in women with anorexia nervosa; however, levels of peptide YY, an anorexigenic gut peptide, are paradoxically elevated. Although most, but not all, of these endocrine disturbances are adaptive to the low energy state of chronic starvation and reverse with treatment of the eating disorder, many contribute to impaired skeletal integrity, as well as neuropsychiatric comorbidities, in individuals with anorexia nervosa. Although 5-15% of patients with anorexia nervosa are men, only limited data exist regarding the endocrine impact of the disease in adolescent boys and men. Further research is needed to understand the endocrine determinants of bone loss and neuropsychiatric comorbidities in anorexia nervosa in both women and men, as well as to formulate optimal treatment strategies.

  6. Neurofunctional areas related to food appetency in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Juán José Cervantes-Navarrete

    2012-07-01

    Full Text Available In Anorexia Nervosa the observable phenomenon is the suppression of appetite. Little is known about the biological and psychological (top-down bases that maintain this pathological state. However, Anorexia Nervosa is a biological, psychological and social model where the main behavioral characteristic is the inhibition of eating behavior; not by bottom-up but top-down regulation. Objective: To explore the areas of the brain associated with food appetency through functional magnetic resonance in women with anorexia nervosa. Methods: The subjects include 5 female with Restrictive type of Anorexia Nervosa and five controls female with similar in age and low weigh. The subjects were within the MRI scanner and while took fMRI they saw food images that would generate appetite. The subjects were in fasting state and mentally prepare by instruction “imagine you are eating the food presented in the following images”. Results: Compared differences in the activation between subjects four regions were found significant: the anterior cingulate, left front medial region and the left and right midbrain. Conclusions: The patients with Anorexia Nervosa present different activated cerebral areas to those of the controls during the visual exposition to food in hungry state and with evoke cognitions associated with eat food; those regions may be implicated in reward and self-control.

  7. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  8. Plasma ghrelin concentrations, food intake, and anorexia in liver failure.

    Science.gov (United States)

    Marchesini, Giulio; Bianchi, Giampaolo; Lucidi, Paola; Villanova, Nicola; Zoli, Marco; De Feo, Pierpaolo

    2004-05-01

    Ghrelin is related to feeding behavior and nutrition in several physiological and pathological conditions. We tested the hypothesis that the anorexia and the decreased food intake of advanced liver failure might be associated with hyperghrelinemia. Fasting ghrelin was measured in 43 cirrhotic patients, food intake was self-assessed using the Corli score and a 3-d dietary record (n = 25), and anorexia/hunger was tested by a Likert scale. Fifty healthy subjects, matched for age and body mass index, served as controls. Ghrelin levels were not systematically increased in cirrhosis (414 +/- 164 vs. 398 +/- 142 pmol/liter in controls) but increased with decreasing Corli score (P = 0.014) and along the scale of anorexia/hunger (P = 0.0001), which were both related to the 3-d dietary record (P = 0.009 and P 500 pmol/liter) was significantly associated with a low calorie intake [odds ratio (OR), 3.03 for any 100-calorie reduced intake; P = 0.015], a reduced Corli score (OR, 3.09; P = 0.031), and the anorexia score (OR, 3.37; P = 0.009), after adjustment for body mass index. The study confirms the previously observed relationship of fasting ghrelin with food intake in disease-associated malnutrition. In the presence of anorexia, hyperghrelinemia might indicate a compensatory mechanism trying to stimulate food intake, which is nonetheless ineffective in the physiological range.

  9. Clima motivacional en Educación Física: concordancia entre las percepciones de los alumnos y las de sus profesores

    Directory of Open Access Journals (Sweden)

    Melchor Guti\\u00E9rrez

    2011-01-01

    Full Text Available En este estudio se han comparado las percepciones de alumnos y profesores sobre el clima motivacional de las clases de educación física. Los participantes, 2189 alumnos de 13 a 17 años y sus 94 profesores, completaron una versión española de L'Echelle de Perception du Climat Motivational (EPCM. Los análisis factoriales confirmatorios (AFC de primer y segundo orden han confirmado la estructura factorial de la versión original de la escala. Un análisis de concordancia entre las percepciones de los alumnos y las de sus profesores sobre el clima motivacional de la clase indicó que únicamente coinciden en el factor Búsqueda de Comparación por los Alumnos. Por otro lado, los análisis diferenciales han mostrado que los alumnos perciben un Clima de Ejecución más elevado, mientras que los profesores perciben mayor Clima de Maestría en las clases de educación física. Se discuten los resultados de cara a sus implicaciones para los educadores físicos.

  10. The Treatment of Anorexia Nervosa and Bulimia: A Multidimensional Group Approach.

    Science.gov (United States)

    Richards, P. Scott

    This paper defines the eating disorders of anorexia nervosa, bulimia, and bulimia nervosa, a bulimic subtype of anorexia nervosa. The diagnosis of these disorders is discussed and similarities and differences among the three disorders are reviewed. Etiological factors are considered and current trends in treatment of anorexia nervosa, bulimia, and…

  11. Readiness to Recover in Adolescent Anorexia Nervosa: Prediction of Hospital Admission

    Science.gov (United States)

    Ametller, L.; Castro, J.; Serrano, E.; Martinez, E.; Toro, J.

    2005-01-01

    Objectives: To determine if motivation to change in anorexia nervosa during treatment is a predictor of hospitalisation in adolescent patients. Method: The Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), the Eating Disorders Inventory-2 (EDI-2) and the Beck Depression Inventory (BDI) were administered to a group of 70 anorexia nervosa…

  12. Remission of anorexia nervosa after thyroidectomy: A report of two cases with Graves' disease and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Noguchi Hitoshi

    2011-12-01

    Full Text Available Abstract We report two patients with anorexia nervosa and Graves' disease who received subtotal thyroidectomy for Graves' disease and concomitantly experienced remission from anorexia nervosa. Both were young women (aged 20 and 26 at the time of surgery. Both had well controlled thyroid function and eating behavior at the time of surgery. Both were followed for over five years without relapse of anorexia nervosa or hyperthyroidism. These cases suggest the existence of an endocrine factor originating from the thyroid gland that is involved in the pathogenesis of anorexia nervosa. Since patients of thyroidectomy can remain in good health with supplement of thyroxine alone, it can be hypothesized that this anorexigenic endocrine factor is an evolutionary relic not necessary for the normal function of humans and does not have physiological effects unless secreted beyond normal levels. Given that, it implies the existence of a creature in the animal kingdom for which such an anorexigenic hormone is essential for survival. Migrating birds eat beyond their caloric expenditure before migration and become anorexic for the duration of their flight. It is also known that their thyroid function is elevated during migration. The normal physiology of migration is a complex mechanism involving the hypothalamic, pituitary, thyroid, adrenal and reproductive hormones. The mechanism of disease, however, can be simpler. A review of the literature is presented that suggest a heretofore unreported thyroid hormone, which is involved in the regulation of migration behavior, may be the responsible factor behind anorexia nervosa.

  13. Pro-anorexia, weight-loss drugs and the internet: an "anti-recovery" explanatory model of anorexia.

    Science.gov (United States)

    Fox, Nick; Ward, Katie; O'Rourke, Alan

    2005-11-01

    This paper explores the online "pro-anorexia" underground, a movement that supports those with anorexia and adopts an "anti-recovery" perspective on the disease. While encouraging a "healthy" diet to sustain an anorexic way-of-life, the movement also recommends the radical use of weight-loss pharmaceuticals to pursue and maintain low body weight, in contrast to their conventional use to treat obesity. Using ethnographic and interview data collected from participants in the "Anagrrl" website and online forum, we analyse the pro-anorexia (or "pro-ana") movement in terms of its underlying "explanatory model" of the disease, and contrast it with medical, psychosocial, sociocultural and feminist models that encourage a "normalisation" of body shape and weight. We suggest that for participants in pro-ana, anorexia represents stability and control, and Anagrrl offers support and guidance for those who wish to remain in this "sanctuary". We discuss the pro-anorexia movement's use of the internet to facilitate resistance to medical and social theories of disease, and its subversion of pharmaceutical technologies.

  14. Biased Interpretation of Ambiguous Social Scenarios in Anorexia Nervosa.

    Science.gov (United States)

    Cardi, Valentina; Turton, Robert; Schifano, Sylvia; Leppanen, Jenni; Hirsch, Colette R; Treasure, Janet

    2017-01-01

    Patients with anorexia nervosa experience increased sensitivity to the risk of social rejection. The aims of this study were to assess the interpretation of ambiguous social scenarios depicting the risk of rejection and to examine the relationship between interpretation biases and clinical symptoms. Thirty-five women with anorexia nervosa and 30 healthy eaters completed clinical questionnaires, alongside a sentence completion task. This task required participants to generate completions to ambiguous social scenarios and to endorse their best completion. Responses were rated as being negative, neutral or positive. Patients endorsed more negative interpretations and fewer neutral and positive interpretations compared with healthy eaters. The frequency of endorsed negative interpretations correlated with depression, anxiety and fear of weight gain and body disturbance. A negative interpretation bias towards social stimuli is present in women with anorexia nervosa and correlates with clinical symptoms. Interventions aimed at reducing this bias could improve illness prognosis. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

  15. [Are there specific factors in the psychotherapy of anorexia nervosa?].

    Science.gov (United States)

    Zipfel, Stephan; Resmark, Gaby

    2015-01-01

    The present literature review examines the question of how general and specific factors can be differentiated in the psychotherapy of anorexia nervosa. Over the past 10 years different research trends have appeared. On the one hand subclassifications of new therapy approaches from several schools of therapy have been propagated (e.g. CBT-E, FPT), on the other hand generic treatment manuals have been published that are rather adapted to patients needs (e.g. SSCM, TTM). On a third way, currently therapy manuals for special subgroups have been developed, e.g. for chronic patients with anorexia nervosa or family-based manuals for adolescents. A completely different direction follows those approaches that are based on neuropsychological models and deficits in anorexia nervosa. Overall, the results of current studies have been promising, however, there has not been a winner yet, the race is still open!

  16. The occupational roles of women with anorexia nervosa.

    Science.gov (United States)

    Quiles-Cestari, Leila Maria; Ribeiro, Rosane Pilot Pessa

    2012-01-01

    This study's objective was to understand how occupational roles of individuals with anorexia nervosa are configured. The sample was composed of a control group and 11 adult women with anorexia nervosa being cared for by the Eating Disorders Care Group in a hospital in Ribeirão Preto, SP, Brazil. Socio-demographic and anthropometric data were collected and the Role Checklist was applied. The results revealed a significant loss of roles for women with anorexia nervosa in relation to the performance of the roles worker, friend, and amateur/hobbyist, supporting the idea that psychosocial harm may arise from this eating disorder. The evaluation of occupational roles in the treatment of eating disorders is an important strategy for planning Occupational Therapy activities and supporting the creation of healthier spaces to enable individuals to resume occupational roles, and acquire independence and autonomy.

  17. Anorexia and Attachment: Dysregulated Defense and Pathological Mourning

    Directory of Open Access Journals (Sweden)

    elisa edelvecchio

    2014-10-01

    Full Text Available The role of Defensive exclusion (Deactivation and Segregated Systems in the development of early relationships and related to subsequent manifestations of symptoms of eating disorders was assessed using the Adult Attachment Projective Picture System (AAP. Fifty-one DSM-IV diagnosed women with anorexia participated in the study. Anorexic patients were primarily classified as dismissing or unresolved. Quantitative and qualitative analyses of defensive exclusion were carried out. Results showed potential benefits of using the AAP defense exclusion coding system, in addition to the main attachment classifications, in order to better understand the developmental issues involved in anorexia. Discussion concerned the processes, such as pathological mourning, that may underlie the associations between dismissing and unresolved attachment and anorexia. Implications for developmental research and clinical nosology are discussed.

  18. Gut Dysbiosis in Patients with Anorexia Nervosa.

    Science.gov (United States)

    Morita, Chihiro; Tsuji, Hirokazu; Hata, Tomokazu; Gondo, Motoharu; Takakura, Shu; Kawai, Keisuke; Yoshihara, Kazufumi; Ogata, Kiyohito; Nomoto, Koji; Miyazaki, Kouji; Sudo, Nobuyuki

    2015-01-01

    Anorexia nervosa (AN) is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25), including restrictive (ANR, n = 14) and binge-eating (ANBP, n = 11) subtypes, with those of age-matched healthy female controls (n = 21) using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA-targeted RT-quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients.

  19. Gut Dysbiosis in Patients with Anorexia Nervosa.

    Directory of Open Access Journals (Sweden)

    Chihiro Morita

    Full Text Available Anorexia nervosa (AN is a psychological illness with devastating physical consequences; however, its pathophysiological mechanism remains unclear. Because numerous reports have indicated the importance of gut microbiota in the regulation of weight gain, it is reasonable to speculate that AN patients might have a microbial imbalance, i.e. dysbiosis, in their gut. In this study, we compared the fecal microbiota of female patients with AN (n = 25, including restrictive (ANR, n = 14 and binge-eating (ANBP, n = 11 subtypes, with those of age-matched healthy female controls (n = 21 using the Yakult Intestinal Flora-SCAN based on 16S or 23S rRNA-targeted RT-quantitative PCR technology. AN patients had significantly lower amounts of total bacteria and obligate anaerobes including those from the Clostridium coccoides group, Clostridium leptum subgroup, and Bacteroides fragilis group than the age-matched healthy women. Lower numbers of Streptococcus were also found in the AN group than in the control group. In the analysis based on AN subtypes, the counts of the Bacteroides fragilis group in the ANR and ANBP groups and the counts of the Clostridium coccoides group in the ANR group were significantly lower than those in the control group. The detection rate of the Lactobacillus plantarum subgroup was significantly lower in the AN group than in the control group. The AN group had significantly lower acetic and propionic acid concentrations in the feces than the control group. Moreover, the subtype analysis showed that the fecal concentrations of acetic acid were lower in the ANR group than in the control group. Principal component analysis confirmed a clear difference in the bacterial components between the AN patients and healthy women. Collectively, these results clearly indicate the existence of dysbiosis in the gut of AN patients.

  20. The anorexia of aging in humans.

    Science.gov (United States)

    Hays, Nicholas P; Roberts, Susan B

    2006-06-30

    Energy intake is reduced in older individuals, with several lines of evidence suggesting that both physiological impairment of food intake regulation and non-physiological mechanisms are important. Non-physiological causes of the anorexia of aging include social (e.g. poverty, isolation), psychological (e.g. depression, dementia), medical (e.g. edentulism, dysphagia), and pharmacological factors. Physiological factors include changes in taste and smell, diminished sensory-specific satiety, delayed gastric emptying, altered digestion-related hormone secretion and hormonal responsiveness, as well as food intake-related regulatory impairments for which specific mechanisms remain largely unknown. Studies in healthy elderly individuals have shown that men who consume diets over several weeks providing either too few or too many calories relative to dietary energy needs subsequently do not compensate for the resulting energy deficit or surplus when provided an ad libitum diet. Healthy elders have also been shown to be less hungry at meal initiation and to become more rapidly satiated during a standard meal compared to younger adults. Studies in animal models are required to investigate potential mechanisms underlying these observations, while human studies should focus on examining the potential consequences of this phenomenon and practical therapeutic strategies for the maintenance of appropriate energy intake with increasing age. In light of this need, we have recently demonstrated that low reported hunger assessed using a simple questionnaire predicts unintentional weight loss in a sample of healthy older women, and thus may provide a clinically useful tool for identifying older individuals at risk for undesirable weight change and therefore at high priority for intervention.

  1. Anorexia resulting from fear of vomiting in four adolescent girls.

    Science.gov (United States)

    Manassis, K; Kalman, E

    1990-08-01

    Four adolescent girls were referred for psychiatric assessment because of suspected anorexia nervosa. Although all of them had lost at least 15% of their body weight, investigation showed that they did not meet the criteria for anorexia nervosa. In all cases, refusal to eat resulted from fear of vomiting following a viral illness and not from a desire to lose weight. Their family configurations and personal histories showed many similarities, including constricted range of affect and a notable lack of anger. With counseling and, in one case, psychotropic medication, the patients recovered promptly.

  2. Early-onset anorexia nervosa in girls with Asperger syndrome

    Directory of Open Access Journals (Sweden)

    Dudova I

    2015-07-01

    Full Text Available Iva Dudova, Jana Kocourkova, Jiri Koutek Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic Abstract: Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases of an eleven-year-old girl and a five-and-a-half-year-old girl with comorbid eating disorders and Asperger syndrome. Keywords: eating disorders, early-onset anorexia nervosa, autism spectrum disorders, Asperger syndrome, diagnostics, therapy

  3. Opportunities for targeting the fatigue-anorexia-cachexia symptom cluster.

    Science.gov (United States)

    Alesi, Erin R; del Fabbro, Egidio

    2014-01-01

    Cancer patients experience multiple symptoms throughout their illness trajectory. Symptoms consistently occurring together, known as symptom clusters, share common pathophysiologic mechanisms. Understanding and targeting such symptom clusters may allow for more effective and efficient use of treatments for a variety of symptoms. Fatigue-anorexia-cachexia is one of the most prevalent symptom clusters and significantly impairs quality of life. In this review, we explore the fatigue-anorexia-cachexia symptom cluster and focus on current and emerging therapies with an emphasis on pharmacologic management.

  4. Understanding the working alliance with clients diagnosed with anorexia nervosa.

    Science.gov (United States)

    Oyer, Laura; O'Halloran, Mary Sean; Christoe-Frazier, Liesel

    2016-01-01

    The therapeutic working alliance is a vital ingredient of psychotherapy, specifically for clients diagnosed with anorexia nervosa, as progress is often slow and treatment difficult. This qualitative phenomenological study investigated the experiences of eight clients with anorexia nervosa and seven therapists who work with this population, regarding which therapist factors aided in and challenged the working alliance formation in individual psychotherapy. Data was gathered through semi-structured interviews. Some helpful therapist factors included collaboration, appropriate self-disclosure, providing a warm and safe environment, and willingness to be contacted outside of a session. Unhelpful factors included lack of attunement and objectivity and failure to individualize treatment.

  5. The analyst's desire in the clinic of anorexia

    Directory of Open Access Journals (Sweden)

    Mariana Benatto Pereira da Silva

    2010-06-01

    Full Text Available The present work deals with the issue of the analyst's desire in the psychoanalytical treatment of anorexia. It analyzes important elements to establish transference in these cases, as the pursuit of death and the choice of refusing food as a way of controlling the demands of the Other. It then discusses the "analist's desire" function in this clinic. Rejecting the definition of a treatment model and the structural categorization of anorexia, we can find in the cases of the girl of Angouleme (Charcot and Sidonie (M. Mannoni present possible subjective ways to get out of this psychopathological impasse, by means of this function.

  6. alpha-MSH enhances activity-based anorexia.

    Science.gov (United States)

    Hillebrand, Jacquelien J G; Kas, Martien J H; Adan, Roger A H

    2005-10-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa (AN). In ABA, scheduled feeding in combination with voluntary access to running wheels, results in hyperactivity, hypophagia, body weight loss and activation of the HPA axis. Since stimulation of the melanocortin (MC) system has similar effects, this system is a candidate system involved in ABA. Here it is shown that chronic alpha-MSH treatment enhances ABA by increasing running wheel activity (RWA), decreasing food intake and increasing HPA axis activation.

  7. The limits to pride: A test of the pro-anorexia hypothesis.

    Science.gov (United States)

    Cornelius, Talea; Blanton, Hart

    2016-01-01

    Many social psychological models propose that positive self-conceptions promote self-esteem. An extreme version of this hypothesis is advanced in "pro-anorexia" communities: identifying with anorexia, in conjunction with disordered eating, can lead to higher self-esteem. The current study empirically tested this hypothesis. Results challenge the pro-anorexia hypothesis. Although those with higher levels of pro-anorexia identification trended towards higher self-esteem with increased disordered eating, this did not overcome the strong negative main effect of pro-anorexia identification. These data suggest a more effective strategy for promoting self-esteem is to encourage rejection of disordered eating and an anorexic identity.

  8. Therapist adherence in the strong without anorexia nervosa (SWAN) study:A randomized controlled trial of three treatments for adults with anorexia nervosa

    OpenAIRE

    2015-01-01

    Objective To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM). Method The SWAN Psychother...

  9. Correlación y concordancia entre instrumentos de control del asma en niños Correlation and agreement between the instruments of asthma control in children

    Directory of Open Access Journals (Sweden)

    Alberto Vidal G

    2012-03-01

    Full Text Available Introducción: Se ha demostrado que el control del asma y la calidad de vida en niños se correlacionan en forma moderada, sin embargo, el VEF1 sólo tendría una correlación débil con dichos indicadores de control. El objetivo de este estudio fue medir la correlación clínica y concordancia entre indicadores de control del asma pediátrica en niños chilenos. Pacientes y Métodos: Estudio realizado en el policlínico de enfermedades respiratorias del Hospital Roberto del Río, entre noviembre de 2009 y mayo de 2010, con un grupo de asmáticos persistentes de 12 a 17 años. Se midió la correlación y concordancia entre calidad de vida (PAQLQ de Juniper, control del asma (ACT y VEF1 (porcentaje delpredicho. Se utilizó el coeficiente de correlación por rangos de Spearman (rs e índice de kappa. El tamaño muestral se calculó considerando un poder de 80% y p Introduction: It has been shown that asthma control and quality of life in children have moderate correlation, however FEV1 would have only a weak correlation with these control parameters. Our objective was to measure clinical correlation and concordance between parameters of pediatric asthma control in Chilean children. Methods: Study carried out in the Unit of Respiratory Diseases, Roberto del Río Children's Hospital, between November 2009 and May 2010, in a series of persistent asthmatic children between 12 and 17years old. We measured the correlation and agreement between asthma quality of life (PAQLQ Juniper, asthma control (ACT and FEV1 (percentage predicted. We used coefficient of Spearman rank correlation (rs and kappa index. The sample size was calculated considering a power of 80% andp < 0.05. Results: We enrolled 88patients, average age 13.4 years old, 61% male. Correlation PAQLQ and ACT (rs: 0.48, ACT and FEV1 (rs: 0.11, PAQLQ and FEV1 (rs:-0.1. Concordance PAQLQ < 6 points and ACT < 20 points (kappa: 0.46. Concordance ACT < 20 points with FEV1 < 80% (kappa: -0

  10. A Psychoeducational Group Approach for Individuals Recovering from Anorexia Nervosa.

    Science.gov (United States)

    Kapp, Lisa

    Although in-depth, long-term group psychotherapy is a beneficial therapeutic experience for adolescent females suffering from anorexia nervosa, these clients are notoriously resistant to treatment and to long-term, open-ended group settings. This dissidence may stem from a motivational deficiency toward changing their eating patterns and…

  11. Increased hypothalamic serotonin turnover in inflammation-induced anorexia

    NARCIS (Netherlands)

    Dwarkasing, J.T.; Witkamp, R.F.; Boekschoten, M.V.; Laak, ter M.C.; Heins, M.S.; Norren, van K.

    2016-01-01

    Background: Anorexia can occur as a serious complication of disease. Increasing evidence suggests that inflammation plays a major role, along with a hypothalamic dysregulation characterized by locally elevated serotonin levels. The present study was undertaken to further explore the connections b

  12. [Neurofeedback in the Treatment of Anorexia Nervosa: a Case Report].

    Science.gov (United States)

    Lackner, N; Unterrainer, H F; Skliris, D; Wood, G; Dunitz-Scheer, M; Wallner-Liebmann, S J; Scheer, P J Z; Neuper, C

    2016-02-01

    Anorexia nervosa has been related to alterations in brain activity in terms of hyperactive EEG patterns. This case report illustrates the principles and results of a five-week neurofeedback treatment in a 29-year-old woman suffering from anorexia nervosa. A neurofeedback protocol to enhance alpha activity (8 - 12 Hz) was developed and conducted additionally to the standardized treatment for eating disorders in training sessions twice a week. Pre- and post-test measurements included resting state EEG measurements and a psychological test battery. The results show improvements from pre- to post-test in eating disorder psychopathology including psychological wellbeing, emotional competence, and eating behavior traits. In addition, a decrease in theta power (4 - 7 Hz), a well-known trait marker of anorexia nervosa, was measured. However, our data should be interpreted with caution because this is a single case study. Nevertheless, this report documents the practicability and method of neurofeedback as treatment adjunct in eating disorders from the clinical perspective. Although the use of neurofeedback in the treatment of anorexia nervosa is recommended in literature, empirical studies are still lacking. Randomized controlled trials to evaluate short- and long-term effects of neurofeedback are needed.

  13. ["Family groups" for relatives of patients with anorexia nervosa].

    Science.gov (United States)

    Brunswick, Astrid; Guy-Rubin, Aurore; Satori, Nadine

    2016-01-01

    Anorexia nervosa affects mainly young adults. During care, caregivers seek alliance with patients' friends and family to be able to relate to the patients' symptoms and also their environment. Collaborative work with families helps build confidence. The "family group" is an example of well-intended partnership.

  14. A Primary Prevention Program to Reduce Bulimia and Anorexia Nervosa.

    Science.gov (United States)

    Cullari, Salvatore; Redmon, William K.

    This paper presents a theoretical model for a primary prevention program for bulimia and anorexia nervosa to be used with adolescents and young women considered most at risk of developing these eating disorders. Characteristics of potential anorexics and bulimics are identified to aid in the selection of target groups for the program. It is…

  15. Biological Aspects of Anorexia Nervosa and Bulimia Nervosa.

    Science.gov (United States)

    Kaplan, Allan S.; Woodside, D. Blake

    1987-01-01

    Reviews biological factors relevant to the understanding of anorexia nervosa and bulimia nervosa. Considers the physical presentation of these disorders; the medical complications of starvation, binging, and purging; and the cognitive and behavioral effects of starvation. Reviews neurophysiological and neurochemical aspects of these illnesses and…

  16. Anorexia Nervosa in Adolescence and Maudsley Family-Based Treatment

    Science.gov (United States)

    Hurst, Kim; Read, Shelly; Wallis, Andrew

    2012-01-01

    Anorexia nervosa is a serious psychiatric disorder that usually occurs in adolescence. The course of the illness can be protracted. Current empirical evidence suggests that the Maudsley Family-Based Treatment (MFBT) is efficacious for adolescents. MFBT empowers parents as a crucial treatment resource to assist in their child's recovery. The…

  17. Cognitive Profile of Children and Adolescents with Anorexia Nervosa

    DEFF Research Database (Denmark)

    Kjaersdam Telléus, Gry; Jepsen, Jens Richardt; Bentz, Mette

    2014-01-01

    OBJECTIVE: Few studies of cognitive functioning in children and adolescents with anorexia nervosa (AN) have been conducted. The aim of this study was to examine the neurocognitive and intelligence profile of this clinical group. METHOD: The study was a matched case-control (N = 188), multi...

  18. [Anorexia, treating and caring for the mistreated body].

    Science.gov (United States)

    Blanchet-Collet, Corinne; Moro, Marie Rose

    2015-01-01

    Anorexia is a complex, multifactorial disease, emerging during puberty and requiring cross-disciplinary care. The body, taken hostage, expresses psychological suffering and the patient's developmental impasse. Compassionate treatment and the care given to this mistreated and undernourished body facilitate the access to the psychological care and are an essential step towards recovery.

  19. Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

    Science.gov (United States)

    Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

    2008-01-01

    This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…

  20. Nutritional adequacy of dietary intake in women with anorexia nervosa

    Science.gov (United States)

    Background: Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the establishment of dietary treatment. Design: Women, aged 19 to 30 years, with both restricting and binge purge types of AN, participating in an ecological momentary assessment study, completed three nonc...

  1. The Anorexia Relapse Prevention Guideline in Practice: A case report

    NARCIS (Netherlands)

    Meijel, Berno van; Berends, Tamara; Elburg, Annemarie van

    2014-01-01

    Dit artikel biedt inzicht in de wijze waarop hulpverleners in de geestelijke gezondheidszorg een bijdrage kunnen leveren aan het voorkomen van terugval bij patiënten met de psychiatrische ziekte anorexia nervosa. De auteurs ontwikkelden een praktische richtlijn bestemd voor hulpverleners, patenten e

  2. Dronabinol in severe, enduring anorexia nervosa: A randomized controlled trial

    DEFF Research Database (Denmark)

    Andries, Alin; Frystyk, Jan; Flyvbjerg, Allan

    2013-01-01

    The evidence for pharmacological treatment of severe, longstanding anorexia nervosa (AN) is sparse and the few controlled pharmacologic studies have focused on a narrow range of drugs. The aim of the present study was to investigate the effects of treatment with a synthetic cannabinoid agonist...

  3. Perceived Personality Traits of Individuals with Anorexia Nervosa

    Science.gov (United States)

    Watters, Jessica E.; Malouff, John M.

    2012-01-01

    Background: Prior research has found evidence of a general negative personality stereotype for individuals who have anorexia nervosa (AN). Methods: This study examined the expected personality characteristics of individuals with AN using the Five-Factor Model of personality to allow identification of specific personality traits that are part of…

  4. [New aspects in the treatment of adolescent anorexia nervosa].

    Science.gov (United States)

    Herpertz-Dahlmann, Beate

    2015-01-01

    Adolescent anorexia nervosa often takes a chronic and disabling course associated with reduced health-related quality of life in adulthood. The aim of this short review is to introduce new aspects on the somatic and psychotherapeutic treatment of AN, such as nutritional rehabilitation, prophylaxis of osteoporosis as well as new findings on the effect of treatment settings and new psychotherapeutic methods.

  5. Reduced Automatic Motivational Orientation Towards Food in Restricting Anorexia Nervosa

    NARCIS (Netherlands)

    Veenstra, Esther M.; de Jong, Peter J.

    2011-01-01

    A striking and characteristic feature of the restricting subtype of anorexia nervosa (AN) is that they are extremely successful in regulating their food intake in a destructive manner. A possible explanation for the persistent character of their restricted food intake could be a loss of the motivati

  6. Outpatient Treatment of Primary Anorexia Nervosa in Adult Males.

    Science.gov (United States)

    Ziesat, Harold A., Jr.; Ferguson, James M.

    1984-01-01

    Describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. (JAC)

  7. Anorexia Nervosa and Bulimia: Questions and Answers for School Personnel.

    Science.gov (United States)

    Mallick, M. Joan

    1984-01-01

    School personnel can have a vital role in the early detection and treatment of anorexia nervosa and bulimia by understanding certain signs and symptoms. This article provides specific information about early detection, approaches to use when confronting the student, and methods to facilitate treatment. (Author/DF)

  8. Epidemiology and course of anorexia nervosa in the community

    NARCIS (Netherlands)

    Keski-Rahkonen, Anna; Hoek, Hans W.; Susser, Ezra S.; Linna, Milla S.; Sihvola, Elina; Raevuori, Anu; Bulik, Cynthia M.; Kaprio, Jaakko; Rissanen, Aila

    2007-01-01

    Objective: Most previous studies of the prevalence, incidence, and outcome of anorexia nervosa have been limited to cases detected through the health care system, which may bias our understanding of the disorder's incidence and natural course. The authors sought to describe the onset and outcomes of

  9. A genome-wide association study of anorexia nervosa

    NARCIS (Netherlands)

    Boraska, V; Franklin, C S; Floyd, J A B; Thornton, L M; Huckins, L M; Southam, L; Rayner, N W; Tachmazidou, I; Klump, K L; Treasure, J; Lewis, C M; Schmidt, U; Tozzi, F; Kiezebrink, K; Hebebrand, J; Gorwood, P; Adan, R A H; Kas, M J H; Favaro, A; Santonastaso, P; Fernández-Aranda, F; Gratacos, M; Rybakowski, F; Dmitrzak-Weglarz, M; Kaprio, J; Keski-Rahkonen, A; Raevuori, A; Van Furth, E F; Slof-Op 't Landt, M C T; Hudson, J I; Reichborn-Kjennerud, T; Knudsen, G P S; Monteleone, P; Kaplan, A S; Karwautz, A; Hakonarson, H; Berrettini, W H; Guo, Y; Li, D; Schork, N J; Komaki, G; Ando, T; Inoko, H; Esko, T; Fischer, K; Männik, K; Metspalu, A; Baker, J H; Cone, R D; Dackor, J; DeSocio, J E; Hilliard, C E; O'Toole, J K; Pantel, J; Szatkiewicz, J P; Taico, C; Zerwas, S; Trace, S E; Davis, O S P; Helder, S; Bühren, K; Burghardt, R; de Zwaan, M; Egberts, K; Ehrlich, S; Herpertz-Dahlmann, B; Herzog, W; Imgart, H; Scherag, A; Scherag, S; Zipfel, S; Boni, C; Ramoz, N; Versini, A; Brandys, M K; Danner, U N; de Kovel, C; Hendriks, J; Koeleman, B P C; Ophoff, R A; Strengman, E; van Elburg, Annemarie; Bruson, A; Clementi, M; Degortes, D; Forzan, M; Tenconi, E; Docampo, E; Escaramís, G; Jiménez-Murcia, S; Lissowska, J; Rajewski, A; Szeszenia-Dabrowska, N; Slopien, A; Hauser, J; Karhunen, L; Meulenbelt, I; Slagboom, P E; Tortorella, A; Maj, M; Dedoussis, G; Dikeos, D; Gonidakis, F; Tziouvas, K; Tsitsika, A; Papezova, H; Slachtova, L; Martaskova, D; Kennedy, J L; Levitan, R D; Yilmaz, Z; Huemer, J; Koubek, D; Merl, E; Wagner, G; Lichtenstein, P; Breen, G; Cohen-Woods, S; Farmer, A; McGuffin, P; Cichon, S; Giegling, I; Herms, S; Rujescu, D; Schreiber, S; Wichmann, H-E; Dina, C; Sladek, R; Gambaro, G; Soranzo, N; Julia, A; Marsal, S; Rabionet, R; Gaborieau, V; Dick, D M; Palotie, A; Ripatti, S; Widén, E; Andreassen, O A; Espeseth, T; Lundervold, A; Reinvang, I; Steen, V M; Le Hellard, S; Mattingsdal, M; Ntalla, I; Bencko, V; Foretova, L; Janout, V; Navratilova, M; Gallinger, S; Pinto, D; Scherer, S W; Aschauer, H; Carlberg, L; Schosser, A; Alfredsson, L; Ding, B; Klareskog, L; Padyukov, L; Courtet, P; Guillaume, S; Jaussent, I; Finan, C; Kalsi, G; Roberts, M; Logan, D W; Peltonen, L; Ritchie, G R S; Barrett, J C; Estivill, X; Hinney, A; Sullivan, P F; Collier, D A; Zeggini, E; Bulik, C M

    2014-01-01

    Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countri

  10. Bulimia and Anorexia Nervosa in Dental and Dental Hygiene Curricula.

    Science.gov (United States)

    Gross, Karen B. W.; And Others

    1990-01-01

    Dentists and dental hygienists are in a unique position to identify an eating disorder patient from observed oral manifestations and to refer the patient for psychological therapy. The inclusion of information on general and oral complications of bulimia and anorexia nervosa in dental and dental hygiene curriculum was examined. (MLW)

  11. Cancer anorexia: clinical implications, pathogenesis, and therapeutic strategies.

    Science.gov (United States)

    Laviano, Alessandro; Meguid, Michael M; Rossi-Fanelli, Filippo

    2003-11-01

    Anorexia and reduced food intake are important issues in the management of patients with cancer because they contribute to the development of malnutrition, increase morbidity and mortality, and impinge on quality of life. Accumulating evidence indicates that cancer anorexia is multifactorial in its pathogenesis, and most of the hypothalamic neuronal signalling pathways modulating energy intake are likely to be involved. Several factors are considered to be putative mediators of cancer anorexia, including hormones (eg, leptin), neuropeptides (eg, neuropeptide Y), cytokines (eg, interleukin 1 and 6, and tumour necrosis factor), and neurotransmitters (eg, serotonin and dopamine). These pathways are not isolated and distinct pathogenic mechanisms but are closely inter-related. However, convincing evidence suggests that cytokines have a vital role, triggering the complex neurochemical cascade which leads to the onset of cancer anorexia. Increased expression of cytokines during tumour growth prevents the hypothalamus from responding appropriately to peripheral signals, by persistently activating anorexigenic systems and inhibiting prophagic pathways. Hypothalamic monoaminergic neurotransmission may contribute to these effects. Thus, the optimum therapeutic approach to anorectic cancer patients should include changes in dietary habits, achieved via nutritional counselling, and drug therapy, aimed at interfering with cytokine expression or hypothalamic monoaminergic neurotransmission.

