WorldWideScience

Sample records for anorexia nervosa

  1. Anorexia nervosa

    OpenAIRE

    Lock, James; Fitzpatrick, Kathleen Kara

    2009-01-01

    Anorexia nervosa is characterised by a low BMI, fear of gaining weight, denial of current low weight and its impact on health, and amenorrhoea. Estimated prevalence is highest in teenage girls, and may affect up to 0.7% of this group.Anorexia nervosa is related to family, sociocultural, genetic, and other biological factors. Psychiatric and personality disorders such as depression, anxiety disorders, obsessive compulsive disorder, and perfectionism, are commonly found in people who have an...

  2. Anorexia nervosa

    OpenAIRE

    Fitzpatrick, Kathleen Kara; Lock, James

    2011-01-01

    Anorexia nervosa is characterised by a low body mass index (BMI), fear of gaining weight, denial of current low weight and its impact on health, and amenorrhoea. Estimated prevalence is highest in teenage girls, and the condition may affect up to 0.7% of this group.Anorexia nervosa is related to family, sociocultural, genetic, and other biological factors. Psychiatric and personality disorders such as depression, anxiety disorders, obsessive compulsive disorder, and perfectionism are commo...

  3. Anorexia Nervosa.

    Science.gov (United States)

    Westerlage, Patricia A.

    The author traces the case histories of five anorexic female patients treated in the therapeutic milieu in a psychiatric inpatient unit. The history of anorexia nervosa is reviewed, incidence of the disorder is cited, and common characteristics are described. Case histories are presented in terms of events precipitating the weight loss, behavior…

  4. Anorexia nervosa.

    Science.gov (United States)

    Treasure, Janet; Zipfel, Stephan; Micali, Nadia; Wade, Tracey; Stice, Eric; Claudino, Angélica; Schmidt, Ulrike; Frank, Guido K; Bulik, Cynthia M; Wentz, Elisabet

    2015-01-01

    Anorexia nervosa (AN) is a psychiatric condition characterized by severe weight loss and secondary problems associated with malnutrition. AN predominantly develops in adolescence in the peripubertal period. Without early effective treatment, the course is protracted with physical, psychological and social morbidity and high mortality. Despite these effects, patients are noted to value the beliefs and behaviours that contribute to their illness rather than regarding them as problematic, which interferes with screening, prevention and early intervention. Involving the family to support interventions early in the course of the illness can produce sustained changes; however, those with a severe and/or protracted illness might require inpatient nursing support and/or outpatient psychotherapy. Prevention programmes aim to moderate the overvaluation of 'thinness' and body dissatisfaction as one of the proximal risk factors. The low prevalence of AN limits the ability to identify risk factors and to study the timing and sex distribution of the condition. However, genetic profiles, premorbid features, and brain structures and functions of patients with AN show similarities with other psychiatric disorders and contrast with obesity and metabolic disorders. Such studies are informing approaches to address the neuroadaptation to starvation and the other various physical and psychosocial deficits associated with AN. This Primer describes the epidemiology, diagnosis, screening and prevention, aetiology, treatment and quality of life of patients with AN. PMID:27189821

  5. Anorexia Nervosa

    Science.gov (United States)

    ... hard to adapt to a new culture (a theory called "culture clash"). The stress of trying to ... job), can lead to the onset of anorexia. Personality traits. Someone with anorexia may not like her ...

  6. Osteoporosis in anorexia nervosa.

    Science.gov (United States)

    Mehler, Philip S; Cleary, Barbara S; Gaudiani, Jennifer L

    2011-01-01

    Osteoporosis is common in anorexia nervosa. It places these patients at increased lifetime risk for fractures. Bone loss may never recover completely even once weight is restored. The strongest predictors of osteoporosis include low body weight and amenorrhea. Loss of bone density can occur rapidly and very early in the course of anorexia nervosa. The etiology of bone loss in the patient with anorexia nervosa is multifactorial. In addition to reduced estrogen and progesterone, excess cortisol levels and low levels of insulin growth factor (IGF-1), a correlate for bone formation, are observed. Dual energy x-ray absorptiometry screening is important to assess bone density. However, successful treatments to reverse bone loss, in those with anorexia nervosa, are lacking. Early diagnosis and treatment of anorexia nervosa are paramount to prevent initial weight loss and subsequent loss of bone. PMID:21360368

  7. Anorexia nervosa and bulimia nervosa.

    OpenAIRE

    Goldbloom, D S; Kennedy, S H; Kaplan, A S; Woodside, D. B.

    1989-01-01

    No definitive therapy exists for anorexia nervosa (AN) or bulimia nervosa (BN). Nevertheless, biologic and psychologic research into these disorders has increased over the last decade. We examine the various drugs available for treatment. Advances in pharmacotherapy for AN have been modest and have reflected efforts either to stimulate hunger and weight gain or to control complications of the starvation process. Food remains the "drug" of choice. Antidepressants have been found to be benefici...

  8. 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. PMID:27166107

  9. 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

  10. 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…

  11. 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...

  12. Endocrinological changes in anorexia nervosa

    OpenAIRE

    Selma Bozkurt Zincir; Bilge Burcak Annagur

    2011-01-01

    Anorexia nervosa is an eating disorder that begins between the ages of 12 to18 and characterized by conscious trials of being excessively thin because of weight gain fears. Anorexia nervosa is mostly seen in girls and lifetime prevalence among young women is approximately 0.3%. It is suggested that endocrinological changes seen in anorexia nervosa are not due to primary endocrinological disorders and that they are usually common consequences of long duration fasting and excessive weight loss....

  13. Anorexia nervosa medical issues.

    Science.gov (United States)

    Mehler, Philip S; Krantz, Mori

    2003-05-01

    Anorexia nervosa is an increasingly common chronic psychiatric disorder with a multitude of medical complications. Most of these complications are reversible if there is timely restoration of body weight. A few of them, particularly osteoporosis, refeeding complications, and cardiac arrhythmia, are potentially much more serious. In the end, a multidisciplinary team approach with input from a primary care provider who is familiar with these medical sequelae, together with psychiatric and dietary expertise, can effectuate a successful outcome. PMID:12804340

  14. Anorexia Nervosa and Bone

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors...

  15. Anorexia nervosa en adolescenten

    OpenAIRE

    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 performed by experts. RESULTS: Youngsters with AN run considerable physical risks because their bodies are less well developed and are more easily injured. These injuries can be a lifelong handicap ...

  16. Neurobiologie der Anorexia Nervosa

    OpenAIRE

    Ehrlich, Stefan

    2011-01-01

    According to the biopsychosocial model of Anorexia Nervosa (AN), neurobiological factors contribute to the vulnerability towards eating disorders and also seem to play a role after the onset of the disorder (Treasure and Campbell, 1994). In this work, I will focus on three important aspects in the neurobiology of AN: (1) In the state of undernutrition, many patients with AN show signs of cortical brain atrophy and an abnormal cerebral metabolism. These changes co-occur with a marked redu...

  17. Early onset anorexia nervosa.

    OpenAIRE

    Fosson, A; Knibbs, J; Bryant-Waugh, R; Lask, B

    1987-01-01

    This paper describes 48 children, aged 14 years or less, who met diagnostic criteria for anorexia nervosa modified from Morgan and Russell. The characteristics of the sample (13 boys and 35 girls) are described along with features of the illness, associated family characteristics, treatment in hospital, and a brief description of treatment. Difficulties in diagnosis are addressed, with reference in particular to the high incidence of depression in this group. Finally, the importance and diffi...

  18. Acrocyanosis in anorexia nervosa.

    OpenAIRE

    Bhanji, S; Mattingly, D

    1991-01-01

    Acrocyanosis, an uncommon disorder of the peripheral circulation, may occur in patients with anorexia nervosa. It is not known why this should be, nor whether acrocyanosis correlates with any other features of the disorder. The findings in an unselected series of 155 anorectics are reported. Acrocyanosis occurred in 32 and was more prevalent among the more severely ill. It was associated also with pallor of the face and trunk, slower pulse rates and higher fasting plasma glucose levels. Acroc...

  19. Severe hypophosphataemia in anorexia nervosa.

    OpenAIRE

    Cariem, A. K.; Lemmer, E. R.; Adams, M. G.; Winter, T. A.; O'Keefe, S J

    1994-01-01

    In addition to well-described acid-base and electrolyte disturbances, anorexia nervosa may be complicated by severe hypophosphataemia. We report a case of anorexia nervosa complicated by life-threatening hypophosphataemia manifesting as generalized muscle weakness and bulbar muscle dysfunction, resulting in an aspiration pneumonia and cardiorespiratory arrest.

  20. Anorexia nervosa and necrotizing colitis.

    OpenAIRE

    Kaye, J. C.; Madden, M V; Leaper, D J

    1985-01-01

    Anorexia nervosa is associated with a mortality approaching 5% in patients severely enough affected to warrant hospital care (Hsu, 1980). The main causes of death are inanition, electrolyte disturbances or suicide. We report here a case of necrotizing colitis associated with anorexia nervosa, an association which has not been described previously.

  1. 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. PMID:26608248

  2. [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. PMID:3061914

  3. 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...

  4. Lengdevekst ved anorexia nervosa

    OpenAIRE

    Mortensen, Synnøve Gjelsten

    2012-01-01

    Bakgrunn:Normal pubertetsutvikling krever god ernæringsstatus og normale hormonelle forhold. Ved anorexia nervosa (AN) sees en rekke endokrine adaptasjonsresponser sekundært til sult, bl.a. hypogonadotrop hypogonadisme og en karakteristisk, høy GH-sekresjon med perifer GH-resistans og medfølgende lav produksjon av IGF-1 i lever og annet vev. Det er observert at mange som behandles for AN er små for alderen og forblir lave etter tilfriskning. Dette kan skyldes at den dysfunksjonelle regulering...

  5. 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…

  6. Anorexia nervosa and the kidney.

    Science.gov (United States)

    Bouquegneau, Antoine; Dubois, Bernard E; Krzesinski, Jean-Marie; Delanaye, Pierre

    2012-08-01

    Anorexia nervosa is a common psychiatric disorder that disproportionately affects adolescents and young adults and is associated with high rates of morbidity and mortality. Anorexia nervosa can affect the kidney in numerous ways, including increased rates of acute kidney injury and chronic kidney disease, electrolyte abnormalities, and nephrolithiasis. Additionally, the diagnosis and treatment of anorexia nervosa-associated kidney diseases are challenging, reflecting complications such as refeeding syndrome, as well as the limitations of serum creatinine level in this population to estimate kidney function and the psychosocial challenges inherent with treating systemic manifestations of psychiatric conditions. In this review, we discuss kidney diseases and kidney-associated conditions that occur in individuals with anorexia nervosa, summarizing many of the challenges in treating patients with this disease. PMID:22609034

  7. Acrodermatitis enteropathica with anorexia nervosa.

    Science.gov (United States)

    Kim, Sang Tae; Kang, Jin Seuk; Baek, Jae Woo; Kim, Tae Kwon; Lee, Jin Woo; Jeon, Young Seung; Suh, Kee Suck

    2010-08-01

    Acrodermatitis enteropathica is a rare hereditary or acquired disorder of hypozincemia. It is characterized by acral and periorificial dermatitis, alopecia, diarrhea and growth retardation. Anorexia nervosa is characterized by low body weight, body image distortion with an obsessive fear and is also associated with various cutaneous findings including acrodermatitis enteropathica. We report a 37-year-old female with acrodermatitis enteropathica showing acquired zinc deficiency with anorexia nervosa. PMID:20649716

  8. Neurobiologische Faktoren bei Anorexia nervosa

    OpenAIRE

    Schott, Regina

    2013-01-01

    Central serotonergic pathways may play an important role in the aetiology of anorexia nervosa (AN). This thesis aimed to investigate the serotonergic system in acute patients with anorexia nervosa (acAN), weight-recovered patients (recAN) and healthy controls (HCW). Platelets served as a validated model for peripheral serotonergic neurons. We investigated functional characteristics of the platelet 5-HT transporter, platelet 5-HT content, MAO-B activity and the relationship between MAO-B activ...

  9. Chronic Anorexia Nervosa: Medical Mimic

    OpenAIRE

    Borson, Soo; Katon, Wayne

    1981-01-01

    While anorexia nervosa is typically construed as an acute, dramatic disorder of younger women, long-term follow-up studies indicate that morbidity is chronic or relapsing in 30 percent to 50 percent of cases and sometimes leads to death. In older patients or those with atypical clinical features or obscure complications, chronic starvation may mimic other diseases, and rigid adherence to current diagnostic criteria may impede recognition and appropriate treatment. Anorexia nervosa should be v...