  12. The Impact of Childhood Sexual Abuse in Anorexia Nervosa

    Science.gov (United States)

    Carter, Jacqueline C.; Bewell, Carmen; Blackmore, Elizabeth; Woodside, D. Blake

    2006-01-01

    Objective: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). Method: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder…

  13. [Anorexia nervosa and bulimia nervosa. Psychological considerations for its treatment].

    Science.gov (United States)

    Barriguete Meléndez, J Armando; Rojo, Luis; Emmelhainz, Marisa

    2004-11-01

    It is presented the current perspectives in the study and treatment of the eating disorders, in specific: anorexia nervosa and bulimia nervosa, epidemiology, and the interface among the different medical specialties, nutrition and sciences of the behavior, the diagnostic approaches, instruments and current therapeutic models.

  14. Nurse evaluation of hyperactivity in anorexia nervosa : A comparative study

    NARCIS (Netherlands)

    van Elburg, Annemarie A.; Hoek, Hans W.; Kas, Martien J.H.; van Engeland, Herman

    2007-01-01

    Up to 80% of patients with anorexia nervosa (AN) manifest elevated levels of physical activity or hyperactivity. A variety of methods have been used to evaluate activity levels, mostly questionnaires but also expensive and invasive methods such as actometry or other measurements of energy expenditur

  15. Long-term outcome in anorexia nervosa in the community

    NARCIS (Netherlands)

    Mustelin, Linda; Raevuori, Anu; Bulik, Cynthia M.; Rissanen, Aila; Hoek, Hans W.; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2015-01-01

    ObjectiveFew studies have assessed outcomes of anorexia nervosa (AN) outside clinical settings. We aimed to assess mortality, recovery, and socio-demographic outcomes of AN in a community sample. MethodWomen in the nationwide FinnTwin16 cohort (born 1975-1979) were followed for 10 years after baseli

  16. Heightened sensitivity to punishment and reward in anorexia nervosa

    NARCIS (Netherlands)

    Glashouwer, Klaske A; Bloot, Lotte; Veenstra, Esther M; Franken, Ingmar H A; de Jong, Peter J

    2014-01-01

    OBJECTIVE: The aim of this study was to investigate reinforcement sensitivity in anorexia nervosa (AN). It was tested whether self-reported punishment (PS) and reward sensitivity (RS) differed between adolescents with AN and healthy controls, and/or between AN-subtypes. In addition, the predictive v

  17. Neurobiology of hyperactivity and reward : Agreeable restlessness in Anorexia Nervosa

    NARCIS (Netherlands)

    Scheurink, Anton J. W.; Boersma, Gretha J.; Nergardh, Ricard; Sodersten, Per; Nergårdh, Ricard; Södersten, Per

    2010-01-01

    Restricted food intake is associated with increased physical activity, very likely an evolutionary advantage, initially both functional and rewarding. The hyperactivity of patients with Anorexia Nervosa, however, is a main problem for recovery. This seemingly paradoxical reward of hyperactivity in A

  18. Ensayo sobre una vida nerviosa

    OpenAIRE

    De Prada, Juan Manuel

    2015-01-01

    Juan Manuel de Prada: Escritor, crítico literario y articulista, alma máter Universidad de Salamanca, España. Un profesor universitario amigo me confiesa desolado que una amplia mayoría de sus alumnos son por completo incapaces de leer un libro; y que, entre los pocos que afrontan su lectura, sólo un puñado puede comprenderlo.

  19. Anorexia Nervosa: A Unified Neurological Perspective

    Directory of Open Access Journals (Sweden)

    Tasneem Fatema Hasan, Hunaid Hasan

    2011-01-01

    Full Text Available The roles of corticotrophin-releasing factor (CRF, opioid peptides, leptin and ghrelin in anorexia nervosa (AN were discussed in this paper. CRF is the key mediator of the hypothalamo-pituitary-adrenal (HPA axis and also acts at various other parts of the brain, such as the limbic system and the peripheral nervous system. CRF action is mediated through the CRF1 and CRF2 receptors, with both HPA axis-dependent and HPA axis-independent actions, where the latter shows nil involvement of the autonomic nervous system. CRF1 receptors mediate both the HPA axis-dependent and independent pathways through CRF, while the CRF2 receptors exclusively mediate the HPA axis-independent pathways through urocortin. Opioid peptides are involved in the adaptation and regulation of energy intake and utilization through reward-related behavior. Opioids play a role in the addictive component of AN, as described by the “auto-addiction opioids theory”. Their interactions have demonstrated the psychological aspect of AN and have shown to prevent the functioning of the physiological homeostasis. Important opioids involved are β-lipotropin, β-endorphin and dynorphin, which interact with both µ and κ opioids receptors to regulate reward-mediated behavior and describe the higher incidence of AN seen in females. Moreover, ghrelin is known as the “hunger” hormone and helps stimulate growth hormone (GH and hepatic insulin-like-growth-factor-1(IGF-1, maintaining anabolism and preserving a lean body mass. In AN, high levels of GH due to GH resistance along with low levels of IGF-1 are observed. Leptin plays a role in suppressing appetite through the inhibition of neuropeptide Y gene. Moreover, the CRF, opioid, leptin and ghrelin mechanisms operate collectively at the HPA axis and express the physiological and psychological components of AN. Fear conditioning is an intricate learning process occurring at the level of the hippocampus, amygdala, lateral septum and the

  20. Neurobiology of anorexia and bulimia nervosa.

    Science.gov (United States)

    Kaye, Walter

    2008-04-22

    Anorexia nervosa (AN) and bulimia nervosa (BN) are related disorders of unknown etiology that most commonly begin during adolescence in women. AN and BN have unique and puzzling symptoms, such as restricted eating or binge-purge behaviors, body image distortions, denial of emaciation, and resistance to treatment. These are often chronic and relapsing disorders, and AN has the highest death rate of any psychiatric disorder. The lack of understanding of the pathogenesis of this illness has hindered the development of effective interventions, particularly for AN. Individuals with AN and BN are consistently characterized by perfectionism, obsessive-compulsiveness, and dysphoric mood. Individuals with AN tend to have high constraint, constriction of affect and emotional expressiveness, ahendonia and asceticism, whereas individuals with BN tend to be more impulsive and sensation seeking. Such symptoms often begin in childhood, before the onset of an eating disorder, and persist after recovery, suggesting they are traits that create a vulnerability for developing an ED. There is growing acknowledgement that neurobiological vulnerabilities make a substantial contribution to the pathogenesis of AN and BN. Considerable evidence suggests that altered brain serotonin (5-HT) function contributes to dysregulation of appetite, mood, and impulse control in AN and BN. Brain imaging studies, using 5-HT specific ligands, show that disturbances of 5-HT function occur when people are ill, and persist after recovery from AN and BN. It is possible that a trait-related disturbance of 5-HT neuronal modulation predates the onset of AN and contributes to premorbid symptoms of anxiety, obsessionality, and inhibition. This dysphoric temperament may involve an inherent dysregulation of emotional and reward pathways which also mediate the hedonic aspects of feeding, thus making these individuals vulnerable to disturbed appetitive behaviors. Restricting food intake may become powerfully

  1. Concordancia de métodos para susceptibilidad antimicrobiana en cepas de Mycobacterium tuberculosis aisladas en Montería, Córdoba: tubo indicador de crecimiento micobacteriano vs. método de las proporciones múltiples.

    Directory of Open Access Journals (Sweden)

    Jorge Miranda

    2009-11-01

    Full Text Available Objetivo: Evaluar la concordancia del método manual MGIT AST SIRE (mycobacteria growth indicator tube for antimicrobial susceptibility testing to isoniazid, rifampin, ethambutol and streptomycin frente al método de proporciones múltiples (PM para determinar susceptibilidad antimicrobiana en cepas de Mycobacterium tuberculosis. Métodos: Se analizaron 45 cepas de M. tuberculosis aisladas en la ciudad de Montería, entre 2003 y 2005, para susceptibilidad a (INH, rifampicina (RMP, etambutol (EMB y estreptomicina (SM. El análisis de concordancia del método MGIT manual vs PM, se realizó con la prueba Kappa. Resultados: De las 45 cepas analizadas, 38 tuvieron idéntico resultado con ambos métodos y 7 tuvieron resultados discordantes. Los porcentajes globales de resistencia a drogas antituberculosas de las cepas analizadas por el MGIT manual y las PM fueron de 33.3% y 31.1%, respectivamente, la MDR fue 5 (11.1% por PM y de 4 (8.8% por MGIT manual. La concordancia del MGIT AST SIRE con el PM fue 95.5% para cada una de las drogas analizadas y kappa global de 0.8374. En cada antibiótico se encontraron dos cepas discordantes para INH, RIF (un falso resistente y un falso susceptible. En STR y EMB (dos falsos sensibles. El tiempo promedio de resultado para cualquiera de los antimicrobianos fue 6.5 días (rango 5-8 días por MGIT, mientras que para PM fue 20 a 25 días. Conclusión: El presente estudio mostró que MGIT manual es concordante con PM, es rápido, sencillo y eficaz, para determinar la susceptibilidad de cepas de M. tuberculosis.

  2. Concordancia de métodos para susceptibilidad antimicrobiana en cepas de Mycobacterium tuberculosis aisladas en Montería, Córdoba: tubo indicador de crecimiento micobacteriano vs. método de las proporciones múltiples

    Directory of Open Access Journals (Sweden)

    Jorge Miranda

    2008-06-01

    Full Text Available Objetivo: Evaluar la concordancia del método manual MGIT AST SIRE (mycobacteria growth indicator tube for antimicrobial susceptibility testing to isoniazid, rifampin, ethambutol and streptomycin frente al método de proporciones múltiples (PM para determinar susceptibilidad antimicrobiana en cepas de Mycobacterium tuberculosis. Métodos: Se analizaron 45 cepas de M. tuberculosis aisladas en la ciudad de Montería, entre 2003 y 2005, para susceptibilidad a (INH, rifampicina (RMP, etambutol (EMB y estreptomicina (SM. El análisis de concordancia del método MGIT manual vs PM, se realizó con la prueba kappa. Resultados: De las 45 cepas analizadas, 38 tuvieron idéntico resultado con ambos métodos y 7 tuvieron resultados discordantes. Los porcentajes globales de resistencia a medicamentos antituberculosos de las cepas analizadas por el MGIT manual y las PM fueron de 33.3% y 31.1%, respectivamente, la MDR fue 5 (11.1% por PM y de 4 (8.8% por MGIT manual. La concordancia del MGIT AST SIRE con el PM fue 95.5% para cada una de las drogas analizadas y Kappa global de 0.8374. En cada antibiótico se encontraron dos cepas discordantes para INH, RIF (un falso resistente y un falso susceptible. En STR y EMB (dos falsos sensibles. El tiempo promedio de resultado para cualquiera de los antimicrobianos fue 6.5 días (rango 5-8 días por MGIT, mientras que para PM fue 20 a 25 días. Conclusión: El presente estudio mostró que MGIT manual es concordante con PM, es rápido, sencillo y eficaz, para determinar la susceptibilidad de cepas de M. tuberculosis.

  3. Anorexia nervosa versus hyperinsulinism: therapeutic effects of neuropharmacological manipulation

    Directory of Open Access Journals (Sweden)

    Fuad Lechin

    2011-02-01

    Full Text Available Fuad Lechin1,2, Bertha van der Dijs1,2, Betty Pardey-Maldonado1, Scarlet Baez1, Marcel E Lechin31Sections of Neuroendocrinology, Neuropharmacology, and Neurochemistry, Department of Pathophysiology, Institute of Experimental Medicine, Faculty of Medicine, Universidad Central de Venezuela, Caracas; 2Instituto de Vias Digestivas Caracas, Centro Clínico Profesional Caracas, Venezuela; 3Department of Internal Medicine, Texas A & M Health Science Center, College of Medicine, Texas, USABackground: We have demonstrated that anorexia nervosa is underpinned by overwhelming adrenal sympathetic activity which abolishes the neural sympathetic branch of the peripheral autonomic nervous system. This physiological disorder is responsible for gastrointestinal hypomotility, hyperglycemia, raised systolic blood pressure, raised heart rate, and other neuroendocrine disorders. Therefore, we prescribed neuropharmacological therapy to reverse this central and autonomic nervous system disorder, in order to normalize the clinical and neuroendocrine profile.Methods: The study included 22 female patients with anorexia nervosa (10 restricted type, 12 binge-eating type who received three months of treatment with amantadine 100 mg/day. We measured blood pressure, heart rate, and circulating neurotransmitters, (noradrenaline, adrenaline, dopamine, platelet serotonin, free plasma serotonin during supine resting, one minute of orthostasis, and a five-minute exercise test before and after one, two, and three months of treatment with amantadine, a drug which abrogates adrenal sympathetic activity by acting at the C1(Ad medullary nuclei responsible for this branch of the peripheral sympathetic activity.Results: We found the amantadine abolished symptoms of anorexia nervosa from the first oral dose onwards. Normalization of autonomic and cardiovascular parameters was demonstrated within the early days of therapy. Abrupt and sustained increases in the plasma noradrenaline

  4. Evaluación de la sintomatología negativista desafiante en niños de 6 a 8 años: concordancia entre padres y maestros

    OpenAIRE

    Angulo Rincón, Rosalba; Jané i Ballabriga, M. del Claustre; Bonillo Martín, Albert; Viñas i Poch, Ferran; Corcoll Champredonde, Agnès; González Rodríguez, Gustavo; Zepeda Burgos, Raquel Marina; Dos Santos Pérez, Neuza Cristina; Carbonés, Jaume

    2010-01-01

    El objetivo principal de este estudio es conocer el grado de concordancia entre los informes proporcionados por padres y maestros acerca de la sintomatología negativista desafiante en niños en edad escolar (6-8 años). Además, se pretende analizar si la edad y el sexo del niño afectan el nivel de acuerdo entre informantes. Padres y maestros evaluaron a 702 niños y niñas de 25 escuelas de la Comarca de Osona, Barcelona (España), mediante el Child Sympton Inventory-4 (versión padres y maestros)....

  5. Concordancia radiológica intra e interobservador del método de Sharp-Van der Heijde / Radiological agreement intra and interobserver of Sharp–Van der Heijde method

    OpenAIRE

    Luna Hernández, David Ricardo

    2010-01-01

    El método de Sharp–Van der Heijde es utilizado para evaluar y medir la progresión del daño articular y establecer los efectos del tratamiento en radiografías de manos y pies de pacientes con artritis reumatoidea. El objetivo de este estudio fue evaluar la confiabilidad de la escala de SVdH determinando la concordancia intra e interobservador entre radiólogos utilizando radiografías de pacientes colombianos con artritis reumatoidea. Se incluyeron 102 radiografías digitalizadas (51 de manos (en...

  6. Validez y concordancia de la historia clínica electrónica de atención primaria (AP-Madrid) en la vigilancia epidemiológica de la diabetes mellitus. Estudio PREDIMERC

    OpenAIRE

    Elisa Gil Montalbán; Honorato Ortiz Marrón; Dulce López-Gay Lucio-Villegas; Belén Zorrilla Torrás; Francisco Arrieta Blanco; Pedro Nogales Aguado

    2014-01-01

    Objetivo: Estudiar la validez y la concordancia de los datos de diabetes en la historia clínica electrónica de atención primaria (AP-Madrid) comparándola con el estudio PREDIMERC. Métodos: En una muestra poblacional de 2268 individuos se calcularon la sensibilidad, la especificidad, el valor predictivo positivo, el valor predictivo negativo y el índice kappa de los casos de diabetes registrados en la historia clínica AP-Madrid, comparándolos con el estudio PREDIMERC (como referencia). Se e...

  7. Correlación y concordancia entre ecocardiografía y cateterismo cardiaco derecho para determinación de la presión sistólica de arteria pulmonar

    OpenAIRE

    Aguilera Pacheco, Emil Alberto; Conde Camacho, Rafael; Perez-Fernandez, Oscar-Mauricio

    2015-01-01

    Introducción. El cateterismo cardiaco derecho representa el estándar de referencia para el diagnóstico de hipertensión pulmonar, sin embargo el rendimiento de la ecocardiografía como estudio inicial ha mostrado buena correlación con las variables medidas por cateterismo. El presente estudio pretende describir el grado de correlación y concordancia entre la ecocardiografía y el cateterismo cardiaco derecho para la medición de la presión sistólica de la arteria pulmonar. Materiales y méto...

  8. Pathogen-Mediated Inhibition of Anorexia Promotes Host Survival and Transmission.

    Science.gov (United States)

    Rao, Sheila; Schieber, Alexandria M Palaferri; O'Connor, Carolyn P; Leblanc, Mathias; Michel, Daniela; Ayres, Janelle S

    2017-01-26

    Sickness-induced anorexia is a conserved behavior induced during infections. Here, we report that an intestinal pathogen, Salmonella Typhimurium, inhibits anorexia by manipulating the gut-brain axis. Inhibition of inflammasome activation by the S. Typhimurium effector, SlrP, prevented anorexia caused by IL-1β-mediated signaling to the hypothalamus via the vagus nerve. Rather than compromising host defenses, pathogen-mediated inhibition of anorexia increased host survival. SlrP-mediated inhibition of anorexia prevented invasion and systemic infection by wild-type S. Typhimurium, reducing virulence while increasing transmission to new hosts, suggesting that there are trade-offs between transmission and virulence. These results clarify the complex and contextual role of anorexia in host-pathogen interactions and suggest that microbes have evolved mechanisms to modulate sickness-induced behaviors to promote health of their host and their transmission at the expense of virulence.

  9. Increased P-wave dispersion a risk for atrial fibrillation in adolescents with anorexia nervosa.

    Science.gov (United States)

    Ertuğrul, İlker; Akgül, Sinem; Derman, Orhan; Karagöz, Tevfik; Kanbur, Nuray

    2016-01-01

    Studies have shown that a prolonged P-wave dispersion is a risk factor for the development of atrial fibrillation. The aim of this study was to evaluate P-wave dispersion in adolescents with anorexia nervosa at diagnosis. We evaluated electrocardiographic findings, particularly the P-wave dispersion, at initial assessment in 47 adolescents with anorexia nervosa. Comparison of P-wave dispersion between adolescents with anorexia nervosa and controls showed a statistically significant higher P-wave dispersion in patients with anorexia nervosa (72 ± 16.3 msec) when compared to the control group (43.8 ± 9.5 msec). Percent of body weight lost, lower body mass index, and higher weight loss rate in the patients with anorexia nervosa had no effect on P-wave dispersion. Due to the fact that anorexia nervosa has a high mortality rate we believe that cardiac pathologies such as atrial fibrillation must also be considered in the medical evaluation.

  10. The Disjointed Historical Trajectory of Anorexia Nervosa Before 1970.

    Science.gov (United States)

    Court, John P M; Kaplan, Allan S

    2016-01-01

    Responses in pre-modern eras to anorexia nervosa (as now understood) varied widely, from religious piety and sanctity through fear and superstition. While noting briefly the limited conceptualizations from pre-modern history this article is primarily focused from the late 19th century, commencing with helpful but tentative formulations of anorexia nervosa for early-modern medicine that were laid out, consistently between themselves, by Lesègue, Gull and Osler. Yet that promising biomedical advent was superseded for more than a half-century by deep, internal divisions and bitter rifts that festered between three medical disciplines: neurology; Freudian psychotherapy; and Kraepelinian biological psychiatry. Mid-20th century developments preceded the 1960-1980s' improved understanding of suffering and movement toward effective remediation introduced by Dr. Hilde Bruch.

  11. Peculiar enlargement of the nasopharynx in patients with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Okamoto, K. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Ito, J. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Tokiguchi, S. [Department of Radiology, School of Dentistry, Niigata Univ. (Japan); Kuwabara, G. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan); Nishihara, M. [Department of Radiology, School of Medicine, Niigata University, Niigata (Japan)

    1995-11-01

    We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance. (orig.). With 5 figs., 3 tabs.

  12. A Brief Review of the Biology of Anorexia Nervosa

    DEFF Research Database (Denmark)

    Sjögren, Magnus

    2015-01-01

    Background: The etiology of Anorexia Nervosa (AN) is unknown. A stress model for AN and other Eating Disorders, has been proposed by Connan and depicts risk factors and precipitating events, including biological, but several steps in this have yet to be evidenced. In order to elucidate the biology...... PUBMED and the following search terms: “Anorexia Nervosa” and “biomarker” revealed 180 articles (8th of May 2015). Additional searches included the search terms “gene”, “genetic”, “epigenetic”, “appetite”, “hormone”, and a specific search on “biology” and “review”. Furthermore, articles of interest were...... retrieved from the reference lists of the identified articles of the first PUBMED search. Results: In general, there is a shortage of studies on biomarkers and the biology of AN, at least when you compare to similar fields of research in Affective disorders and Schizophrenia. The studies performed reveals...

  13. MRI demonstration of orbital lipolysis in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, Philippe; Dekimpe, Piet; Wilms, Guy [Department of Radiology, University Hospitals, Herestraat 49, 3000 Leuven (Belgium); Muls, Erik [Department of Endocrinology, University Hospitals, Herestraat 49, 3000 Leuven (Belgium)

    2002-07-01

    The purpose of this article is to describe the orbital changes due to lipolysis in anorexia nervosa. We examined a cachectic patient with MR imaging using T1-weighted images before and after contrast enhancement. Orbital fat edema has been observed in extreme forms of cachexia and the CT and MR findings have recently been reported. The imaging appearances have been explained by the disappearance of the fat tissue and the appearance of edema due to a disturbance in the electrolyte fluid balance. In the recent literature particular attention has been paid to the increased lipid peroxidation and lipolysis in anorexia nervosa. These metabolic processes result in an increased permeability of the vessel wall endothelium, which can explain the extravasation of the contrast agent in the orbital fat on MR imaging. (orig.)

  14. Transcranial direct current stimulation in the treatment of anorexia.

    Science.gov (United States)

    Hecht, David

    2010-06-01

    Transcranial direct current stimulation (tDCS) is a non-invasive technique for brain stimulation and it increasingly being used in the treatments of some neurological/psychiatric conditions (e.g. chronic pain, epilepsy, depression, motor rehabilitation after stroke and Parkinson's disease). With tDCS, cortical neurons excitability increases in the vicinity of the anodal electrode and suppressed near the cathodal electrode. There is evidence that anorexia is associated with hyperactivity in right-hemisphere frontal regions. tDCS, therefore has a promising potential in facilitating inter-hemispheric balance. A tDCS protocol is proposed: the anode electrode placed over the left prefrontal cortex and the cathode electrode located, either on the right homotopic region for non-SSRI-medicated anorexics, or on a non-cephalic site for SSRI-medicated anorexics. Together with nutritional supplements, psychotherapy and other treatments, tDCS have a good potential, as a complementary tool, in the treatment of anorexia.

  15. Prolonged QT interval in a man with anorexia nervosa

    Science.gov (United States)

    Macías-Robles, María Dolores; Perez-Clemente, Ana María; Maciá-Bobes, Carmen; Alvarez-Rueda, María Asunción; Pozo-Nuevo, Sergio

    2009-01-01

    Anorexia nervosa is an eating disorder characterized by the avoidance of food intake, which usually leads to a weight loss. Cardiac co-morbility is common and we can find sometimes a mass loss from the left ventricle, which can be seen by echocardiography. But the commonest complications are rhythm variations, typically bradycardia with a prolonged QT interval in up to a 40% of the cases, which altogether elevates ventricular tachycardia and sudden death risk. We present the case of a male who was diagnosed with anorexia nervosa and developed asthenia, a long QT interval and also a severe both hypokalaemia and hypomagnesaemia. We intend to discuss the pathogenic paths as well as prophylactic and therapeutic measures to this potentially-lethal pathology. PMID:19646241

  16. Nutritional rehabilitation of anorexia nervosa. Goals and dangers.

    Science.gov (United States)

    Golden, Neville H; Meyer, Wendy

    2004-01-01

    Nutritional rehabilitation of adolescents with anorexia nervosa is both a science and an art. The goals are to promote metabolic recovery; restore a healthy body weight; reverse the medical complications of the disorder and to improve eating behaviors and psychological functioning. Most, but not all of the medical complications are reversible with nutritional rehabilitation. Refeeding patients with anorexia nervosa results in deposition of lean body mass initially, followed by restoration of adipose tissue as treatment goal weight is approached. The major danger of nutritional rehabilitation is the refeeding syndrome, characterized by fluid and electrolyte, cardiac, hematological and neurological complications, the most serious of which is sudden unexpected death. The refeeding syndrome is most likely to occur in those who are severely malnourished. In such patients, this complication can be avoided by slow refeeding with careful monitoring of body weight, heart rate and rhythm and serum electrolytes, especially serum phosphorus. This paper reviews our clinical experience.

  17. Medical complications of anorexia nervosa and their treatments: an update on some critical aspects.

    Science.gov (United States)

    Brown, Carrie; Mehler, Philip S

    2015-12-01

    Anorexia nervosa has the highest mortality rate of any psychiatric disorder. Many of the deaths are attributable to medical complications which arise as the malnutrition and weight loss worsens. Every body system may be adversely affected by anorexia nervosa. Yet, remarkably, most of the medical complications of anorexia nervosa are treatable and reversible with optimal medical care, as part of a multidisciplinary team who are often involved in the care of these patients. Herein, we will describe the medical complications of anorexia nervosa and their treatments.

  18. Intracerebroventricular Injection of Metformin Induces Anorexia in Rats

    OpenAIRE

    2012-01-01

    Background Metformin, an oral biguanide insulin-sensitizing agent, is well known to decrease appetite. Although there is evidence that metformin could affect the brain directly, the exact mechanism is not yet known. Methods To evaluate whether metformin induces anorexia via the hypothalamus, various concentrations of metformin were injected into the lateral ventricle of rats through a chronically implanted catheter and food intake was measured for 24 hours. The hypothalamic neuropeptides asso...

  19. Minoxidil-associated anorexia in an infant with refractory hypertension.

    Science.gov (United States)

    Vesoulis, Zachary A; Attarian, Stephanie J; Zeller, Brandy; Cole, Francis Sessions

    2014-12-01

    Minoxidil is a potent antihypertensive used as an adjunctive agent in refractory hypertension. It exerts an antihypertensive effect through two mechanisms: selective arterial vasodilation by activation of potassium channels in the vascular smooth muscle and stimulation of carotid and aortic baroreceptors, leading to downstream release of renin and norepinephrine. Although frequently cited in reviews of antihypertensive agents, limited data about the use of minoxidil in neonates are available. We describe an infant girl, born at 35 weeks of gestation, who was diagnosed with idiopathic hypertension after extensive diagnostic evaluation. Adequate blood pressure control was not achieved with captopril, amlodipine, and clonidine. Oliguria secondary to captopril and rapid-onset congestive heart failure due to persistent hypertension led to the introduction of intravenous agents labetalol and nitroprusside. Although adequate blood pressure control was achieved, attempts to transition back to oral agents were unsuccessful, prompting the use of minoxidil as an alternative agent. Although good blood pressure control was achieved, the infant's oral intake plummeted from 210 to 63 ml/kg/day. The anorexia quickly resolved after stopping minoxidil, and she was discharged home at 5 months of age receiving propranolol, amlodipine, and doxazosin. Use of the Naranjo adverse drug reaction probability scale indicated a definite relationship (score of 10) between the patient's development of anorexia and minoxidil therapy. To our knowledge, there have been no previous reports of minoxidil-associated anorexia in preterm or term infants. Clinicians should be aware that anorexia is a possible adverse effect of minoxidil in this patient population when initiating the drug in similar patients.

  20. Early-onset anorexia nervosa in girls with Asperger syndrome.

    Science.gov (United States)

    Dudova, Iva; Kocourkova, Jana; Koutek, Jiri

    2015-01-01

    Eating disorders frequently occur in conjunction with autism spectrum disorders, posing diagnostic and therapeutic difficulties. The comorbidity of anorexia nervosa and Asperger syndrome is a significant clinical complication and has been associated with a poorer prognosis. The authors are presenting the cases of an eleven-year-old girl and a five-and-a-half-year-old girl with comorbid eating disorders and Asperger syndrome.

  1. Impact of exercise on energy metabolism in anorexia nervosa

    OpenAIRE

    Zipfel, Stephan; Mack, Isabelle; Baur, Louise A; Hebebrand, Johannes; Touyz, Stephen; Herzog, Wolfgang; Abraham, Suzanne; Davies, Peter SW; Russell, Janice

    2013-01-01

    Background Excessive physical activity is one of the most paradoxical features of anorexia nervosa (AN). However, there is individual variation in the degree of physical activity found in AN-patients. As a result, marked differences in energy expenditure may be expected. Furthermore, exercise has a positive impact on a variety of psychological disorders and the psychopathology may be different in AN displaying high exercise levels versus AN displaying low exercise levels. We analyzed the ener...

  2. Anorexia nervosa: treatment expectations – a qualitative study

    Directory of Open Access Journals (Sweden)

    Paulson-Karlsson G

    2012-07-01

    Full Text Available Gunilla Paulson-Karlsson,1 Lauri Nevonen21Academy of Health and Medical Sciences, Örebro University, Örebro and Anorexia-Bulimia Unit, Child and Adolescent Psychiatry Centre, Queen Silvia Children's Hospital, Göteborg, Sweden; 2Academy of Health and Medical Sciences, Örebro University, Örebro, SwedenBackground: Anorexia nervosa is a serious illness with a high mortality rate, a poor outcome, and no empirically supported treatment of choice for adults. Patients with anorexia nervosa strive for thinness in order to obtain self-control and are ambivalent toward change and toward treatment. In order to achieve a greater understanding of patients' own understanding of their situation, the aim of this study was to examine the expectations of potential anorexic patients seeking treatment at a specialized eating-disorder unit.Methods: A qualitative study design was used. It comprised 15 women between 18 and 25 years of age waiting to be assessed before treatment. The initial question was, "What do you expect, now that you are on the waiting list for a specialized eating-disorder unit?" A content analysis was used, and the text was coded, categorized according to its content, and further interpreted into a theme.Results: From the results emerged three main categories of what participants expected: "treatment content," "treatment professionals," and "treatment focus." The overall theme, "receiving adequate therapy in a collaborative therapeutic relationship and recovering," described how the participants perceived that their expectations could be fulfilled.Discussion: Patients' expectations concerning distorted thoughts, eating behaviors, a normal, healthy life, and meeting with a professional with knowledge and experience of eating disorders should be discussed before treatment starts. In the process of the therapeutic relationship, it is essential to continually address patients' motivations, in order to understand their personal motives behind

  3. Amenorrhea as a Diagnostic Criterion for Anorexia Nervosa

    OpenAIRE

    2012-01-01

    Amenorrhea is a current criterion for the diagnosis of anorexia nervosa (AN) according to the DSM-IV-TR. Nevertheless, when comparing groups of patients who fulfill all the criteria of this manual for AN and groups of women who show them all but amenorrhea, some studies did not find significant differences in the psychopathology typically associated with AN. The purpose of our study was to compare both groups in demographic, anthropometric, psychological and psychopathological variables. Ther...

  4. Anorexia Nervosa and Body Fat Distribution: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Marwan El Ghoch

    2014-09-01

    Full Text Available The aim of this paper was to conduct a systematic review of body fat distribution before and after partial and complete weight restoration in individuals with anorexia nervosa. Literature searches, study selection, method development and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Twenty studies met the inclusion criteria and were consequently analyzed. The review had five main findings. First, during anorexia nervosa adolescent females lose more central body fat, while adult females more peripheral fat. Second, partial weight restoration leads to greater fat mass deposition in the trunk region than other body regions in adolescent females. Third, after short-term weight restoration, whether partial or complete, adults show a central adiposity phenotype with respect to healthy age-matched controls. Fourth, central fat distribution is associated with increased insulin resistance, but does not adversely affect eating disorder psychopathology or cause psychological distress in female adults. Fifth, the abnormal central fat distribution seems to normalize after long-term maintenance of complete weight restoration, indicating that preferential central distribution of body fat is a transitory phenomenon. However, a discrepancy in the findings has been noted, especially between adolescents and adults; besides age and gender, these appear to be related to differences in the methodology and time of body composition assessments. The PROSPERO Registry—Anorexia Nervosa and Body Fat Distribution: A Systematic Review (CRD42014008738.

  5. Anorexia in cancer: role of feeding-regulatory peptides.

    Science.gov (United States)

    Perboni, Simona; Inui, Akio

    2006-07-29

    Anorexia is one of the most common symptoms in advanced cancer and is a frequent cause of discomfort for cancer patients and their families. The pathogenesis of cancer anorexia is multi-factorial and involves most of the hypothalamic neuronal signalling pathways modulating energy homeostasis. It is considered to be the result of a failure of usual appetite and satiety signals. Loss of appetite can arise from decreased taste and smell of food, as well as from dysfunctional hypothalamic signalling pathways and cytokine production. Cytokines in particular, appear to play a key role in energy balance through persistent activation of the melanocortin system and inhibition of the neuropeptide Y pathway. The imbalance between anorexigenic and orexigenic peptides leads to suppression of appetite, and increased satiety and satiation associated with marked weight loss and decline in physical performance. High levels of serotonin also appear to contribute to these effects and recent findings implicate corticotropin-releasing factor in the pathogenesis of cancer anorexia as well. Despite significant advances in our understanding of the regulation of food intake and energy expenditure, few effective therapies are available. A better appreciation of the molecular and neuronal mechanisms that control body weight homeostasis may lead to the development of new therapies for improving the survival and quality of life of these patients.

  6. Dehydration anorexia is attenuated in oxytocin-deficient mice.

    Science.gov (United States)

    Rinaman, Linda; Vollmer, Regis R; Karam, Joseph; Phillips, Donnesha; Li, Xia; Amico, Janet A

    2005-06-01

    Evidence in rats suggests that central oxytocin (OT) signaling pathways contribute to suppression of food intake during dehydration (i.e., dehydration anorexia). The present study examined water deprivation-induced dehydration anorexia in wild-type and OT -/- mice. Mice were deprived of food alone (fasted, euhydrated) or were deprived of both food and water (fasted, dehydrated) for 18 h overnight. Fasted wild-type mice consumed significantly less chow during a 60-min refeeding period when dehydrated compared with their intake when euhydrated. Conversely, fasting-induced food intake was slightly but not significantly suppressed by dehydration in OT -/- mice, evidence for attenuated dehydration anorexia. In a separate experiment, mice were deprived of water (but not food) overnight for 18 h; then they were anesthetized and perfused with fixative for immunocytochemical analysis of central Fos expression. Fos was elevated similarly in osmo- and volume-sensitive regions of the basal forebrain and hypothalamus in wild-type and OT -/- mice after water deprivation. OT-positive neurons expressed Fos in dehydrated wild-type mice, and vasopressin-positive neurons were activated to a similar extent in wild-type and OT -/- mice. Conversely, significantly fewer neurons within the hindbrain dorsal vagal complex were activated in OT -/- mice after water deprivation compared with activation in wild-type mice. These findings support the view that OT-containing projections from the hypothalamus to the hindbrain are necessary for the full expression of compensatory behavioral and physiological responses to dehydration.

  7. Interleukin-1 beta-induced anorexia is reversed by ghrelin.

    Science.gov (United States)

    Gonzalez, Patricia Verónica; Cragnolini, Andrea Beatriz; Schiöth, Helgi Birgir; Scimonelli, Teresa Nieves

    2006-12-01

    Interleukins, in particular interleukin-1beta (IL-1beta), reduce food intake after peripheral and central administration, which suggests that they contribute to anorexia during various infectious, neoplastic, and autoimmune diseases. On the other hand, ghrelin stimulates food intake by acting on the central nervous system (CNS) and is considered an important regulator of food intake in both rodents and humans. In the present study, we investigated if ghrelin could reverse IL-1beta-induced anorexia. Intracerebroventricular (i.c.v.) injection of 15, 30 or 45 ng/microl of IL-1beta caused significant suppression of food intake in 20 h fasting animals. This effect lasted for a 24h period. Ghrelin (0.15 nmol or 1.5 nmol/microl) produced a significant increase in cumulative food intake in normally fed animals. However, it did not alter food intake in 20 h fasting animals. Central administration of ghrelin reduced the anorexic effect of IL-1beta (15 ng/microl). The effect was observed 30 min after injection and lasted for the next 24h. This study provides evidence that ghrelin is an orexigenic peptide capable of antagonizing IL-1beta-induced anorexia.

  8. Concordancia oftalmólogo-enfermera en la primera exploración post-quirúrgica de la cirugía de cataratas Agreement between ophthalmologist and nurse in the first postoperative exploration following cataract extraction

    Directory of Open Access Journals (Sweden)

    M.N. Soto

    2008-12-01

    Full Text Available Introducción. La actividad de enfermería en el proceso quirúrgico de la catarata engloba, desde la realización de la biometría en el preoperatorio y la colaboración en la cirugía, hasta la administración de los primeros cuidados en el postoperatorio y la información al paciente y a la familia durante todo el proceso. El objetivo del presente trabajo es analizar la concordancia entre oftalmólogo y enfermera en los hallazgos de la primera exploración postquirúrgica de los pacientes intervenidos de cataratas mediante facoemulsificación y sin complicaciones en la cirugía. Metodología. El estudio se realizó entre mayo y junio de 2005 en 129 pacientes intervenidos de cataratas, 78 mujeres y 51 hombres con edad media de 73,1 años. Se definieron las variables a valorar en la primera exploración postquirúrgica y se estudió la concordancia entre oftalmólogos y enfermeras en la identificación de las complicaciones más frecuentes de la cirugía de cataratas. Resultados. La concordancia fue del 100% de los casos en la presión intraocular >22 mm de Hg, la irregularidad pupilar, la reacción inflamatoria de cámara anterior y el prolapso de iris; del 65,9% en la presencia de Seidel, y del 60,5% en el edema corneal severo. Conclusiones. El alto índice de concordancia médico-enfermera encontrado en 4 de las variables, puede ofrecer la posibilidad de que la enfermera realice esta primera exploración postquirúrgica. Sin embargo, una concordancia moderada en el resto hace necesario un mayor periodo de formación del personal de enfermería, para conseguir aumentar estos valores.Introduction. Nursing activity in the cataract extraction process extends from carrying out biometry in the preoperative stage and collaboration in surgery, to providing the initial care in the postoperative stage and keeping the patient and family informed throughout the whole process. This article analyses agreement between ophthalmologists and nurses in the

  9. Concordancia entre el diagnóstico clínico y hallazgos de autopsia en dos períodos en el Hospital Universitario del Valle, Cali.

    Directory of Open Access Journals (Sweden)

    María Paula Botero

    2009-11-01

    Full Text Available Contexto: A pesar de que la práctica de la autopsia ha disminuido en todo el mundo, se considera una herramienta esencial para la auditoría y enseñanza médica y útil para la evaluación de la exactitud de los diagnósticos clínicos. Objetivo: Se describe la concordancia entre los diagnósticos clínicos y los hallazgos de autopsia en un hospital de cuidado terciario. Materiales y métodos: Se compara el diagnóstico de las historias clínicas con los informes de 100 autopsias realizadas entre 1970 y 1975, y otras 100 realizadas entre 1990 y 1995 en el Departamento de Patología del Hospital Universitario del Valle. Los diagnósticos de la autopsia se usaron como “estándar de oro”. Resultados: La sensibilidad más alta para el diagnóstico se observó en las entidades de naturaleza neoplásica en ambos períodos y para las alteraciones hemodinámicas, trombosis y choque en la década de 1970. El diagnóstico clínico de la causa básica de muerte se confirma con la autopsia en 73% y 64% de los casos en los períodos de 1970 y 1990, respectivamente. La confirmación fue baja cuando se consideró la causa terminal inmediata de muerte; en 36.5% de los casos, la causa terminal se diagnosticó sólo a la autopsia. De 200 pacientes adultos, 62 (31% tenían una enfermedad infecciosa a la autopsia; en 25 (40.3% de ellos, el diagnóstico de la enfermedad infecciosa fue clínicamente desconocido.La bronconeumonía fue la enfermedad infecciosa menos considerada clínicamente (24.5%, siendo similar en ambos períodos. La diferencia entre el diagnóstico clínico y de autopsia es aún mayor para los diagnósticos secundarios: 63% de ellos no fueron sospechados por el clínico. Las lesiones iatrogénicas fueron relativamente frecuentes (7.5% y 28% de ellas no se describieron en los informes clínicos. Conclusión: Los resultados sugieren que aunque las ayudas de diagnóstico clínico sensibles y específicas son necesarias, no pueden sustituir la pr

  10. Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa

    DEFF Research Database (Denmark)

    Weihe, Johan Petur; Birger Morillon, Melanie; Lambrechtsen, Jess;

    2014-01-01

    Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa......Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa...

  11. Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa

    DEFF Research Database (Denmark)

    Weihe, Johan Petur; Birger Morillon, Melanie; Lambrechtsen, Jess

    Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa......Dual-energy CT (DECT) imaging of tophi and monosodium urate deposits in a patient with longstanding anorexia nervosa...

  12. Cancer-induced anorexia in tumor-bearing mice is dependent on cyclooxygenase-1.

    Science.gov (United States)

    Ruud, Johan; Nilsson, Anna; Engström Ruud, Linda; Wang, Wenhua; Nilsberth, Camilla; Iresjö, Britt-Marie; Lundholm, Kent; Engblom, David; Blomqvist, Anders

    2013-03-01

    It is well-established that prostaglandins (PGs) affect tumorigenesis, and evidence indicates that PGs also are important for the reduced food intake and body weight loss, the anorexia-cachexia syndrome, in malignant cancer. However, the identity of the PGs and the PG producing cyclooxygenase (COX) species responsible for cancer anorexia-cachexia is unknown. Here, we addressed this issue by transplanting mice with a tumor that elicits anorexia. Meal pattern analysis revealed that the anorexia in the tumor-bearing mice was due to decreased meal frequency. Treatment with a non-selective COX inhibitor attenuated the anorexia, and also tumor growth. When given at manifest anorexia, non-selective COX-inhibitors restored appetite and prevented body weight loss without affecting tumor size. Despite COX-2 induction in the cerebral blood vessels of tumor-bearing mice, a selective COX-2 inhibitor had no effect on the anorexia, whereas selective COX-1 inhibition delayed its onset. Tumor growth was associated with robust increase of PGE(2) levels in plasma - a response blocked both by non-selective COX-inhibition and by selective COX-1 inhibition, but not by COX-2 inhibition. However, there was no increase in PGE(2)-levels in the cerebrospinal fluid. Neutralization of plasma PGE(2) with specific antibodies did not ameliorate the anorexia, and genetic deletion of microsomal PGE synthase-1 (mPGES-1) affected neither anorexia nor tumor growth. Furthermore, tumor-bearing mice lacking EP(4) receptors selectively in the nervous system developed anorexia. These observations suggest that COX-enzymes, most likely COX-1, are involved in cancer-elicited anorexia and weight loss, but that these phenomena occur independently of host mPGES-1, PGE(2) and neuronal EP(4) signaling.

  13. Unusual Presentation of Uncommon Disease: Anorexia Nervosa Presenting as Wernicke-Korsakoff Syndrome—A Case Report from Southeast Asia

    OpenAIRE

    Raheel Mushtaq; Sheikh Shoib; Tabindah Shah; Mudasir Bhat; Randhir Singh; Sahil Mushtaq

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa...

  14. Voluntary access to a warm plate reduces hyperactivity in activity-based anorexia

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; de Rijke, Corine E; Brakkee, Jan H; Kas, Martien J H; Adan, Roger A H

    2005-01-01

    Activity-based anorexia (ABA) is considered an animal model of anorexia nervosa. In ABA, scheduled feeding in combination with voluntary wheel running leads to hyperactivity, reduced food intake, severe body weight loss and hypothermia. In this study it was investigated whether hyperactivity in ABA

  15. Bulimics with and without Prior Anorexia Nervosa: A Comparison of Personality Characteristics.

    Science.gov (United States)

    Katzman, Melanie A.; Wolchik, Sharlene A.

    A controversial issue in the literature on eating disorders is whether or not bulimia is a disorder distinct from anorexia nervosa. To compare the personality and behavioral characteristics of bulimic women with and without prior anorexia nervosa, 14 female college students (mean age 19.6 years, 86 percent white) were divided into two groups…

  16. Fearing Fat: A Literature Review of Family Systems Understandings and Treatments of Anorexia and Bulimia.

    Science.gov (United States)

    Killian, Kyle D.

    1994-01-01

    Reviews literature examining family variables associated with anorexia nervosa and bulimia nervosa and family systems treatments for these eating disorders. Presents definitions of and diagnostic criteria for anorexia and bulimia, and discusses prevalence of these disorders. Reviews role played by psychopathological, sociological, and…

  17. Anorexia Nervosa/Bulimia. LC Science Tracer Bullet, TB 85-8.

    Science.gov (United States)

    Halasz, Hisako, Comp.

    This bibliography is intended to help readers locate material on anorexia nervosa and bulimia in the collections of the Library of Congress. A scope note briefly defines the terms "anorexia nervosa" and "bulimia" and discusses similarities and differences between the two eating disorders. Four references are included as introductions to the topic…

  18. Acquiring Research Access: Perspectives from Gatekeepers and Parents of Children with Anorexia Nervosa

    Science.gov (United States)

    Hunt, Tamara Jo-Lynne

    2010-01-01

    The purpose of this study was to understand the conditions necessary to gain research access to parents of children with anorexia. In this study, I also examined and explored avenues parents have for sharing their story and their experiences of parenting a child with anorexia as well as whether gatekeepers have a role in connecting parents and…

  19. Coming Together to Calm the Hunger: Group Therapy Program for Adults Diagnosed with Anorexia Nervosa

    Science.gov (United States)

    Ponech, Heather; McBride, Dawn Lorraine

    2012-01-01

    This project provides a comprehensive overview of the research literature on anorexia nervosa in female adults and concludes by offering 14 group therapy lesson plans for anorexia nervosa that therapists may use in their practice. There is a remarkable lack of research on the efficacy of treatment designed for individuals diagnosed with anorexia…

  20. Simultaneous introduction of a novel high fat diet and wheel running induces anorexia.

    Science.gov (United States)

    Scarpace, E T; Matheny, M; Strehler, K Y E; Shapiro, A; Cheng, K Y; Tümer, N; Scarpace, P J

    2012-02-28

    Voluntary wheel running (WR) is a form of physical activity in rodents that influences ingestive behavior. The present report describes an anorexic behavior triggered by the simultaneous introduction of a novel diet and WR. This study examined the sequential, compared with the simultaneous, introduction of a novel high-fat (HF) diet and voluntary WR in rats of three different ages and revealed a surprising finding; the simultaneous introduction of HF food and voluntary WR induced a behavior in which the animals chose not to eat although food was available at all times. This phenomenon was apparently not due to an aversion to the novel HF diet because introduction of the running wheels plus the HF diet, while continuing the availability of the normal chow diet did not prevent the anorexia. Moreover, the anorexia was prevented with prior exposure to the HF diet. In addition, the anorexia was not related to extent of WR but dependent on the act of WR. The introduction a HF diet and locked running wheels did not induce the anorexia. This voluntary anorexia was accompanied by substantial weight loss, and the anorexia was rapidly reversed by removal of the running wheels. Moreover, the HF/WR-induced anorexia is preserved across the age span despite the intrinsic decrease in WR activity and increased consumption of HF food with advancing age. The described phenomenon provides a new model to investigate anorexia behavior in rodents.

  1. A Comparison of Short- And Long-Term Family Therapy for Adolescent Anorexia Nervosa.

    Science.gov (United States)

    Lock, James; Agras, W. Stewart; Bryson, Susan; Kraemer, Helena C.

    2005-01-01

    Objective: Research suggests that family treatment for adolescents with anorexia nervosa may be effective. This study was designed to determine the optimal length of such family therapy. Method: Eighty-six adolescents (12-18 years of age) diagnosed with anorexia nervosa were allocated at random to either a short-term (10 sessions over 6 months) or…

  2. Manualized Family-Based Treatment for Anorexia Nervosa: A Case Series.

    Science.gov (United States)

    Le Grange, Daniel; Binford, Roslyn; Loeb, Katharine L.

    2005-01-01

    Objective: The purpose of this study was to describe a case series of children and adolescents (mean age = 14.5 years, SD = 2.3; range 9-18) with anorexia nervosa who received manualized family-based treatment for their eating disorder. Method: Forty-five patients with anorexia nervosa were compared pre- and post-treatment on weight and menstrual…

  3. Factors Associated with Recovery from Anorexia Nervosa : A Population-Based Study

    NARCIS (Netherlands)

    Keski-Rahkonen, Anna; Raevuori, Anu; Bulik, Cynthia M.; Hoek, Hans W.; Rissanen, Aila; Kaprio, Jaakko

    2014-01-01

    Background: To examine factors associated with the outcome of anorexia nervosa among women from the general population. Method: Women (N = 2,881) from the 1975-1979 birth cohorts of Finnish twins were screened for lifetime DSM-IV anorexia nervosa (N = 55 cases) using questionnaires and the SCID inte

  4. Plasma Ghrelin Levels Are Associated with Anorexia but Not Cachexia in Patients with NSCLC

    Science.gov (United States)

    Blauwhoff-Buskermolen, Susanne; Langius, Jacqueline A. E.; Heijboer, Annemieke C.; Becker, Annemarie; de van der Schueren, Marian A. E.; Verheul, Henk M. W.

    2017-01-01

    Background and Aims: The ghrelin receptor is one of the new therapeutic targets in the cancer anorexia-cachexia syndrome. Previous studies revealed that plasma ghrelin levels were high in patients with anorexia nervosa and low in obese subjects. We studied to what extent ghrelin levels are related with anorexia and cachexia in patients with cancer. Materials and Methods: Fasted ghrelin levels were determined as well as anorexia and cachexia in patients with stage III/IV non-small cell lung cancer before chemotherapy. Total plasma ghrelin was measured by radioimmunoassay. Anorexia was measured with the FAACT-A/CS questionnaire (cut-off value ≤ 37). Cachexia was determined as >5% weight loss (WL) in 6 months or >2% WL in 6 months in combination with low BMI or low muscle mass. The Kruskal-Wallis test was performed to assess differences in plasma ghrelin levels between four groups: patients with (+) or without (−) anorexia (A) or cachexia (C). Multiple regression analyses were performed to assess differences in plasma ghrelin levels between patients C+ and C− and patients with A+ and A− (adjusted for age and sex). Results: Forty patients with stage III (33%) or stage IV (68%) were recruited, of which 50% was male. Mean age was 59.6 ± 10.3 years. Sixteen patients had no anorexia or cachexia (A−C−), seven patients had both anorexia and cachexia (A+C+), ten patients had anorexia without cachexia (A+C−) and seven patients had cachexia without anorexia (A−C+). The levels of total plasma ghrelin were significantly different between the four groups of patients with or without anorexia or cachexia (p = 0.032): the A+C− patients had significantly higher ghrelin levels [median (IQR): 1,754 (1,404–2,142) compared to the A−C+ patients 1,026 (952–1,357), p = 0.003]. A+ patients had significantly higher ghrelin levels compared A− patients (C+ and C− combined, β: 304, p = 0.020). Plasma ghrelin levels were not significantly different in C+ patients

  5. Cancer anorexia-cachexia syndrome: psychological effect on the patient and family.

    Science.gov (United States)

    McClement, Susan

    2005-01-01

    The majority of patients with advanced cancer experience weight loss, reduced appetite, fatigue, and weakness. Chronic nausea and early satiety may also occur. This constellation of symptoms is known as the cancer anorexia-cachexia syndrome. Together with cancer pain, cancer anorexia-cachexia syndrome has been identified as 1 of the 2 most frequent and devastating problems affecting individuals with advanced malignancies. Research examining the issue of cancer anorexia-cachexia syndrome has been conducted; however, such work is largely biomedical in orientation. In contrast, the psychologic dimensions of the cancer anorexia-cachexia syndrome experience from the perspective of terminally ill patients and their family members is less well explored or described. The ability to provide psychosocial support to patients and families requires that caregivers appreciate the psychologic effect of cancer anorexia and cachexia on these individuals. This article examines that effect in light of existing knowledge and discusses the clinical implications arising from this work.

  6. Drive for muscularity and drive for thinness: the impact of pro-anorexia websites.

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    Juarez, Lilia; Soto, Ernesto; Pritchard, Mary E

    2012-01-01

    In recent years, websites that stress the message of thinness as the ideal and only choice have surfaced on the internet. The possibility that pro-anorexia websites may reinforce restrictive eating and exercise behaviors is an area of concern. In addition, friends may be influencing one another to view these websites, further contributing to drive for thinness in women and drive for muscularity in men. Three hundred male and female undergraduate psychology students responded to questionnaires assessing: internalization of pro-anorexia website content, internalization of general media content, influence of friends to view pro-anorexia websites, peer influence, drive for muscularity, and drive for thinness. Results showed internalization of pro-anorexia website content was positively correlated with drive for thinness in women, and negatively correlated with drive for muscularity in men. Internalization of pro-anorexia website content was found to be related to both drive for thinness in women and drive for muscularity in men.

  7. A longitudinal investigation of mortality in anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Franko, Debra L; Keshaviah, Aparna; Eddy, Kamryn T; Krishna, Meera; Davis, Martha C; Keel, Pamela K; Herzog, David B

    2013-08-01

    OBJECTIVE Although anorexia nervosa has a high mortality rate, our understanding of the timing and predictors of mortality in eating disorders is limited. The authors investigated mortality in a long-term study of patients with eating disorders. METHOD Beginning in 1987, 246 treatment-seeking female patients with anorexia nervosa or bulimia nervosa were interviewed every 6 months for a median of 9.5 years to obtain weekly ratings of eating disorder symptoms, comorbidity, treatment participation, and psychosocial functioning. From January 2007 to December 2010 (median follow-up of 20 years), vital status was ascertained with a National Death Index search. RESULTS Sixteen deaths (6.5%) were recorded (lifetime anorexia nervosa, N=14; bulimia nervosa with no history of anorexia nervosa, N=2). The standardized mortality ratio was 4.37 (95% CI=2.4-7.3) for lifetime anorexia nervosa and 2.33 (95% CI=0.3-8.4) for bulimia nervosa with no history of anorexia nervosa. Risk of premature death among patients with lifetime anorexia nervosa peaked within the first 10 years of follow-up, resulting in a standardized mortality ratio of 7.7 (95% CI=3.7-14.2). The standardized mortality ratio varied by duration of illness and was 3.2 (95% CI=0.9-8.3) for patients with lifetime anorexia nervosa for 0 to 15 years (4/119 died), and 6.6 (95% CI=3.2-12.1) for those with lifetime anorexia nervosa for >15 to 30 years (10/67 died). Multivariate predictors of mortality included alcohol abuse, low body mass index, and poor social adjustment. CONCLUSIONS These findings highlight the need for early identification and intervention and suggest that a long duration of illness, substance abuse, low weight, and poor psychosocial functioning raise the risk for mortality in anorexia nervosa.

  8. Tratamiento farmacológico de la anorexia-caquexia cancerosa Pharmacological therapy of cancer anorexia-cachexia

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    D. Cardona

    2006-05-01

    Full Text Available La anorexia es uno de los síntomas más comunes en los enfermos con cáncer avanzado y se manifiesta con pérdida de apetito por saciedad. Por otro lado, la caquexia se describe en aquellos enfermos con pérdida de peso involuntaria. El proceso canceroso produce un desequilibrio en el balance energético al disminuir la ingesta y aumentar el catabolismo, produciéndose un balance netamente negativo. Se observan diferentes factores que determinan a la caquexia, desde los desequilibrios metabólicos producidos tanto por los productos tumorales como las alteraciones endocrinas o la respuesta inflamatoria producida por las citoquinas, todo ello conlleva a un incremento de la lipólisis, pérdida de proteína muscular y anorexia. Además las causas de la anorexia son múltiples desde el tratamiento con citostáticos, radioterapia o inmunoterapia donde pueden producir diferentes grados de náuseas, vómitos, diarreas y al mismo tiempo contribuyen alterar las percepciones en el sabor y el olor, a la obstrucción del aparato digestivo, dolor, depresión, constipación... A partir de los conocimientos de los diferentes mecanismos que producen el síndrome anorexia-caquexia se han estudiado además de las dietas hipercalóricas de nutrición artificial con éxito relativo, una variedad de fármacos que fueran positivos a la ganancia de apetito como son los progestágenos, corticoesteroides y con menor evidencia clínica los cannabinoides, ciprohepatidina, mirtazapina (antidepresivo y la olanzapina (antipsicótico. Otros, se han estudiado por su efecto antiinflamatorio debido a su acción anticitoquinas como son la melatonina, ácidos polinsaturados omega-3, pentoxifilina y talidomida, excepto los segundos aún son escasos los datos clínicos para su utilización diaria. Otro tanto pasa con los fármacos anabolizantes derivados de la testosterona o los inhibidores metabólicos como el sulfato de hidracina. Sin duda alguna los progestágenos sobre todo el

  9. Anorexia nervosa e família : estudo de caso

    OpenAIRE

    Simone Marques Borges

    2009-01-01

    Os transtornos alimentares têm despertado interesse entre os profissionais de saúde em decorrência do crescente aumento de casos, alguns deles veiculados na mídia. Apesar disso, muitas dúvidas ainda cercam essas patologias. O funcionamento do sistema familiar de adolescentes com diagnóstico de anorexia nervosa tem sido tema de investigação por autores da terapia familiar sistêmica e os estudos têm relacionado o transtorno a algumas características da dinâmica conjugal e familiar. Esta pesquis...

  10. Anorexia: a failure in the work of melancholia

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    Ana Paula Gonzaga

    2012-09-01

    Full Text Available The self-reproach against their own bodies seen in patients with eating disorders has led us to posit the existence of failures in the work of melancholia. Defined by Freud in 1915, this process of melancholia is aimed at repairing a loss felt as unbearable by the ego and that triggers off a violent struggle with ambivalent feelings toward the lost object. The resulting hatred is aimed at the shadow of the object that falls on the ego. Especially in anorexia nervosa, there seems to be a regressive movement that goes beyond this.

  11. The cancer anorexia/weight loss syndrome: therapeutic challenges.

    Science.gov (United States)

    Giordano, Karin F; Jatoi, Aminah

    2005-07-01

    The cancer anorexia/weight loss syndrome is characterized by loss of weight, loss of appetite, overall decline in quality of life, and shortened survival in patients with advanced incurable cancer. It is highly prevalent. To date, treatment options that have been firmly established with good scientific evidence are limited to progestational agents and corticosteroids, both of which have been demonstrated to improve appetite but have otherwise failed to have a favorable impact on some of the other aspects of this syndrome. As the mechanisms behind this syndrome are further elucidated, more effective therapeutic strategies will likely emerge.

  12. Dying To Be Thin: Attachment to Death in Anorexia Nervosa

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    Yael Latzer

    2005-01-01

    Full Text Available Anorexia Nervosa (AN usually follows a prolonged course accompanied by significant morbidity and high mortality. AN patients have been found to have elevated and attempted suicide rates, with suicide being the second most common cause of death in AN after the complications of the disorder itself. The suicide risk in AN is similar to that in major depression or conduct disorder and linked mainly to longer duration of illness, lower weight, bingeing and purging, impulsivity-related manifestations, comorbid substance abuse, and affective disorder. This paper reviews suicidal tendency and disturbed body image, death and eating disorders, and attachment and death with clinical implications related to AN.

  13. Concordancia de las pruebas de tuberculina e Interferón gamma en población reclusa Concordance of tuberculin tests and Interferon gamma release assays in the prison population

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    A. Marco Mouriño

    2011-06-01

    Full Text Available Objetivos: Estudiar en población penitenciaria la concordancia de la prueba de la tuberculina (PT y las pruebas de interferón gamma (IFG. Material y métodos: Estudio prospectivo realizado en una prisión en mayo-junio de 2009. Se estudian los ingresos sin antecedente de tuberculosis (TB o con PT previa negativa o no realizada. Se realizó IDR de Mantoux (positivo ³ 10 mm y extracción sanguínea para prueba de IFG (QuantiFERON®-TB Gold. En los infectados, se realizó despistaje de TB. Se pasó un cuestionario y se solicitó consentimiento informado. El estudio fue aprobado por un Comité ético ajeno a instituciones penitenciarias. La concordancia entre PT e IFG se basó en el índice Kappa. Resultados: Se incluyeron 181 casos. El 62% eran extranjeros, el 17% vacunados por BCG, el 8,4% UDI y el 4% VIH+. En los extranjeros había más vacunados, menos UDI y menos infectados por VIH que en autóctonos (p=0,02, p=0,02, y p=0,01, respectivamente. La PT fue positiva en el 24% y la IFG en el 26%. Hubo información de ambas en 149 (82% casos. El 15,8% fueron discordantes. El índice Kappa fue de 0,6 (0,4-0,7. La concordancia varió según subgrupos, siendo mayor en autóctonos (kappa= 0,8 y menor en vacunados (kappa=0,4 e inmigrantes (kappa=0,5. Conclusión: La concordancia global fue moderada-buena, pero en vacunados e inmigrantes fue menor. El nivel de discordancia aconseja ampliar el estudio, así como evaluar que prueba predice mejor el riesgo de progresión a TB y el coste-beneficio de ambas en la población reclusa de nuestro país.Objective: To study the agreement of Tuberculin Skin Tests (TST and Interferon Gamma Release Assays (IGRA when screening tuberculosis infection amongst inmates recently admitted to prison. Materials and methods: Prospective study conducted in a prison during the months of May and June 2009. Inmates without a TB history, with previous TST negatives or without prior TSTs were included. Participants signed an

  14. Laboratory parameters and appetite regulators in patients with anorexia nervosa.

    Science.gov (United States)

    Himmerich, Hubertus; Schönknecht, Peter; Heitmann, Sabine; Sheldrick, Abigail J

    2010-03-01

    Anorexia nervosa (AN) has serious negative effects on multiple organs and systems of the human body. As patients often do not make their eating disorder the subject of discussion, the physician is forced to rely on the physical examination and laboratory parameters as diagnostic hints. Obvious signs of AN are a body mass index (BMI) below 17.5 kg/m, dry and scaly skin, lanugo, edema, acrocyanosis, petechias, dental problems, and low blood pressure. However, because the often complex laboratory alterations can be difficult for the general psychiatrist to interpret, this article presents some useful guidelines. The plasma of patients with AN often shows alterations in laboratory parameters and appetite regulators, including electrolytes, liver enzymes, leukocyte count, hemoglobin (Hb), leptin, neuropeptide Y (NPY), triiodothyronine (T3), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, ghrelin, pancreatic polypeptide (PP), tumor necrosis factor-alpha (TNF-alpha), and cortisol. Medical problems secondary to AN or due to the treatment itself may lead to further laboratory abnormalities. To date, despite these associated laboratory alterations, the diagnosis of anorexia is a clinical one, based on weight and specific psychopathology.

  15. Literature Review of Cognitive Neuroscience and Anorexia Nervosa.

    Science.gov (United States)

    Reville, Marie-Claire; O'Connor, Lorna; Frampton, Ian

    2016-02-01

    Studies published between the beginning of 2013 and May 2015 on the neuropsychological functioning of patients with anorexia nervosa compared with healthy participants framed in the context of the Research Domain Criteria matrix identifies evidence for functional differences in three domains: Negative Valance Systems-negative attentional biases and lack of neural responsivity to hunger; Cognitive Systems-limited congruence between clinical and cognitive performance, poorer non-verbal than verbal performance, altered attentional styles to disorder related stimuli, perceptual processing impairment in discriminating body images, weaknesses in central coherence, set shifting weaknesses at low weight status, decision-making weaknesses, and greater neural resources required for working memory; Systems for Social Processes-patients appear to have a different attentional response to faces, and perception and understanding of self and others. Hence, there is evidence to suggest that patients with anorexia nervosa have a specific neuropsychological performance style across tasks in three domains of functioning. Some current controversies and areas for future development are identified.

  16. The socio-emotional processing stream in Anorexia Nervosa.

    Science.gov (United States)

    Oldershaw, A; Hambrook, D; Stahl, D; Tchanturia, K; Treasure, J; Schmidt, U

    2011-01-01

    The significance of socio-emotional factors in development and maintenance of Anorexia Nervosa (AN) has been noted, but the literature is poorly integrated without clear models guiding research or treatment. This systematic review retrieved experimental studies of social-cognitive or affective processing in AN and categorised them using Ochsner's "Social-Emotional Processing Stream." Ochsner's "Processing Stream", based on healthy data, comprises five constructs: (1) acquisition of and (2) recognition and response to social-affective stimuli, (3) low-level and (4) high-level mental state inference and (5) context-sensitive emotion regulation. Thirty-seven experimental studies in Anorexia Nervosa were identified, mapping on to four of the five constructs (not Construct 3). A meta-analysis of nine affect recognition studies was conducted. AN patients demonstrated impairments in each of the four domains with preliminary reports that some difficulties are trait-like, and others ameliorate following recovery. Socio-emotional data was integrated with previous reports of neural abnormalities to generate an AN specific model of socio-emotional processing. Additional research is required for further definition and to translate experimental findings into clinical practice.

  17. BODY AND ANOREXIA, CONTRIBUTIONS OF PSYCHOANALYSIS AND CULTURE

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    Luis Vinicius do Nascimento

    2009-07-01

    Full Text Available Through this study, we intend to ask ourselves about anorexia, and their relationship with the body and culture. What this symptom can tell us about the way that the subject establishes his relationship with the Other? The body of the anorexic show a paradox for psychoanalysis, the “Meagers/Phallicisation” in this symptom show us the radical side of the psychoanalytical statutes of the body, drive and “jouissance”. The anorexic, to assert his desire, uses a bad strategy of separation, which meagers his body arresting him in a more voracious alienation into the Other desire. His symptom is a desperate attempt to insert a lack in this devastating Other. From this, we can contemplate if there is a relationship of the current configuration of culture with the increasing cases of anorexia. The contemporaneous, in an attempt to expel the lack of the speech, fall in the same mistake of the modernism, which didn’t considered the subject in his relationship with the “jouissance”.

  18. [Therapeutic itineraries of individuals with symptoms of anorexia and bulimia].

    Science.gov (United States)

    Carvalho, Maria Bernadete de; Val, Alexandre Costa; Ribeiro, Maria Mônica Freitas; Santos, Lúcia Grossi Dos

    2016-08-01

    The scope of this study is to identify and contextualize aspects of the therapeutic itineraries of patients treated at a university medical clinic specialized in nervous anorexia and bulimia. For this purpose, an attempt was made to reconstitute the succession of events triggered in 20 respondents and their families with the classification of anorexia and bulimia as "health problems." The narratives were analyzed in order to link the individual experiences and the social context of their occurrence (organization of health services, characteristics of treatment and medical knowledge and characteristics of contemporary subjectivity), in light of the theoretical studies of Public Health and Psychoanalysis. Data analysis revealed that these itineraries arise from connections and disconnections between two distinct approaches: one that organizes the management of patients and the other governing the conduct of health institutions and families. If the latter presuppose a quest for health, this is not what primarily concerns the individuals in question. Their refusal to moderate their own eating disorders is notable on their itineraries, and indicates the functionality of those practices. Such practices play a part in the reconstruction of their self-images.

  19. An Integrative Bio-Psycho-Social Theory of Anorexia Nervosa.

    Science.gov (United States)

    Munro, Calum; Randell, Louise; Lawrie, Stephen M

    2017-01-01

    The need for novel approaches to understanding and treating anorexia nervosa (AN) is well recognized. The aim of this paper is to describe an integrative bio-psycho-social theory of maintaining factors in AN. We took a triangulation approach to develop a clinically relevant theory with face validity and internal consistency. We developed theoretical ideas from our clinical practice and reviewed theoretical ideas within the eating disorders and wider bio-psycho-social literature. The synthesis of these ideas and concepts into a clinically meaningful framework is described here. We suggest eight key factors central to understanding the maintenance and treatment resistance of anorexia nervosa: genetic or experiential predisposing factors; dysfunctional feelings processing and regulation systems; excessive vulnerable feelings; 'feared self' beliefs; starvation as a maladaptive physiological feelings regulation mechanism; maladaptive psychological coping modes; maladaptive social behaviour; and unmet physical and psychological core needs. Each of these factors serves to maintain the disorder. The concept of universal physical and psychological core needs can provide an underpinning integrative framework for working with this distinctly physical and psychological disorder. This framework could be used within any treatment model. We suggest that treatments which help address the profound lack of trust, emotional security and self-acceptance in this patient group will in turn address unmet needs and improve well-being. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Body weight, anorexia, and undernutrition in older people.

    Science.gov (United States)

    Soenen, Stijn; Chapman, Ian M

    2013-09-01

    Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations and activity, neurotransmitters, and cytokines. A greater understanding of this decrease in appetite and energy intake during aging, and the responsible mechanisms, may aid the search for ways to treat undernutrition and weight loss in older people.

  1. Anorexia of Aging: Risk Factors, Consequences, and Potential Treatments.

    Science.gov (United States)

    Landi, Francesco; Calvani, Riccardo; Tosato, Matteo; Martone, Anna Maria; Ortolani, Elena; Savera, Giulia; Sisto, Alex; Marzetti, Emanuele

    2016-01-27

    Older people frequently fail to ingest adequate amount of food to meet their essential energy and nutrient requirements. Anorexia of aging, defined by decrease in appetite and/or food intake in old age, is a major contributing factor to under-nutrition and adverse health outcomes in the geriatric population. This disorder is indeed highly prevalent and is recognized as an independent predictor of morbidity and mortality in different clinical settings. Even though anorexia is not an unavoidable consequence of aging, advancing age often promotes its development through various mechanisms. Age-related changes in life-style, disease conditions, as well as social and environmental factors have the potential to directly affect dietary behaviors and nutritional status. In spite of their importance, problems related to food intake and, more generally, nutritional status are seldom attended to in clinical practice. While this may be the result of an "ageist" approach, it should be acknowledged that simple interventions, such as oral nutritional supplementation or modified diets, could meaningfully improve the health status and quality of life of older persons.