  10. Executive functions in anorexia nervosa

    OpenAIRE

    Ignacio Jauregui-Lobera

    2014-01-01

    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. Met...

  11. Reproductive issues in anorexia nervosa

    OpenAIRE

    Hoffman, Elizabeth R.; Zerwas, Stephanie C; Bulik, Cynthia M.

    2011-01-01

    Despite a high prevalence of menstrual irregularities, women with anorexia nervosa are becoming pregnant. The physical and psychological demands of pregnancy and motherhood can represent an immense challenge for women already struggling with the medical and psychological stress of an eating disorder. This article summarizes key issues related to reproduction in women with anorexia nervosa, highlighting the importance of preconception counseling, adequate gestational weight gain, and sufficien...

  12. 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. PMID:26169883

  13. Bone health in anorexia nervosa

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2013-01-01

    Purpose of review Anorexia nervosa is associated with low bone mineral density (BMD), concerning for an increased risk of fractures, and decreased bone accrual in adolescents, concerning for suboptimal peak bone mass. This review discusses causes of impaired bone health in anorexia nervosa and potential therapeutic strategies. Recent findings Low BMD in anorexia nervosa is consequent to decreased lean mass, hypogonadism, low insulin-like growth factor-1 (IGF-1), relative hypercortisolemia and alterations in hormones impacted by energy availability. Weight gain causes some improvement in bone accrual, but not to the extent observed in controls, and vitamin D supplementation does not increase BMD. Oral estrogen is not effective in increasing BMD, likely from IGF-1 suppressive effects. In contrast, transdermal estrogen replacement is effective in increasing bone accrual in adolescents with anorexia nervosa, although not to the extent seen in controls. Recombinant human IGF-1 increases bone formation in adolescents, and with oral estrogen increases BMD in adults with anorexia nervosa. Bisphosphonates increase BMD in adults, but not in adolescents, and should be used cautiously given their long half-life. Summary Further investigation is necessary to explore therapies for low BMD in anorexia nervosa. Weight gain is to be encouraged. Transdermal estrogen in adolescents, and bisphosphonates in adults, have a potential therapeutic role. PMID:21897220

  14. 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…

  15. Homeostasis in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    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.

  16. Anorexia nervosa presenting as reversible hypoglycaemic coma.

    OpenAIRE

    Zalin, A. M.; Lant, A F

    1984-01-01

    Hypoglycaemic coma was the presenting feature in two patients with anorexia nervosa, both of whom rapidly regained consciousness following intravenous administration of glucose. This uncommon complication of malnutrition does not appear to have been reported previously in anorexia nervosa.

  17. Anorexia Nervosa or Not? A Case Presentation

    OpenAIRE

    Swanson, Richard W.; Haight, Kenneth R.

    1989-01-01

    The authors of this article present a case of diabetic gastroparesis, initially diagnosed as anorexia nervosa. They compare the symptoms and signs of diabetic gastroparesis with the diagnostic criteria for anorexia nervosa and discuss treatment with domperidone.

  18. Spontaneous pneumomediastinum: a complication of anorexia nervosa?

    OpenAIRE

    Fergusson, R J; Shaw, T R; Turnbull, C M

    1985-01-01

    We describe a patient with anorexia nervosa who developed a spontaneous pneumomediastinum. Five other patients have been reported with this association, suggesting that tissue changes in anorexia nervosa may predispose to this condition.

  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. Anorexia nervosa and bone.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-06-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure, and reduced bone strength, all of which contribute to increased fracture risk. Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising additional concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, and hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiological estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age, given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  1. Anorexia Nervosa and Bone

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiologic estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  2. Anorexia nervosa e retardo mental

    OpenAIRE

    Adriana Trejger Kachani; Táki Athanássios Cordás

    2011-01-01

    OBJETIVO: Revisar a literatura pertinente, observando a prevalência, etiopatogenia, aspectos nutricionais, diagnóstico e tratamento da anorexia nervosa (AN) em pacientes com retardo mental (RM). MÉTODO: Revisão bibliográfica realizada nos sistemas Medline, SciELO e PubMed usando os descritores "transtornos alimentares", "anorexia nervosa" e "retardo mental". RESULTADOS: A AN pode se manifestar de formas atípicas em indivíduos com RM, exigindo critérios diagnósticos específicos. O mais utiliza...

  3. [Menstrual dysfunction in anorexia nervosa].

    Science.gov (United States)

    Jagielska, Gabriela; Wolańczyk, Tomasz; Osuch, Beata

    2010-01-01

    One of the symptoms of anorexia nervosa (a.n.) is cessation of pubescence or secondary amenorrhea. Their origin in anorexia nervosa is multifactorial, partly resulting from starvation-induced hipogonadism. Amenorrhea in a.n. may persist despite weight recovery and is often related to osteoporosis. The authors' present causes of amenorrhea and its persisting in a.n., pointing to the factors influencing prognosis according to resumption of menses. They also review reports of hormonal replacement therapy in this group of patients. PMID:20677446

  4. Adolescent Boys and Anorexia Nervosa.

    Science.gov (United States)

    Romeo, Felicia

    1994-01-01

    Notes that there has been steady increase in reported incidence of male adolescents with anorexia nervosa, from approximately 5% in 1985 to as much as 10% in 1987. Considers role of educators and counselors in early identification of this disorder, noting that young anorectic males have better prognosis for recovery if they receive treatment in…

  5. Hypoglycaemia associated with anorexia nervosa.

    OpenAIRE

    Fonseca, V; Ball, S; Marks, V; Havard, C W

    1991-01-01

    A 41 year old woman with severe emaciation due to longstanding anorexia nervosa presented with recurrent hypoglycaemia. During an episode of hypoglycaemia, serum insulin and C peptide were undetectable and plasma beta hydroxybutyrate, free fatty acids and lactate were inappropriately low. Response to intravenous glucagon was poor. Muscle enzymes were grossly elevated until she gained weight. Hypoglycaemia was abolished by weight gain.

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

    Science.gov (United States)

    ... Osteoporosis Osteoporosis and Other Conditions What People With Anorexia Nervosa Need to Know About Osteoporosis Publication available ... focus(); */ } //--> Print-Friendly Page April 2016 What Is Anorexia Nervosa? Anorexia nervosa is an eating disorder characterized ...

  7. 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. PMID:25874112

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

    OpenAIRE

    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.

  9. Treating Anorexia Nervosa in the Couple Context

    OpenAIRE

    Bulik, Cynthia M.; BAUCOM, DONALD H.; Kirby, Jennifer S.

    2012-01-01

    Anorexia nervosa is a serious mental illness that affects women and men of all ages. Despite the gravity of its chronic morbidity, risk of premature death, and societal burden, the evidence base for its treatment—especially in adults—is weak. Guided by the finding that family-based interventions confer benefit in the treatment of anorexia nervosa in adolescents, we developed a cognitive-behavioral couple-based intervention for adults with anorexia nervosa who are in committed relationships th...

  10. The issues of anorexia nervosa in childhood

    OpenAIRE

    ROUBÍKOVÁ, Alice

    2013-01-01

    Anorexia Nervosa is being described as an extreme starving. According to the International Statistical Classification of Diseases and Related Health Problems, it is a disease caused by an intentional weight loss, when the patient avoids most of the meals and uses other ways to lose his weight, for example induced vomiting, using laxatives, diuretics, excessive physical activity. Anorexia Nervosa means not only a physical illness, mostly a psychological disease. Anorexia Nervosa starts usually...

  11. Does Anorexia Nervosa Resemble an Addiction?

    OpenAIRE

    Barbarich-Marsteller, Nicole C.; Foltin, Richard W.; Walsh, B. Timothy

    2011-01-01

    Anorexia nervosa is a severe psychiatric disorder characterized by unrelenting self-starvation and life-threatening weight loss. The relentlessness with which individuals with anorexia nervosa pursue starvation and in some cases exercise despite the negative physical, emotional, and social consequences parallels features of addictive disorders. From a clinical perspective, individuals with anorexia nervosa behave similarly to individuals with substance abuse by narrowing their behavioral repe...

  12. Compliance and outcome in anorexia nervosa.

    OpenAIRE

    Steiner, H.; Mazer, C.; Litt, I. F.

    1990-01-01

    Anorexia nervosa is notoriously difficult to treat, but little is known regarding the relationship of compliance to treatment outcome. We investigated in 41 adolescents who fulfilled DSM-III-R criteria for anorexia nervosa, the relationship between the completion of a standard psychosocial treatment program, subtypes of anorexia nervosa, and outcome as determined by standardized measurements. These adolescents were observed for an average of 32.4 months. Overall, 29 patients (70%) improved co...

  13. Anorexia Nervosa, Obesity and Bone Metabolism

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2013-01-01

    Anorexia nervosa and obesity are conditions at the extreme ends of the nutritional spectrum, associated with marked reductions versus increases respectively in body fat content. Both conditions are also associated with an increased risk for fractures. In anorexia nervosa, body composition and hormones secreted or regulated by body fat content are important determinants of low bone density, impaired bone structure and reduced bone strength. In addition, anorexia nervosa is characterized by inc...

  14. Endocrine Consequences of Anorexia Nervosa

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is prevalent in adolescents and young adults, and endocrine changes include hypothalamic amenorrhea, a nutritionally acquired growth hormone resistance with low insulin like growth factor-1 (IGF-1), relative hypercortisolemia, decreases in leptin, insulin, amylin and incretins, and increases in ghrelin, PYY and adiponectin. These changes in turn have deleterious effects on bone, and may affect neurocognition, anxiety, depression and eating disorder psychopathology. Low b...

  15. Anorexia nervosa and bone metabolism

    OpenAIRE

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a psychiatric disorder characterized by self-induced starvation with a lifetime prevalence of 2.2% in women. The most common medical co-morbidity in women with AN is bone loss, with over 85% of women having bone mineral density values more than one standard deviation below an age comparable mean. The low bone mass in AN is due to multiple hormonal adaptations to under nutrition, including hypothalamic amenorrhea and growth hormone resistance. Importa...

  16. Anorexia nervosa and pancreatic ascites.

    OpenAIRE

    Isaacs, P.; Saunders, A J; Rosen, B. K.; Sladen, G E

    1986-01-01

    Acute alcoholic pancreatitis was undiagnosed in a patient with anorexia nervosa who subsequently developed pancreatic ascites and oedema, wrongly attributed to protein malnutrition alone. She became hyperphagic in an attempt to reverse the malnutrition and hence the abdominal swelling, indicating that the goal of attaining a thin shape was the major determinant of the eating disorder in this patient. Measurement of ascitic fluid amylase concentration should be carried out in all patients with...

  17. Anorexia nervosa – medical complications

    OpenAIRE

    Mehler, Philip S; Brown, Carrie

    2015-01-01

    In contrast to other mental health disorders, eating disorders have a high prevalence of concomitant medical complications. Specifically, patients suffering from anorexia nervosa (AN) have a litany of medical complications which are commonly present as part of their eating disorders. Almost every body system can be adversely, affected by this state of progressive malnutrition. Moreover, some of the complications can have permanent adverse effects even after there is a successful program of nu...

  18. Psychosomatic syndromes and anorexia nervosa

    OpenAIRE

    Abbate-Daga Giovanni; Delsedime Nadia; Nicotra Barbara; Giovannone Cristina; Marzola Enrica; Amianto Federico; Fassino Secondo

    2013-01-01

    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 inp...

  19. Bone Metabolism in Anorexia Nervosa

    OpenAIRE

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN), a psychiatric disorder predominantly affecting young women, is characterized by self-imposed chronic nutritional deprivation and distorted body image. AN is associated with a number of medical co-morbidities including low bone mass. The low bone mass in AN is due to an uncoupling of bone formation and bone resorption, which is the result of hormonal adaptations aimed at decreasing energy expenditure during periods of low energy intake. Importantly, the low bone mass in ...

  20. Anorexia nervosa und Down Syndrom

    OpenAIRE

    Räder, Klaus; Specht, Friedrich; Reister, Monika

    1989-01-01

    Es wird über eine 24jährige Patientin mit einer Anorexia nervosa (AN) und einem Down-Syndrom (DS) berichtet. Nach Sichtung bisheriger Fallberichte zum gemeinsamen Auftreten beider Krankheiten wird versucht, einen weiteren Beitrag zur kontrovers diskutierten Frage zu leisten, ob bei geistig Retardierten eine primäre Anorexie auftreten kann, oder ob es sich vielmehr um anorektische Reaktionen bei anderweitigen Störungen z.B. im Rahmen depressiver Verstimmung handelt.

  1. QT interval in anorexia nervosa.

    OpenAIRE

    Cooke, R. A.; Chambers, J. B.; Singh, R.; Todd, G J; Smeeton, N C; Treasure, J; Treasure, T.