  2. Current treatment for anorexia nervosa: efficacy, safety, and adherence

    Directory of Open Access Journals (Sweden)

    Lindsay P Bodell

    2010-10-01

    Full Text Available Lindsay P Bodell, Pamela K KeelDepartment of Psychology, Florida State University, Tallahassee, FL, USAAbstract: Anorexia nervosa (AN is a serious psychiatric illness associated with significant medical and psychiatric morbidity, psychosocial impairment, increased risk of death, and chronicity. Given the severity of the disorder, the establishment of safe and effective treatments is necessary. Several treatments have been tried in AN, but few favorable results have emerged. This paper reviews randomized controlled trials in AN, and provides a synthesis of existing data regarding the efficacy, safety, and adherence associated with pharmacologic and psychological interventions. Randomized controlled trials for the treatment of AN published in peer-reviewed journals were identified by electronic and manual searches. Overall, pharmacotherapy has limited benefits in the treatment of AN, with some promising preliminary findings associated with olanzapine, an antipsychotic agent. No single psychological intervention has demonstrated clear superiority in treating adults with AN. In adolescents with AN, the evidence base is strongest for the use of family therapy over alternative individual psychotherapies. Results highlight challenges in both treating individuals with AN and in studying the effects of those treatments, and further emphasize the importance of continued efforts to develop novel interventions. Treatment trials currently underway and areas for future research are discussed.Keywords: anorexia nervosa, treatment, pharmacotherapy, psychotherapy, randomized controlled trials

  3. Symptoms of psychosis in anorexia and bulimia nervosa.

    Science.gov (United States)

    Miotto, Paola; Pollini, Barbara; Restaneo, Antonietta; Favaretto, Gerardo; Sisti, Davide; Rocchi, Marco B L; Preti, Antonio

    2010-02-28

    Despite evidence from case series, the comorbidity of eating disorders with psychosis is less investigated than their comorbidity with anxiety and mood disorders. We investigated the occurrence of symptoms of psychosis in 112 female patients diagnosed with DSM-IV eating disorders (anorexia nervosa=61, bulimia nervosa=51) and 631 high school girls in the same health district as the patients: the items of the SCL-90R symptom dimensions "paranoid ideation" and "psychoticism" were specifically examined. No case of co-morbid schizophrenia was observed among patients. Compared with controls, the patients with anorexia nervosa were more likely to endorse the item "Never feeling close to another person"; the patients with bulimia nervosa were more likely to endorse the item "Feeling others are to blame for your troubles". Both groups of patients were more likely than controls to endorse the item "Idea that something is wrong with your mind". The students who were identified by the EAT and the BITE as being "at risk" for eating disorders were more likely to assign their body a causative role in their problems. Symptoms of psychosis can be observed in patients with eating disorders, but these could be better explained within the psychopathology of the disorders rather than by assuming a link with schizophrenia.

  4. Review article: anorexia and cachexia in gastrointestinal cancer.

    Science.gov (United States)

    Ockenga, J; Valentini, L

    2005-10-01

    In patients with gastrointestinal malignancies, i.e. cancers of the stomach, colon, liver, biliary tract or pancreas, progressive undernutrition can be regularly observed during the course of illness. Undernutrition significantly affects the patients' quality of life, morbidity and survival. Pathogenetically, two different causes are relevant in the development of undernutrition in patients with gastrointestinal cancer. One cause is reduced nutritional intake. This condition is referred to as anorexia and can be worsened by the side effects of cancer therapy. The other cause is the release of endogenous transmitters and/or other products of the tumour leading to the cachexia syndrome, which is characterized by loss of body weight, negative nitrogen balance and fatigue. Cancer anorexia and cancer cachexia may have synergistic negative effects in affecting the patients' status. In this review, current nutritional support strategies with respect to different clinically relevant situations are described. An algorithm of the treatment strategies, including dietetic counselling, oral supplements, enteral and parenteral nutritional support is given. One focus is the approach of nutrition-focused patient care, which shows promising results. In addition, the possibilities of pharmacological intervention are discussed.

  5. Identifying predictors of activity based anorexia susceptibility in diverse genetic rodent populations.

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    Eneda Pjetri

    Full Text Available Animal studies are very useful in detection of early disease indicators and in unravelling the pathophysiological processes underlying core psychiatric disorder phenotypes. Early indicators are critical for preventive and efficient treatment of progressive psychiatric disorders like anorexia nervosa. Comparable to physical hyperactivity observed in anorexia nervosa patients, in the activity-based anorexia rodent model, mice and rats express paradoxical high voluntary wheel running activity levels when food restricted. Eleven inbred mouse strains and outbred Wistar WU rats were exposed to the activity-based anorexia model in search of identifying susceptibility predictors. Body weight, food intake and wheel running activity levels of each individual mouse and rat were measured. Mouse strains and rats with high wheel running activity levels during food restriction exhibited accelerated body weight loss. Linear mixed models for repeated measures analysis showed that baseline wheel running activity levels preceding the scheduled food restriction phase strongly predicted activity-based anorexia susceptibility (mice: Beta  =  -0.0158 (±0.003 SE, P<0.0001; rats: Beta  =  -0.0242 (±0.004 SE, P<0.0001 compared to other baseline parameters. These results suggest that physical activity levels play an important role in activity-based anorexia susceptibility in different rodent species with genetically diverse background. These findings support previous retrospective studies on physical activity levels in anorexia nervosa patients and indicate that pre-morbid physical activity levels could reflect an early indicator for disease severity.

  6. How much should I eat? Estimation of meal portions in anorexia nervosa.

    Science.gov (United States)

    Milos, Gabriella; Kuenzli, Cornelia; Soelch, Chantal Martin; Schumacher, Sonja; Moergeli, Hanspeter; Mueller-Pfeiffer, Christoph

    2013-04-01

    Pathological concern regarding one's weight and weight gain is a crucial feature of anorexia nervosa. Consequently, anorexia nervosa patients often claim that they are uncertain regarding the amount of food they should eat. The present study investigated whether individuals with anorexia nervosa show an altered estimation of meal portion sizes and whether this estimation is modulated by an intent-to-eat instruction (where patients are asked to imagine having to eat the presented meal), meal type and meal portion size. Twenty-four women with anorexia nervosa and 27 healthy women estimated, using a visual analogue scale, the size of six different portions of three different meals, with and without intent-to-eat instructions. Subjects with anorexia nervosa estimated the size of small and medium meal portions (but not large meal servings) as being significantly larger, compared to estimates of healthy controls. The overestimation of small meal portions by anorexia nervosa subjects was significantly greater in the intent-to-eat, compared to general, condition. These findings suggest that disturbed perceptions associated with anorexia nervosa not only include interoceptive awareness (i.e., body weight and shape), but also extend to external disorder-related objects such as meal portion size. Specific therapeutic interventions, such as training regarding meal portion evaluation, could address these difficulties.

  7. Sex differences in severity of inflammation-induced anorexia and weight loss.

    Science.gov (United States)

    Lennie, Terry A

    2004-04-01

    Food intake and body weight changes in response to induction of acute inflammation were examined in intact cycling females, ovariectomized females, and sham-operated male rats. In intact females, body weight and feeding responses were compared between rats in which inflammation was induced on day of estrus with rats in which inflammation was induced on day of diestrus. Anorexia and weight loss were more severe in the female rats with inflammation induced on estrus day, which coincides with peak serum estrogen levels. In ovariectomized females, inflammation was induced the day after rats received injections of estrogen, progesterone, or sesame oil (vehicle). Males received vehicle injections. Among female rats, the group that received estradiol injections the previous day displayed the most severe anorexia. The least severe anorexia was observed in female rats that received progesterone the previous day. Food intake of female rats that received vehicle injections prior to induction of inflammation was greater than the rats receiving estrogen but less than the rats receiving progesterone. Male rats displayed the most severe anorexia and greatest weight loss. These data suggest that, although females exposed to estradiol prior to induction of acute inflammation display more severe anorexia than those exposed to progesterone, it may be that progesterone attenuates severity of anorexia rather than estrogen solely potentiating severity. Male rats, however, appear to experience the most severe anorexia in response to this form of inflammation.

  8. Dehydration-anorexia derives from a reduction in meal size, but not meal number.

    Science.gov (United States)

    Boyle, Christina N; Lorenzen, Sarah M; Compton, Douglas; Watts, Alan G

    2012-01-18

    The anorexia that results from extended periods of cellular dehydration is an important physiological adaptation that limits the intake of osmolytes from food and helps maintain the integrity of fluid compartments. The ability to experimentally control both the development and reversal of anorexia, together with the understanding of underlying hormonal and neuropeptidergic signals, makes dehydration (DE)-anorexia a powerful model for exploring the interactions of neural networks that stimulate and inhibit food intake. However, it is not known which meal parameters are affected by cellular dehydration to generate anorexia. Here we use continuous and high temporal resolution recording of food and fluid intake, together with a drinking-explicit method of meal pattern analysis to explore which meal parameters are modified during DE-anorexia. We find that the most important factor responsible for DE-anorexia is the failure to maintain feeding behavior once a meal has started, rather than the ability to initiate a meal, which remains virtually intact. This outcome is consistent with increased sensitivity to satiation signals and post-prandial satiety mechanisms. We also find that DE-anorexia significantly disrupts the temporal distribution of meals across the day so that the number of nocturnal meals gradually decreases while diurnal meal number increases. Surprisingly, once DE-anorexia is reversed this temporal redistribution is maintained for at least 4 days after normal food intake has resumed, which may allow increased daily food intake even after normal satiety mechanisms are reinstated. Therefore, DE-anorexia apparently develops from a selective targeting of those neural networks that control meal termination, whereas meal initiation mechanisms remain viable.

  9. Potentiation of ghrelin signaling attenuates cancer anorexia-cachexia and prolongs survival.

    Science.gov (United States)

    Fujitsuka, N; Asakawa, A; Uezono, Y; Minami, K; Yamaguchi, T; Niijima, A; Yada, T; Maejima, Y; Sedbazar, U; Sakai, T; Hattori, T; Kase, Y; Inui, A

    2011-07-26

    Cancer anorexia-cachexia syndrome is characterized by decreased food intake, weight loss, muscle tissue wasting and psychological distress, and this syndrome is a major source of increased morbidity and mortality in cancer patients. This study aimed to clarify the gut-brain peptides involved in the pathogenesis of the syndrome and determine effective treatment for cancer anorexia-cachexia. We show that both ghrelin insufficiency and resistance were observed in tumor-bearing rats. Corticotropin-releasing factor (CRF) decreased the plasma level of acyl ghrelin, and its receptor antagonist, α-helical CRF, increased food intake of these rats. The serotonin 2c receptor (5-HT2cR) antagonist SB242084 decreased hypothalamic CRF level and improved anorexia, gastrointestinal (GI) dysmotility and body weight loss. The ghrelin receptor antagonist (D-Lys3)-GHRP-6 worsened anorexia and hastened death in tumor-bearing rats. Ghrelin attenuated anorexia-cachexia in the short term, but failed to prolong survival, as did SB242084 administration. In addition, the herbal medicine rikkunshito improved anorexia, GI dysmotility, muscle wasting, and anxiety-related behavior and prolonged survival in animals and patients with cancer. The appetite-stimulating effect of rikkunshito was blocked by (D-Lys3)-GHRP-6. Active components of rikkunshito, hesperidin and atractylodin, potentiated ghrelin secretion and receptor signaling, respectively, and atractylodin prolonged survival in tumor-bearing rats. Our study demonstrates that the integrated mechanism underlying cancer anorexia-cachexia involves lowered ghrelin signaling due to excessive hypothalamic interactions of 5-HT with CRF through the 5-HT2cR. Potentiation of ghrelin receptor signaling may be an attractive treatment for anorexia, muscle wasting and prolong survival in patients with cancer anorexia-cachexia.

  10. The nucleus accumbens 5-HTR₄-CART pathway ties anorexia to hyperactivity.

    Science.gov (United States)

    Jean, A; Laurent, L; Bockaert, J; Charnay, Y; Dusticier, N; Nieoullon, A; Barrot, M; Neve, R; Compan, V

    2012-12-11

    In mental diseases, the brain does not systematically adjust motor activity to feeding. Probably, the most outlined example is the association between hyperactivity and anorexia in Anorexia nervosa. The neural underpinnings of this 'paradox', however, are poorly elucidated. Although anorexia and hyperactivity prevail over self-preservation, both symptoms rarely exist independently, suggesting commonalities in neural pathways, most likely in the reward system. We previously discovered an addictive molecular facet of anorexia, involving production, in the nucleus accumbens (NAc), of the same transcripts stimulated in response to cocaine and amphetamine (CART) upon stimulation of the 5-HT(4) receptors (5-HTR(4)) or MDMA (ecstasy). Here, we tested whether this pathway predisposes not only to anorexia but also to hyperactivity. Following food restriction, mice are expected to overeat. However, selecting hyperactive and addiction-related animal models, we observed that mice lacking 5-HTR(1B) self-imposed food restriction after deprivation and still displayed anorexia and hyperactivity after ecstasy. Decryption of the mechanisms showed a gain-of-function of 5-HTR(4) in the absence of 5-HTR(1B), associated with CART surplus in the NAc and not in other brain areas. NAc-5-HTR(4) overexpression upregulated NAc-CART, provoked anorexia and hyperactivity. NAc-5-HTR(4) knockdown or blockade reduced ecstasy-induced hyperactivity. Finally, NAc-CART knockdown suppressed hyperactivity upon stimulation of the NAc-5-HTR(4). Additionally, inactivating NAc-5-HTR(4) suppressed ecstasy's preference, strengthening the rewarding facet of anorexia. In conclusion, the NAc-5-HTR(4)/CART pathway establishes a 'tight-junction' between anorexia and hyperactivity, suggesting the existence of a primary functional unit susceptible to limit overeating associated with resting following homeostasis rules.

  11. Megestrol acetate for the palliation of anorexia in advanced, incurable cancer patients.

    Science.gov (United States)

    Mateen, Farrah; Jatoi, Aminah

    2006-10-01

    Anorexia, or loss of appetite, is a troubling symptom for many patients with advanced cancer. The early observation that breast cancer patients, who were prescribed megestrol acetate as a cancer treatment, went on to increase their appetite and gain weight has given rise to a large number of clinical trials that have tested this progestational drug as a palliative agent for the cancer anorexia/weight loss syndrome. This review focuses on these trials, summarizing their findings and providing a practical approach for prescribing megestrol acetate to advanced cancer patients who suffer from the cancer anorexia/weight loss syndrome.

  12. [Acupoint Selection Laws for Massage Therapy of Infantile Anorexia: an Analysis Based on Data Mining].

    Science.gov (United States)

    Liu, Kai; Wang Jie; Wang, Yan-guo

    2016-06-01

    Massage prescriptions for treating infantile anorexia in Chinese Academic Journal Full-Text Database (CNKI, 1979-2012), Chinese Scientific and Technological Journal Full-Text Database (VIP, 1989-2012) and Wanfang Database (1990-2012) were collected. By using Chinese Medicine Inheritance Auxiliary Platform (Version 2.0) Software, 286 massage prescriptions for treatment of infantile anorexia were screened involved 76 acupoints, 20 commonly used acupoints, and 57 core acupoint combinations. Infantile Tuina specific points were used as main acupoints in massage therapy for infantile anorexia, and core acupoints covered Jizhu, Pi meridian, abdomen, Nei-Bagua, Zusanli (ST36), and Ban-men.

  13. Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

    Directory of Open Access Journals (Sweden)

    Senay Akbay

    2014-06-01

    Full Text Available The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervosa. But severe bone marrow supression has rarely been reported. To our knowledge, there is not any publication in the literature about bone marrow supression due to constipation.We reported here a 17 years old girl diagnosed as anorexia nervosa who was not wasted yet, presented with constipation and developed fever and pancytopenia.

  14. Anorexia nervosa complicated by diabetes mellitus: the case for permissive hyperglycemia.

    Science.gov (United States)

    Brown, Carrie; Mehler, Philip S

    2014-09-01

    The coexistence of Type 1 Diabetes Mellitus and anorexia nervosa results in an increased incidence of known diabetic complications such as retinopathy and nephropathy, presumably because blood glucose is difficult to control within the throes of comorbid anorexia nervosa. In addition, even when a diabetic patient with anorexia nervosa has committed to resolving his or her eating disorder, glucose control is again difficult and fraught with complexity and peril as will be highlighted in the following case report. Prudence dictates that strict glucose control is not indicated for the relatively short period of time that constitutes the early stage of refeeding in a patient with severe anorexia nervosa. Rather, "permissive hyperglycemia" may be the more optimal course to pursue, as a clinical strategy which is considerate of both the criticality of the refeeding treatment plan and of the long-term nature of the diabetic illness.

  15. Sexual function of women suffering from anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Gonidakis, Fragiskos; Kravvariti, Vasilliki; Varsou, Eleftheria

    2015-01-01

    The cross-sectional study aimed at examining the sexual function of young adult women suffering from eating disorders. The authors interviewed 53 women (26 with anorexia nervosa and 27 with bulimia nervosa) and 58 female students. Each participant was administered the Female Sexual Function Index, the Eating Attitudes Test, the Body Shape Questionnaire, and the Beck Depression Inventory. Comparisons among the 3 groups showed that patients with anorexia nervosa scored lower in each Female Sexual Function Index subscale than did healthy controls. There was no significant difference between bulimia nervosa and healthy controls. Sexual functionality of patients with anorexia nervosa was correlated only with body mass index (r = 0.5, p =.01). Sexual functionality of patients with bulimia nervosa was correlated only with the Beck Depression Inventory (r = -0.4, p =.03) Patients with anorexia nervosa had more disturbed sexual function than did controls. Sexual function can be related to the level of starvation and symptoms of depression.

  16. Heightened Olfactory Sensitivity in Young Females with Recent-Onset Anorexia Nervosa and Recovered Individuals

    DEFF Research Database (Denmark)

    Bentz, Mette; Guldberg, Johanne; Vangkilde, Signe

    2017-01-01

    INTRODUCTION: Olfaction may be related to food restriction and weight loss. However, reports regarding olfactory function in individuals with anorexia nervosa (AN) have been inconclusive. OBJECTIVE: Characterize olfactory sensitivity and identification in female adolescents and young adults...

  17. Diurnal variation of the serum leptin concentration in patients with anorexia nervosa

    DEFF Research Database (Denmark)

    Støving, R K; Vinten, J; Handberg, A

    1998-01-01

    , however, this has been reported to be absent in normal weighted amenorrheic athletes. Anorexia nervosa is associated with multiple endocrine abnormalities. Hypothalamic amenorrhoea often precedes the weight loss and may persist after weight recovery. We hypothesized that leptin could be involved...... in the regulation of eating behaviour and gonadal function in anorexia nervosa. DESIGN: We measured the concentration of leptin in serum samples taken after an overnight fast in 18 female anorexia nervosa patients and 11 controls. To study diurnal variation, eight patients and 11 controls were hospitalized for 24 h...... and had a standardized diet at regular times. Seven blood samples were obtained at 4 h intervals from each subject. PATIENTS: The patients fulfilled the DSM-IV criteria for anorexia nervosa. The mean body mass index for the patients was 14.2 +/- 2.3 kg/m2 and for controls 20.3 +/- 1.7 kg/m2. RESULTS...

  18. Identifying predictors of activity based anorexia susceptibility in diverse genetic rodent populations

    NARCIS (Netherlands)

    Pjetri, Eneda; de Haas, Ria; de Jong, Simone; Gelegen, Cigdem; Oppelaar, Hugo; Verhagen, Linda A W; Eijkemans, Marinus J C; Adan, Roger A; Olivier, Berend; Kas, Martien J

    2012-01-01

    Animal studies are very useful in detection of early disease indicators and in unravelling the pathophysiological processes underlying core psychiatric disorder phenotypes. Early indicators are critical for preventive and efficient treatment of progressive psychiatric disorders like anorexia nervosa

  19. The management of anorexia by patients with advanced cancer: a critical review of the literature.

    Science.gov (United States)

    Shragge, Jeremy E; Wismer, Wendy V; Olson, Karin L; Baracos, Vickie E

    2006-09-01

    This report presents the results of a critical review of the literature on the experience of anorexia (loss of appetite) by patients with advanced cancer. Although several studies have investigated this experience, the adaptive strategies used by patients to compensate for appetite loss remain poorly elucidated. Based on the small body of extant research, it was concluded that, in many instances, a gap exists between the ability of patients and caregivers to come to terms and deal realistically with the emotional and social consequences of patient anorexia. Patients generally appear to suffer greater discord as a result of this disparity, than from the direct psychological impact of anorexia. A greater understanding of the management of anorexia by patients is essential for the development of dietary and psychosocial interventions that would aid both patients and caregivers to cope with this common symptom.

  20. Phobic memory and somatic vulnerabilities in anorexia nervosa: a necessary unity?

    Directory of Open Access Journals (Sweden)

    Myslobodsky Michael

    2005-09-01

    Full Text Available Abstract Anorexia nervosa is a clinically significant illness that may be associated with permanent medical complications involving almost every organ system. The paper raises a question whether some of them are associated with premorbid vulnerability such as subcellular ion channel abnormalities ('channelopathy' that determines the clinical expression of the bodily response to self-imposed malnutrition. Aberrant channels emerge as a tempting, if rather speculative alternative to the notion of cognitively-driven neurotransmitter modulation deficit in anorexia nervosa. The concept of channelopathies is in keeping with some characteristics of anorexia nervosa, such as a genetically-based predisposition to hypophagia, early onset, cardiac abnormalities, an appetite-enhancing efficacy of some antiepileptic drugs, and others. The purpose of this article is to stimulate further basic research of ion channel biophysics in relation to restrictive anorexia.

  1. An Adolescent Boy with Comorbid Anorexia Nervosa and Hashimoto Thyroiditis.

    Science.gov (United States)

    Pehlivantürk Kızılkan, Melis; Kanbur, Nuray; Akgül, Sinem; Alikaşifoğlu, Ayfer

    2016-03-05

    Low triiodothyronine syndrome is a physiological adaptation encountered in anorexia nervosa (AN) and generally improves with sufficient weight gain. However, when a primary thyroid pathology accompanies AN, both the evaluation of thyroid hormone levels and the management of the co-morbid disease become more challenging. Hashimoto thyroiditis could complicate the management of AN by causing hyper- or hypothyroidism. AN could also negatively affect the treatment of Hashimoto thyroiditis by altering body weight and metabolic rate, as well as by causing drug non-compliance. We present the case of a 15-year-old boy with comorbid AN restrictive sub-type and Hashimoto thyroiditis. In this case report, we aimed to draw attention to the challenges that could be encountered in the diagnosis, treatment, and follow-up of patients with AN when accompanied by Hashimoto thyroiditis.

  2. Perfectionism in anorexia nervosa: novel performance based evidence.

    Science.gov (United States)

    Lloyd, Samantha; Yiend, Jenny; Schmidt, Ulrike; Tchanturia, Kate

    2014-01-01

    Existing research into perfectionism in Anorexia Nervosa (AN) is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study--81 with a diagnosis of AN and 72 healthy controls (HCs). Participants completed two performance based tasks assessing perfectionism--a text replication task and a bead sorting task--along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36) and produced significantly higher quality copies (p = perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group.

  3. Peptides and aging: Their role in anorexia and memory.

    Science.gov (United States)

    Morley, John E

    2015-10-01

    The rapid aging of the world's population has led to a need to increase our understanding of the pathophysiology of the factors leading to frailty and cognitive decline. Peptides have been shown to be involved in the pathophysiology of frailty and cognitive decline. Weight loss is a major component of frailty. In this review, we demonstrate a central role for both peripheral peptides (e.g., cholecystokinin and ghrelin) and neuropeptides (e.g., dynorphin and alpha-MSH) in the pathophysiology of the anorexia of aging. Similarly, peripheral peptides (e.g., ghrelin, glucagon-like peptide 1, and cholecystokinin) are modulators of memory. A number of centrally acting neuropeptides have also been shown to modulate cognitive processes. Amyloid-beta peptide in physiological levels is a memory enhancer, while in high (pathological) levels, it plays a key role in the development of Alzheimer's disease.

  4. Dysphagia and anorexia as presentations of leptomeningeal carcinomatosis.

    Science.gov (United States)

    Aiyer, Rohit; Engelman, Ester; Xue, Wei; Yu, Edward

    2016-04-12

    A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina. Cerebrospinal fluid analysis revealed carcinomatous cells. The patient was diagnosed as having leptomeningeal carcinomatosis secondary to lobular breast cancer and was started on radiation therapy, antihormonal treatments and intrathecal methotrexate.

  5. Cognitive Behavioral Therapy for Anorexia Nervosa: An Update.

    Science.gov (United States)

    Dalle Grave, Riccardo; El Ghoch, Marwan; Sartirana, Massimiliano; Calugi, Simona

    2016-01-01

    Cognitive behavioral therapy (CBT) for anorexia nervosa (AN), based on Beck's cognitive theory, was developed in a "generic" form in the early eighties. In recent years, however, improved knowledge of the mechanisms involved in maintaining eating disorder psychopathology has led to the development of a "specific" form of CBT, termed CBT-E (E = enhanced), designed to treat all forms of eating disorders, including AN, from outpatient to inpatient settings. Although more studies are required to assess the relative effectiveness of CBT-E with respect to other available treatments, the data indicate that in outpatient settings it is both viable and promising for adults and adolescents with AN. Encouraging results are also emerging from inpatient CBT-E, particularly in adolescents, and clinical services offering CBT-E at different levels of care are now offered in several countries around the world. However, CBT-E requires dissemination in order to become widely available to patients.

  6. Anorexia nervosa and bulimia nervosa: brains, bones and breeding.

    Science.gov (United States)

    Starr, Taylor B; Kreipe, Richard E

    2014-05-01

    Recent research has modified both the conceptualization and treatment of eating disorders. New diagnostic criteria reducing the "not otherwise specified" category should facilitate the early recognition and treatment of anorexia nervosa (AN) and bulimia nervosa (BN). Technology-based studies identify AN and BN as "brain circuit" disorders; epidemiologic studies reveal that the narrow racial, ethnic and income profile of individuals no longer holds true for AN. The major organs affected long term-the brain and skeletal system-both respond to improved nutrition, with maintenance of body weight the best predictor of recovery. Twin studies have revealed gene x environment interactions, including both the external (social) and internal (pubertal) environments of boys and of girls. Family-based treatment has the best evidence base for effectiveness for younger patients. Medication plays a limited role in AN, but a major role in BN. Across diagnoses, the most important medicine is food.

  7. Purtscher-Like Retinopathy Associated with Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Bugra Karasu

    2016-01-01

    Full Text Available A 21-year-old girl presented with acute painless vision loss in her right eye. There was no remarkable ocular history and she had a history of anorexia nervosa. At presentation best-corrected visual acuities were counting fingers from 2 meters and 20/20, in the right and left eyes, respectively. Slit lamp examination result was normal. Fundus examination revealed multiple cotton wool spots and intraretinal hemorrhages surrounding the optic disc and macula in the right eye. Fluorescein angiography showed capillary filling defect and leakage from optic disc in the late phase of the angiogram. One week later best-corrected visual acuities remained the same in both eyes with similar fundus appearance. One month after initial presentation visual acuity was 20/20 in both eyes with no abnormality in fundus appearance.

  8. [Pathogenesis of anorexia nervosa. Neurobiological risk factors and possible endophenotypes].

    Science.gov (United States)

    Pászthy, Bea; Törzsök-Sonnevend, Mária

    2014-01-26

    Anorexia nervosa is a serious, chronical state of illness which often starts in childhood or adolescence and has serious consequences on the quality of life. This review focuses on the heterogenity of the disease with emphasis on special diagnostic implications in case of childhood onset. Research findings of the last decade showed that genetic and neurobiological vulnerabilities are at least as potent risk factors as psychological, family constellations and sociocultural preferences. The heritability of eating disorders levels those of diseases predominantly influenced by biological factors. The authors give a summary of the most investigated neurobiologic and neurocognitive factors which could be the fundaments of a biological vulnerablilty. To date, no common risk factor could be identified, but some existing adversities can clearly be related to distinct subgroups with the disorder. The concept of endo- and subphenotypes leads to more specific and more efficient methods of therapy in other somatic and psychiatric diseases.

  9. [Nurses and clientele with anorexia and bulimia: a case study].

    Science.gov (United States)

    Martins, Claudia Regina Carvalho; Caccavo, Paulo Vaccari

    2012-01-01

    The research aimed to identify the interaction of nurses and clients suffering from bulimia and anorexia. We use the case study as a resource in which we collect clinical data and did interviews with eight of fourteen nurses, who have been our subject-object. According to the nurses, clients are isolated from the world living in a world without hunger and mirrors reflecting a body always above the "ideal weight", they were lonely people, personnel who have lost their shine, sending signals that could extinguish their lives at any time. In the study, was possible to identify the manner in which nurses interacted and perceived customers and, as a result, we elucidate a peculiar practice in nursing.

  10. Hypothyroidism due to Hashimoto's thyroiditis masked by anorexia nervosa.

    Science.gov (United States)

    Smalls-Mantey, Adjoa; Steinglass, Joanna; Primack, Marshall; Clark-Hamilton, Jill; Bongiovi, Mary

    2015-11-01

    Anorexia nervosa (AN) is typically associated with altered thyroid function tests, notably a low total and free T3 , and lower, but within normal range, free T4 and TSH. A 16-year-old girl with a four-year history of AN presented with elevated TSH that fluctuated with changes in weight. TSH was within normal limits (1.7-3.64 mIU/L) following periods of weight loss and elevated with weight gain (5.9-21.66 mIU/L). Antithyroperoxidase antibodies were markedly elevated, suggesting chronic Hashimoto's thyroiditis. Of note, the elevated TSH that would be expected in Hashimoto's thyroiditis was blunted by weight loss associated with AN. Physicians should be aware that AN may contribute to masking thyroid abnormalities in Hashimoto's thyroiditis.

  11. Brain endocannabinoid system is involved in fluoxetine-induced anorexia.

    Science.gov (United States)

    Zarate, Jon; Churruca, Itziar; Pascual, Jesús; Casis, Luis; Sallés, Joan; Echevarría, Enrique

    2008-06-01

    In order to describe the effects of chronic fluoxetine administration on the brain endocannabinoid system in lean and obese Zucker rats, brain immunostaining for the CB1 and CB1-phosphorylated cannabinoid receptors was carried out. Obese Zucker rats showed significantly increased the numbers of neural cells positively immunostained for the CB1-phosphorylated receptor in the striatum, compared to their lean litter-mates. Chronic fluoxetine administration decreased the number of neural cells immunostained for CB1-phosphorylated receptor in several striatal and hippocampal regions of obese Zucker rats, compared to controls treated with saline. In contrast, no change in CB1-phosphorylated receptor immunostaining was observed in fluoxetine-treated lean rats, with respect to controls. Taken together, these results suggest the involvement of the hippocampal and striatal endocannabinoid receptor system in fluoxetine-induced anorexia in lean and obese Zucker rats.

  12. Autophagy--A free meal in sickness-associated anorexia.

    Science.gov (United States)

    van Niekerk, Gustav; Loos, Ben; Nell, Theo; Engelbrecht, Anna-Mart

    2016-01-01

    Activation of the immune system is metabolically costly, yet a hallmark of an infection is a reduction in appetite with a subsequent reduction in metabolite provision. What is the functional value of decreasing nutrient intake when an infection imposes large demands on metabolic parameters? Here, we propose that sickness-associated anorexia (SAA) upregulates the ancient process of autophagy systemically, thereby profoundly controlling not only immune- but also nonimmune-competent cells. This allows an advanced impact on the resolution of an infection through direct pathogen killing, enhancement of epitope presentation and the contribution toward the clearance of noxious factors. By rendering a 'free meal,' autophagy is thus most fundamentally harnessed during an anorexic response in order to promote both host tolerance and resistance. These findings strongly suggest a reassessment of numerous SAA-related clinical applications and a re-evaluation of current efforts in patient care.

  13. Treatment of 46 Cases of Anorexia with Tuina plus Acupuncture

    Institute of Scientific and Technical Information of China (English)

    ZHOU Ying-ping; CHEN Tian-yun

    2004-01-01

    Forty-six anorexia kids were treated with pinching muscles along the spine, tonifying Pitu (spleen-earth), pressing and kneading Zusanli (ST 36) as well as needling Sifeng points (Ex-UE 10) and got recovery in 20 cases, better in 24 cases and failure in 2 cases with the total effective rate of 95.7% .%应用捏脊,补脾土和按揉足三里穴方法配合针刺四缝穴,治疗小儿厌食患者46例,结果痊愈20例,好转24例,无效2例,总有效率95.7%.

  14. Clinical Observation of Tuina in Treating Anorexia in 78 Children

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-yu; XIAO Yuan-chun

    2004-01-01

    Seventy-eight children with anorexia were treated by circling Neibagua, rubbing abdomen and kneading navel, parting-pushing Fuyinyang, pressing Zusanli (ST 36) and pinching spine. Results showed cure in 48 cases, improvement in 27 cases and failure in 3 cases, with a total effective rate of 96.1%.%应用运内八卦,摩腹揉脐,分推腹阴阳,按揉足三里穴,捏脊等推拿手法治疗78例小儿厌食患者,结果治愈48例,好转27例,未愈3例.总有效率96.1%.

  15. Anorexia Nervosa and Refeeding Syndrome. A Case Report

    Directory of Open Access Journals (Sweden)

    Kohji Azumagawa

    2007-01-01

    Full Text Available This is a case story of a 14-year-old girl with severe anorexia nervosa (AN (158 cm, 28 kg, –44.1% ideal body mass index, admitted with purpura, edema, and general fatigue. We treated her carefully and paid particular attention to prevent development of refeeding syndrome (RS, and her body weight increased satisfactorily. However, RS (edema, hypoalbuminemia, and heart failure occurred despite careful treatment. We used albumin and diuretics for treatment of RS, but severe liver damage resulted. RS was aggravated by the medical treatment. More attention should have been paid to her weight gain and medical treatment should have been initiated more slowly to prevent dramatic changes in the patient's fluid and electrolyte status.

  16. Dynamic psychiatry and the treatment of anorexia psychosis.

    Science.gov (United States)

    Silver, Ann-Louise S; White, Janice

    2011-01-01

    Dynamic psychotherapy of psychosis works through gradually diminishing terror, replacing this with a clearer and shared understanding of the patient's life history, its traumas and its strengths. It is diametrically opposed to our current push for efficiency and an assumption of an underlying brain disorder that responds to our current medications. Over the course of a long treatment, this patient became a scholar of psychoanalytic contributions to understanding psychosis and is now a philosopher of this field, developing an understanding of anorexia psychosis. She draws on the writings of Freud, Bion, Lacan, and Julian Jaynes, placing the core of psychosis not in primary process but in a preceding, non-self phase of development. She relates this individual development to the history of human development.

  17. [Affective disorders in patients with anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Briukhin, A E; Onegina, E Iu

    2011-01-01

    Authors studied 109 patients with eating disorders, including 49 with anorexia nervosa (AN) and 60 with bulimia nervosa (BN), using psychopathological and experimental/psychological methods, psychometric scales and follow-up. Four variants (2 AN and 2 BN) of clinical presentations and dynamics of affective disorders were singled out. It has been shown that many features of their symptoms and responses of patients to the complex therapy (diet-, psycho- and pharmacotherapy) depend on the belonging of AN or BN to a group of borderline mental disorders or to endogenous diseases. Taking into account the revealed features of affective disorders, the authors have formulated recommendations for treatment tactics and prevention measures for these groups of patients.

  18. Family perception of anorexia and bulimia: a systematic review.

    Science.gov (United States)

    Espíndola, Cybele Ribeiro; Blay, Sérgio Luís

    2009-08-01

    A systematic literature review published between 1990 and 2006 using a qualitative approach was conducted to explore family members' perception of anorexia and bulimia nervosa patients. Articles were critically reviewed and a meta-synthesis analysis was carried out based on a meta-ethnographic method to analyze and summarize data. Of a total of 3,415 studies, nine met the study inclusion and exclusion criteria. Reciprocal translation was used for data interpretation allowing to identifying two concepts: disease awareness and disease impacts. Feelings of impotence were often described in family reorganization. The study results point to distortions in the concept of disease associated with family involvement, resulting in changes in communication, attitudes, and behaviors in a context of impotence.

  19. Constitutional thinness and anorexia nervosa: a possible misdiagnosis?

    Science.gov (United States)

    Estour, Bruno; Galusca, Bogdan; Germain, Natacha

    2014-01-01

    Clinical and biological aspects of restrictive anorexia nervosa (R-AN) are well documented. More than 10,000 articles since 1911 and more than 600 in 2013 have addressed R-AN psychiatric, somatic, and biological aspects. Genetic background, ineffectiveness of appetite regulating hormones on refeeding process, bone loss, and place of amenorrhea in the definition are widely discussed and reviewed. Oppositely, constitutional thinness (CT) is an almost unknown entity. Only 32 articles have been published on this topic since 1953. Similar symptoms associating low body mass index, low fat, and bone mass are reported in both CT and R-AN subjects. Conversely, menses are preserved in CT women and almost the entire hormonal profile is normal, except for leptin and PYY. The aim of the present review is to alert the clinician on the confusing clinical presentation of these two situations, a potential source of misdiagnosis, especially since R-AN definition has changed in DSM5.

  20. Constitutional thinness and anorexia nervosa: a possible misdiagnosis?

    Directory of Open Access Journals (Sweden)

    Bruno eEstour

    2014-10-01

    Full Text Available Clinical and biological aspects of restrictive anorexia nervosa (R-AN are well documented. More than ten thousand articles since 1911 and more than six hundred in 2013 have addressed R-AN psychiatric, somatic and biological aspects. Genetic background, ineffectiveness of appetite regulating hormones on refeeding process, bone loss and place of amenorrhea in the definition are widely discussed and reviewed. Oppositely, constitutional thinness (CT is an almost unknown entity. Only 32 articles have been published on this topic since 1953. Similar symptoms associating low BMI, low fat and bone mass are reported in both CT and R-AN subjects. Conversely, menses are preserved in CT women and almost the entire hormonal profile is normal, except for leptin and PYY. The aim of the present review is to alert the clinician on the confusing clinical presentation of these two situations, a potential source of misdiagnosis, especially since R-AN definition has changed in DSM-5.

  1. A Brief Review of the Biology of Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Magnus Sjogren

    2015-12-01

    Full Text Available Background: The etiology of Anorexia Nervosa (AN is unknown. A stress model for AN and other Eating Disorders, has been proposed by Connan and depicts risk factors and precipitating events, including biological, but several steps in this have yet to be evidenced. In order to elucidate the biology of AN, some studies have investigated the blood biochemistry in AN in the acute state, when BMI (Body Mass Index is very low, and compared this to a recovered state. In this brief review, we present the results of a literature search on potential biomarkers of AN. Method: A literature search using PUBMED and the following search terms: “Anorexia Nervosa” and “biomarker” revealed 180 articles (8th of May 2015. Additional searches included the search terms “gene”, “genetic”, “epigenetic”, “appetite”, “hormone”, and a specific search on “biology” and “review”. Furthermore, articles of interest were retrieved from the reference lists of the identified articles of the first PUBMED search. Results: In general, there is a shortage of studies on biomarkers and the biology of AN, at least when you compare to similar fields of research in Affective disorders and Schizophrenia. The studies performed reveals that heritability is involved and that biological factors independent of BMI may play a role in the pathophysiology of AN. In the acute stage of AN, decreased levels of leptin and increases in ghreline and obestatin, hormones involved in the regulation of appetite, are often found. Conclusion: In view of the rather few studies done, the small number of patients included in the studies, and the lack of additional information relating to behavioral and phenotypic characteristics, the results must be interpreted with caution. Preliminary findings indicate that factors independent of BMI may be involved in the pathophysiology of AN. During acute stages of AN, when BMI is lover than 17, 5, abnormal levels of appetite regulating

  2. Thiamine deficiency induces anorexia by inhibiting hypothalamic AMPK.

    Science.gov (United States)

    Liu, M; Alimov, A P; Wang, H; Frank, J A; Katz, W; Xu, M; Ke, Z-J; Luo, J

    2014-05-16

    Obesity and eating disorders are prevailing health concerns worldwide. It is important to understand the regulation of food intake and energy metabolism. Thiamine (vitamin B1) is an essential nutrient. Thiamine deficiency (TD) can cause a number of disorders in humans, such as Beriberi and Wernicke-Korsakoff syndrome. We demonstrated here that TD caused anorexia in C57BL/6 mice. After feeding a TD diet for 16days, the mice displayed a significant decrease in food intake and an increase in resting energy expenditure (REE), which resulted in a severe weight loss. At the 22nd day, the food intake was reduced by 69% and 74% for male and female mice, respectively in TD group. The REE increased by ninefolds in TD group. The loss of body weight (17-24%) was similar between male and female animals and mainly resulted from the reduction of fat mass (49% decrease). Re-supplementation of thiamine (benfotiamine) restored animal's appetite, leading to a total recovery of body weight. The hypothalamic adenosine monophosphate-activated protein kinase (AMPK) is a critical regulator of food intake. TD inhibited the phosphorylation of AMPK in the arcuate nucleus (ARN) and paraventricular nucleus (PVN) of the hypothalamus without affecting its expression. TD-induced inhibition of AMPK phosphorylation was reversed once thiamine was re-supplemented. In contrast, TD increased AMPK phosphorylation in the skeletal muscle and upregulated the uncoupling protein (UCP)-1 in brown adipose tissues which was consistent with increased basal energy expenditure. Re-administration of thiamine stabilized AMPK phosphorylation in the skeletal muscle as well as energy expenditure. Taken together, TD may induce anorexia by inhibiting hypothalamic AMPK activity. With a simultaneous increase in energy expenditure, TD caused an overall body weight loss. The results suggest that the status of thiamine levels in the body may affect food intake and body weight.

  3. Review of Liebman et al.'s 'An integrated treatment program for anorexia nervosa'.

    Science.gov (United States)

    Wright, Shelagh

    2006-07-01

    This article reviews the paper by Liebman, Minuchin, and Baker (1974) describing the use of a family meal as part of an integrated treatment approach for anorexia nervosa. The ideas laid out in the paper are described and discussed in terms of the understanding of anorexia nervosa at the time as well as placed in a current clinical and theoretical context. A comment is made on whether or not, in this author's opinion, the paper stands 'the test of time'.

  4. Hepatic glycogen deposition in a patient with anorexia nervosa and persistently abnormal transaminase levels.

    Science.gov (United States)

    Kransdorf, Lisa N; Millstine, Denise; Smith, Maxwell L; Aqel, Bashar A

    2016-04-01

    Anorexia nervosa and other eating disorders characterized by calorie restriction have been associated with a variety of hepatic abnormalities. Fatty steatosis has been described in eating disorder patients. We report the rare finding of glycogen accumulation in the liver in a patient with anorexia nervosa, which to our knowledge is only the second such case reported in the literature. This case highlights the importance of monitoring for liver abnormalities in patients with restrictive eating disorders.

  5. Tales from the edge : sufferers’ perspectives of the role of psychotherapy in recovery from anorexia nervosa

    OpenAIRE

    2013-01-01

    As a psychotherapist working in the field of eating disorders, I have a long-standing interest in accessing the subjective expertise of a wider group of sufferers, including what it is like and what it means to suffer from anorexia, the factors that help to support recovery and the role psychotherapy plays in contributing towards the recovery process. This study provides a timely addition to the literature on the nature and role of psychotherapy as a treatment for anorexia. Stu...

  6. Anorexia as a Psychoemotional Pathology of Young Women of the 21 Century

    OpenAIRE

    2015-01-01

    BACKGROUND Anorexia nervosa characterized by deliberate weight loss, induced and sustained by the patient. It occurs most commonly in adolescent girls and young women, but adolescent boys and young men may also be affected. The investigation of anorexia is caused by increase of the number of people with this pathology within the last decade, difficulties of its diagnostics and treatment as well as long-lasting and complicated rehabilitation and possible relapsing course. METHODS The intervent...

  7. [Role of the age factor in forming the clinical picture of anorexia nervosa].

    Science.gov (United States)

    Korkina, M V; Zeĭgarnik, B V; Kareva, M A; Marilov, V V

    1976-12-01

    The results of long-term clinical and experimental-psychological studies of patients with nervous anorexia were analyzed from the point of view of age psychology. Such approaches permitted to distinguish a peculiarity in the formation mechanism of this form of pathology. Dynamical studies of the moving forces in the personality development in morbid conditions allowed one to distinguish certain disorders in the process of periodization of the mental development. This in its turn exerts influence on the development of nervous anorexia.

  8. The parental bonding in families of adolescents with anorexia: attachment representations between parents and offspring

    Science.gov (United States)

    Balottin, Laura; Mannarini, Stefania; Rossi, Maura; Rossi, Giorgio; Balottin, Umberto

    2017-01-01

    Introduction The attachment theory is widely used in order to explain anorexia nervosa origin, course and treatment response. Nevertheless, very little literature specifically investigated parental bonding in adolescents with anorexia, as well as the parents’ own bonding and intergenerational transmission within the family. Purpose This study aims to identify any specific pattern of parental bonding in families of adolescents newly diagnosed with restricting-type anorexia, comparing them to the families of the control group. Patients and methods A total of 168 participants, adolescents and parents (78 belonging to the anorexia group and 90 to the control one), rated the perceived parental styles on the parental bonding instrument. The latent class analysis allowed the exploration of a maternal bonding latent variable and a paternal one. Results The main findings showed that a careless and overcontrolling parental style was recalled by the patients’ parents, and in particular by the fathers. As far as the adolescents’ responses were concerned, patients with anorexia did not seem to express differently their parental bonding perception from participants of the control group. Conclusion Clinical implications driven from the results suggest that a therapeutic intervention working on how the parents’ own attachment representations influence current relationships may help to modify the actual family functioning and thus the outcome of patients with anorexia. PMID:28203082

  9. What can we learn from the history of male anorexia nervosa?

    Science.gov (United States)

    Zhang, Chengyuan

    2014-01-01

    The eating disorders literature has focussed on females and little is known of the male experience. The overall image this has generated suggests a young woman in conflict with socio-cultural pressures which associate thinness with beauty. Historical studies have examined anorexia nervosa from an entirely female focus while ignoring how diagnostic categories have shaped approaches to the male body. This paper will track the case of the male with anorexia nervosa through changing theories of causation and treatment approaches, from when the condition first emerged in 1873 to the present. In doing so, we gain a valuable new insight into how anorexia nervosa has been historically gendered and the far-reaching implications this has had for diagnosis and treatment of the male sufferer. Similarities between the sexes helped to establish male anorexia as a distinct category. However, this shifted focus away from important differences, which have yet unexplored implications in the assessment, diagnosis and management of disordered eating. Throughout history, there has been constant pressure to give a precise definition to anorexia nervosa, despite being fraught with medical uncertainties. This has resulted in inevitably harmful generalisations rooted in the dominant epidemiology. This paper reveals that anorexia nervosa is a truly global phenomenon which cannot be adequately constructed through exclusive studies of the female. There is consequently a pressing need to address the dearth of research examining eating disorders in males.

  10. Practice guidelines for acupuncturists using acupuncture as an adjunctive treatment for anorexia nervosa.

    Science.gov (United States)

    Fogarty, Sarah; Ramjan, Lucie Michelle

    2015-02-01

    Anorexia nervosa is a potentially life-threatening eating disorder where people intentionally refuse to eat sufficient amounts to maintain a healthy body-weight for fear of becoming fat. The intense preoccupation with restriction of food and control of body weight makes this one of the most complex and confusing conditions for practitioners to treat. While no single treatment has been found to be superior to another in the treatment of anorexia nervosa, general practice guidelines are available to guide mainstream treatment, however there are no guidelines for practitioners of complementary therapies. Complementary therapies such as acupuncture show promise as an adjunctive therapy in improving co-morbidities such as depression and anxiety levels among people with anorexia nervosa, by strengthening mind, body and overall well-being. The aim of this guideline is to assist and support acupuncture practitioners to deliver effective and safe adjunctive acupuncture treatments to people with anorexia nervosa, by providing a practice guideline that is underpinned by an ethical and evidence-based framework. The use of complementary therapies and specifically acupuncture in the treatment of anorexia nervosa may provide important adjunctive care to allow a comprehensive treatment approach that potentially improves quality of life, reduces anxiety and instils hope for recovery. It is hoped that acupuncture practitioners treating patients with anorexia nervosa will refer to these guidelines and apply the guidance (as deemed appropriate).

  11. Interleukin-7 Plasma Levels in Human Differentiate Anorexia Nervosa, Constitutional Thinness and Healthy Obesity

    Science.gov (United States)

    Germain, Natacha; Viltart, Odile; Loyens, Anne; Bruchet, Céline; Nadin, Katia; Wolowczuk, Isabelle; Estour, Bruno; Galusca, Bogdan

    2016-01-01

    Introduction Interleukin-7 (IL-7) is a cytokine involved in energy homeostasis as demonstrated in rodents. Anorexia nervosa is characterized by restrained eating behavior despite adaptive orexigenic regulation profile including high ghrelin plasma levels. Constitutional thinness is a physiological condition of resistance to weight gain with physiological anorexigenic profile including high Peptide YY plasma level. Healthy obesity can be considered as a physiological state of resistance to weight loss with opposite appetite regulating profile to constitutional thinness including low Peptide YY plasma level. No studies in IL-7 are yet available in those populations. Therefore we evaluated circadian plasma levels of IL-7 in anorexia nervosa compared to constitutional thinness, healthy obese and control females. Materials and Methods 10 restrictive-type anorexia nervosa women, 5 bingeing/purging anorexia nervosa woman, 5 recovered restrictive anorexia nervosa women, 4 bulimic females, 10 constitutional thinness women, 7 healthy obese females, and 10 normal weight women controls were enrolled in this cross-sectional study, performed in endocrinology unit and academic laboratory. Twelve-point circadian profiles of plasma IL-7 levels were measured in each subject. Results 24h mean IL-7 plasma levels (pg/ml, mean±SEM) were decreased in restrictive-type anorexia nervosa (123.4±14.4, pobese patients (51±3.2, pobesity, with low IL-7, is once again in mirror image of constitutional thinness with normal high IL-7. PMID:27611669

  12. Effects of omega-3 fatty acids on orexigenic and anorexigenic modulators at the onset of anorexia.

    Science.gov (United States)

    Ramos, Eduardo J B; Romanova, Irina V; Suzuki, Susumu; Chen, Chung; Ugrumov, Michael V; Sato, Tomoi; Goncalves, Carolina G; Meguid, Michael M

    2005-06-07

    In cancer anorexia, a decrease in food intake (FI) occurs concomitant with changes in orexigenic peptides such as neuropeptide Y (NPY) and anorexigenic peptides such as alpha-melanocyte-stimulating hormone (alpha-MSH) and anorexigenic neurotransmitter serotonin. omega-3 Fatty acid (omega-3FA) inhibits cytokine synthesis, and delays tumor appearance, tumor growth, and onset of anorexia in tumor-bearing rats. We hypothesize that, in cancer anorexia, omega-3FA is associated with quantitative reversal of hypothalamic NPY, alpha-MSH, and serotonin receptor (5-HT(1B)-receptor) enhancing FI. Fischer rats were divided into: MCA tumor bearing fed chow (TB-Chow) or omega-3FA diet (TB-omega-3FA) and controls: non-tumor bearing fed chow (NTB-Chow) or omega-3FA diet (NTB-omega-3FA). Rats were euthanized at anorexia and brains were removed for hypothalamic immunohistochemical study, using NPY, alpha-MSH, and 5-HT(1B)-receptor-specific antibodies and slides assessed by image analysis. Immunostaining specificity was controlled by omission of primary or secondary antibodies and pre-absorption test. At anorexia, FI decreased (P anorexia, concomitant with an increase in FI, were probably mediated by omega-3FA inhibition of tumor-induced cytokines.

  13. Fenfluramine treatment in female rats accelerates the weight loss associated with activity-based anorexia.

    Science.gov (United States)

    Atchley, Deann P D; Eckel, Lisa A

    2005-02-01

    Serotonin plays an important role in controlling food intake and regulating body weight. Thus, altered serotonergic function may be involved in the etiology of anorexia nervosa. To investigate this hypothesis, we examined whether activation of the serotonin system increases the severity of activity-based anorexia, an animal model of anorexia nervosa in which food-restricted rats are housed with access to running wheels. This paradigm promotes symptoms of anorexia nervosa, including hypophagia, hyperactivity, and weight loss. Food-restricted rats received injections of a serotonin agonist, fenfluramine, or saline 1.5 h prior to their daily 2-h period of food access. A third saline-injected group was pair-fed to the fenfluramine group. Drug treatment and food restriction were terminated following a 25% weight loss. During food restriction, each group developed symptoms of activity-based anorexia. Although similar reductions in food intake were observed in fenfluramine-treated and pair-fed rats, only fenfluramine-treated rats displayed an accelerated rate of weight loss, relative to saline-treated rats. Thus, some other nonanorexic aspect of fenfluramine, perhaps its influence on metabolism, must underlie the accelerated rate of weight loss in this group. Our results suggest that increased activation of the serotonin system exacerbates the weight loss associated with activity-based anorexia.

  14. Autism spectrum disorder in individuals with anorexia nervosa and in their first- and second-degree relatives

    DEFF Research Database (Denmark)

    Koch, Susanne V; Tidselbak Larsen, Janne; Mouridsen, Svend E

    2015-01-01

    BACKGROUND: Clinical and population-based studies report increased prevalence of autism spectrum disorders (ASD) in individuals with anorexia nervosa and in their relatives. No nationwide study has yet been published on co-occurrence of these disorders. AIMS: To investigate comorbidity of ASD...... in individuals with anorexia nervosa, and aggregation of ASD and anorexia nervosa in their relatives. METHOD: In Danish registers we identified all individuals born in 1981-2008, their parents, and full and half siblings, and linked them to data on hospital admissions for psychiatric disorders. RESULTS: Risk...... of comorbidity of ASD in probands with anorexia nervosa and aggregation of ASD in families of anorexia nervosa probands were increased. However, the risk of comorbid and familial ASD did not differ significantly from comorbid and familial major depression or any psychiatric disorder in anorexia nervosa probands...

  15. Severe and enduring anorexia nervosa (SEED-AN): a qualitative study of patients with 20+ years of anorexia nervosa.

    Science.gov (United States)

    Robinson, Paul H; Kukucska, Roza; Guidetti, Giulia; Leavey, Gerard

    2015-07-01

    Little is known about how patients with long-term eating disorders manage their clinical problems. We carried out a preliminary qualitative study (using Thematic Analysis) of patients with severe and enduring anorexia nervosa (SEED-AN) in which we undertook recorded interviews in eight participants whose conditions had lasted 20-40 years. We found 15 principle features in physical, psychological, social, family, occupational and treatment realms. Psychological and social realms were most affected. Severe physical problems were reported. They described feelings of unworthiness, frugality regarding money and obsessive time-keeping. Persisting with negligible social networks, participants described depression and hopelessness, while somehow achieving a sense of pride at their endurance and survival in spite of the eating disorder. They emphasized the importance of professional help in managing their care. The severe and enduring description, often reserved for people with psychotic illness, is appropriately applied to SEED-AN, which has major impacts in all realms.

  16. Freud: enfermedades nerviosas, angustia y estrés. O del estatuto del cuerpo implicado en las dolencias del sujeto. // Freud: nervous system diseases, anxiety and stress. Or of the status of the body involved in subject’s ailments

    Directory of Open Access Journals (Sweden)

    Gloria Gómez

    2008-12-01

    Full Text Available What was the destiny of the so-called nervous system diseases in times of Freud? ¿What role do they play in current nosography? New terms are coined for old conditions: stress, irritable bowel syndrome, fibromyalgia, chronic fatigue… Since Freud, the psychoanalytic clinic is made of what causes an impasse to medicine, whose idiopathic symptoms disturb the organ systems and, particularly, the bodily functions in their two orders: Vegetative life, and animal or relationship life. The body of the subject represents a problem for medical practice since this latter focuses on its dysfunctions and diseases but faces up to a body occupied by a speaking-being, a body that beyond being just a living being is a body molded by language: body of a desiring and enjoying subject. // ¿Cuál fue el destino de las llamadas enfermedades nerviosas en la época de Freud? ¿Qué lugar ocupan ellas en la nosografía actual? Se acuñan nuevos términos para viejas afecciones: estrés, síndrome de intestino irritable, fibromialgia, fatiga crónica… Desde Freud la clínica psicoanalítica del cuerpo está hecha con aquello que hace impasse a la medicina, cuyos cuadros idiopáticos perturban los sistemas orgánicos y, sobre todo, las funciones corporales en sus dos órdenes: vida vegetativa y vida animal o de relación. El cuerpo del sujeto constituye un problema para la práctica médica que apunta a sus disfunciones y enfermedades pero se confronta con un cuerpo habitado por un ser-hablante, un cuerpo que más allá de ser sólo organismo viviente, es cuerpo moldeado por el lenguaje: cuerpo de un sujeto de deseo y goce.

  17. Desnutrición en Anorexia Nervosa: enfoque psicosomático y tratamiento multidisciplinar Malnutrition in anorexia nervosa: psychosomatic approach an multidisciplinary treatment

    OpenAIRE

    2004-01-01

    Objetivo: Empleando el método cuantitativo y estadístico para estudiar la psicopatología de esta enfermedad, consideramos que la melancolía subyace en toda anorexia, falla psíquica estructural en la personalidad del narcisismo primario, instalada al comienzo de la vida. La melancolía conlleva su opuesto, la "manía", que en la anorexia se manifiesta en ejercicio físico agotador y en una perpetua actitud circular de "atracón-purga", con vómitos continuos, dañando dientes y esófago y produciendo...

  18. Concordancia entre los porcentajes de grasa corporal estimados mediante el área adiposa del brazo, el pliegue del tríceps y por impedanciometría brazo-brazo

    Directory of Open Access Journals (Sweden)

    Martín Moreno Vicente

    2003-01-01

    Full Text Available Fundamento: La valoración del estado nutricional a partir de los miembros superiores es útil a nivel clínico. El objetivo de este trabajo es analizar el grado de acuerdo entre los porcentajes de grasa corporal (%GC estimados mediante el área adiposa del brazo (%GC BRAZO, la ecuación de Siri para el pliegue del tríceps (%GC TRÍCEPS y por bioimpedanciometría brazo-brazo (%GC BIA, así como con la ecuación de Siri para cuatro pliegues (%GC SIRI. Métodos: Estudio descriptivo transversal. Se valoró antropométricamente y por impedanciometría (Omron BF 300© a 145 personas (83 varones, 62 mujeres. La concordancia entre métodos se analizó mediante el coeficiente de correlación intraclase (CCI y el método de Bland-Altman. Resultados: el CCI entre %GC BRAZO-%GC TRÍCEPS fue de 0,8322 (intervalo de confianza al 95% 0,7672-0,8791; entre %GCB RAZO-%GC BIA de 0,7337 (0,6305-0,8080 y entre %GC TRICEPS-%GC BIA de 0,9290 (0,9015; 0,9488. Con el método de Bland-Altman el intervalo de concordancia entre %GC BRAZO-%GC TRÍCEPS (-11,2; 16,96 y entre %GC BRAZO-%GC BIA (-13,04; 21,76 superó el punto de corte (±10%, pero no entre %G CTRICEPS-%GC BIA (-6,64; 9,6, %GC SIRI-%GC TRÍCEPS (-5,27; 4,52 y %GC SIRI-%GC BIA (-6,31; 8,52. El IMC no influyó en el resultado. Conclusiones: El método utilizado influye en la valoración nutricional realizada a partir de los miembros superiores. El área adiposa del brazo sobreestima el %GC con relación a la ecuación de Siri para el pliegue del tríceps o para cuatro pliegues y a la impedanciometría, y aunque este resultado sugiere que el área adiposa del brazo puede no ser un indicador válido de la adiposidad global, este extremo deberá ser confirmado frente a una técnica patrón.

  19. Concordancia entre los porcentajes de grasa corporal estimados mediante el área adiposa del brazo, el pliegue del tríceps y por impedanciometría brazo-brazo

    Directory of Open Access Journals (Sweden)

    Juan Benito Gómez Gandoy

    2003-01-01

    Full Text Available Fundamento: La valoración del estado nutricional a partir de los miembros superiores es útil a nivel clínico. El objetivo de este trabajo es analizar el grado de acuerdo entre los porcentajes de grasa corporal (%GC estimados mediante el área adiposa del brazo (%GCBRAZO, la ecuación de Siri para el pliegue del tríceps (%GCTRÍ- CEPS y por bioimpedanciometría brazo-brazo (%GCBIA, así como con la ecuación de Siri para cuatro pliegues (%GCSIRI. Métodos: Estudio descriptivo transversal. Se valoró antropométricamente y por impedanciometría (Omron BF 300© a 145 personas (83 varones, 62 mujeres. La concordancia entre métodos se analizó mediante el coeficiente de correlación intraclase (CCI y el método de Bland-Altman. Resultados: el CCI entre %GCBRAZO-%GCTRÍCEPS fue de 0,8322 (intervalo de confianza al 95% 0,7672-0,8791; entre %GCBRAZO- %GCBIA de 0,7337 (0,6305-0,8080 y entre %GCTRICEPS-%GCBIA de 0,9290 (0,9015; 0,9488. Con el método de Bland-Altman el intervalo de concordancia entre %GCBRAZO-%GCTRÍCEPS (-11,2; 16,96 y entre %GCBRAZO-%GCBIA (–13,04; 21,76 superó el punto de corte (±10%, pero no entre %GCTRICEPS-%GCBIA (-6,64; 9,6, %GCSIRI- %GCTRÍCEPS (-5,27; 4,52 y %GCSIRI-%GCBIA (-6,31; 8,52. El IMC no influyó en el resultado. Conclusiones: El método utilizado influye en la valoración nutricional realizada a partir de los miembros superiores. El área adiposa del brazo sobreestima el %GC con relación a la ecuación de Siri para el pliegue del tríceps o para cuatro pliegues y a la impedanciometría, y aunque este resultado sugiere que el área adiposa del brazo puede no ser un indicador válido de la adiposidad global, este extremo deberá ser confirmado frente a una técnica patrón.

  20. Unusual presentation of uncommon disease: anorexia nervosa presenting as wernicke-korsakoff syndrome-a case report from southeast Asia.

    Science.gov (United States)

    Mushtaq, Raheel; Shoib, Sheikh; Shah, Tabindah; Bhat, Mudasir; Singh, Randhir; Mushtaq, Sahil

    2014-01-01

    Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome.

  1. Unusual Presentation of Uncommon Disease: Anorexia Nervosa Presenting as Wernicke-Korsakoff Syndrome—A Case Report from Southeast Asia

    Directory of Open Access Journals (Sweden)

    Raheel Mushtaq

    2014-01-01

    Full Text Available Anorexia nervosa presenting as Wernicke-Korsakoff syndrome is rare. The causes of Wernicke-Korsakoff syndrome are multiple like alcohol abuse, thyrotoxicosis, haemodialysis, severe malnutrition because of gastric carcinoma and pyloric obstruction, hyperemesis gravidarum, and prolonged parenteral feeding. We report a case of anorexia nervosa, who presented with Wernicke's encephalopathy and progressed to Korsakoff's syndrome. Knowledge, awareness, and early intervention of anorexia nervosa by mental health professionals can prevent development of Wernicke-Korsakoff syndrome.

  2. Efectividad de la terapia manual y de la electroestimulación nerviosa transcutánea en la reducción del dolor en pacientes con cervicalgia mecánica: ensayo clínico aleatorio en atención primaria

    OpenAIRE

    Escortell Mayor, Esperanza

    2012-01-01

    Objetivo: Evaluar la efectividad de la terapia manual y de la electroestimulación nerviosa transcutánea (TENS) en la disminución de la intensidad del dolor en pacientes con cervicalgia mecánica subaguda o crónica atendidos en Unidades de Fisioterapia de atención primaria, tanto a corto (al finalizar la terapia) como a medio plazo (a los 6 meses). Diseño: Ensayo clínico multicéntrico con grupos paralelos, asignación aleatoria y evaluación ciega de la variable respuesta. Emplazamiento: 13 Unida...

  3. Partially restored resting-state functional connectivity in women recovered from anorexia nervosa

    Science.gov (United States)

    Boehm, Ilka; Geisler, Daniel; Tam, Friederike; King, Joseph A.; Ritschel, Franziska; Seidel, Maria; Bernardoni, Fabio; Murr, Julia; Goschke, Thomas; Calhoun, Vince D.; Roessner, Veit; Ehrlich, Stefan

    2016-01-01

    Background We have previously shown increased resting-state functional connectivity (rsFC) in the frontoparietal network (FPN) and the default mode network (DMN) in patients with acute anorexia nervosa. Based on these findings we investigated within-network rsFC in patients recovered from anorexia nervosa to examine whether these abnormalities are a state or trait marker of the disease. To extend the understanding of functional connectivity in patients with anorexia nervosa, we also estimated rsFC between large-scale networks. Methods Girls and women recovered from anorexia nervosa and pair-wise, age- and sex-matched healthy controls underwent a resting-state fMRI scan. Using independent component analyses (ICA), we isolated the FPN, DMN and salience network. We used standard comparisons as well as a hypothesis-based approach to test the findings of our previous rsFC study in this recovered cohort. Temporal correlations between network time-course pairs were computed to investigate functional network connectivity (FNC). Results Thirty-one patients recovered from anorexia nervosa and 31 controls participated in our study. Standard group comparisons revealed reduced rsFC between the dorsolateral prefrontal cortex (dlPFC) and the FPN in the recovered group. Using a hypothesis-based approach we extended the previous finding of increased rsFC between the angular gyrus and the FPN in patients recovered from anorexia nervosa. No group differences in FNC were revealed. Limitations The study design did not allow us to conclude that the difference found in rsFC constitutes a scar effect of the disease. Conclusion This study suggests that some abnormal rsFC patterns found in patients recovered from anorexia nervosa normalize after long-term weight restoration, while distorted rsFC in the FPN, a network that has been associated with cognitive control, may constitute a trait marker of the disorder. PMID:27045551

  4. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa.

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    Sheng, Min; Lu, Hanzhang; Liu, Peiying; Thomas, Binu P; McAdams, Carrie J

    2015-05-30

    Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to quantify regional and global cerebral blood flow (CBF) in 25 healthy women (HC), 23 patients currently with anorexia (AN-C) and 19 patients in long-term weight recovery following anorexia (AN-WR). Specifically, CBF was measured with pseudo-continuous arterial spin labeling (pCASL) MRI and then verified by a different technique, phase contrast (PC) MRI. Venous T2 values were determined by T2 relaxation under spin tagging (TRUST) MRI, and were used to corroborate the CBF results. These novel techniques were implemented on a standard 3T MRI scanner without any exogenous tracers, and the total scan duration was less than 10min. Voxel-wise comparison revealed that the AN-WR group showed lower CBF in bilateral temporal and frontal lobes than the AN-C group. Compared with the HC group, the AN-C group also showed higher CBF in the right temporal lobe. Whole-brain-averaged CBF was significantly decreased in the AN-WR group compared with the AN-C group, consistent with the PC-MRI results. Venous T2 values were lower in the AN-WR group than in the AN-C group, consistent with the CBF results. A review of prior work examining CBF in anorexia nervosa is included in the discussion. This study identifies several differences in the cerebral physiological alterations in anorexia nervosa, and finds specific differences relevant to the current state of the disorder.

  5. In silico exploration of the mechanisms that underlie parasite-induced anorexia in sheep.

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    Laurenson, Yan C S M; Bishop, Stephen C; Kyriazakis, Ilias

    2011-10-01

    A model was used to investigate two mechanisms describing reductions in food intake (anorexia) observed during gastrointestinal parasitism in lambs, and to explore relationships between anorexia and food composition. The mechanisms were either a reduction in intrinsic growth rate, leading to a consequent reduction in food intake (mechanism 1; M1), or a direct reduction in food intake (mechanism 2; M2). For both mechanisms, lambs growing from 2 to 6 months of age were modelled, with one of three levels of trickle challenge with Teladorsagia circumcincta. Scenarios were simulated for feeds varying in either protein or energy content, or both. Major differences were found between the predictions resulting from M1 and M2 on low-energy foods that constrained the intake of uninfected lambs through bulk. With M1, food intake was governed by the first operating constraint, whereas with M2 an additivity of constraints was observed. On the other foods, the duration of anorexia increased with increasing energy content of feed for M1, whilst the duration of anorexia decreased with increasing protein content of feed for M2.For foods that did not have an impact upon lambs' gastrointestinal tract capacity, published data were consistent with predictions of M2. Due to an absence of experimental data, no conclusions could be drawn for relationships between anorexia and food composition in the presence of other limiting constraints, such as bulk for low-energy foods. In conclusion, available experimental data and model predictions were consistent with anorexia having an impact directly on food intake, and with impacts of anorexia increasing with decreasing protein content.

  6. 厌食散配合刺四缝穴治疗小儿厌食症%Treatment of Children Anorexia with Anorexia San and Acupuncture Sifeng Point

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    谢彬; 沈红岩

    2011-01-01

    目的:探寻治疗小儿厌食症的有效方法.方法:将156例患儿随机分为治疗组和对照组各78例,对照组仅采用刺四缝穴治疗,治疗组采用口服厌食散(辽宁中医药大学附属医院院内制剂)配合剌四缝穴,疗程均为2周.结果:治疗组总有效率100%,优于对照组的92.3%(P<0.05).结论:厌食散配合刺四缝穴治疗小儿厌食症安全、有效、简单、经济,值得临床推广使用.%Objective: To explore an effective way to treat children anorexia.Methods: The 156 patients were randomly divided into treatment group and control group 78 patients, control group treated with points Sifeng, treatment group were anorexia san and acupuncture Sifeng point.Groups are 2 weeks as a course of treatment.Results: The total effective rate is 100% in treatment group and 92.3% in control group, the difference has statistical significance(P<0.05).Conclusion: Anorexia san and acupuncture sifeng point in treating children anorexia were safe, effective, simple, economical, should be widely applied.

  7. Concordancia entre dos observadores en la medición del consumo de tabaco y del uso del cinturón de seguridad y del teléfono móvil en vehículos Agreement between two observers in the measurement of smoking and use of safety belt and cell phones in vehicles

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    José M. Martínez-Sánchez

    2012-02-01

    Full Text Available El objetivo de este trabajo es evaluar la factibilidad de realizar observaciones directas del consumo de tabaco y del uso del cinturón de seguridad y del teléfono móvil del conductor del vehículo en la ciudad de Barcelona, así como analizar el grado de concordancia entre dos observadores. Se realizaron 315 pares de observaciones. El porcentaje simple de concordancia interobservador de las variables consumo de tabaco del conductor y de los pasajeros fue del 100%, con un índice Kappa de 1,0. También se obtuvo la máxima concordancia interobservador en la medición del uso del teléfono móvil y del número de pasajeros menores de 14 años. La variable con menor concordancia fue la edad del conductor. En conclusión, los estudios mediante observación directa se muestran como un buen recurso para monitorizar el consumo de tabaco, el uso del cinturón de seguridad y el uso del teléfono móvil del conductor del vehículo.The aim of this study was to assess the feasibility of direct observations of smoking and use of seat belts and cell phones in drivers in the city of Barcelona, and to analyze the agreement between two observers. We performed 315 pairs of observations. The simple percentage inter-observer agreement between driver and passenger smoking was 100% with a Kappa coefficient=1.0. There was high inter-observer agreement in measurement of cell phone use and the number of passengers aged less than 14 years old. The variable with the lowest agreement was the driver's age. In conclusion, direct observation studies are a good resource for monitoring smoking and use of seat belts and cell phones in the drivers of motor vehicles.