    1994-01-01

    OBJECTIVES--To determine the incidence of a long QT interval as a marker for sudden death in patients with anorexia nervosa and to assess the effect of refeeding. To define a long QT interval by linear regression analysis and estimation of the upper limit of the confidence interval (95% CI) and to compare this with the commonly used Bazett rate correction formula. DESIGN--Prospective case control study. SETTING--Tertiary referral unit for eating disorders. SUBJECTS--41 consecutive patients wi...

  2. Skin signs in anorexia nervosa

    OpenAIRE

    Strumia, Renata

    2009-01-01

    Anorexia nervosa (AN) is a significant cause of morbidity and mortality among adolescent females and young women. AN is associated with severe medical and psychological consequences, including death, osteoporosis, growth delay, and developmental delay. Skin signs are almost always detectable in severe AN and awareness of them may help in the early diagnosis of hidden AN. Skin signs are the expression of the medical consequences of starvation, vomiting, abuse of drugs, such as laxatives and di...

  3. Endocrine consequences of anorexia nervosa.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-07-01

    Anorexia nervosa is prevalent in adolescents and young adults, and endocrine changes include hypothalamic amenorrhoea; a nutritionally acquired growth-hormone resistance leading to low concentrations of insulin-like growth factor-1 (IGF-1); relative hypercortisolaemia; decreases in leptin, insulin, amylin, and incretins; and increases in ghrelin, peptide YY, and adiponectin. These changes in turn have harmful effects on bone and might affect neurocognition, anxiety, depression, and the psychopathology of anorexia nervosa. Low bone-mineral density (BMD) is particularly concerning, because it is associated with changes in bone microarchitecture, strength, and clinical fractures. Recovery leads to improvements in many--but not all--hormonal changes, and deficits in bone accrual can persist. Oestrogen-replacement therapy, primarily via the transdermal route, increases BMD in adolescents, although catch-up is incomplete. In adults, oral oestrogen--combined with recombinant human IGF-1 in one study and bisphosphonates in another--increased BMD, but not to the normal range. More studies are necessary to investigate the optimum therapeutic approach in patients with, or recovering from, anorexia nervosa. PMID:24731664

  4. Anorexia nervosa with herpes simplex encephalitis

    OpenAIRE

    George, G. C. W.

    1981-01-01

    Studies of patients suffering from anorexia nervosa appear to show an increased immunity to certain infections, as well as immunological deficiencies. This is the report of a patient with anorexia nervosa who developed herpes simplex encephalitis, a condition associated with lowered immunological defence mechanisms.

  5. 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…

  6. 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

  7. 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)

  8. 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…

  9. Measuring Severity and Change in Anorexia Nervosa.

    Science.gov (United States)

    Piazza, Eugene; And Others

    1983-01-01

    Describes the State of Mind (SOM) Questionnaire, which measures severity and change of clinical state in anorexia nervosa. A study of 42 anorexia patients and 4 control groups showed a strong correlation between depression as measured by the Beck Depression Inventory and the Anorexia Scale, which comprise the SOM. (JAC)

  10. Anorexia nervosa and bulimia nervosa: An appraisal.

    Science.gov (United States)

    Sharma, Ajay

    2001-04-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are eating disorders characterized by an aberrant pattern of eating behavior, relentless pursuit of thinness, an intense fear about weight gain and an altered perception of body shape. The pathobiology of eating disorders is complex. Several social, psychological and developmental phenomena are proposed to contribute to the etiology of eating disorders. The role of neuropeptide Y, corticotropin releasing hormone and leptin has also been investigated to understand the pathogenesis of eating disorders. However, most of the neuropeptide alterations noted in eating disorders are secondary to starvation. Several nonpharmacological approaches such as cognitive and behavior-based therapy and interpersonal therapy have been developed to assist weight gain and to modify the behavioral impairment associated with eating disorders. Pharmacotherapy serves as an adjunct in AN, whereas it plays a more significant role in the management of BN. Antidepressants are effective in a limited number of AN patients with comorbid depression. On the other hand, the efficacy of fluoxetine in BN patients in reducing the frequency of binge eating and in the severity of behavioral abnormalities is quite impressive. Several adjunct therapies such as prokinetics and anxiolytics have also been used in AN and BN to assist eating behavior. An insight into genetic and neurochemical abnormalities occurring in eating disorders will help to find better therapeutic agents for these disorders. (c) 2001 Prous Science. All rights reserved. PMID:12768223

  11. Anorexia Nervosa: A Lifestyle Disorder

    OpenAIRE

    Talbot, Yves

    1983-01-01

    Anorexia nervosa is a real lifestyle disorder. The apparent increase in frequency has been linked to the change of position of women in society. If families have an important role to play in the maintenance of the drama, they also hold the key to its resolution. The family physician in early contact with the anorectic patient is in an important position to involve the family in therapy and maximize the chances of recovery. The steps required are reframing, preparing the family involved for fa...

  12. Case Report on Anorexia Nervosa

    OpenAIRE

    Preeti Srinivasa; Chandrashekar, M; Nikitha Harish; Gowda, Mahesh R.; Sumit Durgoji

    2015-01-01

    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 i...

  13. [Anorexia nervosa and the kidney].

    Science.gov (United States)

    Schneiter, Sabine; Berwert, Lorenzo; Bonny, Olivier; Teta, Daniel; Burnier, Michel; Vogt, Bruno

    2009-02-25

    Anorexia nervosa (AN) is a severe and potentially lethal disease of the young woman. It is defined as an anxious disorder not to gain weight, and an obsessive behavior regarding body weight and physical appearance. Different and variable patterns of behaviour are observed. This article focuses on the renal problems observed in anorexic patients. Anorexia is often associated with severe electrolyte disturbances, such as hypokalemia and hypophosphatemia, and alterations of water metabolism with hyponatremia and edema. Hypokalemia and chronic dehydration may contribute to the development of renal failure. Even end stage renal disease can be observed in these patients. A better understanding of the pathophysiology might improve treatment of patients suffering from AN. PMID:19317309

  14. Anorexia nervosa and estrogen receptors.

    Science.gov (United States)

    Ramoz, Nicolas; Versini, Audrey; Gorwood, Philip

    2013-01-01

    Anorexia nervosa (AN) is a chronic psychiatric disorder with a high prevalence of 0.6% and the highest mortality rates among psychiatric diseases, around 10%, mostly due to undernutrition and suicide. AN is characterized by physiological features with a body mass index less than 17.5 kg/m(2), low bone mineral density and amenorrhea, psychological symptoms with a distortion of image body, and behavioral abnormalities. Estrogen molecules and estrogen biological pathway are clearly involved in food intake and body weight in animals and humans. Further, hypoestrogenism has been demonstrated in AN patients and convergent evidence involves the estrogen pathway in the development of AN. AN presents a high heritability and polymorphisms in genes coding the estrogen receptors alpha and beta have been found significantly associated with the disorder. This chapter shows the implication of estrogens in AN and suggests investigation to develop future pharmacological treatments for anorexia. PMID:23601424

  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. 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.

  17. 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.

  18. 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)

  19. Anorexia nervosa: aetiology, assessment, and treatment.

    Science.gov (United States)

    Zipfel, Stephan; Giel, Katrin E; Bulik, Cynthia M; Hay, Phillipa; Schmidt, Ulrike

    2015-12-01

    Anorexia nervosa is an important cause of physical and psychosocial morbidity. Recent years have brought advances in understanding of the underlying psychobiology that contributes to illness onset and maintenance. Genetic factors influence risk, psychosocial and interpersonal factors can trigger onset, and changes in neural networks can sustain the illness. Substantial advances in treatment, particularly for adolescent patients with anorexia nervosa, point to the benefits of specialised family-based interventions. Adults with anorexia nervosa too have a realistic chance of achieving recovery or at least substantial improvement, but no specific approach has shown clear superiority, suggesting a combination of re-nourishment and anorexia nervosa-specific psychotherapy is most effective. To successfully fight this enigmatic illness, we have to enhance understanding of the underlying biological and psychosocial mechanisms, improve strategies for prevention and early intervention, and better target our treatments through improved understanding of specific disease mechanisms. PMID:26514083

  20. Adolescence, Sexual Conflict, and Anorexia Nervosa.

    Science.gov (United States)

    Romeo, Felicia F.

    1984-01-01

    Suggests that the high incidence of anorexia nervosa in adolescent girls may be related to developmental sexual pressure. Symptoms appear with the onset of puberty and are related to physiological and psychological changes. (JAC)

  1. Anorexia nervosa, obesity and bone metabolism.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2013-09-01

    Anorexia nervosa and obesity are conditions at the extreme ends of the nutritional spectrum, associated with marked reductions versus increases respectively in body fat content. Both conditions are also associated with an increased risk for fractures. In anorexia nervosa, body composition and hormones secreted or regulated by body fat content are important determinants of low bone density, impaired bone structure and reduced bone strength. In addition, anorexia nervosa is characterized by increases in marrow adiposity and decreases in cold activated brown adipose tissue, both of which are related to low bone density. In obese individuals, greater visceral adiposity is associated with greater marrow fat, lower bone density and impaired bone structure. In this review, we discuss bone metabolism in anorexia nervosa and obesity in relation to adipose tissue distribution and hormones secreted or regulated by body fat content. PMID:24079076

  2. 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)

  3. 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)

  4. 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)

  5. Anorexia Nervosa, Obesity and Bone Metabolism

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa and obesity are conditions at the extreme ends of the nutritional spectrum, associated with marked reductions versus increases respectively in body fat content. Both conditions are also associated with an increased risk for fractures. In anorexia nervosa, body composition and hormones secreted or regulated by body fat content are important determinants of low bone density, impaired bone structure and reduced bone strength. In addition, anorexia nervosa is characterized by increases in marrow adiposity and decreases in cold activated brown adipose tissue, both of which are related to low bone density. In obese individuals, greater visceral adiposity is associated with greater marrow fat, lower bone density and impaired bone structure. In this review, we discuss bone metabolism in anorexia nervosa and obesity in relation to adipose tissue distribution and hormones secreted or regulated by body fat content. PMID:24079076

  6. 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…

  7. 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....

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

    OpenAIRE

    Hartman, D.

    1995-01-01

    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...

  9. Effectiveness of psychopharmacology in Anorexia Nervosa treatment

    OpenAIRE

    Zadka Lukasz

    2015-01-01

    The eating disorder that generates the highest death rate is that of anorexia nervosa, and current treatment is a combination of equalization of somatic state and patient education. Moreover, psychical symptoms occurring in the course of anorexia nervosa are thought to have a crucial influence on the course of the disease. Hence, in medical literature, the effectiveness of psychotherapeutic interventions is also widely described. Still, the implementation of appropriate psychopharmacology is ...

  10. Anorexia nervosa, seasonality, and polyunsaturated fatty acids.

    Science.gov (United States)

    Scolnick, Barbara; Mostofsky, David I

    2015-09-01

    Anorexia nervosa is a serious neurobehavioral disorder marked by semistarvation, extreme fear of weight gain, frequently hyperactivity, and low body temperature. The etiology remains unknown. We present a speculation that a primary causative factor is that polyunsaturated fatty acids are skewed to prevent oxidative damage in phospholipid membranes. This causes a change in the trade off of oxidation protection vs homeoviscous adaptation to lower temperatures, which sets off a metabolic cascade that leads to the rogue state of anorexia nervosa. PMID:25981875

  11. Ödipale Konstellationen bei Anorexia nervosa

    OpenAIRE

    Deegener, Günther

    1982-01-01

    Es wird davon ausgegangen, daß ödipale Konflikte bei der Therapie von Patienten mit Anorexia nervosa oft nicht genügend beachtet werden. Nach allgemeinen theoretischen Einführungen zum ödipalen Konflikt sowie der psychosexuellen Entwicklung im Rahmen verschiedener Modellvorstellungen werden diese Probleme dann speziell in den Zusammenhang der Psychodynamik und Pathogenese der Anorexia nervosa integriert. Die Darstellungen werden anhand eines Fallbeispiels verdeutlicht.

  12. Bone metabolism in anorexia nervosa.

    Science.gov (United States)

    Fazeli, Pouneh K; Klibanski, Anne

    2014-03-01

    Anorexia nervosa (AN), a psychiatric disorder predominantly affecting young women, is characterized by self-imposed, chronic nutritional deprivation and distorted body image. AN is associated with a number of medical comorbidities including low bone mass. The low bone mass in AN is due to an uncoupling of bone formation and bone resorption, which is the result of hormonal adaptations aimed at decreasing energy expenditure during periods of low energy intake. Importantly, the low bone mass in AN is associated with a significant risk of fractures and therefore treatments to prevent bone loss are critical. In this review, we discuss the hormonal determinants of low bone mass in AN and treatments that have been investigated in this population. PMID:24419863

  13. Bone disease in anorexia nervosa.

    Science.gov (United States)

    Dede, Anastasia D; Lyritis, George P; Tournis, Symeon

    2014-01-01

    Anorexia nervosa is a serious psychiatric disorder accompanied by high morbidity and mortality. It is characterized by emaciation due to self-starvation and displays a unique hormonal profile. Alterations in gonadal axis, growth hormone resistance with low insulin-like growth factor I levels, hypercortisolemia and low triiodothyronine levels are almost universally present and constitute an adaptive response to malnutrition. Bone metabolism is likewise affected resulting in low bone mineral density, reduced bone accrual and increased fracture risk. Skeletal deficits often persist even after recovery from the disease with serious implications for future skeletal health. The pathogenetic mechanisms underlying bone disease are quite complicated and treatment is a particularly challenging task. PMID:24722126

  14. Anorexia nervosa and bone metabolism.

    Science.gov (United States)

    Fazeli, Pouneh K; Klibanski, Anne

    2014-09-01

    Anorexia nervosa (AN) is a psychiatric disorder characterized by self-induced starvation with a lifetime prevalence of 2.2% in women. The most common medical co-morbidity in women with AN is bone loss, with over 85% of women having bone mineral density values more than one standard deviation below an age comparable mean. The low bone mass in AN is due to multiple hormonal adaptations to under nutrition, including hypothalamic amenorrhea and growth hormone resistance. Importantly, this low bone mass is also associated with a seven-fold increased risk of fracture. Therefore, strategies to effectively prevent bone loss and increase bone mass are critical. We will review hormonal adaptations that contribute to bone loss in this population as well as promising new therapies that may increase bone mass and reduce fracture risk in AN. PMID:24882734

  15. 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

  16. 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

  17. Anorexia nervosa and bone metabolism

    Science.gov (United States)

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a psychiatric disorder characterized by self-induced starvation with a lifetime prevalence of 2.2% in women. The most common medical co-morbidity in women with AN is bone loss, with over 85% of women having bone mineral density values more than one standard deviation below an age comparable mean. The low bone mass in AN is due to multiple hormonal adaptations to under nutrition, including hypothalamic amenorrhea and growth hormone resistance. Importantly, this low bone mass is also associated with a seven-fold increased risk of fracture. Therefore, strategies to effectively prevent bone loss and increase low bone mass are critical. We will review hormonal adaptations that contribute to bone loss in this population as well as promising new therapies that may increase bone mass and reduce fracture risk in AN. PMID:24882734

  18. Bone Metabolism in Anorexia Nervosa

    Science.gov (United States)

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN), a psychiatric disorder predominantly affecting young women, is characterized by self-imposed chronic nutritional deprivation and distorted body image. AN is associated with a number of medical co-morbidities including low bone mass. The low bone mass in AN is due to an uncoupling of bone formation and bone resorption, which is the result of hormonal adaptations aimed at decreasing energy expenditure during periods of low energy intake. Importantly, the low bone mass in AN is associated with a significant risk of fractures and therefore treatments to prevent bone loss are critical. In this review, we discuss the hormonal determinants of low bone mass in AN and treatments that have been investigated in this population. PMID:24419863

  19. Anorexia nervosa e retardo mental

    Directory of Open Access Journals (Sweden)

    Adriana Trejger Kachani

    2011-01-01

    Full Text Available OBJETIVO: Revisar a literatura pertinente, observando a prevalência, etiopatogenia, aspectos nutricionais, diagnóstico e tratamento da anorexia nervosa (AN em pacientes com retardo mental (RM. MÉTODO: Revisão bibliográfica realizada nos sistemas Medline, SciELO e PubMed usando os descritores "transtornos alimentares", "anorexia nervosa" e "retardo mental". RESULTADOS: A AN pode se manifestar de formas atípicas em indivíduos com RM, exigindo critérios diagnósticos específicos. O mais utilizado atualmente é o Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation, conhecido por DC-LC. A prevalência é incerta e o tratamento ainda não está estabelecido, apesar de exigir treinamento específico da equipe. A alimentação costuma ser "pobre" e alimentos que engordam normalmente são evitados. Na maioria das vezes, é difícil acessar a complexa psicopatologia da AN nesses pacientes, em virtude das dificuldades de obter o relato de insatisfação e/ou distorção da imagem corporal, baixa autoestima e crenças alimentares. CONCLUSÃO: Muitos fatores indicam a necessidade de maiores estudos de AN no RM, entre eles a falta de critérios diagnósticos próprios validados e diretrizes para tratamento. Paralelamente, o debate da forma de acesso à conceitualização e ao tratamento dos distúrbios da imagem corporal nessa população deve ser intensificado.

  20. Junior MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa).

    Science.gov (United States)

    Marikar, Dilshad; Reynolds, Sarah; Moghraby, Omer S

    2016-06-01

    We present a review of the Junior MARSIPAN (Management of Really Sick Patients with Anorexia Nervosa) guideline, which provides paediatricians with a framework for managing Anorexia Nervosa in the inpatient setting. PMID:26407730

  1. Recovery from adolescent onset anorexia nervosa : a longitudinal study

    OpenAIRE

    Nilsson, Karin

    2007-01-01

    Anorexia Nervosa is a psychiatric illness with peak onset in ages 14-17. Most cases recover within a few years, but the illness can have a fatal outcome or long duration. Multifactor causes of anorexia nervosa include genetics, personality, family, and socio-cultural factors. This study measures mortality, recovery from anorexia nervosa, and psychosocial outcome of patients with adolescent onset anorexia nervosa that were treated in Child and Adolescent Psychiatry in northern Sweden from 1980...

  2. The diet of an individual diagnosed with anorexia nervosa

    OpenAIRE

    SRBOVÁ, Martina

    2015-01-01

    The aim of this Bachelor thesis entitled "A diet of individual with a diagnosis of anorexia nervosa" was to monitor the content and quality of the diet of people with a diagnosis of anorexia nervosa. Anorexia nervosa is a very serious disease belonging to the group of eating disorders. The prevalence of this disease increases, to which primarily affect media and requirements of today's society excessively slender figure, other factors that influence the formation of anorexia nervosa include b...

  3. "Fasting Girls": Reflections on Writing the History of Anorexia Nervosa

    Science.gov (United States)

    Brumberg, Joan Jacobs

    1986-01-01

    Reflects on the history of anorexia nervosa among adolescent ("fasting") girls, suggesting that its psychodynamics have changed over time. Focuses on the social and cultural processes by which anorexia nervosa became a disease. Argues for a conception of anorexia nervosa that incorporates culture as well as biomedical and psychological models.…

  4. [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. PMID:12218886

  5. Dermatologic signs in anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Gupta, M A; Gupta, A K; Haberman, H F

    1987-10-01

    The dermatologic changes in anorexia nervosa and bulimia nervosa may be the first signs to give the clinician a clue that an eating disorder is present, as many of these patients either deny their symptoms or secretly refuse to comply with treatment. The dermatologic signs are a result of (1) starvation or malnutrition, eg, lanugolike body hair, asteatotic skin, brittle hair and nails, and carotenodermia; (2) self-induced vomiting, eg, hand calluses, dental enamel erosion, gingivitis, and a Sjögrenlike syndrome; (3) use of laxatives, diuretics, or emetics and their dermatologic side effects; and (4) other concomitant psychiatric illness, eg, hand dermatitis from compulsive handwashing. Further, as most of the cutaneous signs are not specific to anorexia nervosa and bulimia nervosa, failure to include eating disorders in the differential diagnosis may lead to misdiagnosis of the cutaneous symptoms. PMID:3310913

  6. Skin signs in anorexia nervosa.

    Science.gov (United States)

    Strumia, Renata

    2009-09-01

    Anorexia nervosa (AN) is a significant cause of morbidity and mortality among adolescent females and young women. AN is associated with severe medical and psychological consequences, including death, osteoporosis, growth delay, and developmental delay. Skin signs are almost always detectable in severe AN and awareness of them may help in the early diagnosis of hidden AN. Skin signs are the expression of the medical consequences of starvation, vomiting, abuse of drugs, such as laxatives and diuretics, and of the psychiatric morbidity. They include xerosis, lanugo-like body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrhoeic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, acquired striae distensae, acral coldness.The most characteristic cutaneous sign of vomiting is Russell's sign (knuckle calluses). Symptoms due to laxative or diuretic abuse include adverse reactions by drugs. Symptoms due to psychiatric morbidity (artefacta) include the consequences of self-induced trauma. The role of the dermatologist in the management of eating disorders is to make an early diagnosis of the "hidden" signs of eating disorders in patients who tend to minimize or deny their disorder. PMID:20808514

  7. Cognitive processes in anorexia nervosa and bulimia nervosa

    OpenAIRE

    Cooper, Myra; Fairburn, Christopher G.; Clark, David M.; David Clark; Christopher Fairburn

    1991-01-01

    The series of studies reported in this thesis aimed to improve our knowledge of the cognitive disturbance in anorexia nervosa and bulimia nervosa. Techniques from experimental cognitive psychology were used to test predictions made by cognitive theories of eating disorders. In the first study, subjects performed three tasks related to eating, weight and shape and self-statements were measured using concurrent verbalisation and a selfreport questionnaire. Compared to dieters ...

  8. Leptina e anorexia nervosa Leptin and anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Roberta de Oliveira Corrêa

    2012-01-01

    Full Text Available Estudos recentes comprovam a importância da leptina no comportamento alimentar. A diminuição das concentrações séricas desse hormônio está diretamente relacionada com a variação da taxa de gordura corporal e provoca alterações em eixos neuroendócrinos, levando à amenorreia e à hiperatividade, entre outras consequências. Neste trabalho estamos apresentando uma revisão bibliográfica dos principais focos de estudo que relacionam a LEP com a ANN, bem como dos efeitos do excesso e da deficiência desse hormônio sobre o comportamento alimentar. Trata-se de um esforço para converter uma grande gama de conhecimentos obtidos da literatura em um texto, objetivando prover uma visão de como a LEP, funcionando como um sinal periférico de disponibilidade de energia, pode influenciar a atividade de circuitos neuronais que controlam mecanismos associados à regulação da homeostasia energética.Recent studies demonstrate the importance of leptin in feeding behavior. The decreasing of the serum concentration of this hormone is directly related to the body fatty amount and provokes alterations in neuroendocrine axis, causing amenorrhea and hyperactivity, among others consequences. In this paper, a review of the main aspects interconnecting leptin and anorexia nervosa is made, as well as of the effects of excess and deficiency of this hormone on feeding disease. It was an effort to convert a large amount of knowledge obtained from literature into a condensed text, aiming to provide an updated view, how leptin functioning as a peripheral signal of energy availability to central nervous system influences on the neural activity involved in regulation of body weight and energy homeostasis.

  9. Anorexia nervosa: un estudio de casos

    OpenAIRE

    Lillyana Zusman Tinman

    2013-01-01

    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 retraí...

  10. [Zinc in patients with anorexia nervosa].

    Science.gov (United States)

    Røijen, S B; Worsaae, U; Zlotnik, G

    1991-03-01

    In a multicenter study, the relation between zinc status and anorexia nervosa was studied in 18 patients (15 females and 3 males in the age range of 11 to 25 years). Analysis of plasma zinc (by atomic absorption), plasma albumin (by electro-immuno diffusion method) and sense of taste (comparing quinine, zinc sulfate and water solutions), showed no significant abnormalities. Thus, the investigation does not support the hypothesis, that zinc status plays a significant role in the symptomatology of anorexia nervosa. PMID:2008719

  11. Recovering from anorexia nervosa by machine.

    Science.gov (United States)

    Södersten, Per; Bergh, Cecilia

    2014-10-01

    Any healthy person can develop anorexia nervosa. Prolonged dieting causes reversible endocrine changes that emerge to combat starvation, the main threat to survival. Animals have evolved to develop strategies to cope with this challenge, assisted by hormonal systems that facilitate food hoarding but which can also inhibit eating, reinforcing the anorexic state. However, a simple machine that provides feedback on how to eat can allow patients to escape from anorexia and restore their health. PMID:25228234

  12. Normal gastric antral myoelectrical activity in early onset anorexia nervosa.

    OpenAIRE

    Ravelli, A M; Helps, B A; Devane, S P; Lask, B D; Milla, P J

    1993-01-01

    Anorexia, epigastric discomfort, nausea, and vomiting may result from disordered gastric motility and emptying. These features have been found in many adults with anorexia nervosa, but have never been investigated in early onset anorexia nervosa. In 14 patients with early onset anorexia nervosa (eight of whom had upper gastrointestinal tract symptoms), six children with other eating disorders, four children with non-ulcer dyspepsia, and 10 controls matched for age and sex, the non-invasive te...