  8. Nutritional Adequacy of Dietary Intake in Women with Anorexia Nervosa

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    Susan K. Raatz

    2015-05-01

    Full Text Available Understanding nutrient intake of anorexia nervosa (AN patients is essential for the treatment. Therefore, estimates of total energy and nutrient consumption were made in a group of young women (19 to 30 years with restricting and binge purge subtypes of AN participating in an ecological momentary assessment study. Participants completed three nonconsecutive 24-hour diet recalls. Mean nutrient intakes were stratified by subtype and by quartiles of energy intake and compared to the age specific Dietary Reference Intake (DRI levels, as well as to the reported intakes from the What We Eat In America (WWEIA dietary survey 2011–2012. Reported intake was determined for energy, macronutrients, and micronutrients. The mean body mass index (BMI for all participants was 17.2 ± 0.1 kg/m2. Reported nutrient intake was insufficient for participants in quartiles 1–3 of both AN subtypes when compared to the DRIs. Intake reported by participants in quartile 4 of both subgroups met requirements for most nutrients and even met or exceeded estimated energy needs. Counseling of AN patients should be directed to total food consumption to improve energy intake and to reduce individual nutritional gaps.

  9. Gyrification brain abnormalities as predictors of outcome in anorexia nervosa.

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    Favaro, Angela; Tenconi, Elena; Degortes, Daniela; Manara, Renzo; Santonastaso, Paolo

    2015-12-01

    Gyrification brain abnormalities are considered a marker of early deviations from normal developmental trajectories and a putative predictor of poor outcome in psychiatric disorders. The aim of this study was to explore cortical folding morphology in patients with anorexia nervosa (AN). A MRI brain study was conducted on 38 patients with AN, 20 fully recovered patients, and 38 healthy women. Local gyrification was measured with procedures implemented in FreeSurfer. Vertex-wise comparisons were carried out to compare: (1) AN patients and healthy women; (2) patients with a full remission at a 3-year longitudinal follow-up assessment and patients who did not recover. AN patients exhibited significantly lower gyrification when compared with healthy controls. Patients with a poor 3-year outcome had significantly lower baseline gyrification when compared to both healthy women and patients with full recovery at follow-up, even after controlling for the effects of duration of illness and gray matter volume. No significant correlation has been found between gyrification, body mass index, amount of weight loss, onset age, and duration of illness. Brain gyrification significantly predicted outcome at follow-up even after controlling for the effects of duration of illness and other clinical prognostic factors. Although the role of starvation in determining our findings cannot be excluded, our study showed that brain gyrification might be a predictor of outcome in AN. Further studies are needed to understand if brain gyrification abnormalities are indices of early neurodevelopmental alterations, the consequence of starvation, or the interaction between both factors.

  10. Anorexia nervosa: estudo de caso com uma abordagem de sucesso

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    Márcia Cecília Vianna Cañete

    2008-12-01

    Full Text Available A anorexia nervosa (AN é doença grave de etiologia multifatorial, que envolve predisposição genética, fatores socioculturais, vulnerabilidades biológicas e também psicológicas. Caracteriza-se por séria restrição alimentar auto-imposta, com conseqüências orgânicas e psíquicas graves, e alta taxa de mortalidade. O objetivo deste artigo é descrever um caso de AN, tratado em grupo psicoterápico, heterogêneo, de adolescentes, sem focar no comportamento anoréxico. Analisaram-se as implicações da doença nos aspectos familiar, social, na escolaridade e na sexualidade da paciente. O método terapêutico empregado, em grupo heterogêneo, sem focar no comportamento anoréxico, mostrou-se eficaz tanto na aderência ao tratamento quanto na evolução do caso.

  11. Functional connectivity correlates of response inhibition impairment in anorexia nervosa.

    Science.gov (United States)

    Collantoni, Enrico; Michelon, Silvia; Tenconi, Elena; Degortes, Daniela; Titton, Francesca; Manara, Renzo; Clementi, Maurizio; Pinato, Claudia; Forzan, Monica; Cassina, Matteo; Santonastaso, Paolo; Favaro, Angela

    2016-01-30

    Anorexia nervosa (AN) is a disorder characterized by high levels of cognitive control and behavioral perseveration. The present study aims at exploring inhibitory control abilities and their functional connectivity correlates in patients with AN. Inhibitory control - an executive function that allows the realization of adaptive behavior according to environmental contingencies - has been assessed by means of the Stop-Signal paradigm. The study involved 155 patients with lifetime AN and 102 healthy women. A subsample underwent resting-state functional magnetic resonance imaging and was genotyped for COMT and 5-HTTLPR polymorphisms. AN patients showed an impaired response inhibition and a disruption of the functional connectivity of the ventral attention circuit, a neural network implicated in behavioral response when a stimulus occurs unexpected. The 5-HTTLPR genotype appears to significantly interact with the functional connectivity of ventral attention network in explaining task performance in both patients and controls, suggesting a role of the serotoninergic system in mechanisms of response selection. The disruption of the ventral attention network in patients with AN suggests lower efficiency of bottom-up signal filtering, which might be involved in difficulties to adapt behavioral responses to environmental needs. Our findings deserve further research to confirm their scientific and therapeutic implications.

  12. Impaired processing of self-face recognition in anorexia nervosa.

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    Hirot, France; Lesage, Marine; Pedron, Lya; Meyer, Isabelle; Thomas, Pierre; Cottencin, Olivier; Guardia, Dewi

    2016-03-01

    Body image disturbances and massive weight loss are major clinical symptoms of anorexia nervosa (AN). The aim of the present study was to examine the influence of body changes and eating attitudes on self-face recognition ability in AN. Twenty-seven subjects suffering from AN and 27 control participants performed a self-face recognition task (SFRT). During the task, digital morphs between their own face and a gender-matched unfamiliar face were presented in a random sequence. Participants' self-face recognition failures, cognitive flexibility, body concern and eating habits were assessed with the Self-Face Recognition Questionnaire (SFRQ), Trail Making Test (TMT), Body Shape Questionnaire (BSQ) and Eating Disorder Inventory-2 (EDI-2), respectively. Subjects suffering from AN exhibited significantly greater difficulties than control participants in identifying their own face (p = 0.028). No significant difference was observed between the two groups for TMT (all p > 0.1, non-significant). Regarding predictors of self-face recognition skills, there was a negative correlation between SFRT and body mass index (p = 0.01) and a positive correlation between SFRQ and EDI-2 (p < 0.001) or BSQ (p < 0.001). Among factors involved, nutritional status and intensity of eating disorders could play a part in impaired self-face recognition.

  13. Perfectionism in anorexia nervosa: novel performance based evidence.

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    Samantha Lloyd

    Full Text Available Existing research into perfectionism in Anorexia Nervosa (AN is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study--81 with a diagnosis of AN and 72 healthy controls (HCs. Participants completed two performance based tasks assessing perfectionism--a text replication task and a bead sorting task--along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36 and produced significantly higher quality copies (p = <0.01, d = 0.45. In the bead sorting task, there was a trend towards more participants in the AN group choosing to check their work compared with the HC group (p = 0.07, d = 0.30 and the AN group took significantly longer checking than those in the HC group (p = <0.01, d = 0.45. Only copy quality uniquely predicted scores on self report measures of perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group.

  14. Relacionamentos Afetivo-Familiares em Mulheres com Anorexia e Bulimia

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    Carolina Leonidas

    Full Text Available RESUMOEste estudo teve por objetivo investigar a rede social de apoio de mulheres com anorexia e bulimia, com ênfase em suas relações afetivo-familiares. A amostra foi composta por 12 participantes atendidas em hospital universitário. Os instrumentos utilizados foram: roteiro de entrevista semiestruturada, Mapa de Rede e Genograma. Os resultados indicaram que as redes sociais das participantes têm configuração restrita, com proeminência de membros da família em sua composição. Os relacionamentos familiares oscilam, contudo, entre turbulência e distanciamento afetivo. As relações de afeto mantidas com pais, cônjuges e namorados são marcadas por divergências e insatisfações. A baixa densidade da rede de amizades e o empobrecimento da vida social resultam em isolamento e dificuldades de dar início e/ou manter relacionamentos afetivos duradouros.

  15. Resting Energy Expenditure in Anorexia Nervosa: Measured versus Estimated

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    Marwan El Ghoch

    2012-01-01

    Full Text Available Introduction. Aim of this study was to compare the resting energy expenditure (REE measured by the Douglas bag method with the REE estimated with the FitMate method, the Harris-Benedict equation, and the Müller et al. equation for individuals with BMI < 18.5 kg/m2 in a severe group of underweight patients with anorexia nervosa (AN. Methods. 15 subjects with AN participated in the study. The Douglas bag method and the FitMate method were used to measure REE and the dual energy X-ray absorptiometry to assess body composition after one day of refeeding. Results. FitMate method and the Müller et al. equation gave an accurate REE estimation, while the Harris-Benedict equation overestimated the REE when compared with the Douglas bag method. Conclusion. The data support the use of the FitMate method and the Müller et al. equation, but not the Harris-Benedict equation, to estimate REE in AN patients after short-term refeeding.

  16. Radionuclide gastric emptying studies in patients with anorexia nervosa

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    Domstad, P.A.; Shih, W.J.; Humphries, L.; DeLand, F.H.; Digenis, G.A.

    1987-05-01

    To evaluate gastric emptying in anorexia nervosa patients, 26 patients (17 females, two males, ranging in age from 13 to 40 yr) with upper GI symptoms ingested 150-200 microCi (/sup 99m/Tc)triethelenetetraamine polysterene resin in cereal and were imaged in the supine position. Data were accumulated at 5 min intervals to obtain the gastric emptying time (GET). The results of the studies were divided into three categories: prolonged, 13 patients; rapid, 11; and normal 3. Twelve of 13 patients with prolonged GET were given 10 mg metoclopramide i.v. injections; nine of the 12 patients had a good response and three had no response. Five of the nine patients underwent metoclopramide therapy and four of the patients showed benefit from the therapy. One patient discontinued metoclopramide therapy because of somnolence. Although all patients had subjective symptoms of gastric dysfunction, our results indicated only 50% had objectively prolonged GET, and another 50% showed normal or even rapid GET. Therefore, this radionuclide study enables quantitatively objective documentation of gastric emptying, separation of those patients with rapid or normal GET from those with prolonged GET, thereby avoiding the possible side effects from metoclopramide medication, and prediction of effectiveness of metoclopramide therapy in patients with prolonged GET.

  17. [Anesthesia in patients with anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Zenker, J; Hagenah, U; Rossaint, R

    2010-03-01

    Eating disorders are typical diseases of adolescence and early adulthood. About 1-3% of female juveniles suffer from anorexia nervosa (AN) or bulimia nervosa (BN). Today AN is still the psychiatric disease with the highest mortality rate. The peri-operative mortality rate of patients suffering from AN is in the range up to 15%. The beginning of AN is a lingering process and the majority of patients show increasingly restrictive eating habits ending in cachexia. Patients are obsessed by the predominant idea of being obese in spite of having a significant underweight. Patients suffering from bulimia break the strict regimen by eating enormous amounts of high calorie food. Such eating attacks are followed by weight reducing measures, mostly vomiting. Most of the physical changes caused by AN are due to starvation and loss of weight. The most significant medical complications are alterations of the cardiovascular system accompanied by decreasing contractility of the heart, bradycardia, electrocardiographic changes as well as disequilibrium of electrolytic and water balance. Most of these symptoms can be reversed by putting on weight.

  18. ACTIVITY-BASED ANOREXIA AS A THERMOREGULATION PHENOMENON

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    Carlos Javier Flores Aguirre

    2012-12-01

    Full Text Available Activity Based Anorexia (ABA is a phenomenon that results from exposing rats to a feeding program of about 1 to 1.5 h per day, giving them free access to an activity wheel the rest of the time. The reported effects are high levels of activity without a visible compensation in food intake, and in consequence a low body weight. There is a variety of interpretations about the causes of this phenomenon. However, there are two main theories: one of them says that ABA is a product of adaptive failure to the new feeding regime and that the activity in the wheel interferes with such adaptation. The second theoretical position says that the activity acquires reinforcing properties due to feeding restrictions which causes body weight loss and, in turn, more activity. At present, both theories have been interpreted as contradictory. Nevertheless, a series of studies have revealed that the temperature of the environment and in consequence the subjects’ body tem-perature play an essential role in the findings of the field, giving sense to both theories and evidencing their complementariness. The aim of this paper is to re-view the empirical evidence that supports the hypothesis of ABA as a thermoregu-lation phenomenon.

  19. Clinical investigation of set-shifting subtypes in anorexia nervosa.

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    Abbate-Daga, Giovanni; Buzzichelli, Sara; Marzola, Enrica; Amianto, Federico; Fassino, Secondo

    2014-11-30

    While evidence continues to accumulate on the relevance of cognitive inflexibility in anorexia nervosa (AN), its clinical correlates remain unclear. We aimed at examining the relationship between set-shifting and clinical variables (i.e., eating psychopathology, depression, and personality) in AN. Ninety-four individuals affected by AN and 59 healthy controls (HC) were recruited. All participants were assessed using: Eating Disorders Inventory-2 (EDI-2), Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI), and Wisconsin Card Sorting Test (WCST). The AN group scored worse than HCs on set-shifting. According to their neuropsychological performances, AN patients were split into two groups corresponding to poor (N=30) and intact (N=64) set-shifting subtypes. Interoceptive awareness, impulse regulation, and maturity fears on the EDI-2 and depression on the BDI differed across all groups (HC, intact, and poor set-shifting subtype). Self-directedness on the TCI differed significantly among all groups. Cooperativeness and reward dependence differed instead only between HC and AN poor set-shifting subtype. After controlling for depression, only interoceptive awareness remained significant with reward dependence showing a trend towards statistical significance. These findings suggest that multiple clinical variables may be correlated with set-shifting performances in AN. The factors contributing to impaired cognitive inflexibility could be more complex than heretofore generally considered.

  20. Choice of diet in patients with anorexia nervosa

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    I. Jáuregui Lobera

    Full Text Available Objective: To analyse the diets chosen by anorexic patients and a control group, assessing several nutritional aspects. Method: Forty-four outpatients with an initial diagnosis of restrictive anorexia nervosa (normal BMI at the time of the study and 34 undergraduates chose their diet from a list of common foods. Nutritional content, frequency of consumption, and influence of illness and treatment duration on the diet chosen were all analysed. Results: Patients' diets had a lower caloric content (P = 0.01. Their diets were also lower in niacin (P = 0.03, vitamin B12 (P = 0.04, sodium (P = 0.003, zinc (P = 0.04, phosphorus, copper and selenium (P = 0.01. Frequency of consumption was lower among patients for bread and cereals, meat and cured meats (P = 0.01, sweet foods (P = 0.001, and fatty and fried foods (P = 0.05, but higher for vegetables (P = 0.01. Discussion: Patients tend to maintain some characteristic eating patterns and modify others, not so much in terms of therapeutic objectives but, rather, as a way of following more closely the usual eating patterns of the context.

  1. Anorexia nervosa, perfectionism, and dopamine D4 receptor (DRD4).

    Science.gov (United States)

    Bachner-Melman, Rachel; Lerer, Elad; Zohar, Ada H; Kremer, Ilana; Elizur, Yoel; Nemanov, Lubov; Golan, Moria; Blank, Shulamit; Gritsenko, Inga; Ebstein, Richard P

    2007-09-05

    The dopamine D4 receptor (DRD4), a well-characterized, polymorphic gene, is an attractive candidate for contributing risk to disordered eating and anorexia nervosa (AN). We tested association using UNPHASED for 5 DRD4 polymorphic loci, 3 promoter region SNPs (C-521T, C-616G, A-809G), the 120 bp promoter region tandem duplication and the exon III repeat, in 202 AN trios and 418 control families. Since perfectionism characterizes AN, we tested these five loci for association with the Child and Adolescent Perfectionism Scale (CAPS) in the AN and control groups. Single locus analysis showed significant association between the 'C' C-521T allele and AN. Haplotype analysis also showed significant association, particularly a 4-locus haplotype (exon III&120 bp repeat&C-521T&A-809G). Association was also observed between DRD4 and CAPS scores both for AN and control subjects. The insulin-like growth factor 2 (IGF2) and the arginine vasopressin 1a receptor (AVPR1a), previously shown to be associated with disordered eating, were also associated with CAPS scores. Three genes associated with AN were also associated with perfectionism. Personality traits are potential endophenotypes for understanding the etiology of eating disorders and one of the several pathways to eating pathology may be mediated by the impact of DNA sequences on perfectionism.

  2. Neurocognitive and social cognition deficits in patients with anorexia nervosa

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    Kułakowska, Dorota

    2014-06-01

    Full Text Available In the first part of the article the authors present a set of the actual concepts explaining problems of cognitive functions and social cognition currently observed in patients with anorexia nervosa (AN. It is possible; through the neuroimaging research, to get better understanding of the brain specifics in these individuals. Even though, the AN remains a disease with very complex and multifactorial etiology which remains a huge medical challenge. Currently, popular is the view that takes into consideration the integrating role of the insula and subcortical structures (such as hippocampus, amygdala, thalamus in the regulation of cognitive and emotional processes in people suffering from AN. There is still an open problem, however, of the selection of therapeutic interventions targeting these deficits. The second part of the article presents the attempt to describe deficits in neurocognitive and social cognition in people with AN occurring prior to illness, during and after the recovery. Particular attention has been paid to the most frequently described in the literature – neuro- cognitive deficits such as rigidity of thinking, weak central coherence, and deficits in social cognition, including mental processes of perception and expression of emotions, disorders of the theory of mind (ToM and empathy. The results of previous studies, their scarcity in Poland, do not give a satisfactory answer to the question whether the above mentioned disorders are a feature of endophenotype or condition in an episode of the disease. Research point to the more permanent nature, which may be more resistant to therapeutic modifications.

  3. Emotion Acceptance Behavior Therapy for Anorexia Nervosa: A Pilot Study

    Science.gov (United States)

    Wildes, Jennifer E.; Marcus, Marsha D.; Cheng, Yu; McCabe, Elizabeth B.; Gaskill, Jill A.

    2015-01-01

    Objective This study aimed to evaluate the preliminary efficacy of Emotion Acceptance Behavior Therapy (EABT), an outpatient psychotherapeutic intervention for anorexia nervosa (AN) based on a disorder-specific model of symptom maintenance that emphasizes emotion avoidance. EABT combines standard behavioral interventions that are central to the clinical management of AN with evidence-supported strategies to increase emotion awareness, decrease emotion avoidance, and encourage resumption of valued activities and relationships outside the eating disorder. Method Twenty-four individuals aged ≥17 years with AN were treated using the EABT manual. EABT was delivered in 33–58 individual sessions provided over 38–53 weeks. Assessments were conducted before and after treatment, and at 3- and 6-month follow-ups. Results Thirteen patients (54.2%) completed EABT; 11 (45.8%) dropped out or were withdrawn. EABT was associated with significant improvements in weight, disordered eating symptoms, and emotion avoidance that were maintained over 6-month follow-up. The majority of EABT completers achieved a body mass index >18.5 (n=9/13) or had a normal Eating Disorder Examination Global score (n=10/13) at post-treatment. Discussion Preliminary data suggest that EABT may have utility for a subset of adults with AN. Future research will focus on improving outcomes in EABT non-responders and identifying of mechanisms that drive treatment response. PMID:24407934

  4. Cognitive Behavioural Therapy for anorexia nervosa: a systematic review.

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    Galsworthy-Francis, Lisa; Allan, Steven

    2014-02-01

    Evidence for the effectiveness of psychological therapies for anorexia nervosa (AN) is inconsistent. There have been no systematic reviews solely on the effectiveness for Cognitive Behavioural Therapy (CBT) for AN. This review aimed to synthesise and appraise the recent evidence for CBT as a treatment for AN. Using specific search criteria, 16 relevant articles were identified which evaluated CBT alone or as part of a broader randomised/non-randomised trial. Various formats of CBT were utilised in the reviewed papers. Studies were evaluated using established quality criteria. The evidence reviewed suggested that CBT demonstrated effectiveness as a means of improving treatment adherence and minimising dropout amongst patients with AN. While CBT appeared to demonstrate some improvements in key outcomes (body mass index, eating-disorder symptoms, broader psychopathology), it was not consistently superior to other treatments (including dietary counselling, non-specific supportive management, interpersonal therapy, behavioural family therapy). Numerous methodological limitations apply to the available evidence. Further research and ongoing review is needed to evaluate the settings, patient groups and formats in which CBT may be effective as a treatment for AN.

  5. A abordagem familiar no tratamento da anorexia e bulimia nervosa Family assessment in the treatment of anorexia and bulimia nervosa

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    Alicia Weisz Cobelo

    2004-01-01

    Full Text Available O final do século XX enfatiza a inclusão da família no tratamento de pacientes portadores de anorexia e bulimia nervosa. Pesquisas (Castro et al.,2000; Webster et al.,2000 colocam como relevante considerar a estrutura familiar, as práticas conversacionais e os legados transgeracionais como elementos que podem estar contribuindo, de modo significativo, no desenvolvimento ou na manutenção dos transtornos alimentares. No Ambulatório de Bulimia e Transtornos Alimentares e no Projeto de Atendimento a Crianças e Adolescentes do IPQ, o grande desafio dos terapeutas de família tem sido compartilhar com famílias e pacientes suas histórias repletas de inseguranças e angústias e construir uma ponte de união entre a família e a equipe multidisciplinar, para que a compreensão dos significados, refletida por todos, possa ser agilizada e transformada em novas contribuições de vida para as pacientes e seus familiares.The end of the 20th century emphasizes the inclusion of the family in the treatment of the patients with anorexia and bulimia nervosa. Researches (Castro et al.,2000; Webster et al.,2000 determine as relevant to consider the family structure, the interaction pattern, and the "transgeneration bequest" - the legacy that goes from one generation to the next - as elements that might contribute in a significant way to the development or maintenance of the eating disorders. At the Bulimia and Eating Disorders Ambulatory and in the IPQ's Project for Attendance of Children and Adolescents, the great challenge for the family therapists has been to share with the families and patients their histories full of insecurity and anguish. The therapists must also overcome the difficulties of building a bridge that brings together the family and the multidisciplinary team so that the comprehension of the meanings, reflected by all, might be quickly transformed into new life contributions to these patients and their families.

  6. Anorexia Nervosa and Bulima Nervosa Critical Analysis of It's Treatment: Implications and Interventions

    Directory of Open Access Journals (Sweden)

    Flourish Itulua-Abumere

    2013-06-01

    Full Text Available The diagnostic consideration of the eating disorders anorexia nervosa and bulimia nervosa has been given much focus over the last two decades than previously, as clinicians have become more aware of the frequency of these disorders and the difficulties associated with their treatment. Anorexia nervosa and bulimia nervosa as known in the DSM-IV as eating disorders are characterized by physically and/or psychologically harmful eating patterns. Although the psychological explanation of what we now call anorexia nervosa have been known about for centuries, it has only recently attracted much interest, due to greater public knowledge and increased incidence (according to Gross and MclLveen 2006, the latter claim has been disputed. Most people suffering from anorexia nervosa and bulimia nervosa start by fasting. Anorexia nervosa is a deliberate self-starvation. A person whose body weight is less than expected for his or her body height and weight is considered to be anorexic. In contract, bulimia involves binge eating a large quantity of food followed by purging by self-induced vomiting, enemas, laxatives, or diuretics.

  7. Reduced ghrelin secretion in the hypothalamus of rats due to cisplatin-induced anorexia.

    Science.gov (United States)

    Yakabi, Koji; Sadakane, Chiharu; Noguchi, Masamichi; Ohno, Shino; Ro, Shoki; Chinen, Katsuya; Aoyama, Toru; Sakurada, Tomoya; Takabayashi, Hideaki; Hattori, Tomohisa

    2010-08-01

    Although chemotherapy with cisplatin is a widely used and effective cancer treatment, the undesirable gastrointestinal side effects associated with it, such as nausea, vomiting, and anorexia, markedly decrease patients' quality of life. To elucidate the mechanism underlying chemotherapy-induced anorexia, focusing on the hypothalamic ghrelin secretion-anorexia association, we measured hypothalamic ghrelin secretion in fasted and cisplatin-treated rats. Hypothalamic ghrelin secretion changes after vagotomy or administration of cisplatin. Cisplatin + rikkunshito, a serotonin 2C receptor antagonist or serotonin 3 receptor antagonist, was investigated. The effects of intracerebroventricular (icv) administration of ghrelin or the serotonin 2C receptor antagonist SB242084 on food intake were also evaluated in cisplatin-treated rats. Hypothalamic ghrelin secretion significantly increased in 24-h-fasted rats compared to freely fed rats and was markedly reduced 24 and 48 h after cisplatin treatment in cisplatin-treated rats compared to saline-treated rats, although their plasma ghrelin levels were comparable. In cisplatin-treated rats, icv ghrelin administration reversed the decrease in food intake, vagotomy partially restored hypothalamic ghrelin secretion, and hypothalamic serotonin 2C receptor mRNA expression increased significantly. Administration of rikkunshito (an endogenous ghrelin enhancer) or a serotonin 2C receptor antagonist reversed the decrease in hypothalamic ghrelin secretion and food intake 24 h after cisplatin treatment. Cisplatin-induced anorexia is mediated through reduced hypothalamic ghrelin secretion. Cerebral serotonin 2C receptor activation partially induces decrease in hypothalamic ghrelin secretion, and rikkunshito suppresses cisplatin-induced anorexia by enhancing this secretion.

  8. [An anorexia nervosa case and an approach to this case with pharmacotherapy and psychodrama techniques].

    Science.gov (United States)

    Ozdel, Osman; Ateşci, Figen; Oğuzhanoğlu, Nalan K

    2003-01-01

    Anorexia nervosa in an eating disorder that primarily affects female adolescents and is more commonly seen in westernized countries. Although it is a sociocultural problem of developed societies, nowadays it is also increasing rapidly in developing cultures such as Turkey. Difficulties in the treatment of anorexia nervosa have directed clinicians to understand the disorder better. Although it is well known that various factors play a role in the etiology of anorexia nervosa, psychodynamic factors also have considerable importance. In addition, social and familial interactions contribute to the development of anorexia nervosa. In the light of these facts, treatment with psychotherapy and pharmacotherapy might be used to cure this disorder. In this article, the definitive features and process of anorexia nervosa along with its psychodynamics were discussed on the basis of a case. In the treatment of the patient, psychodrama techniques with drugs were thought to be useful. The patient became aware of the unfavourable relationship and improved by the use of this method. Thus she gained emotional-cognitive insight.

  9. Anorexia: uma conjugação do amor no feminino?

    Directory of Open Access Journals (Sweden)

    Cristina Moreira Marcos

    Full Text Available Este artigo busca discutir a incidência preponderante da anorexia em jovens mulheres nos dias atuais, buscando extrair uma possível relação entre a anorexia e o feminino. Parte-se do pressuposto de que a anorexia não é do gênero feminino por causa da cultura, mas é antes uma posição do sujeito na qual se evidencia uma afinidade estrutural com o feminino. A incidência da causalidade social sobre o sujeito não é negligenciada, entretanto é preciso interrogá-la na medida em que ela não se constitui como uma causa eficiente. Não podemos deixar de considerar que, nos dias de hoje, o corpo magro é um semblante do feminino. Ser magra indica a adequação do corpo ao ideal feminino transmitido pelo discurso social. Entretanto devemos nos interrogar também a respeito da posição do sujeito enquanto tal. Por que a anorexia encontra expressão privilegiada nas jovens mulheres? - tal é nossa questão. Nossa hipótese é que a anorexia pode ser, ao mesmo tempo, uma resposta aos impasses encontrados na sexuação feminina e uma demanda de amor.

  10. Two diagnoses become one? Rare case report of anorexia nervosa and Cushing’s syndrome

    Directory of Open Access Journals (Sweden)

    Sawicka N

    2013-03-01

    Full Text Available Nadia Sawicka,* Maria Gryczyńska,* Jerzy Sowiński, Monika Tamborska-Zedlewska, Marek Ruchała Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland*These authors contributed equally to this workAbstract: Hypothalamic-pituitary-adrenal axis impairment in anorexia nervosa is marked by hypercortisolemia, and psychiatric disorders occur in the majority of patients with Cushing’s syndrome. Here we report a patient diagnosed with anorexia nervosa who also developed Cushing’s syndrome. A 26-year-old female had been treated for anorexia nervosa since she was 17 years old, and also developed depression and paranoid schizophrenia. She was admitted to the Department of Endocrinology, Metabolism, and Internal Medicine with a preliminary diagnosis of Cushing’s syndrome. Computed tomography revealed a 27 mm left adrenal tumor, and she underwent laparoscopic adrenalectomy. She was admitted to hospital 6 months after this procedure, at which time she did not report any eating or mood disorder. This is a rare case report of a patient with anorexia nervosa in whom Cushing’s syndrome was subsequently diagnosed. Diagnostic difficulties were caused by the signs and symptoms presenting in the course of both disorders, ie, hypercortisolemia, osteoporosis, secondary amenorrhea, striae, hypokalemia, muscle weakness, and depression.Keywords: anorexia nervosa, Cushing’s syndrome, adrenalectomy, osteoporosis

  11. An open trial of Acceptance-based Separated Family Treatment (ASFT) for adolescents with anorexia nervosa.

    Science.gov (United States)

    Timko, C Alix; Zucker, Nancy L; Herbert, James D; Rodriguez, Daniel; Merwin, Rhonda M

    2015-06-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12-18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed.

  12. Excitatory Hindbrain-Forebrain Communication Is Required for Cisplatin-Induced Anorexia and Weight Loss.

    Science.gov (United States)

    Alhadeff, Amber L; Holland, Ruby A; Zheng, Huiyuan; Rinaman, Linda; Grill, Harvey J; De Jonghe, Bart C

    2017-01-11

    Cisplatin chemotherapy is commonly used to treat cancer despite severe energy balance side effects. In rats, cisplatin activates nucleus tractus solitarius (NTS) projections to the lateral parabrachial nucleus (lPBN) and calcitonin-gene related peptide (CGRP) projections from the lPBN to the central nucleus of the amygdala (CeA). We demonstrated previously that CeA glutamate receptor signaling mediates cisplatin-induced anorexia and body weight loss. Here, we used neuroanatomical tracing, immunofluorescence, and confocal imaging to demonstrate that virtually all NTS→lPBN and lPBN→CeA CGRP projections coexpress vesicular glutamate transporter 2 (VGLUT2), providing evidence that excitatory projections mediate cisplatin-induced energy balance dysregulation. To test whether lPBN→CeA projection neurons are required for cisplatin-induced anorexia and weight loss, we inhibited these neurons chemogenetically using a retrograde Cre-recombinase-expressing canine adenovirus-2 in combination with Cre-dependent inhibitory Designer Receptors Exclusive Activated by Designer Drugs (DREADDs) before cisplatin treatment. Inhibition of lPBN→CeA neurons attenuated cisplatin-induced anorexia and body weight loss significantly. Using a similar approach, we additionally demonstrated that inhibition of NTS→lPBN neurons attenuated cisplatin-induced anorexia and body weight loss significantly. Together, our data support the view that excitatory hindbrain-forebrain projections are necessary for cisplatin's untoward effects on energy intake, elucidating a key neuroanatomical circuit driving pathological anorexia and weight loss that accompanies chemotherapy treatment.

  13. Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Harrington, Brian C; Jimerson, Michelle; Haxton, Christina; Jimerson, David C

    2015-01-01

    Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ed., includes updated diagnostic criteria for anorexia nervosa (e.g., elimination of amenorrhea as a diagnostic criterion) and for bulimia nervosa (e.g., criterion for frequency of binge episodes decreased to an average of once per week). In addition to the role of environmental triggers and societal expectations of body size and shape, research has suggested that genes and discrete biochemical signals contribute to the development of eating disorders. Anorexia nervosa and bulimia nervosa occur most often in adolescent females and are often accompanied by depression and other comorbid psychiatric disorders. For low-weight patients with anorexia nervosa, virtually all physiologic systems are affected, ranging from hypotension and osteopenia to life-threatening arrhythmias, often requiring emergent assessment and hospitalization for metabolic stabilization. In patients with frequent purging or laxative abuse, the presence of electrolyte abnormalities requires prompt intervention. Family-based treatment is helpful for adolescents with anorexia nervosa, whereas short-term psychotherapy, such as cognitive behavior therapy, is effective for most patients with bulimia nervosa. The use of psychotropic medications is limited for anorexia nervosa, whereas treatment studies have shown a benefit of antidepressant medications for patients with bulimia nervosa. Treatment is most effective when it includes a multidisciplinary, teambased approach.

  14. Severity of eating disorder symptoms related to oxytocin receptor polymorphisms in anorexia nervosa.

    Science.gov (United States)

    Acevedo, Summer F; Valencia, Celeste; Lutter, Michael; McAdams, Carrie J

    2015-08-30

    Oxytocin is a peptide hormone important for social behavior and differences in psychological traits have been associated with variants of the oxytocin receptor gene in healthy people. We examined whether single nucleotide polymorphisms (SNPs) of the oxytocin receptor gene (OXTR) correlated with clinical symptoms in women with anorexia nervosa, bulimia nervosa, and healthy comparison (HC) women. Subjects completed clinical assessments and provided DNA for analysis. Subjects were divided into four groups: HC, subjects currently with anorexia nervosa (AN-C), subjects with a history of anorexia nervosa but in long-term weight recovery (AN-WR), and subjects with bulimia nervosa (BN). Five SNPs of the oxytocin receptor were examined. Minor allele carriers showed greater severity in most of the psychiatric symptoms. Importantly, the combination of having had anorexia and carrying either of the A alleles for two SNPS in the OXTR gene (rs53576, rs2254298) was associated with increased severity specifically for ED symptoms including cognitions and behaviors associated both with eating and appearance. A review of psychosocial data related to the OXTR polymorphisms examined is included in the discussion. OXTR polymorphisms may be a useful intermediate endophenotype to consider in the treatment of patients with anorexia nervosa.

  15. A central role for the mammalian target of rapamycin in LPS-induced anorexia in mice.

    Science.gov (United States)

    Yue, Yunshuang; Wang, Yi; Li, Dan; Song, Zhigang; Jiao, Hongchao; Lin, Hai

    2015-01-01

    Bacterial lipopolysaccharide (LPS), also known as endotoxin, induces profound anorexia. However, the LPS-provoked pro-inflammatory signaling cascades and the neural mechanisms underlying the development of anorexia are not clear. Mammalian target of rapamycin (mTOR) is a key regulator of metabolism, cell growth, and protein synthesis. This study aimed to determine whether the mTOR pathway is involved in LPS-induced anorexia. Effects of LPS on hypothalamic gene/protein expression in mice were measured by RT-PCR or western blotting analysis. To determine whether inhibition of mTOR signaling could attenuate LPS-induced anorexia, we administered an i.c.v. injection of rapamycin, an mTOR inhibitor, on LPS-treated male mice. In this study, we showed that LPS stimulates the mTOR signaling pathway through the enhanced phosphorylation of mTOR(Ser2448) and p70S6K(Thr389). We also showed that LPS administration increased the phosphorylation of FOXO1(Ser256), the p65 subunit of nuclear factor kappa B (Panorexia by decreasing the phosphorylation of p70S6K(Thr389), FOXO1(Ser256), and FOXO1/3a(Thr) (24) (/) (32). These results suggest promising approaches for the prevention and treatment of LPS-induced anorexia.