  13. 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.

  14. Reward processing in anorexia nervosa.

    Science.gov (United States)

    Keating, Charlotte; Tilbrook, Alan J; Rossell, Susan L; Enticott, Peter G; Fitzgerald, Paul B

    2012-04-01

    Individuals with anorexia nervosa (AN) demonstrate a relentless engagement in behaviors aimed to reduce their weight, which leads to severe underweight status, and occasionally death. Neurobiological abnormalities, as a consequence of starvation are controversial: evidence, however, demonstrates abnormalities in the reward system of patients, and recovered individuals. Despite this, a unifying explanation for reward abnormalities observed in AN and their relevance to symptoms of the illness, remains incompletely understood. Theories explaining reward dysfunction have conventionally focused on anhedonia, describing that patients have an impaired ability to experience reward or pleasure. We review taste reward literature and propose that patients' reduced responses to conventional taste-reward tasks may reflect a fear of weight gain associated with the caloric nature of the tasks, rather than an impaired ability to experience reward. Consistent with this, we propose that patients are capable of 'liking' hedonic taste stimuli (e.g., identifying them), however, they do not 'want' or feel motivated for the stimuli in the same way that healthy controls report. Recent brain imaging data on more complex reward processing tasks provide insights into fronto-striatal neural circuit dysfunction related to altered reward processing in AN that challenges the relevance of anhedonia in explaining reward dysfunction in AN. In this way, altered activity of the anterior cingulate cortex and striatum could explain patients' pathological engagement in behaviors they consider rewarding (e.g., self-starvation) that are otherwise aversive or punishing, to those without the eating disorder. Such evidence for altered patterns of brain activity associated with reward processing tasks in patients and recovered individuals may provide important information about mechanisms underlying symptoms of AN, their future investigation, and the development of treatment approaches. PMID:22349445

  15. 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.

  16. Self-injurious behavior in anorexia nervosa.

    Science.gov (United States)

    Favaro, A; Santonastaso, P

    2000-08-01

    Recent reports have postulated the existence of two different types of self-injurious behavior: impulsive and compulsive. The aim of the present study is to analyze the dimensionality of self-injurious behavior and to study the link between self-injurious behavior and clinical features in anorexia nervosa. The study involved 236 consecutive patients with anorexia nervosa, diagnosed by DSM-IV criteria. Subjects were evaluated by means of a semistructured interview and self-reported questionnaires, such as the Eating Disorders Inventory and Hopkins Symptom Checklist. A principal component analysis was used to study the dimensionality of different types of self-injurious behavior, including purging. Our findings confirm the distinction between impulsive and compulsive self-injurious behavior. The dimensions appear to be represented as a continuum in both the anorexia nervosa diagnostic subgroups. A third distinct dimension emerged that included self-induced vomiting and laxative/diuretics abuse. Childhood sexual abuse and anxiety significantly predict the presence of impulsive self-injury, whereas obsessionality and age predict compulsive self-injury. The coexistence of a positive score on both dimensions of self-injurious behavior was the strongest predictor of treatment dropout. The present study highlights the importance of self-injurious behavior; it should be given due consideration in future outcome studies on anorexia nervosa PMID:10972574

  17. 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…

  18. 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…

  19. The Physical Educator and Anorexia Nervosa.

    Science.gov (United States)

    Romeo, Felicia F.

    1984-01-01

    The physical education teacher is in an advantageous position to observe a student who may have anorexia nervosa. Severe weight loss, hyperactivity, body image delusion, and amenorrhea are symptoms of this behavior disorder. Implications for the physical education teacher and athletic coach are offered. (DF)

  20. Anorexia Nervosa--A Teacher's Perspective.

    Science.gov (United States)

    Rittner, Max

    The paper describes the physical and psychological symptoms of anorexia nervosa, treatment methods, and implications for the classroom. A rationale is offered for the predominance of upper-middle and upper class female adolescents in the anorectic population. Four models of treatment for the anorectic individual are considered: medical,…

  1. Eco-Systemic Analysis of Anorexia Nervosa.

    Science.gov (United States)

    Sheppy, Margarette I.; And Others

    1988-01-01

    Tested eco-systemic approach to understanding of anorexia nervosa. Compared 30 anorexics and parents to 34 matched control subjects and parents. Found that, compared to controls, families of anorexics were less supportive, helpful, and committed to each other. Family interactions perceived by anorexics were characterized by overprotective,…

  2. 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…

  3. Anorexia Nervosa with Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Pani, Adyapad; Santra, Gouranga; Biswas, Kali Das

    2015-09-01

    We report the case of an adolescent female, previously nonobese, belonging to educated average socioeconomic Muslim family. She stopped taking food, developed a perception of distorted body image with occasional episodes of binge eating and forced vomiting. She became amenorrheic and emaciated with loss of secondary sexual characters. She satisfied the criteria for anorexia nervosa with obsessive-compulsive disorder. PMID:27608877

  4. Increased Bone Marrow Fat in Anorexia Nervosa

    OpenAIRE

    Bredella, Miriam A.; Fazeli, Pouneh K.; Miller, Karen K.; Misra, Madhusmita; Torriani, Martin; Thomas, Bijoy J.; Ghomi, Reza Hosseini; Rosen, Clifford J; Klibanski, Anne

    2009-01-01

    Context: Although women with anorexia nervosa (AN) have severe depletion of body fat, a paradoxical increase in bone marrow fat has been described. Recent data suggest that marrow fat measured by 1H-magnetic resonance spectroscopy (MRS) in combination with bone mineral density (BMD) may be more valuable than either parameter alone in detecting bone weakness.

  5. 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…

  6. Diagnosed Anxiety Disorders and the Risk of Subsequent Anorexia Nervosa

    DEFF Research Database (Denmark)

    Meier, Sandra M; Bulik, Cynthia M; Thornton, Laura M;

    2015-01-01

    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...

  7. The clinical features of late onset anorexia nervosa.

    OpenAIRE

    Joughin, N. A.; Crisp, A H; Gowers, S. G.; Bhat, A V

    1991-01-01

    This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960-1990. Patients with a late onset were compared to other selected patient samples. The population comprised 12 patients with a first onset of anorexia nervosa at or after the age of 30, 415 patients with an onset after 15 but before 20 and 9 patients with an onset ...

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

    OpenAIRE

    Krantz Mori J; Mehler Philip S

    2004-01-01

    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 su...

  9. Can A Rational Choice Framework Make Sense of Anorexia Nervosa?

    OpenAIRE

    Goldfarb, Robert S.; Thomas C. Leonard; Sara Markowitz; Steven Suranovic

    2009-01-01

    Can a rational choice modeling framework help broaden our understanding of anorexia nervosa? This question is interesting because anorexia nervosa is a serious health concern, and because of the following issue: could a rational choice approach shed useful light on a condition which appears to involve "choosing" to be ill? We present a model of weight choice and dieting applicable to anorexia nervosa, and the sometimes-associated purging behavior. We also present empirical evidence about fact...

  10. Bullae, Bronchiectasis and Nutritional Emphysema in Severe Anorexia Nervosa

    OpenAIRE

    Cook, Victoria J; Coxson, Harvey O.; Mason, Andrew G; Tony R Bai

    2001-01-01

    STUDY OBJECTIVES: Pulmonary complications of anorexia nervosa are rarely documented. The case of a patient with anorexia nervosa and pulmonary disease is presented, a new quantitative computed tomography (CT) method for the detection of emphysema is employed, the literature is reviewed and the concept of 'nutritional' emphysema is discussed.RESULTS: The case of a 34-year-old, nonsmoking woman with long-standing severe anorexia nervosa who was evaluated for cough and progressive shortness of b...

  11. Social Cognition in Child and Adolescents with Anorexia Nervosa

    OpenAIRE

    ipek Percinel; Kemal Utku Yazici; Oznur Bilac; Sezen Kose; Burcu Ozbaran

    2015-01-01

    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...

  12. [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. PMID:26886039

  13. The role of zinc in anorexia nervosa: etiology and treatment.

    Science.gov (United States)

    Bakan, R

    1979-07-01

    Zinc deficiency may play a role in the etiology of anorexia nervosa. The symptoms of anorexia nervosa and zinc deficiency are similar in a number of respects, e.g., weight loss, loss of appetite, amenorrhea in females, impotence in males, nausea and skin lesions. In both conditions females under 25 are most at risk. Stress, estrogen and dietary habits may also be involved in the complex of factors which create or exacerbate a zinc deficiency and result in anorexia nervosa. It is proposed that effectiveness in the treatment of anorexia nervosa. PMID:514114

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

    OpenAIRE

    Noguchi Hitoshi; Murakami Tsukasa; Uchino Shinya; Yamashita Hiroto; Noguchi Shiro

    2011-01-01

    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 ori...

  16. Effectiveness of psychopharmacology in Anorexia Nervosa treatment

    Directory of Open Access Journals (Sweden)

    Zadka Lukasz

    2015-06-01

    Full Text Available The eating disorder that generates the highest death rate is that of anorexia nervosa, and current treatment is a combination of equalization of somatic state and patient education. Moreover, psychical symptoms occurring in the course of anorexia nervosa are thought to have a crucial influence on the course of the disease. Hence, in medical literature, the effectiveness of psychotherapeutic interventions is also widely described. Still, the implementation of appropriate psychopharmacology is now considered an additional method of treatment, rather than a therapy of choice. Yet, in spite of many years of research, there are no absolute recommendations given, nor are instructions within the scope of psychopharmacological treatment proffered, although the selection of psychopharmacological items must respect both the patient’s psychic and somatic states. In recent years, the popularity of psychopharmacological treatment has increased; therefore, we feel that it is justified to present the latest scientific information in this respect.

  17. Treatment of anorexia nervosa with antidepressants.

    Science.gov (United States)

    Hudson, J I; Pope, H G; Jonas, J M; Yurgelun-Todd, D

    1985-02-01

    Nine patients with anorexia nervosa were treated with antidepressant medications from three classes: tricyclics, monoamine oxidase inhibitors, and triazolopyridines. A tenth patient was treated with the combination of lithium carbonate and carbamazepine. With either the initial or a subsequent medication trial, four patients had displayed significant improvement in weight and in other anorexic and bulimic symptoms. Three additional patients had a marked or moderate improvement in bulimic symptoms, one with moderate and two without any weight gain. Two other patients had moderate weight gain. Side effects were a significant problem in many of the patients. These preliminary results suggest that antidepressants may be of benefit in the treatment of some patients with anorexia nervosa. PMID:3919068

  18. Olfactory identification ability in anorexia nervosa.

    OpenAIRE

    Kopala, L C; Good, K; Goldner, E M; Birmingham, C L

    1995-01-01

    OBJECTIVE: The hypothesis tested was that patients with severe eating disorders would demonstrate olfactory identification deficits as a result of zinc deficiency or malnutrition. METHOD: The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 27 hospitalized female patients with anorexia nervosa and 50 normal control female subjects. For a subgroup of patients, serum zinc levels and body mass indices were obtained at pre- and post-nutritional repletion phases. RE...

  19. [Role of leptin in anorexia nervosa].

    Science.gov (United States)

    Riccioni, G; D'Orazio, N; Menna, V; Lambo, M S; Guagnano, M T; Di Ilio, C

    2003-01-01

    Anorexia and bulimia nervosa are the main psychiatric disorders characterised by abnormal models of feeding and perception of people's personal physical appearance and weight. These symptoms are associated with a severe psychosocial uneasiness that leads to severe medical complications and this, to its turn, has a big impact on morbidity and sick rate of general population. Although researchers have made big improvements in individualising some likely pathogenic mechanisms that include different factors (genetic, neurochemical and sociocultural) and psychological development, the pathogenesis of these kinds of feeding disorders is still unknown. Leptina is a neurochemical factor particularly relevant. It is a 17 KD hormone, produced by adipocytes. At hypothalamic level, it is essential for regulating body weight and body development. Recent studies have identified some factors responsible for the production and the secretion of leptina. They are micro and macronurishing factors, hormones and the sympatic neurotic system that is the most important among them. It plays a very important role for some disorders of feeding behaviour, specifically for the anorexia nervosa, where we notice a reduction of leptina levels strictly correlated to a reduction of the fat component. Since anorexia nervosa is associated to medical, nourishing and psychological components, it involves different areas and needs complete measurement and administration. Therefore the approach to this kind of pathology has necessarily to predict a multidisciplinary administration of patients. The aim of our work has been to point out the possible interactions between leptina and the development and progression of anorexia nervosa, on the basis of recent works and reviews in medical literature. PMID:14994520

  20. Body perception and evaluation in anorexia nervosa

    OpenAIRE

    Lutz, Annika

    2015-01-01

    Body image disturbance is a prominent feature in anorexia nervosa (AN) and encompasses alterations across the different dimensions of body image, that is, perception, affect, cognition, and behaviour. There is a wealth of research regarding the subjective experience of body image disturbance and evidence for underlying neuronal alterations is beginning to emerge. The present project was designed to assess basic processes underlying body image disturbance with the help of psychophysiological m...

  1. Anorexia Nervosa : Emotion, Cognition, and Treatment

    OpenAIRE

    Parling, Thomas

    2011-01-01

    Anorexia nervosa (AN) is a serious disorder with long-term consequences for those afflicted. No evidence-based care is available for adults with full or subthreshold AN. The thesis research investigated aspects of emotion and cognition relevant to the maintenance of AN that might inform psychological treatment. In addition, the effectiveness of a recent psychotherapy model of AN was investigated. Study I investigated alexithymia and emotional awareness and their associations with depression, ...

  2. The Significance of Bradycardia in Anorexia Nervosa

    OpenAIRE

    Yahalom, Malka; Spitz, Marcelo; Sandler, Ludmila; Heno, Nawaf; Roguin, Nathan; Turgeman, Yoav

    2013-01-01

    Anorexia nervosa (AN) is a life-threatening condition, with a significant risk for death, due to cardiovascular complications. It is characterized by abnormal eating behavior and has the highest mortality rate of all psychiatric disorders. It has been associated with bradycardia (a heart rate [HR] of less than 60 beats per minute) (up to 95%), hypotension, mitral valve prolapse, and heart failure. The diagnosis of AN can be elusive, and more than half of all cases are undetected. The purpose ...

  3. Anorexia nervosa y terapia del comportamiento

    OpenAIRE

    Alfonso Martínez Taboas

    1981-01-01

    The clinical effectiveness of therapeutic techníques for the treatment of anorexia nervosa are reviewed. The most commonly used technique has been operant conditioning, of proved efficacy in the hospital but not always in the natural environment of the patient. Many cases su.ccessfuUy.treated show recovery of the problem. Recent atudies extend the treatment to the family and consider all the variables involved in the behavior. Severa! methodological shortcomings of the re...

  4. Factors Associated With Recovery from Anorexia Nervosa

    OpenAIRE

    Zerwas, Stephanie; Lund, Brian C.; Holle, Ann Von; Thornton, Laura M.; Berrettini, Wade H.; Brandt, Harry; Crawford, Steven; Fichter, Manfred M.; Halmi, Katherine A.; Johnson, Craig; Kaplan, Allan S.; La Via, Maria; Mitchell, James; Rotondo, Alessandro; Strober, Michael

    2013-01-01

    Previous studies of prognostic factors of anorexia nervosa (AN) course and recovery have followed clinical populations after treatment discharge. This retrospective study examined the association between prognostic factors—eating disorder features, personality traits, and psychiatric comorbidity—and likelihood of recovery in a large sample of women with AN participating in a multi-site genetic study. The study included 680 women with AN. Recovery was defined as the offset of AN symptoms if th...

  5. Bone Metabolism in Adolescents with Anorexia Nervosa

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2011-01-01

    Adolescents with anorexia nervosa (AN) are at risk for low bone mass at multiple sites, associated with decreased bone turnover. Bone microarchitecture is also affected, with a decrease in bone trabecular volume and trabecular thickness, and an increase in trabecular separation. The adolescent years are typically the time when marked increases occur in bone mass accrual towards the attainment of peak bone mass, an important determinant of bone health and fracture risk in later life. AN often ...

  6. Extreme Achalasia Presenting as Anorexia Nervosa

    OpenAIRE

    Goldsmith, P. J.; Decadt, B.

    2012-01-01

    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. Becau...

  7. Behavioral neuroendocrinology and treatment of anorexia nervosa.

    Science.gov (United States)

    Södersten, P; Nergårdh, R; Bergh, C; Zandian, M; Scheurink, A

    2008-10-01

    Outcome in anorexia nervosa remains poor and a new way of looking at this condition is therefore needed. To this aim, we review the effects of food restriction and starvation in humans. It is suggested that body weight remains stable and relatively low when the access to food requires a considerable amount of physical activity. In this condition, the human homeostatic phenotype, body fat content is also low and as a consequence, the synthesis and release of brain neurotransmitters are modified. As an example, the role of neuropeptide Y is analyzed in rat models of this state. It is suggested that the normal behavioral role of neuropeptide Y is to facilitate the search for food and switch attention from sexual stimuli to food. Descriptive neuroendocrine studies on patients with anorexia nervosa have not contributed to the management of the patients and the few studies in which hormones have been administered have, at best, reversed an endocrine consequence secondary to starvation. In a modified framework for understanding the etiology and treatment of anorexia nervosa it is suggested that the condition emerges because neural mechanisms of reward and attention are engaged. The neural neuropeptide Y receptor system may be involved in the maintenance of the behavior of eating disorder patients because the localization of these receptors overlaps with the neural systems engaged in cue-conditioned eating in limbic and cortical areas. The eating behavior of patients with anorexia nervosa, and other eating disorders as well, is viewed as a cause of the psychological changes of the patients. Patients are trained to re-learn normal eating habits using external support and as they do, their symptoms, including the psychological symptoms, dissolve. PMID:18602416

  8. Behavioral neuroendocrinology and treatment of anorexia nervosa

    OpenAIRE

    Sodersten, P.; Nergardh, R.; Bergh, C.; Zandian, M; Scheurink, A.

    2008-01-01

    Outcome in anorexia nervosa remains poor and a new way of looking at this condition is therefore needed. To this aim, we review the effects of food restriction and starvation in humans. It is suggested that body weight remains stable and relatively low when the access to food requires a considerable amount of physical activity. In this condition, the human homeostatic phenotype, body fat content is also low and as a consequence, the synthesis and release of brain neurotransmitters are modifie...

  9. Compulsivity in anorexia nervosa: a transdiagnostic concept

    OpenAIRE

    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...

  10. Compulsivity in Anorexia Nervosa: a transdiagnostic concept

    OpenAIRE

    LaurenRoseGodier

    2014-01-01

    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 a...

  11. Anorexia nervosa and food avoidance emotional disorder.

    OpenAIRE

    Higgs, J F; Goodyer, I M; Birch, J.

    1989-01-01

    A retrospective and longitudinal study was carried out on all children and adolescents who presented to a child psychiatry service over a period of 26 years to identify the nature, course, and outcome of cases meeting criteria for anorexia nervosa (n = 27). Two groups of the same age were identified for comparison, firstly those with food avoidance and emotional disorders (n = 23), and secondly those with emotional disorders but no symptoms associated with eating (n = 22). The results confirm...

  12. OLANZAPINE TREATMENT IN ANOREXIA NERVOSA: CASE REPORT

    OpenAIRE

    Dadić-Hero, Elizabeta; Ružić, Klementina; Pernar, Mirjana; Kabalin, Milena; Medved, Paola

    2009-01-01

    A 15 year old patient suffering from psychiatric disturbances looked for psychiatric help but refused hospital admission. Following an ambulatory treatment, the patient was diagnosed with Anorexia nervosa. The patient, a girl, was 175 centimeters tall, weighting only 39 kilos. Within the clinical picture, there were few dominant disorders present; anxiety, depression, low self-esteem, fear of feminization, with recurrent psychotic episodes. By the implementation of an intensive psychothera...

  13. Anorexia nervosa complicating inflammatory bowel disease.

    OpenAIRE

    Mallett, P; MURCH, S.

    1990-01-01

    Two cases of inflammatory bowel disease, occurring in adolescence and complicated by anorexia nervosa, are presented. The management of the bowel disease with corticosteroids appeared to precipitate the eating disorder in one case whereas covert withdrawal of steroid treatment led to life threatening complications of inflammatory bowel disease in the other. The difficulties of managing two serious conditions, each ideally treated in a specialist centre, are discussed and the dangers of treati...

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

    OpenAIRE

    Fabiano Gonçalves Nery; Antônio Lúcio Teixeira-Jr; Gislene Valadares Miranda; Maurício Viotti Daker

    2002-01-01

    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 hy...

  15. The CT appearance of ''reversible'' cerebral pseudoatrophy in anorexia nervosa

    International Nuclear Information System (INIS)

    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)

  16. An Adolescent with Anorexia Nervosa – A Case Report

    OpenAIRE

    Khairani, O; Majmin, SH; Saharuddin, A; Loh, SF; Azimah, NM; Tohid, H

    2011-01-01

    This case report illustrates an adolescent with clinical presentation of moderate anorexia nervosa with no significant co-morbidities. It highlights the management of anorexia nervosa in the outpatient setting by a multi-disciplinary health care team which includes a family physician, a dietician, a psychologist and a child psychiatrist.

  17. Adrenal Glucocorticoid and Androgen Precursor Dissociation in Anorexia Nervosa

    OpenAIRE

    Lawson, E. A.; Misra, M.; Meenaghan, E; Rosenblum, L.; Donoho, D. A.; Herzog, D.; Klibanski, A.; Miller, K K

    2009-01-01

    Context: Anorexia nervosa is characterized by hypogonadism and relative hypercortisolemia. We have demonstrated that free testosterone levels are low in women with anorexia nervosa, with the lowest levels in those receiving oral contraceptives (OCPs), and that dehydroepiandrosterone (DHEA) sulfate is reduced only in those receiving OCPs.

  18. Anorexia nervosa: an increasing problem in children and adolescents

    OpenAIRE

    Halmi, Katherine A.

    2009-01-01

    Information from eating disorder clinics across five continents suggests that anorexia nervosa is becoming an increasing problem in children and young adolescents. There is some indication that anxiety disorders in childhood may be a major risk factor for the development of anorexia nervosa. Early recognition and family treatment for this disorder are essential to prevent chronic impairment.

  19. Symptoms, Causes and Possible Treatment of Anorexia Nervosa.

    Science.gov (United States)

    Odebunmi, Akin

    This document provides research findings, a discussion of etiology, case studies, and treatment approaches for anorexia nervosa. The research findings classify the anorexic patient by sex, age, presenting characteristics, socioeconomic status, premorbid personality, and cultural and familial characteristics. The etiology of anorexia nervosa is…

  20. 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…

  1. Special Issue: Outcome of Anorexia Nervosa with Teenage Onset.

    Science.gov (United States)

    Casper, Regina C., Ed.

    1996-01-01

    The articles of this special issue report on studies of the outcomes of treatment of adolescent anorexia nervosa. These studies leave no doubt about the mortality risk and debilitating nature of chronic anorexia nervosa, but they do suggest that the prognosis, given expert treatment, is favorable for the most part. (SLD)

  2. Bullae, Bronchiectasis and Nutritional Emphysema in Severe Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    Victoria J Cook

    2001-01-01

    Full Text Available STUDY OBJECTIVES: Pulmonary complications of anorexia nervosa are rarely documented. The case of a patient with anorexia nervosa and pulmonary disease is presented, a new quantitative computed tomography (CT method for the detection of emphysema is employed, the literature is reviewed and the concept of 'nutritional' emphysema is discussed.

  3. Anorexia Nervosa: A Misdiagnosis of the Adolescent Male.

    Science.gov (United States)

    Svec, Henry

    1987-01-01

    Discusses rarity of anorexia nervosa among male population with primary reference to differences from female symptomatology. Presents case which implies that anorexia nervosa in the male may be a marker for other more severe pathology. Presents findings which suggest a diagnostic strategy based on familial, behavioral, environmental, educational,…

  4. 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

  5. Anorexia nervosa associated with energy-wasting disorders.

    OpenAIRE

    Sreenivasan, U.

    1984-01-01

    Some patients with anorexia nervosa and energy-wasting disorders have been found to be able to use their illness to lose weight. This paper presents two patients with diabetes mellitus and one with ulcerative colitis in whom the illness was complicated by anorexia nervosa.