  16. The anorexia of ageing: physiopathology, prevalence, associated comorbidity and mortality. A systematic review.

    Science.gov (United States)

    Malafarina, Vincenzo; Uriz-Otano, Francisco; Gil-Guerrero, Lucía; Iniesta, Raquel

    2013-04-01

    The physiological processes of ageing and factors prevalent in the elderly such as comorbidities and polypharmacy often cause loss of appetite in the elderly, which we call anorexia of ageing. Social factors, together with changes in the sensory organs, can be important causes of a reduction in both appetite and ingestion. This review assesses the regulation of appetite in the elderly and the development of anorexia of ageing. It also examines the prevalence of this type of anorexia, its associated comorbidities and mortality rates. We have reviewed 27 studies, with a total of 6208 patients. These reported changes in the secretion and response of both central and peripheral hormones that regulate appetite. Anorexia, very prevalent among hospitalized and institutionalized elderly people, is associated with comorbidity and represents a predictive factor for mortality. No treatment for it has been proved to be effective. The mechanism regulating ingestion in elderly people is complex and difficult to resolve. Comorbidity as a cause or a consequence of anorexia of ageing has become a research field of great interest in geriatrics. A correct nutritional evaluation is a fundamental part of an integrated geriatric assessment.

  17. Pathophysiologic basis of anorexia: focus on the interaction between ghrelin dynamics and the serotonergic system.

    Science.gov (United States)

    Takeda, Hiroshi; Nakagawa, Koji; Okubo, Naoto; Nishimura, Mie; Muto, Shuichi; Ohnishi, Shunsuke; Sakamoto, Naoya; Hosono, Hidetaka; Asaka, Masahiro

    2013-01-01

    Anorexia is an important issue in the management of elderly patients with cancer because it contributes to the development of malnutrition, increases morbidity and mortality, and negatively affects patients' quality of life. This review summarizes the potential mechanisms of the development of anorexia in three animal models that mimic the situations commonly seen in elderly patients receiving chemotherapy. Cisplatin-induced anorexia is attributable to a decrease in peripheral and central ghrelin secretion caused by the stimulation of serotonin (5-hydroxytryptamine; 5-HT)2B and 5-HT2C receptors via 5-HT secretion. Age-associated anorexia is caused by an increase in plasma leptin, which results from disturbed reactivity of ghrelin in the hypothalamus and regulation of ghrelin secretion. Environmental change causes the activation of central 5-HT1B and 5-HT2C receptors and the melanocortin-4 receptor system, resulting in a decrease in circulating ghrelin levels which lowers food intake. New therapeutic approaches based on these pathophysiological mechanisms are warranted for the treatment of anorexia in cancer patients, especially elderly ones.

  18. Increased resting state functional connectivity in the default mode network in recovered anorexia nervosa.

    Science.gov (United States)

    Cowdrey, Felicity A; Filippini, Nicola; Park, Rebecca J; Smith, Stephen M; McCabe, Ciara

    2014-02-01

    Functional brain imaging studies have shown abnormal neural activity in individuals recovered from anorexia nervosa (AN) during both cognitive and emotional task paradigms. It has been suggested that this abnormal activity which persists into recovery might underpin the neurobiology of the disorder and constitute a neural biomarker for AN. However, no study to date has assessed functional changes in neural networks in the absence of task-induced activity in those recovered from AN. Therefore, the aim of this study was to investigate whole brain resting state functional connectivity in nonmedicated women recovered from anorexia nervosa. Functional magnetic resonance imaging scans were obtained from 16 nonmedicated participants recovered from anorexia nervosa and 15 healthy control participants. Independent component analysis revealed functionally relevant resting state networks. Dual regression analysis revealed increased temporal correlation (coherence) in the default mode network (DMN) which is thought to be involved in self-referential processing. Specifically, compared to healthy control participants the recovered anorexia nervosa participants showed increased temporal coherence between the DMN and the precuneus and the dorsolateral prefrontal cortex/inferior frontal gyrus. The findings support the view that dysfunction in resting state functional connectivity in regions involved in self-referential processing and cognitive control might be a vulnerability marker for the development of anorexia nervosa.

  19. Therapy insight: Cancer anorexia-cachexia syndrome--when all you can eat is yourself.

    Science.gov (United States)

    Laviano, Alessandro; Meguid, Michael M; Inui, Akio; Muscaritoli, Maurizio; Rossi-Fanelli, Filippo

    2005-03-01

    Tumor growth is associated with profound metabolic and neurochemical alterations, which can lead to the onset of anorexia-cachexia syndrome. Anorexia is defined as the loss of the desire to eat, while cachexia results from progressive wasting of skeletal muscle mass--and to a lesser extent adipose tissue--occurring even before weight loss becomes apparent. Cancer anorexia-cachexia syndrome is highly prevalent among cancer patients, has a large impact on morbidity and mortality, and impinges on patient quality of life. However, its clinical relevance is frequently overlooked, and treatments are usually only attempted during advanced stages of the disease. The pathogenic mechanisms of cachexia and anorexia are multifactorial, but cytokines and tumor-derived factors have a significant role, thereby representing a suitable therapeutic target. Energy expenditure in anorexia is frequently increased while energy intake is decreased, which further exacerbates the progressive deterioration of nutritional status. The optimal therapeutic approach to anorectic-cachectic cancer patients should be based on both changes in dietary habits, achieved via nutritional counseling; and drug therapy, aimed at interfering with cytokine expression or activity. Our improved understanding of the influence a tumor has on the host's metabolism is advancing new therapeutic approaches, which are likely to result in better preservation of nutritional status if started concurrently with specific antineoplastic treatment.

  20. Evidence that the anorexia induced by lipopolysaccharide is mediated by the 5-HT2C receptor.

    Science.gov (United States)

    von Meyenburg, Claudia; Langhans, Wolfgang; Hrupka, Brian J

    2003-01-01

    Rats consistently reduce their food intake following injections of bacterial lipopolysaccharides (LPS). Because inhibition of serotonergic (5-HT) activity by 8-OH-DPAT (5-HT(1A) activation) attenuates LPS-induced anorexia, we conducted a series of studies to examine whether other 5-HT-receptors are involved in the mediation of peripheral LPS-induced anorexia. In all experiments, rats were injected with LPS (100 microg/kg body weight [BW] ip) at lights out (hour 0). Antagonists were administered peripherally at hour 4, shortly after the onset of anorexia, which presumably follows the enhanced cytokine production after LPS. Food intake was then recorded during the subsequent 2 h or longer. 5-HT receptor antagonists cyanopindolol and SB 224289 (5-HT(1B)), ketanserin (5-HT(2A)), RS-102221 (5-HT(2C)), and metoclopramide (5-HT(3)) failed to attenuate LPS-induced anorexia. In contrast, both ritanserin (5-HT(2A/C)-receptor antagonist) (0.5 mg/kg BW) and SB 242084 (5-HT(2C)) (0.3 mg/kg BW) attenuated LPS-induced anorexia at doses that did not alter food intake in non-LPS-treated rats (all Panorexia following peripheral LPS administration is mediated through an enhanced 5-HT-ergic activity and the 5-HT(2C) receptor.

  1. Focus on anorexia nervosa: modern psychological treatment and guidelines for the adolescent patient

    Directory of Open Access Journals (Sweden)

    Espie J

    2015-01-01

    Full Text Available Jonathan Espie,1 Ivan Eisler2 1Child and Adolescent Eating Disorders Service, Michael Rutter Centre, South London and Maudsley Hospital Foundation NHS Trust, 2Institute of Psychiatry, King's College London, London, UK Abstract: Anorexia nervosa is a serious condition associated with high mortality. Incidence is highest for female adolescents, and prevalence data highlight a pressing unmet need for treatment. While there is evidence that adolescent-onset anorexia has relatively high rates of eventual recovery, the illness is often protracted, and even after recovery from the eating disorder there is an ongoing vulnerability to psychosocial problems in later life. Family therapy for anorexia in adolescence has evolved from a generic systemic treatment into an eating disorder-specific format (family therapy for anorexia nervosa, and this approach has been evidenced as an effective treatment. Individual treatments, including cognitive behavioral therapy, also have some evidence of effectiveness. Most adolescents can be effectively and safely managed as outpatients. Day-patient treatment holds promise as an alternative to inpatient treatment or as an intensive program following a brief medical admission. Evidence is emerging of advantages in detecting and treating adolescent anorexia nervosa in specialist community-based child and adolescent eating-disorder services accessible directly from primary care. Limitations and future directions for modern treatment are considered. Keywords: AN, evidence, family, therapy, FT-AN, inpatient, outpatient, day patient, specialist 

  2. Aberrant brain microRNA target and miRISC gene expression in the anx/anx anorexia mouse model

    DEFF Research Database (Denmark)

    Mercader, Josep M; González, Juan R; Lozano, Juan José

    2012-01-01

    The anorexia mouse model, anx/anx, carries a spontaneous mutation not yet identified and homozygous mutants are characterized by anorexia-cachexia, hyperactivity, and ataxia. In order to test if the microRNA function was altered in these mice, hypothalamus and cortex transcriptomes were evaluated...

  3. The CT appearance of ``reversible`` cerebral pseudoatrophy in anorexia nervosa; Obraz KT ``odwracalnego`` rzekomego zaniku mozgu w jadlowstrecie nerwowym

    Energy Technology Data Exchange (ETDEWEB)

    Boron, Z.; Kozlowska, R.; Grzegorzewski, M.; Nawrot, M.; Bulawska, I. [Katedra i Zaklad Radiologii i Diagnostyki Narzadowej, Akademia Medyczna, Bydgoszcz (Poland)

    1995-12-31

    The CT appearance of ``reversible`` cerebral pseudoatrophy resulting from anorexia nervosa was demonstrated. The CT studies were performed in 3 young women with typical clinical course of anorexia nervosa. In all of them computed tomography revealed dilatation of the subarachnoid fluid space. After 5 months of therapy the follow-up scans have reverted to normal in all cases. (author) 5 refs, 2 figs

  4. A Cross-Sectional and Follow-Up Functional MRI Study with a Working Memory Task in Adolescent Anorexia Nervosa

    Science.gov (United States)

    Castro-Fornieles, Josefina; Caldu, Xavier; Andres-Perpina, Susana; Lazaro, Luisa; Bargallo, Nuria; Falcon, Carles; Plana, Maria Teresa; Junque, Carme

    2010-01-01

    Structural and functional brain abnormalities have been described in anorexia nervosa (AN). The objective of this study was to examine whether there is abnormal regional brain activation during a working memory task not associated with any emotional stimuli in adolescent patients with anorexia and to detect possible changes after weight recovery.…

  5. Effect of Sipjeondaebo-tang on cancer-induced anorexia and cachexia in CT-26 tumor-bearing mice.

    Science.gov (United States)

    Choi, Youn Kyung; Jung, Ki Yong; Woo, Sang-Mi; Yun, Yee Jin; Jun, Chan-Yong; Park, Jong Hyeong; Shin, Yong Cheol; Cho, Sung-Gook; Ko, Seong-Gyu

    2014-01-01

    Cancer-associated anorexia and cachexia are a multifactorial condition described by a loss of body weight and muscle with anorexia, asthenia, and anemia. Moreover, they correlate with a high mortality rate, poor response to chemotherapy, poor performance status, and poor quality of life. Cancer cachexia is regulated by proinflammatory cytokines such as interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor- α (TNF- α). In addition, glucagon like peptide-1 (GIP-1), peptide YY (PYY), ghrelin, and leptin plays a crucial role in food intake. In this study, we investigated the therapeutic effects of one of the traditional herbal medicines, Sipjeondaebo-tang (Juzen-taiho-to in Japanese; SJDBT), on cancer anorexia and cachexia in a fundamental mouse cancer anorexia/cachexia model, CT-26 tumor-bearing mice. SJDBT was more significantly effective in a treatment model where it was treated after anorexia and cachexia than in a prevention model where it was treated before anorexia and cachexia on the basis of parameters such as weights of muscles and whole body and food intakes. Moreover, SJDBT inhibited a production of IL-6, MCP-1, PYY, and GLP-1 and ameliorated cancer-induced anemia. Therefore, our in vivo studies provide evidence on the role of SJDBT in cancer-associated anorexia and cachexia, thereby suggesting that SJDBT may be useful for treating cancer-associated anorexia and cachexia.

  6. Treatment of chronic anorexia nervosa: a 4-year follow-up of adult patients treated in an acute inpatient setting.

    Science.gov (United States)

    Long, Clive G; Fitzgerald, Kirsty-Anne; Hollin, Clive R

    2012-01-01

    Despite evidence from a number of long-term follow-up studies of anorexia nervosa that nearly 50% of patients eventually make a full recovery, controlled trials of psychotherapy for anorexia nervosa are lacking. Those with severe and enduring problems represent a considerable therapeutic challenge. Thirty-four consecutive adult referrals to the inpatient treatment unit who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for anorexia nervosa were examined pre-admission, post-discharge and 4 years after admission. Characteristics of remitted and non-remitted patients were examined. Secondary analyses considered the differences between patients with anorexia nervosa, restricting type and anorexia nervosa binging/purging type. The findings highlight a number of differences between patients with anorexia nervosa (restricting type) versus anorexia nervosa (binging/purging type) as well as remitted versus non-remitted patients. The use of a comprehensive battery of assessments found that resolution of eating disorder symptomatology was paralleled by improvements in emotional and psychological distress and improvement in body image perception and coping skills. Better results were obtained for those who had continuity of care on an outpatient basis. This pattern is particularly significant given the more 'chronic' nature of the sample that were older, with a higher incidence of binge-eating and purging than previous samples. Results provide some encouragement for the treatment of those adults with anorexia nervosa who typically have less favourable outcomes. 

  7. Dying on the Inside: What Every Teacher Needs to Know About Anorexia Nervosa, Bulimia, and the Individual Child.

    Science.gov (United States)

    Zimmer, Marc

    This document provides teachers with information on the identifying features of anorexia nervosa and bulimia and suggests steps which teachers can take to encourage individual children in more positive behavior. The paper makes clear distinctions between anorexia nervosa, bulimia, and bulimarexia, describing the symptoms of each disorder. It is…

  8. Underweight subjects with anorexia nervosa have an enhanced salivary cortisol response not seen in weight restored subjects with anorexia nervosa.

    Science.gov (United States)

    Monteleone, Alessio Maria; Monteleone, Palmiero; Serino, Ismene; Amodio, Roberta; Monaco, Francesco; Maj, Mario

    2016-08-01

    The cortisol response to awakening (CAR) has been reported to be enhanced in symptomatic patients with anorexia nervosa (AN). However, it has been not established whether the dysregulation of CAR was a primary phenomenon or a change secondary to malnutrition. Therefore, we aimed to explore the salivary CAR in both underweight and weigh-restored women with AN. Fifty-nine women volunteered for the study. They were 18 underweight AN women, 15 weight-restored AN women and 26 normal-weight healthy women. Saliva samples were collected in the morning, immediately on awakening and after 15, 30 and 60min to measure saliva levels of cortisol. Participants' anxiety levels in the morning of sampling were measured by the State-Trait Anxiety Inventory. As compared to control women, underweight AN patients showed an enhanced CAR whereas weight-restored patients had a normal CAR. These results could be not explained by group differences in body mass index or levels of anxiety. These findings show, for the first time, that the enhanced CAR occurring in the acute phase of AN is not seen in weight-recovered patients, suggesting that the dysregulated activity of the hypothalamus-pituitary-adrenal axis of symptomatic AN patients is a state-dependent phenomenon.

  9. An interpretative phenomenological analysis of participation in a pro-anorexia internet site and its relationship with disordered eating.

    Science.gov (United States)

    Mulveen, Ruaidhri; Hepworth, Julie

    2006-03-01

    Pro-anorexia Internet sites aim to promote, support and discuss anorexia nervosa. Media coverage has raised concerns that sites may increase the level of eating disorders. This research examines the meaning of participation in a pro-anorexia Internet site and its relationship with disordered eating by using an interpretative phenomenological analysis of fifteen separate message 'threads' followed over a six-week period. Four themes were identified: (1) tips and techniques; (2) 'ana' v. anorexia nervosa; (3) social support; and (4) need for anorexia. Findings suggest participation was multi-purpose, providing a coping function in relation to weight loss, and the contribution of sites to increased levels of eating disorders is not inevitable.

  10. Inpatient cognitive behaviour therapy for adolescents with anorexia nervosa: immediate and longer-term effects

    Directory of Open Access Journals (Sweden)

    Riccardo eDalle Grave

    2014-02-01

    Full Text Available Introduction: Inpatient treatment for anorexia nervosa is often successful in restoring body weight, but a high percentage of patients relapse following discharge. The aim of the present study was to establish the immediate and longer-term effects of a novel inpatient program for adolescents that was designed to produce enduring change. Method: Twenty-seven consecutive patients with severe anorexia nervosa were admitted to a 20-week inpatient treatment program based upon enhanced cognitive behaviour therapy (CBT-E. The patients were assessed before and after hospitalization, and six and 12 months later. Results: Twenty-six patients (96% completed the program. In these patients there was a substantial improvement in weight, eating disorder features and general psychopathology that was well maintained at 12-month follow-up. Conclusions: These findings suggest that inpatient CBT-E is a promising approach to the treatment of adolescents with severe anorexia nervosa.

  11. Increased reverse T/sub 3/ concentration in patients with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Baranowska, B.; Kaniewski, M.; Zgliczynski, S. (Centrum Medyczne Ksztalcenia Podyplomowego, Warsaw (Poland))

    1980-01-01

    In 20 female patients with anorexia nervosa, aging 16 - 26 years, the thyroid function was estimated by +- determining TSH secretion in response to TRH, and serum thyroxine (T/sub 4/), 3,5,3'L-triiodothyronine (T/sub 3/) and 3,3',5'L-triiodothyronine (reverse T/sub 3/) concentrations. 14 healthy women of the same age were included into the control group. If compared with control group, a marked supression of TRH stimulated TSH secretion and a lowering of serum T/sub 3/ concentration was found in patients with anorexia nervosa. On the other hand, serum reverse T/sub 3/ concentration was markedly higher in patients with anorexia nervosa than in control ones. Gain of body weight leads to normalization of thyroid hormones level in the serum. Obtained results show for peripheral mechanism of described hormonal disorders.

  12. [Bulimia, bulimia-anorexia and nocturnal secretion of melatonin and cortisol].

    Science.gov (United States)

    Parienti, V; Kennedy, S H; Brown, G M; Costa, D

    1988-01-01

    The authors compared nocturnal variations of melatonin (MT) and cortisol levels in subjects with bulimia (n = 12), 6 with a normal body weight and 6 with anorexia nervosa, as well as 6 control subjects. The hypothesis, formulated for anorexia nervosa, that a decrease of noradrenergic activity induces a decrease of pineal activity, therefore a decrease of melatonin secretion, was not confirmed by our study. Moreover, in subjects with bulimia in the absence of anorexia nervosa, no significant decrease of nocturnal melatonin secretion was reported. Significant differences were due to cortisol variations when comparing MTmax/Cmin ratios. Melatonin did not add any complementary biological cue for diagnostic assessment for subjects with eating disorder and depression. The results of this study suggest that melatonin does not appear to be a useful biological marker in bulimia.

  13. Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970-1989

    DEFF Research Database (Denmark)

    Pagsberg, A K; Wang, A R

    1994-01-01

    In a retrospective study of anorexia nervosa and bulimia nervosa, potential cases were traced, studied, and diagnosed according to ICD-10. Forty-two cases were found in Bornholm County, comprising the island of Bornholm in Denmark, in a population of 47,000 from 1970 to 1989. Less than half...... the number of cases in the population year by year, also increased during the late part of the study period. In 1989 the incidence rate of the high-risk group of females 10 to 24 years of age was 136 per 100,000 for anorexia nervosa and 45 per 100,000 for bulimia nervosa, and the prevalence rate was 222 per...... 100,000 for anorexia nervosa and 89 per 100,000 for bulimia nervosa....

  14. BDNF regulation in the rat dorsal vagal complex during stress-induced anorexia.

    Science.gov (United States)

    Charrier, Céline; Chigr, Fatiha; Tardivel, Catherine; Mahaut, Stéphanie; Jean, André; Najimi, Mohamed; Moyse, Emmanuel

    2006-08-30

    The dorsal vagal complex (DVC) is the satiety reflex-integrating center of adult mammals. Immobilization stress (IS) is known to elicit anorexia and to up-regulate BDNF expression in adult rat forebrain; intra-DVC delivery of BDNF was shown to elicit anorexia. Therefore, we addressed here whether IS would increase BDNF signaling in rat DVC by using PCR and western-blot on microdissected tissue extracts. Significant variations of BDNF expression in DVC after IS include exon V mRNA increase at 3 h, decreases of both protein and exon III mRNA at 24 h, and exon I mRNA decrease at 72 h. At the receptor level, IS elicited a highly significant induction of both full-length and truncated-1 TrkB mRNAs at 24 h after IS. In vivo recruitment of BDNF signaling in DVC during stress thus differs from hypothalamus, the relevance of which to anorexia is discussed.

  15. The involvement of prostaglandin E2 in interleukin-1β evoked anorexia is strain dependent.

    Science.gov (United States)

    Nilsson, Anna; Elander, Louise; Hallbeck, Martin; Örtegren Kugelberg, Unn; Engblom, David; Blomqvist, Anders

    2017-02-01

    From experiments in mice in which the prostaglandin E2 (PGE2) synthesizing enzyme mPGES-1 was genetically deleted, as well as from experiments in which PGE2 was injected directly into the brain, PGE2 has been implicated as a mediator of inflammatory induced anorexia. Here we aimed at examining which PGE2 receptor (EP1-4) that was critical for the anorexic response to peripherally injected interleukin-1β (IL-1β). However, deletion of neither EP receptor in mice, either globally (for EP1, EP2, and EP3) or selectively in the nervous system (EP4), had any effect on the IL-1β induced anorexia. Because these mice were all on a C57BL/6 background, whereas previous observations demonstrating a role for induced PGE2 in IL-1β evoked anorexia had been carried out on mice on a DBA/1 background, we examined the anorexic response to IL-1β in mice with deletion of mPGES-1 on a C57BL/6 background and a DBA/1 background, respectively. We confirmed previous findings that mPGES-1 knock-out mice on a DBA/1 background displayed attenuated anorexia to IL-1β; however, mice on a C57BL/6 background showed the same profound anorexia as wild type mice when carrying deletion of mPGES-1, while displaying almost normal food intake after pretreatment with a cyclooxygenase-2 inhibitor. We conclude that the involvement of induced PGE2 in IL-1β evoked anorexia is strain dependent and we suggest that different routes that probably involve distinct prostanoids exist by which inflammatory stimuli may evoke an anorexic response and that these routes may be of different importance in different strains of mice.

  16. Cancer Incidence among Patients with Anorexia Nervosa from Sweden, Denmark and Finland.

    Science.gov (United States)

    Mellemkjaer, Lene; Papadopoulos, Fotios C; Pukkala, Eero; Ekbom, Anders; Gissler, Mika; Christensen, Jane; Olsen, Jørgen H

    2015-01-01

    A diet with restricted energy content reduces the occurrence of cancer in animal experiments. It is not known if the underlying mechanism also exists in human beings. To determine whether cancer incidence is reduced among patients with anorexia nervosa who tend to have a low intake of energy, we carried out a retrospective cohort study of 22 654 women and 1678 men diagnosed with anorexia nervosa at ages 10-50 years during 1968-2010 according to National Hospital Registers in Sweden, Denmark and Finland. The comparison group consisted of randomly selected persons from population registers who were similar to the anorexia nervosa patients in respect to sex, year of birth and place of residence. Patients and population comparisons were followed for cancer by linkage to Cancer Registries. Incidence rate ratios (IRR) were estimated using Poisson models. In total, 366 cases of cancer (excluding non-melanoma skin cancer) were seen among women with anorexia nervosa, and the IRR for all cancer sites was 0.97 (95% CI = 0.87-1.08) adjusted for age, parity and age at first child. There were 76 breast cancers corresponding to an adjusted IRR of 0.61 (95% CI = 0.49-0.77). Significantly increased IRRs were observed for esophageal, lung, and liver cancer. Among men with anorexia nervosa, there were 23 cases of cancer (age-adjusted IRR = 1.08; 95% CI = 0.71-1.66). There seems to be no general reduction in cancer occurrence among patients with anorexia nervosa, giving little support to the energy restriction hypothesis.

  17. Illness-induced anorexia and its possible function in the caterpillar, Manduca sexta.

    Science.gov (United States)

    Adamo, Shelley A; Fidler, Tara L; Forestell, Catherine A

    2007-03-01

    Although many animals exhibit illness-induced anorexia when immune-challenged, the adaptive significance of this behavior remains unclear. Injecting Manduca sexta larvae (caterpillars) with live bacteria (Serratia marcescens), heat-killed bacteria or bacterial lipopolysaccharides resulted in a decline in feeding, demonstrating illness-induced anorexia in this species. We used M. sexta to test four commonly suggested adaptive functions for illness-induced anorexia. (1) Food deprivation did not reduce the iron content of the hemolymph. (2) Immune-challenged M. sexta were not more likely to move to a different part of the plant. Therefore, the decline in feeding is unlikely to be an adaptive response allowing the animal to move away from a patch of contaminated food. (3) M. sexta force-fed S. marcescens bacteria were not more susceptible to a S. marcescens systemic infection than were M. sexta force-fed nutrient broth. (4) Force-feeding infected M. sexta during illness-induced anorexia did not increase mortality and short-term food deprivation did not enhance survival. However, force-feeding M. sexta with a high lipid diet (linseed oil and water) resulted in an increase in mortality when challenged with S. marcescens. Force-feeding sucrose or water did not reduce resistance. Force-feeding a high lipid diet into healthy animals did not reduce weight gain, suggesting that it was not toxic. We hypothesize that there is a conflict between lipid metabolism and immune function, although whether this conflict has played a role in the evolution of illness-induced anorexia remains unknown. The adaptive function of illness-induced anorexia requires further study in both vertebrates and invertebrates.

  18. Development of, and recovery from, activity-based anorexia in female rats.

    Science.gov (United States)

    Dixon, Deann P; Ackert, Allison M; Eckel, Lisa A

    2003-11-01

    Activity-based anorexia occurs in rats maintained on a restricted-feeding schedule while given free access to running wheels. These conditions induce high levels of wheel running and rapid weight loss. Although this procedure was developed as an animal model of anorexia nervosa, it has been studied primarily in male rats. Our goal was to examine the development of, and recovery from, activity-based anorexia in female rats. Food intake, wheel running, body weight, and phase of the estrous cycle were monitored daily prior to, during, and after a period of restricted feeding in which access to food was limited to 2 h/day. Food intake, body weight, and estrous cyclicity were also monitored in a control group housed without access to running wheels. Prior to food restriction, rats with wheels displayed high levels of wheel running and consumed more food than rats without wheels. Despite that both groups consumed similar amounts of food during the restricted-feeding phase, only rats with wheels developed symptoms of activity-based anorexia, including increased wheel running, rapid weight loss, and disruptions in estrous cyclicity. Recovery from activity-based anorexia was associated with hypoactivity and hyperphagia. Resumption of estrous cycles occurred when the weight lost during food restriction was regained. Hyperphagia, but not hypoactivity, was maintained following resumption of estrous cycles; however, this hyperphagia was limited to nonestrous phases. Our findings suggest that recovery from activity-based anorexia is mediated primarily by an increase in orexigenic signaling that promotes pronounced hyperphagia, and that the increase in satiogenic signaling during estrus abolishes this compensatory hyperphagia.

  19. Complement C3 serum levels in anorexia nervosa: a potential biomarker for the severity of disease?

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    Long Carlin S

    2011-05-01

    Full Text Available Abstract Background Anorexia nervosa carries the highest mortality rate of any psychiatric disorder. Even the most critically ill anorexic patients may present with normal 'standard' laboratory values, underscoring the need for a new sensitive biomarker. The complement cascade, a major component of innate immunity, represents a driving force in the pathophysiology of multiple inflammatory disorders. The role of complement in anorexia nervosa remains poorly understood. The present study was designed to evaluate the role of complement C3 levels, the extent of complement activation and of complement hemolytic activity in serum, as potential new biomarkers for the severity of anorexia nervosa. Patients and methods This was a prospective cohort study on 14 patients with severe anorexia nervosa, as defined by a body mass index (BMI 2. Serum samples were obtained in a biweekly manner until hospital discharge. A total of 17 healthy subjects with normal BMI values served as controls. The serum levels of complement C3, C3a, C5a, sC5b-9, and of the 50% hemolytic complement activity (CH50 were quantified and correlated with the BMIs of patients and control subjects. Results Serum C3 levels were significantly lower in patients with anorexia nervosa than in controls (median 3.7 (interquartile range (IQR 2.5-4.9 vs 11.4 (IQR 8.9-13.7, P P Conclusions Complement C3 serum levels may represent a sensitive new biomarker for monitoring the severity of disease in anorexia nervosa. The finding from this preliminary pilot study will require further investigation in future prospective large-scale multicenter trials.

  20. Abnormal white matter properties in adolescent girls with anorexia nervosa

    Science.gov (United States)

    Travis, Katherine E.; Golden, Neville H.; Feldman, Heidi M.; Solomon, Murray; Nguyen, Jenny; Mezer, Aviv; Yeatman, Jason D.; Dougherty, Robert F.

    2015-01-01

    Anorexia nervosa (AN) is a serious eating disorder that typically emerges during adolescence and occurs most frequently in females. To date, very few studies have investigated the possible impact of AN on white matter tissue properties during adolescence, when white matter is still developing. The present study evaluated white matter tissue properties in adolescent girls with AN using diffusion MRI with tractography and T1 relaxometry to measure R1 (1/T1), an index of myelin content. Fifteen adolescent girls with AN (mean age = 16.6 years ± 1.4) were compared to fifteen age-matched girls with normal weight and eating behaviors (mean age = 17.1 years ± 1.3). We identified and segmented 9 bilateral cerebral tracts (18) and 8 callosal fiber tracts in each participant's brain (26 total). Tract profiles were generated by computing measures for fractional anisotropy (FA) and R1 along the trajectory of each tract. Compared to controls, FA in the AN group was significantly decreased in 4 of 26 white matter tracts and significantly increased in 2 of 26 white matter tracts. R1 was significantly decreased in the AN group compared to controls in 11 of 26 white matter tracts. Reduced FA in combination with reduced R1 suggests that the observed white matter differences in AN are likely due to reductions in myelin content. For the majority of tracts, group differences in FA and R1 did not occur within the same tract. The present findings have important implications for understanding the neurobiological factors underlying white matter changes associated with AN and invite further investigations examining associations between white matter properties and specific physiological, cognitive, social, or emotional functions affected in AN. PMID:26740918

  1. Cholecystokinin revisited: CCK and the hunger trap in anorexia nervosa.

    Directory of Open Access Journals (Sweden)

    Ulrich Cuntz

    Full Text Available OBJECTIVE: Despite a number of studies in the past decades, the role of Cholecystokinin (CCK in anorexia nervosa (AN has remained uncertain. In this study a highly specific assay for the biologically active part of CCK was used in patients with bulimic as well as with the restricting type of AN who were followed over the course of weight gain. METHODS: Ten patients with restricting and 13 with bulimic AN were investigated upon admission (T0, after a weight gain of at least 2 kg on two consecutive weighting dates (T1, and during the last week before discharge (T2 from inpatient treatment in a specialized clinic. Blood samples were drawn under fasting conditions and 20 and 60 minutes following a standard meal (250 kcal. Data were compared to those of eight controls matched for sex and age. Gastrointestinal complaints of patients were measured by a questionnaire at each of the follow-up time points. RESULTS: At admission, AN patients exhibited CCK-levels similar to controls both prior to and after a test meal. Pre and post-meal CCK levels increased significantly after an initial weight gain but decreased again with further weight improvement. CCK release was somewhat lower in bulimic than in restricting type AN but both subgroups showed a similar profile. There was no significant association of CCK release to either initial weight or BMI, or their changes, but CCK levels at admission predicted gastrointestinal symptom improvement during therapy. CONCLUSIONS: Normal CCK profiles in AN at admission indicates hormonal responses adapted to low food intake while change of eating habits and weight gain results in initially increased CCK release (counteracting the attempts to alter eating behavior that returns towards normal levels with continuous therapy.

  2. Atypical antipsychotics as augmentation therapy in anorexia nervosa.

    Directory of Open Access Journals (Sweden)

    Enrica Marzola

    Full Text Available Anorexia nervosa (AN is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings.

  3. Abnormal white matter properties in adolescent girls with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Katherine E. Travis

    2015-01-01

    Full Text Available Anorexia nervosa (AN is a serious eating disorder that typically emerges during adolescence and occurs most frequently in females. To date, very few studies have investigated the possible impact of AN on white matter tissue properties during adolescence, when white matter is still developing. The present study evaluated white matter tissue properties in adolescent girls with AN using diffusion MRI with tractography and T1 relaxometry to measure R1 (1/T1, an index of myelin content. Fifteen adolescent girls with AN (mean age = 16.6 years ± 1.4 were compared to fifteen age-matched girls with normal weight and eating behaviors (mean age = 17.1 years ± 1.3. We identified and segmented 9 bilateral cerebral tracts (18 and 8 callosal fiber tracts in each participant's brain (26 total. Tract profiles were generated by computing measures for fractional anisotropy (FA and R1 along the trajectory of each tract. Compared to controls, FA in the AN group was significantly decreased in 4 of 26 white matter tracts and significantly increased in 2 of 26 white matter tracts. R1 was significantly decreased in the AN group compared to controls in 11 of 26 white matter tracts. Reduced FA in combination with reduced R1 suggests that the observed white matter differences in AN are likely due to reductions in myelin content. For the majority of tracts, group differences in FA and R1 did not occur within the same tract. The present findings have important implications for understanding the neurobiological factors underlying white matter changes associated with AN and invite further investigations examining associations between white matter properties and specific physiological, cognitive, social, or emotional functions affected in AN.