  6. Anorexia Nervosa and Bulima Nervosa Critical Analysis of It's Treatment: Implications and Interventions

    OpenAIRE

    Flourish Itulua-Abumere

    2013-01-01

    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 n...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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. PMID:24705938

  9. Anorexia nervosa, bulimia nervosa: causal theories and treatment.

    Science.gov (United States)

    Palmer, T A

    1990-04-01

    Anorexia nervosa and bulimia nervosa are eating disorders characterized by gross disturbances in eating behavior. Recently these disorders have reached near-epidemic proportions, affecting approximately 1.2 million adolescent and young adult females in the United States. The incidence in males is considerably less, and the prevalence rate has remained fixed at 5 percent during the last five years. The estimates of mortality range between 1 and 15 percent and are equally divided between medical complications (electrolyte disturbance, acute kidney failure, cardiac complications) and suicide. Successful treatment requires a combination of aggressive medical management, psychotherapy, behavioral management, food-intake management and nutritional counseling. This requires health care providers to understand 1) the psychological ramifications of these disorders, 2) the types of depression associated with them, 3) antidepressants used and therapeutic dosages, 4) correction of nutritional deficiencies, 5) outpatient management and 6) indications for hospitalization (inpatient management). PMID:2183095

  10. [Anorexia nervosa and bulimia nervosa. II. Somatic complications of undernourishment].

    Science.gov (United States)

    van Rijn, C A

    1998-08-15

    In anorexia nervosa and bulimia nervosa, cachexia and deficient nourishment cause various physical abnormalities, especially of the endocrine and digestive systems and the heart. Disorders in the serotoninergic and dopaminergic systems contribute to development of an eating disorder, whereas an acquired deficiency of tryptophan impairs the serotoninergic system. Any problems of nutritional deficiencies, low blood sugar levels and gastrointestinal disorders disappear after normal nourishment is resumed. Hypotension and sinus bradycardia are manifestations of a physiological adjustment to a lower basal metabolism and need no treatment. Osteoporosis occurs from two years after the onset of weight loss; oestrogen supplementation may protect against this. In patients with infections, symptoms such as fever, leukocytosis and high BSE may be lacking. Hypoglycaemia incidentally leads to coma and death, and a lengthened QT interval to acute cardiac death. During restoration of the nutritional status, the intake of fluid and calories should initially be limited. During the first two weeks, the risk of cardiovascular complications is increased. PMID:9856167

  11. Anorexia nervosa: uma revisão

    Directory of Open Access Journals (Sweden)

    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. Anorexia Nervosa with Binge Eating: A Case Report

    OpenAIRE

    Mendhekar, D.N.; Arora, K; Jiloha, R.C.

    2003-01-01

    Anorexia nervosa is regarded a s a typical culture bound syndrome, and its existence is negligible in nonwestern countries due to protective biological and socio-cultural factors. Most of the cases reported from nonwestern countries are atypical in presentation with lack of body image disturbances. Recent studies showed that anorexia nervosa is no more culture bound, in fact it is a "culture change syndrome" due to westernization and no differences are seen in the phenomenology of anorexia ne...

  13. 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. PMID:24779385

  14. Anorexia Nervosa: A Unified Neurological Perspective

    OpenAIRE

    Hasan, Tasneem Fatema; Hasan, Hunaid

    2011-01-01

    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 a...

  15. Påvirker anorexia nervosa hjernestrukturer?

    OpenAIRE

    Aanerød, Ingrid Norstad

    2015-01-01

    Formål: Det vi ville med denne studien var å undersøke om, og i så fall hvordan, anorexia nervosa (AN) påvirker hjernen. Materiale og metode: Det ble tatt MR-bilder av 10 testdeltagere bestående av 5 pasienter med AN og 5 friske kontroller. Deretter vurderte vi om det var forskjeller mellom kontrollene og AN-pasientene med tanke på hjernestrukturer ved bruk av tre forskjellige MR-metoder: Visuell inspeksjon av ventrikkelstørrelse, volumetriske målinger av hjernestrukturer i hvit substans (...

  16. Anorexia nervosa y terapia del comportamiento

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez Taboas

    1981-01-01

    Full Text Available The clinical effectiveness of therapeutic techníques for the treatment of anorexia nervosa are reviewed. The most commonly used technique has been operant conditioning, of proved efficacy in the hospital but not always in the natural environment of the patient. Many cases su.ccessfuUy.treated show recovery of the problem. Recent atudies extend the treatment to the family and consider all the variables involved in the behavior. Severa! methodological shortcomings of the research in the area are analyzed

  17. Anorexia nervosa: uma revisão

    OpenAIRE

    Eder Schmidt; Gustavo Ferreira da Mata

    2008-01-01

    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, Édi...

  18. [Body and subjectivity: about anorexia nervosa].

    Science.gov (United States)

    Pereña Garcia, Francisco

    2007-01-01

    To start with the clinical description of anorexia nervosa is indicative of the difficulty involved not only with regard to its etiology (whether it is an endocrine, neurological or psychological disorder) but also with regard to its diagnosis (whether or not it is a hysterical disorder, whether or not it is a disease as such) and with regard to its treatment (the stubbornness of the symptom). The early-onset differential criterion is rejection. The subject's eating-related problem must be placed within the framework of the radical dependency the human organism has with regard to the mother's body, thus breaking the close connection between need and demand, which throws the instinctive life out of balance. Drive is the name given to this imbalance. Drived life must be controlled by wish. The transmitting of life is the transmitting of the innermost wish to live, without which the body fails or life and the body separate from one another. Rejection, which is the subjectivity-related aspect, then turns into anorexia in rejection of the body and in submission to bewildering ideals with which anorexic subjects attempt to find their bearings. Bulimia marks the most addictive aspect of impulsive imbalance. There is no ready answer to the question as to why anorexia occurs more among females than males. Female sexuality (the relationship with sexual wish and reproduction), as well as how in a aboundance society, women symbolize the trimming on the cake, an inert virtual figure. Anorexia nervosa can be taken as a pronouncement against an automated, devitalized family life and of a society characterized by commodity fetishism and cannibalism. PMID:18274356

  19. Anorexia nervosa: a mistaken diagnosis.

    Science.gov (United States)

    Nicholls, Katie; Boggis, Nicola; Pandya, Nikila

    2016-01-01

    Eating disorders in the form of anorexia and bulimia are becoming increasingly common in young adults and children. Most of the patients are initially seen by their general practitioner (GP) and it may take several months before the facts are pieced together and an underlying eating disorder is identified. However, other medical conditions, albeit rare, should be considered when assessing these young adults as potentially missing them can lead to devastating consequences. This case highlights how a 15-year-old girl who presented to her GP with a history suggestive of an eating disorder and had a body mass index below the 0.4th centile, in fact had classical symptoms and clinical signs of primary adrenal failure, or Addison's disease. PMID:27005795

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Altered social reward and attention in anorexia nervosa

    Directory of Open Access Journals (Sweden)

    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.

  2. Adipocytokines, gut hormones and growth factors in anorexia nervosa.

    Science.gov (United States)

    Kowalska, Irina; Karczewska-Kupczewska, Monika; Strączkowski, Marek

    2011-09-18

    Anorexia nervosa is a complex eating disorder of unknown etiology which affects adolescent girls and young women and leads to chronic malnutrition. Clinical manifestations of prolonged semistarvation include a variety of physical features and psychiatric disorders. The study of different biological factors involved in the pathophysiology of anorexia nervosa is an area of active interest. In this review we have described the role of adipocytokines, neurotrophins, peptides of the gastrointestinal system and growth factors in appetite regulation, energy balance and insulin sensitivity in anorexia nervosa patients. PMID:21699889

  3. Osteoporosis: prevention and treatment in anorexia nervosa.

    Science.gov (United States)

    Wolfert, A; Mehler, P S

    2002-06-01

    One of the most serious and potentially permanently disabling medical complications of anorexia nervosa is osteoporosis, which greatly increases the long-term risk of bone fractures. The decreased bone density in patients with anorexia nervosa (AN) is due to the many effects on bone metabolism of amenorrhea, reduced levels of insulin growth factor-1 (IGF-1), high cortisol levels and weight loss. Although estrogen replacement therapy is clearly efficacious in preventing postmenopausal osteoporosis, its efficacy in AN is uncertain. Clinicians caring for patients with AN need to be aware of this because, despite such therapy, there may be an inexorable decline in bone mineral density in what is a relatively young group of patients. AN frequently has its onset during adolescence, when peak bone mass is normally reached, and an anorectic episode in youth may permanently impair skeletal integrity and lead to debilitating fractures and pain. It is important to recognise this formidable risk, counsel AN patients about the longterm and possibly permanent sequelae of low body weight, use densitometry to screen for bone loss and treat it accordingly. The most effective treatment is still early weight restoration and the resumption of menses. PMID:17644861

  4. 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 <3.0×10(9) litre(-1), or both, potentially fatal complications frequently occur. Accordingly, patients need strict nutritional support to avoid re-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. PMID:24366724

  5. Anorexia nervosa and bulimia in adolescent males.

    Science.gov (United States)

    Andersen, A E

    1984-12-01

    Anorexia nervosa or bulimia in adolescent males occurs ten times less frequently than in adolescent females. When they occur, however, they can be clearly identified and differentiated from disorders also associated with weight loss such as swallowing phobias. Early diagnosis and treatment leads to improved outcome. While the formal psychopathology of male anorectics is similar to that of females, there is often a different motivation for the initial weight loss in males. They are more often concerned with attaining an idealized male body and avoiding teasing or criticism about their appearance. When males become ill, they tend to develop the full anorectic syndrome or not to become ill at all. Recognition of the special needs of adolescent males for individualized treatment increases the change of optimal outcome. Anorexia nervosa and bulimia in the teenage male should be seen as an ineffective method of dealing with developmental crises by gaining a sense of effectiveness and control through weight reduction and food restriction. Treatment seeks to improve quickly the starvation-related aspects of the illness while attempting to find more appropriate methods of dealing with the life crises prompting the illness. The real goal of treatment is to make the anorectic or bulimic illness unnecessary by encouraging the patient to continue the work of individuation and separation so that challenges in development and problems in living are resolved in a direct rather than an indirect way through an eating disorder. PMID:6596548

  6. Do girls with anorexia nervosa have elevated autistic traits?

    OpenAIRE

    Baron-Cohen, Simon; Jaffa, Tony; Davies, Sarah; Auyeung, Bonnie; Allison, Carrie; Wheelwright, Sally

    2013-01-01

    Background Patients with anorexia may have elevated autistic traits. In this study, we tested test whether patients with anorexia nervosa (anorexia) have an elevated score on a dimensional measure of autistic traits, the Autism Spectrum Quotient (AQ), as well as on trait measures relevant to the autism spectrum: the Empathy Quotient (EQ), and the Systemizing Quotient (SQ). Methods Two groups were tested: (1) female adolescents with anorexia: n = 66, aged 12 to 18 years; and (2) female adolesc...

  7. Diagnostik und Therapie der Anorexia und Bulimia nervosa

    OpenAIRE

    2003-01-01

    Obwohl es keine überzeugenden Hinweise darauf gibt, daß die Frequenz der Eßstörungen zunimmt, so ist doch die Anzahl der Patientinnen, die zur Behandlung kommen, in den letzten Jahren enorm angestiegen. Die Prävalenz der Anorexia nervosa liegt bei 1 %, die der Bulimia nervosa bei bis zu 3 % bei Mädchen in der Adoleszenz und bei jungen Frauen. AllgemeinmedizinerInnen entdecken nur etwa 12 % aller Patientinnen mit Bulimia nervosa und etwa 45 % aller Patientinnen mit Anorexia nervosa. Da ihne...

  8. Massa óssea em pacientes com anorexia nervosa Bone mass in patients with anorexia nervosa

    OpenAIRE

    Evaldo dos Santos; Rosane Pilot Pena Ribeiro; José Ernesto dos Santos; Ana Carolina Japur de Sá Rosa e Silva; Marcos Felipe Silva de Sá

    2004-01-01

    OBJETIVO: avaliar a ingestão diária de cálcio e estabelecer sua correlação com a densidade óssea de pacientes com anorexia nervos. PACIENTES E MÉTODOS: quatorze mulheres com anorexia nervosa registraram, em diário alimentar padronizado, sua ingestão em 24 horas e foram submetidas ao exame de densitometria óssea. A análise estatística foi feita pelos testes do c² e correlação de Pearson, adotando-se como significância estatística p

  9. Determinants of delayed gastric emptying in anorexia nervosa and bulimia nervosa.

    OpenAIRE

    Robinson, P H; M Clarke; Barrett, J.

    1988-01-01

    Gastric emptying was measured using a gamma camera in 22 patients with anorexia nervosa, in 10 patients of normal or high weight with bulimia nervosa and in 10 controls. Patients with anorexia nervosa were tested (1) while underweight and selecting their own diet (10 patients); (2) underweight, but receiving an adequate diet on an inpatient unit (refeeding diet) (12 patients); and (3) under refeeding diet conditions after weight gain (eight patients). Three meals, each labelled with technetiu...

  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. Physical activity in patients with anorexia nervosa.