  4. A genome-wide association study of anorexia nervosa.

    Science.gov (United States)

    Boraska, V; Franklin, C S; Floyd, J A B; Thornton, L M; Huckins, L M; Southam, L; Rayner, N W; Tachmazidou, I; Klump, K L; Treasure, J; Lewis, C M; Schmidt, U; Tozzi, F; Kiezebrink, K; Hebebrand, J; Gorwood, P; Adan, R A H; Kas, M J H; Favaro, A; Santonastaso, P; Fernández-Aranda, F; Gratacos, M; Rybakowski, F; Dmitrzak-Weglarz, M; Kaprio, J; Keski-Rahkonen, A; Raevuori, A; Van Furth, E F; Slof-Op 't Landt, M C T; Hudson, J I; Reichborn-Kjennerud, T; Knudsen, G P S; Monteleone, P; Kaplan, A S; Karwautz, A; Hakonarson, H; Berrettini, W H; Guo, Y; Li, D; Schork, N J; Komaki, G; Ando, T; Inoko, H; Esko, T; Fischer, K; Männik, K; Metspalu, A; Baker, J H; Cone, R D; Dackor, J; DeSocio, J E; Hilliard, C E; O'Toole, J K; Pantel, J; Szatkiewicz, J P; Taico, C; Zerwas, S; Trace, S E; Davis, O S P; Helder, S; Bühren, K; Burghardt, R; de Zwaan, M; Egberts, K; Ehrlich, S; Herpertz-Dahlmann, B; Herzog, W; Imgart, H; Scherag, A; Scherag, S; Zipfel, S; Boni, C; Ramoz, N; Versini, A; Brandys, M K; Danner, U N; de Kovel, C; Hendriks, J; Koeleman, B P C; Ophoff, R A; Strengman, E; van Elburg, A A; Bruson, A; Clementi, M; Degortes, D; Forzan, M; Tenconi, E; Docampo, E; Escaramís, G; Jiménez-Murcia, S; Lissowska, J; Rajewski, A; Szeszenia-Dabrowska, N; Slopien, A; Hauser, J; Karhunen, L; Meulenbelt, I; Slagboom, P E; Tortorella, A; Maj, M; Dedoussis, G; Dikeos, D; Gonidakis, F; Tziouvas, K; Tsitsika, A; Papezova, H; Slachtova, L; Martaskova, D; Kennedy, J L; Levitan, R D; Yilmaz, Z; Huemer, J; Koubek, D; Merl, E; Wagner, G; Lichtenstein, P; Breen, G; Cohen-Woods, S; Farmer, A; McGuffin, P; Cichon, S; Giegling, I; Herms, S; Rujescu, D; Schreiber, S; Wichmann, H-E; Dina, C; Sladek, R; Gambaro, G; Soranzo, N; Julia, A; Marsal, S; Rabionet, R; Gaborieau, V; Dick, D M; Palotie, A; Ripatti, S; Widén, E; Andreassen, O A; Espeseth, T; Lundervold, A; Reinvang, I; Steen, V M; Le Hellard, S; Mattingsdal, M; Ntalla, I; Bencko, V; Foretova, L; Janout, V; Navratilova, M; Gallinger, S; Pinto, D; Scherer, S W; Aschauer, H; Carlberg, L; Schosser, A; Alfredsson, L; Ding, B; Klareskog, L; Padyukov, L; Courtet, P; Guillaume, S; Jaussent, I; Finan, C; Kalsi, G; Roberts, M; Logan, D W; Peltonen, L; Ritchie, G R S; Barrett, J C; Estivill, X; Hinney, A; Sullivan, P F; Collier, D A; Zeggini, E; Bulik, C M

    2014-10-01

    Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

  5. A genome-wide association study of anorexia nervosa

    Science.gov (United States)

    Boraska, Vesna; Franklin, Christopher S; Floyd, James AB; Thornton, Laura M; Huckins, Laura M; Southam, Lorraine; Rayner, N William; Tachmazidou, Ioanna; Klump, Kelly L; Treasure, Janet; Lewis, Cathryn M; Schmidt, Ulrike; Tozzi, Federica; Kiezebrink, Kirsty; Hebebrand, Johannes; Gorwood, Philip; Adan, Roger AH; Kas, Martien JH; Favaro, Angela; Santonastaso, Paolo; Fernández-Aranda, Fernando; Gratacos, Monica; Rybakowski, Filip; Dmitrzak-Weglarz, Monika; Kaprio, Jaakko; Keski-Rahkonen, Anna; Raevuori, Anu; Van Furth, Eric F; Landt, Margarita CT Slof-Op t; Hudson, James I; Reichborn-Kjennerud, Ted; Knudsen, Gun Peggy S; Monteleone, Palmiero; Kaplan, Allan S; Karwautz, Andreas; Hakonarson, Hakon; Berrettini, Wade H; Guo, Yiran; Li, Dong; Schork, Nicholas J.; Komaki, Gen; Ando, Tetsuya; Inoko, Hidetoshi; Esko, Tõnu; Fischer, Krista; Männik, Katrin; Metspalu, Andres; Baker, Jessica H; Cone, Roger D; Dackor, Jennifer; DeSocio, Janiece E; Hilliard, Christopher E; O'Toole, Julie K; Pantel, Jacques; Szatkiewicz, Jin P; Taico, Chrysecolla; Zerwas, Stephanie; Trace, Sara E; Davis, Oliver SP; Helder, Sietske; Bühren, Katharina; Burghardt, Roland; de Zwaan, Martina; Egberts, Karin; Ehrlich, Stefan; Herpertz-Dahlmann, Beate; Herzog, Wolfgang; Imgart, Hartmut; Scherag, André; Scherag, Susann; Zipfel, Stephan; Boni, Claudette; Ramoz, Nicolas; Versini, Audrey; Brandys, Marek K; Danner, Unna N; de Kovel, Carolien; Hendriks, Judith; Koeleman, Bobby PC; Ophoff, Roel A; Strengman, Eric; van Elburg, Annemarie A; Bruson, Alice; Clementi, Maurizio; Degortes, Daniela; Forzan, Monica; Tenconi, Elena; Docampo, Elisa; Escaramís, Geòrgia; Jiménez-Murcia, Susana; Lissowska, Jolanta; Rajewski, Andrzej; Szeszenia-Dabrowska, Neonila; Slopien, Agnieszka; Hauser, Joanna; Karhunen, Leila; Meulenbelt, Ingrid; Slagboom, P Eline; Tortorella, Alfonso; Maj, Mario; Dedoussis, George; Dikeos, Dimitris; Gonidakis, Fragiskos; Tziouvas, Konstantinos; Tsitsika, Artemis; Papezova, Hana; Slachtova, Lenka; Martaskova, Debora; Kennedy, James L.; Levitan, Robert D.; Yilmaz, Zeynep; Huemer, Julia; Koubek, Doris; Merl, Elisabeth; Wagner, Gudrun; Lichtenstein, Paul; Breen, Gerome; Cohen-Woods, Sarah; Farmer, Anne; McGuffin, Peter; Cichon, Sven; Giegling, Ina; Herms, Stefan; Rujescu, Dan; Schreiber, Stefan; Wichmann, H-Erich; Dina, Christian; Sladek, Rob; Gambaro, Giovanni; Soranzo, Nicole; Julia, Antonio; Marsal, Sara; Rabionet, Raquel; Gaborieau, Valerie; Dick, Danielle M; Palotie, Aarno; Ripatti, Samuli; Widén, Elisabeth; Andreassen, Ole A; Espeseth, Thomas; Lundervold, Astri; Reinvang, Ivar; Steen, Vidar M; Le Hellard, Stephanie; Mattingsdal, Morten; Ntalla, Ioanna; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Navratilova, Marie; Gallinger, Steven; Pinto, Dalila; Scherer, Stephen; Aschauer, Harald; Carlberg, Laura; Schosser, Alexandra; Alfredsson, Lars; Ding, Bo; Klareskog, Lars; Padyukov, Leonid; Finan, Chris; Kalsi, Gursharan; Roberts, Marion; Logan, Darren W; Peltonen, Leena; Ritchie, Graham RS; Barrett, Jeffrey C; Estivill, Xavier; Hinney, Anke; Sullivan, Patrick F; Collier, David A; Zeggini, Eleftheria; Bulik, Cynthia M

    2015-01-01

    Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2,907 cases with AN from 14 countries (15 sites) and 14,860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery datasets. Seventy-six (72 independent) SNPs were taken forward for in silico (two datasets) or de novo (13 datasets) replication genotyping in 2,677 independent AN cases and 8,629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication datasets comprised 5,551 AN cases and 21,080 controls. AN subtype analyses (1,606 AN restricting; 1,445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01×10-7) in SOX2OT and rs17030795 (P=5.84×10-6) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76×10-6) between CUL3 and FAM124B and rs1886797 (P=8.05×10-6) near SPATA13. Comparing discovery to replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4×10-6), strongly suggesting that true findings exist but that our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field. PMID:24514567

  6. Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Mathieu eMéquinion

    2013-02-01

    Full Text Available Food intake and associated disorders are gaining large emphasis in our societies due to their dramatic physiological and psychological consequences on health. Chronic food restriction is a major symptom described in restrictive anorexia nervosa (AN patients. This disease, mostly observed in young women is the third cause of chronic illness in teenagers. It leads to central and/or peripheral reprogramming that permits the organism to endure the reduced energy supplies. These drastic conditions induce severe weight loss, metabolic disturbances, infertility, osteopenia and osteoporosis. Moreover, increasing number of arguments consider AN as an addictive behaviour to food deprivation or weight loss or physical activity, usually associated with mood disorders. This suggests a potential alteration of the central reward system. Significant changes in hormones involved in energy metabolism, regulation of feeding behaviours and bone formation are described in AN patients, but also in animal models presenting a strong face validity. Surprisingly, the plasma levels of ghrelin, an orexigenic hormone, are increased. This hormone acts centrally to modulate food intake, but also peripherally mainly to maintain blood glucose and to regulate gastric motility. Such increase in plasma ghrelin levels seems paradoxical in light of the restrained eating adopted by these AN patients, but adaptive. The aim of this review is to describe the role played by ghrelin in AN focusing on its central vs peripheral action. The chronic food restriction induces both in AN patients and in rodent models a profound alteration in the « ghrelin » signal integration that lead to the development of inappropriate behaviours like hyperactivity or addiction to food starvation and therefore a greater depletion in energy reserves. The question of a transient insensitivity to ghrelin and/or a potential metabolic reprogramming is discussed in regard of new clinical treatments currently

  7. Family functioning in two treatments for adolescent anorexia nervosa

    Science.gov (United States)

    Ciao, Anna C.; Accurso, Erin C.; Fitzsimmons-Craft, Ellen E.; Lock, James; Le Grange, Daniel

    2015-01-01

    Objective Family functioning impairment is widely reported in the eating disorders literature, yet few studies have examined the role of family functioning in treatment for adolescent anorexia nervosa (AN). This study examined family functioning in two treatments for adolescent AN from multiple family members’ perspectives. Method Participants were 121 adolescents with AN ages 12–18 from a randomized-controlled trial comparing family-based treatment (FBT) to individual adolescent-focused therapy (AFT). Multiple clinical characteristics were assessed at baseline. Family functioning from the perspective of the adolescent and both parents was assessed at baseline and after one year of treatment. Full remission from AN was defined as achieving both weight restoration and normalized eating disorder psychopathology. Results In general, families dealing with AN reported some baseline impairment in family functioning, but average ratings were only slightly elevated compared to published impaired functioning cutoffs. Adolescents’ perspectives on family functioning were the most impaired and were generally associated with poorer psychosocial functioning and greater clinical severity. Regardless of initial level of family functioning, improvements in several family functioning domains were uniquely related to full remission at the end of treatment in both FBT and AFT. However, FBT had a more positive impact on several specific aspects of family functioning compared to AFT. Discussion Families seeking treatment for adolescent AN report some difficulties in family functioning, with adolescents reporting the greatest impairment. While FBT may be effective in improving some specific aspects of family dynamics, remission from AN was associated with improved family dynamics, regardless of treatment type. PMID:24902822

  8. Self-reported and behavioural impulsivity in anorexia nervosa

    Science.gov (United States)

    Phillipou, Andrea; Abel, Larry Allen; Castle, David Jonathan; Gurvich, Caroline; Hughes, Matthew Edward; Rossell, Susan Lee

    2016-01-01

    AIM To examine how self-reported and behavioural impulsivity are related in anorexia nervosa (AN). METHODS Twenty-four females with AN and 25 healthy controls (HC) participant in the study. Self-reported impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). The scale yields three second-order factors: Attentional, motor and non-planning. Behavioural impulsivity was investigated with the continuous performance test (CPT), a computer-based task of sustained attention in which numbers are flashed briefly on screen and participants are required to click the mouse when the same number appears consecutively. The rate of commission and omission errors can be used a measure of behavioural imulsivity. RESULTS AN participants self-reported increased attentional [AN: 20.67 (3.64), HC: 13.88 (2.91), P = 0.001] and reduced motor impulsivity [AN: 11.55 (2.28), HC: 14.08 (2.78), P = 0.002]. The rate of omission or commission errors on the CPT did not differ between groups (P > 0.05). BIS-11 and CPT measures did not significantly correlate, but attentional impulsivity was related to negative mood states in AN (depression: r = 0.52, P = 0.010, anxiety: r = 0.55, P = 0.006, stress: r = 0.57, P = 0.004). CONCLUSION The discrepancy between self-reported and behavioural impulsivity are discussed in terms of perfectionism in AN. Furthermore, it is suggested that improving negative mood states may resolve this inconsistency in AN. PMID:27679774

  9. [Prevention and Treatment of Eating Disorders: The Health Care Network Anorexia and Bulimia nervosa].

    Science.gov (United States)

    Weigel, Angelika; Gumz, Antje; Kästner, Denise; Romer, Georg; Wegscheider, Karl; Löwe, Bernd

    2015-07-01

    The "Health care network anorexia and bulimia nervosa", a subproject of psychenet - the Hamburg network for mental health - aims to decrease the incidence of eating disorders as well as the risk for chronic illness courses. One focal project, therefore, evaluates a school-based prevention manual in a randomized controlled trial. The other one examines the impact of a systemic public health intervention on early treatment initiation in anorexia nervosa. The present article provides an overview about study design and interventions in both focal projects as well as preliminary results.

  10. The experience of specialist inpatient treatment for anorexia nervosa: A qualitative study from adult patients' perspectives.

    Science.gov (United States)

    Smith, Vivien; Chouliara, Zoe; Morris, Paul G; Collin, Paula; Power, Kevin; Yellowlees, Alex; Grierson, David; Papageorgiou, Elena; Cook, Moira

    2016-01-01

    This qualitative study aimed to explore experiences of women currently undergoing specialist inpatient treatment for anorexia nervosa. Interviews were carried out with 21 women with a diagnosis of anorexia nervosa from a specialist adult inpatient eating disorder unit. Five master themes emerged using thematic analysis: (1) shifts in control, (2) experience of transition, (3) importance of supportive staff relationships, (4) sharing with peers and (5) process of recovery and self-discovery. Findings suggest that patients experience a process of change and adjustment in relation to levels of perceived personal control, attachment to the treatment environment and a sense of self-identity.

  11. Chronic anorexia nervosa: enteral nutrition via percutaneous endoscopic gastrostomy and liaison psychiatry.

    Science.gov (United States)

    Malfi, G; Agnello, E; Da Pont, M C; Palmo, A; Zullo, G; Monero, A; Macario, P F; Sterpone, S; Munno, D

    2006-12-01

    Anorexia nervosa is a complex mental disorder characterized by altered eating behaviour often resulting in life-threatening weight loss (1 month) enteral feeding at home, a percutaneous endoscopic gastrostomy was performed and a home nutrition support regimen that met her energy-protein intake requirements was prescribed. During the follow-up period, an overall improvement in nutritional status, general condition, mood and cognitive functioning was observed. Patient compliance with refeeding is notoriously problematic; however, enteral feeding interventions may be feasible in the long-term treatment of selected anorexia nervosa patients when closely followed-up by a multidisciplinary medical team.

  12. [Eating disorders in childhood and adolescence. Anorexia nervosa, bulimia nervosa, binge eating disorder].

    Science.gov (United States)

    Gerlinghoff, M; Backmund, H

    2004-03-01

    The most important eating disorders are anorexia and bulimia, which most frequently occur for the first time during adolescence and continue into adulthood. Medical complications and accompanying psychological disturbances cause a significant mortality rate of up to 6% in anorexia and up to 3% in bulimia. The pathogenesis of eating disorders is still unclear. Current etiological concepts are multidimensional including biological, individual, familial, and sociocultural factors. In spite of a great variety of therapeutic possibilities, the prognosis for eating disorders is quite poor. In the long term, only about 50% of the persons affected overcome their illness. Preventive measures are therefore indispensable.

  13. [Adaptation of psychodrama in psychotherapy of patients with anorexia nervosa and bulimia nervosa].

    Science.gov (United States)

    Izydorczyk, Bernadetta

    2011-01-01

    The aim of the article was an attempt to present selected theoretical motifs and moreover self experience in the adaptation of elements of psychodrama by Moreno in psychodynamic psychotherapy (individual and group psychotherapy) in a group of people with anorexia and bulimia nervosa. Psychodrama through own creativity, spontaneity and taking action on the "here and now" stage helps to attain and intensify therapeutic aims which concern the consciousness of inner conflict of persons with anorexia and bulimia nervosa, which is translocated on their body.

  14. Therapist adherence in the strong without anorexia nervosa (SWAN) study: A randomized controlled trial of three treatments for adults with anorexia nervosa

    Science.gov (United States)

    Andony, Louise J; Tay, Elaine; Allen, Karina L; Wade, Tracey D; Hay, Phillipa; Touyz, Stephen; McIntosh, Virginia VW; Treasure, Janet; Schmidt, Ulrike H; Fairburn, Christopher G; Erceg-Hurn, David M; Fursland, Anthea; Crosby, Ross D; Byrne, Susan M

    2015-01-01

    Objective To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CBT-E), the Maudsley Anorexia Nervosa Treatment for Adults (MANTRA), and Specialist Supportive Clinical Management (SSCM). Method The SWAN Psychotherapy Rating Scale (SWAN-PRS) was developed, after consultation with the developers of the treatments, and refined. Using the SWAN-PRS, two independent raters initially rated 48 audiotapes of treatment sessions to yield inter-rater reliability data. One rater proceeded to rate a total of 98 audiotapes from 64 trial participants. Results The SWAN-PRS demonstrated sound psychometric properties, and was considered a reliable measure of therapist adherence. The three treatments were highly distinguishable by independent raters, with therapists demonstrating significantly more behaviors consistent with the actual allocated treatment compared to the other two treatment modalities. There were no significant site differences in therapist adherence observed. Discussion The findings provide support for the internal validity of the SWAN study. The SWAN-PRS was deemed suitable for use in other trials involving CBT-E, MANTRA, or SSCM. © 2015 The Authors. International Journal of Eating Disorders Published by Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:1170–1175) PMID:26769445

  15. Inflammation-induced anorexia and fever are elicited by distinct prostaglandin dependent mechanisms, whereas conditioned taste aversion is prostaglandin independent.

    Science.gov (United States)

    Nilsson, Anna; Wilhelms, Daniel Björk; Mirrasekhian, Elahe; Jaarola, Maarit; Blomqvist, Anders; Engblom, David

    2017-03-01

    Systemic inflammation evokes an array of brain-mediated responses including fever, anorexia and taste aversion. Both fever and anorexia are prostaglandin dependent but it has been unclear if the cell-type that synthesizes the critical prostaglandins is the same. Here we show that pharmacological inhibition or genetic deletion of cyclooxygenase (COX)-2, but not of COX-1, attenuates inflammation-induced anorexia. Mice with deletions of COX-2 selectively in brain endothelial cells displayed attenuated fever, as demonstrated previously, but intact anorexia in response to peripherally injected lipopolysaccharide (10μg/kg). Whereas intracerebroventricular injection of a cyclooxygenase inhibitor markedly reduced anorexia, deletion of COX-2 selectively in neural cells, in myeloid cells or in both brain endothelial and neural cells had no effect on LPS-induced anorexia. In addition, COX-2 in myeloid and neural cells was dispensable for the fever response. Inflammation-induced conditioned taste aversion did not involve prostaglandin signaling at all. These findings collectively show that anorexia, fever and taste aversion are triggered by distinct routes of immune-to-brain signaling.

  16. Evidence that PGE2 in the dorsal and median raphe nuclei is involved in LPS-induced anorexia in rats.

    Science.gov (United States)

    Kopf, Brigitte S; Langhans, Wolfgang; Geary, Nori; Hrupka, Brian; Asarian, Lori

    2011-09-01

    Anorexia is an element of the acute-phase immune response. Its mechanisms remain poorly understood. Activation of inducible cyclooxygenase-2 (COX-2) in blood-brain-barrier endothelial cells and subsequent release of prostaglandins (e.g., prostaglandin E2, PGE2) may be involved. Therefore, we sought to relate the effects of prostaglandins on the anorexia following gram-negative bacterial lipopolysaccharide treatment (LPS) to neural activity in the dorsal and median raphe nuclei (DRN and MnR) in rats. COX-2 antagonist (NS-398, 10mg/kg; IP) administration prior to LPS (100μg/kg; IP) prevented anorexia and reduced c-Fos expression the DRN, MnR, nucleus tractus solitarii and several related forebrain areas. These data indicate that COX-2-mediated prostaglandin synthesis is necessary for LPS anorexia and much of the initial LPS-induced neural activation. Injection of NS-398 into the DRN and MnR (1ng/site) attenuated LPS-induced anorexia to nearly the same extent as IP NS-398, suggesting that prostaglandin signaling in these areas is necessary for LPS anorexia. Because the DRN and MnR are sources of major serotonergic projections to the forebrain, these data suggest that serotonergic neurons originating in the midbrain raphe play an important role in acute-phase response anorexia.

  17. The Role of Essential Fatty Acids in Anorexia Nervosa and Obesity.

    Science.gov (United States)

    Yehuda, Shlomo; Rabinovitz, Sharon

    2016-09-09

    The two basic questions in food intake study are what we eat, and how much do we eat. Most research is directed toward the control of how much is eaten. This is likely the result of the increased number of individuals with eating disorders in the Western world. Feeding behavior is highly complex, and is controlled by many psychological, physiological, biochemical, and immunological factors. The aim of this review is to clarify the involvement of fatty acids in eating disorders such as anorexia and binge eating disorder. The review will describe the modified fatty acid profile observed in individuals with anorexia or binge eating disorder, and discuss on what factors fatty acids can exert beneficial effects. In addition, the differences and similarities between anorexia and binge eating disorder will be discussed. We suggest that beneficial effects of essential fatty acids on both anorexia and binge eating disorder can be explained by the stabilizing effect of those fatty acids on the neuronal membrane fluidity index.

  18. A Virtual Reality Full Body Illusion Improves Body Image Disturbance in Anorexia Nervosa

    NARCIS (Netherlands)

    Keizer, Anouk; van Elburg, Annemarie; Helms, Rossa; Dijkerman, H Chris

    2016-01-01

    BACKGROUND: Patients with anorexia nervosa (AN) have a persistent distorted experience of the size of their body. Previously we found that the Rubber Hand Illusion improves hand size estimation in this group. Here we investigated whether a Full Body Illusion (FBI) affects body size estimation of bod

  19. Sociocultural factors in the development of anorexia nervosa in a black woman

    NARCIS (Netherlands)

    Hoek, HW; Willemsen, E.M.C.

    2006-01-01

    Background: in an earlier study, we found that anorexia nervosa (AN) does not occur among Black women on the Caribbean island of Curacao. Method: A case report is presented of a Black Antillean woman with AN, who was referred to a center for eating disorders in The Netherlands. In Curacao, our patie

  20. Lifetime anorexia nervosa in young men in the community : Five cases and their co-twins

    NARCIS (Netherlands)

    Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W.; Sihvola, Elina; Rissanen, Aila; Kaprio, Jaakko

    2008-01-01

    Objective: To describe patterns, comorbidity, and outcomes from a case series of anorexia nervosa (AN) among young men from the general population and their co-twins. Method: Men (N = 2,122) born between 1975 and 1979 from Finnish twin cohorts were screened for lifetime eating disorders by questionn

  1. Differential methylation of the oxytocin receptor gene in patients with anorexia nervosa: a pilot study.

    Directory of Open Access Journals (Sweden)

    Youl-Ri Kim

    Full Text Available BACKGROUND AND AIM: Recent studies in patients with anorexia nervosa suggest that oxytocin may be involved in the pathophysiology of anorexia nervosa. We examined whether there was evidence of variation in methylation status of the oxytocin receptor (OXTR gene in patients with anorexia nervosa that might account for these findings. METHODS: We analyzed the methylation status of the CpG sites in a region from the exon 1 to the MT2 regions of the OXTR gene in buccal cells from 15 patients and 36 healthy women using bisulfite sequencing. We further examined whether methylation status was associated with markers of illness severity or form. RESULTS: We identified six CpG sites with significant differences in average methylation levels between the patient and control groups. Among the six differentially methylated CpG sites, five showed higher than average methylation levels in patients than those in the control group (64.9-88.8% vs. 6.6-45.0%. The methylation levels of these five CpG sites were negatively associated with body mass index (BMI. BMI, eating disorders psychopathology, and anxiety were identified in a regression analysis as factors affecting the methylation levels of these CpG sites with more variation accounted for by BMI. CONCLUSIONS: Epigenetic misregulation of the OXTR gene may be implicated in anorexia nervosa, which may either be a mechanism linking environmental adversity to risk or may be a secondary consequence of the illness.

  2. Reduced capacity in automatic processing of facial expression in restrictive anorexia nervosa and obesity

    NARCIS (Netherlands)

    Cserjesi, Renata; Vermeulen, Nicolas; Lenard, Laszlo; Luminet, Olivier

    2011-01-01

    There is growing evidence that disordered eating is associated with facial expression recognition and emotion processing problems. In this study, we investigated the question of whether anorexia and obesity occur on a continuum of attention bias towards negative facial expressions in comparison with

  3. Anorexia Nervosa and Autism Spectrum Disorders: Guided Investigation of Social Cognitive Endophenotypes

    Science.gov (United States)

    Zucker, Nancy L.; Losh, Molly; Bulik, Cynthia M.; LaBar, Kevin S.; Piven, Joseph; Pelphrey, Kevin A.

    2007-01-01

    Death by suicide occurs in a disproportionate percentage of individuals with anorexia nervosa (AN), with a standardized mortality ratio indicating a 57-fold greater risk of death from suicide relative to an age-matched cohort. Longitudinal studies indicate impaired social functioning increases risk for fatal outcomes, while social impairment…

  4. The Paradox of Virtue: (Re)Thinking Deviance, Anorexia and Schooling

    Science.gov (United States)

    Halse, Christine; Honey, Anne; Boughtwood, Desiree

    2007-01-01

    In this paper we posit a radical retheorization of anorexia as a form of deviance. We examine how the disciplinary practices and moral technologies typical of contemporary secondary schooling signify and enter into the articulation of three "virtue discourses" (discipline, achievement and healthism), and tease out how these "virtue discourses"…

  5. Family lunch session: an introduction to family therapy in anorexia nervosa.

    Science.gov (United States)

    Rosman, B L; Minuchin, S; Liebman, R

    1975-10-01

    Family lunch sessions have proved a useful diagnostic and therapeutic technique in the treatment of anorexia nervosa. This paper describes the goals of these sessions and the strategies employed in the restructuring of family relationships. Data are presented illustrating changes in eating behavior of eight identified patients.

  6. Childhood Risk Factors for Lifetime Anorexia Nervosa by Age 30 Years in a National Birth Cohort

    Science.gov (United States)

    Nicholls, Dasha E.; Viner, Russell M.

    2009-01-01

    Whether previously identified childhood risk factors for anorexia nervosa (AN) predict self-reported lifetime AN by age 30 is examined. The cohort confirmed four risk and two protective factors out of the 22 suggested risk factors. The study used data from the 1970 British Cohort Study.

  7. [Pregnancy in anorexia nervosa--an oxymoron that has become reality].

    Science.gov (United States)

    Wohl, Michal Lotan; Gur, Eitan

    2015-07-01

    In the last decade there has been a significant increase in the incidence of pregnancy in patients suffering from anorexia nervosa. This change is partly explained by the social processes that constitute a significant factor in the etiology of the disease. Yearning for thinness as representing the values of control and success has become a major cultural desire and this swept into a vortex of the disease many sexually active women at childbearing age, which was rare in anorexic patients in the past. Additionally, because amenorrhea is a common condition in anorexia nervosa, pregnancy during active disease seems to be an impossible oxymoron. While some patients succeed in conceiving spontaneously, fertility clinics provide an alternative solution for those who have difficulties conceiving. It seems that fertility professionals have little knowledge about anorexia nervosa and even when they diagnose it, the dilemma as to whether to refuse to treat these patients is not easy to solve. Pregnancy in anorectic patients during active disease puts the fetus at increased risk for complications during pregnancy and labor. Common complications are spontaneous abortion and growth retardation. One must take into consideration that underweight pregnant women require a professional eating disorders assessment and, if indeed it turns out that anorexia nervosa is active, it is necessary to refer her to an eating disorders clinic for treatment and to define the pregnancy as a pregnancy at-risk.

  8. Eating Disorders. What Parents Need to Know About Anorexia and Bulimia.

    Science.gov (United States)

    Our Children, 1998

    1998-01-01

    Examines facts about eating disorders, which typically affect females in their teens, discussing the causes of anorexia and bulimia, describing their effects on the body, and explaining available treatment. Though eating disorders are very serious and potentially fatal, they are treatable. Treatment includes physician evaluation, possible…

  9. Anorexia and Bulimia: An Inventory of Public Awareness and Popular Questions.

    Science.gov (United States)

    Zimmer, Marc A.

    Prevention and early intervention in cases of anorexia and bulimia require that both professionals and the general public have knowledge about these eating disorders. A study was conducted to identify the questions about these disorders most often asked by the general public and to develop a guide to answer those questions for individuals of…

  10. How Schools Can Help Combat Student Eating Disorders. Anorexia Nervosa and Bulimia.

    Science.gov (United States)

    Levine, Michael P.

    This book presents a comprehensive review of anorexia nervosa and bulimia and the roles that schools can have in preventing, identifying, and treating these disorders. Chapter 1 provides an overview of student eating disorders and presents a case study of a high school student with an eating disorder. Chapter 2 discusses the nature of anorexia…

  11. Anorexia nervosa in a girl of Chinese origin: psychological, somatic and transcultural factors.

    Science.gov (United States)

    Demarque, Mélissa; Guzman, Gabriela; Morrison, Elodie; Ahovi, Jonathan; Moro, Marie Rose; Blanchet-Collet, Corinne

    2015-04-01

    The increased prevalence of anorexia nervosa reported in non-Western societies inevitably raises the issue of the influence of cultural factors in the genesis and the patterns of this disorder. Anorexia nervosa is not a straightforward Western culture-bound syndrome, although an influence of Western ideals of thinness does exist. The illness seems more related to rapid cultural shifts, either societal or individual, such as those occurring in the migratory process. Migrants and their children have to face the acculturation process and may experience a culture-clash. The pathology can also fulfil a positive acculturative function. This is a case study concerning a second-generation Chinese girl born in France presenting with anorexia nervosa. This case leads us to raise the issue of the choice of diagnostic criteria in relation to cultural background. We will also discuss the impact of the family's migratory history on the construction of identity in adolescence. Finally we will explore the specific features of care provision for anorexia nervosa in a transcultural setting.

  12. Association study in eating disorders : TPH2 associates with anorexia nervosa and self-induced vomiting

    NARCIS (Netherlands)

    't Landt, M. C. T. Slof-Op; Meulenbelt, I.; Bartels, M.; Suchiman, E.; Middeldorp, C. M.; Houwing-Duistermaat, J. J.; van Trier, J.; Onkenhout, E. J.; Vink, J. M.; van Beijsterveldt, C. E. M.; Brandys, M. K.; Sanders, N.; Zipfel, S.; Herpertz-Dahlmann, B.; Klampfl, K.; Fleischhaker, C.; Zeeck, A.; de Zwaan, M.; Herpertz, S.; Ehrlich, S.; van Elburg, A. A.; Adan, R. A. H.; Scherag, S.; Hinney, A.; Hebebrand, J.; Boomsma, D. I.; van Furth, E. F.; Slagboom, P. E.; Herzog, W.

    2011-01-01

    Twin studies suggest that genetic factors play a substantial role in anorexia nervosa (AN) and self-induced vomiting (SV), a key symptom that is shared among different types of eating disorders (EDs). We investigated the association of 25 single nucleotide polymorphisms (SNPs), capturing 71-91% of t

  13. The Importance of Emotional Insight in Cognitive Behaviour Therapy for Anorexia Nervosa: An Adolescent Case Study

    Science.gov (United States)

    Rupa, Megha; Girimaji, Satish; Muthuswamy, Selvi; Jacob, Preeti; Ravi, Malavika

    2013-01-01

    Anorexia nervosa is a rare but sever psychiatric disorder in adolescence, with chronicity and death being the most feared consequence. Emotional Insight into one's problem is considered a key determinant of success in therapy. The following case study of a 14-year-old client, describes the process of therapy as it unfolded across 45 sessions. An…

  14. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders

    NARCIS (Netherlands)

    Hoek, Hans Wijbrand

    2006-01-01

    Purpose of review The purpose of this review is to evaluate the recent literature on the incidence and prevalence of and mortality associated with eating disorders. Recent findings General-practice studies shove that the overall incidence rates of anorexia nervosa remained stable during the 1990s, c

  15. Comorbid Depression and Anxiety in Childhood and Adolescent Anorexia Nervosa: Prevalence and Implications for Outcome

    Science.gov (United States)

    Hughes, Elizabeth K.

    2012-01-01

    Background: Comorbid conditions are common in individuals with anorexia nervosa (AN) and can raise issues for diagnosis, prognosis, and treatment planning. Methods: First, reported prevalence rates for depression and anxiety in children and adolescents with AN were reviewed. Diagnostic issues and current understanding of the temporal onset and…

  16. Reflections on involuntary treatment in the prevention of fatal anorexia nervosa: A review of five cases

    DEFF Research Database (Denmark)

    Holm, Janni Schmidt; Brixen, Kim; Andries, Alin

    2011-01-01

    OBJECTIVE: Involuntary treatment in the prevention of fatal anorexia nervosa (AN) is still controversial. METHOD: Five fatal cases of AN were identified out of 1,160 patients who attended a specialized eating disorder unit between 1994 and 2006. Information on inpatient, ambulatory, and emergency...

  17. Theory of Mind and the Brain in Anorexia Nervosa: Relation to Treatment Outcome

    Science.gov (United States)

    Schulte-Ruther, Martin; Mainz, Verena; Fink, Gereon R.; Herpertz-Dahlmann, Beate; Konrad, Kerstin

    2012-01-01

    Objective: Converging evidence suggests deficits in theory-of-mind (ToM) processing in patients with anorexia nervosa (AN). The present study aimed at elucidating the neural mechanisms underlying ToM-deficits in AN. Method: A total of 19 adolescent patients with AN and 21 age-matched controls were investigated using functional magnetic resonance…

  18. Reversible brain atrophy and subcortical high signal on MRI in a patient with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Drevelengas, A. [Asklipios-Aristotelio Diagnostic Centre, Thessaloniki (Greece); Dept. of Radiology, AHEPA University Hospital, Thessaloniki (Greece); Chourmouzi, D.; Boulogianni, G. [Asklipios-Aristotelio Diagnostic Centre, Thessaloniki (Greece); Pitsavas, G. [Paediatric Clinic, AHEPA University Hospital, Thessaloniki (Greece); Charitandi, A. [Dept. of Radiology, AHEPA University Hospital, Thessaloniki (Greece)

    2001-10-01

    Anorexia nervosa (AN), usually seen in young girls, is characterised by severe emaciation induced by self-imposed starvation. Enlargement of the ventricular system and sulci has been reported, as has high signal on T2-weighted images. We present a case with atrophic changes and high signal on T2-weighted images, which resolved completely following weight gain. (orig.)

  19. Anticipation of Body-Scaled Action Is Modified in Anorexia Nervosa

    Science.gov (United States)

    Guardia, Dewi; Lafargue, Gilles; Thomas, Pierre; Dodin, Vincent; Cottencin, Olivier; Luyat, Marion

    2010-01-01

    Patients with anorexia nervosa frequently believe they are larger than they really are. The precise nature of this bias is not known: is it a false belief related to the patient's aesthetic and emotional attitudes towards her body? Or could it also reflect abnormal processing of the representation of the body in action? We tested this latter…

  20. Incidence of severe anorexia nervosa in Switzerland : 40 years of development (vol 35, pg 250, 2004)

    NARCIS (Netherlands)

    Milos, G; Spindler, A; Schnyder, U; Martz, J; Hoek, HW; Willi, J

    2004-01-01

    Objective: The current study examined the development of the incidence of severe anorexia nervosa with five sampling periods covering the years 1956-1995 in a geographically defined region of Switzerland. Method: Applying the same methodology as in the earlier sampling periods, the medical records o