    Science.gov (United States)

    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. PMID:27052638

  12. Recovery from anorexia nervosa: a Durkheimian interpretation.

    Science.gov (United States)

    Garrett, C J

    1996-11-01

    Attempts to explain "eating disorders" in contemporary western society have concentrated on aetiology at the expense of resolution. Most "recovered" anorectics, however, question medical definitions of "anorexia nervosa" and clinical criteria for recovery. This article refers to a study of 32 people at different stages of the recovery process, to reconceptualize the problem in sociological terms. Durkheim's account of asceticism offers a fresh interpretive framework in which anorexia and recovery are understood as the negative and positive phases respectively of a ritual of self-transformation. In western culture, where appropriate myths and rituals of re-incorporation are not readily available following a period of symbolic fasting, it is not surprising that recovery from anorexia is not automatic. Participants in this study referred to anorexia as a spiritual quest and for them recovery involved a re-discovery (or creation) of a threefold connection: inner, with others and with "nature". These connections are, for them, the defining features of spirituality. The negative phase of the ritualistic quest (anorexia) involves a confrontation with the inevitability of death as a condition of the positive phase (recovery) in which people actively choose life. This new theoretical approach provides a non-medicalized understanding of anorexia and simultaneously enables a re-interpretation of the fasting of medieval women saints. Recent scholarship in this area is re-evaluated to demonstrate that the continuity between asceticism and anorexia lies in the use of food as a metaphorical attempt to confront the universal problem of one's own mortality. In certain historical situations, asceticism served a socially valuable symbolic purpose. In contemporary society, however, this meaning is no longer available. Instead, it is recovery which constitutes the active and metaphorical "rebellion" against forces of social control. Finally, the work of Van Gennep is used to explore

  13. Anorexia Nervosa: The More It Grows, the More It Starves.

    Science.gov (United States)

    Oldis, Katherine O.

    1986-01-01

    Presents a bibliography of books on anorexia nervosa that are appropriate for young adults. Includes fiction, autobiographies, informational books, and books on the related topics of bulimia, bulimarexia, and therapy. (EL)

  14. Disturbances of sex hormones in anorexia nervosa in the male.

    OpenAIRE

    McNab, D.; Hawton, K

    1981-01-01

    Sex hormone levels were measured in a male patient with anorexia nervosa throughout the course of his illness and recovery. Gonadotrophin levels returned to normal with weight gain but his testosterone remained low. Possible explanations for these findings are discussed.

  15. Anorexia Nervosa: Why Do Some People Starve Themselves?

    Science.gov (United States)

    Chng, Chwee Lye

    1983-01-01

    Written for the school and/or community health professional, this article defines anorexia nervosa, discusses its prevalence, causes, symptoms, and treatment, and draws implications about health education's role in its prevention and treatment. (Author/CJ)

  16. 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...

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

    OpenAIRE

    Marwan El Ghoch; Simona Calugi; Silvia Lamburghini; Riccardo Dalle Grave

    2014-01-01

    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 ado...

  18. Defining recovery in Anorexia Nervosa - The importance of concept clarification

    OpenAIRE

    2007-01-01

    Objective: The purpose of this dissertation is to identify major problems that obscure understanding of recovery in Anorexia Nervosa, to differentiate recovery from other closely related concepts, and to highlight the importance of reaching a consensus on the use of terminology. Method: Literature review based on papers that address the concepts of recovery, remission and outcome in Anorexia Nervosa. Relevant literature included in this review was identified by searching the elect...

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

    OpenAIRE

    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 Anorexia Nervosa is one of the main aspects in our framework for the neurobiological changes that may underlie the development of the disorder. Here, we focus on the neurobiological basis of hyperac...

  20. 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 ...

  1. Neurological Soft Signs in Stadien der Anorexia nervosa

    OpenAIRE

    Oskamp, Andrea

    2013-01-01

    Loss of cerebral gray and white matter volume which cause brain function deficits are described in patients with anorexia nervosa (AN). Neurological soft signs (NSS) are minor neurological signs which indicate non-specific cerebral dysfunction. First investigations have shown their presence in Anorexia nervosa (AN) - including particularly poor motor coordination and difficulties in sequencing complex motor tasks. It is uncertain whether these deficiencies are endophenotype of AN, independent...

  2. Adolescent male with anorexia nervosa: a case report from Iraq

    Directory of Open Access Journals (Sweden)

    Younis Maha S

    2012-01-01

    Full Text Available Abstract This is the first reported case of an adolescent male with anorexia nervosa in Iraq. This disorder is believed to be rare in males across cultures and uncommon for both genders in Arab countries. The patient met the DSM-IV diagnostic criteria for anorexia nervosa. He was hospitalized and received medical and psychiatric treatment at local facilities as discussed below and responded well to treatment.

  3. Emotional facial expression in women recovered from anorexia nervosa

    OpenAIRE

    Davies, Helen; Schmidt, Ulrike; Tchanturia, Kate

    2013-01-01

    Background Recent models of anorexia nervosa (AN) have emphasised the importance of social and emotional difficulties as maintenance factors of the disorder, however, empirical data are limited. The aim of this study was to examine whether altered emotional facial expression, previously observed in people currently ill with anorexia nervosa, is limited to the ill state or present in people recovered from the illness. Methods The sample consisted of 123 participants [49 AN, 21 recovered AN (Re...

  4. Anorexia nervosa among teenage girls: Emerging or prevalent?

    OpenAIRE

    Hisam, Aliya; Rahman, Mahmood Ur; Mashhadi, Syed Fawad

    2015-01-01

    Objectives: To find out frequency of anorexia nervosa (AN) among teenage girls (TG) and to find out the knowledge and practice regarding anorexia nervosa among teenage girls. Methods: A cross sectional study was conducted at higher secondary public school, Rawalpindi from June 2013 till December 2013. A sample of 100 female students of the age group 13-19 years were inducted by systematic sampling technique. Mixed pretested questionnaire was filled after informed verbal consent. Data was ente...

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

    OpenAIRE

    Guido eFrank

    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 fa...

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

    OpenAIRE

    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 ...

  7. The Disjointed Historical Trajectory of Anorexia Nervosa Before 1970

    OpenAIRE

    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 ad...

  8. 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.

  9. 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. PMID:25988121

  10. 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

  11. 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. PMID:25591200

  12. 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 of...... counting 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....

  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. 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.

  15. Olanzapine treatment in anorexia nervosa: case report.

    Science.gov (United States)

    Dadić-Hero, Elizabeta; Ruzić, Klementina; Pernar, Mirjana; Kabalin, Milena; Medved, Paola

    2009-03-01

    A 15 year old patient suffering from psychiatric disturbances looked for psychiatric help but refused hospital admission. Following an ambulatory treatment, the patient was diagnosed with Anorexia nervosa. The patient, a girl, was 175 centimeters tall, weighting only 39 kilos. Within the clinical picture, there were few dominant disorders present; anxiety, depression, low self-esteem, fear of feminization, with recurrent psychotic episodes. By the implementation of an intensive psychotherapeutic treatment, without the use of psychopharmacs, the weight was kept stable. In accordance with the girl's mother, a psychopharmacotherapy was commenced, a combination of olanzapine and paroxetine (the choice of psychopharmacs was lead by the side effects known). At the end of a 24-month period of a psychological treatment which was combined with psychopharmacotherapy, the patient exhibited no symptomatology and a stable clinical remission of the illness was achieved. PMID:19270636

  16. 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.

  17. Specificity of eating disorders diagnoses in families of probands with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Woodside, D B; Field, L L; Garfinkel, P E; Heinmaa, M

    1998-01-01

    This study examines the prevalence of anorexia nervosa and bulimia nervosa in relatives of probands, and examines the probandwise specificity of any familial clustering. Data were collected from probands using the family history method. Probands were recruited in a sequential cohort fashion. Information collected from probands was rated semiblindly by two of the authors, and a diagnostic hierarchy applied to arrive at a diagnosis for each of the relatives assessed. Data are reported on 2,125 family members, collected from 93 probands. Diagnostic agreement between raters was high, with serious disagreement present in three of 167 possible cases of an eating disorder. Rates of anorexia nervosa, bulimia nervosa, major depression, and substance abuse declined from first- to third-degree relatives, which is consistent with genetic clustering, and there was evidence of a cohort effect operating for anorexia nervosa and bulimia nervosa. The rates of anorexia nervosa and bulimia nervosa in all family members were 5.1%, and 4.3% respectively. An analysis of maternal and paternal descent showed no evidence for X-linked dominant transmission in these families. Preliminary analysis of the clustering of diagnoses in relatives showed a tendency (chi 2 = 14.47, P = .006) for family members to be affected by the same diagnosis as was the proband. This trend was strongest for anorexia nervosa, but there was overlap when the proband had a lifetime diagnosis of bulimia nervosa, with or without anorexia nervosa. These results are compatible with the existence of genetic factors influencing predisposition to eating disorders, but do not prove such. PMID:9777277

  18. 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...

  19. 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...

  20. Dysfunctional metacognition and drive for thinness in typical and atypical anorexia nervosa

    OpenAIRE

    Davenport, Emily; Rushford, Nola; Soon, Siew; McDermott, Cressida

    2015-01-01

    Background Anorexia nervosa is complex and difficult to treat. In cognitive therapies the focus has been on cognitive content rather than process. Process-oriented therapies may modify the higher level cognitive processes of metacognition, reported as dysfunctional in adult anorexia nervosa. Their association with clinical features of anorexia nervosa, however, is unclear. With reclassification of anorexia nervosa by DSM-5 into typical and atypical groups, comparability of metacognition and d...

  1. An examination of autism spectrum traits in adolescents with anorexia nervosa and their parents.

    OpenAIRE

    Rhind, C.; Bonfioli, E.; Hibbs, R.; Goddard, E; MacDonald, P; Gowers, S; Schmidt, U.; Tchanturia, K.; Micali, N; Treasure, J

    2014-01-01

    Background There may be a link between anorexia nervosa and autism spectrum disorders. The aims of this study were to examine whether adolescents with anorexia nervosa have autism spectrum and/or obsessive-compulsive traits, how many would meet diagnostic criteria for autism spectrum disorder, and whether these traits are shared by parents. Methods A total of 150 adolescents receiving outpatient treatment for anorexia nervosa or subthreshold anorexia nervosa and their parents completed the au...

  2. Bilateral insufficiency fracture of the femoral neck in a male patient with anorexia nervosa.

    Science.gov (United States)

    Carpintero, Pedro; Lopez-Soroche, Eva; Carpintero, Rocio; Morales, Rafael

    2013-02-01

    Anorexia nervosa is a risk factor for secondary osteoporosis. Anorexia nervosa-related metabolic disturbances lead to disminished bone resistance and increased risk of fractures. We report a case of bilateral femoral neck fracture as the first symptom of anorexia nervosa in a male patient. PMID:23547526

  3. Psychopharmacotherapy of anorexia nervosa, bulimia nervosa and binge-eating disorder

    OpenAIRE

    S. Kruger; Kennedy, SH

    2000-01-01

    Pharmacotherapy for anorexia nervosa is considered to be of limited efficacy. However, many studies suffer methodological limitations, and the utility of newer drugs in the treatment of anorexia has not been examined yet. Although there have been more fruitful investigations on the efficacy of medication in the management of bulimia nervosa, there are still many unresolved issues regarding the optimal management of partial remission during the acute treatment phase and the intensity and durat...

  4. Wait Not, Want Not: Factors Contributing to the Development of Anorexia Nervosa and Bulimia Nervosa.

    Science.gov (United States)

    Murray, Trish

    2003-01-01

    The purpose of this literature review is to examine prevalence and incident rates of both anorexia nervosa and bulimia nervosa. In addition, this article will review the psychological and sociological factors that contribute to the development and maintenance of an eating disorder. Finally, different treatment approaches will be discussed in…

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

    International Nuclear Information System (INIS)

    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

  6. 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.

  7. 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.

  8. Oral zinc supplementation in anorexia nervosa.

    Science.gov (United States)

    Safai-Kutti, S

    1990-01-01

    There is evidence to suggest that zinc (Zn) deficiency may be involved in the pathogenesis of anorexia nervosa (AN). In an open study of 20 females, aged 14-26 years, afflicted with AN the effect of oral zinc supplementation was investigated. In each case the diagnosis of AN was based on the criteria of DSM-III-R. After a careful history, complete physical examination and laboratory screening the subjects were started on 45-90 mg of Zn2+, as zinc sulfate, (SolvezinkR, Tika, Sweden) per day. During a follow-up period of 8-56 months 17 patients increased their body weight by more than 15%. The maximum gradual weight gain of 57% was encountered in one patient after 24 months of zinc therapy. The most rapid weight gain was recorded in a patient who increased her body weight by 24% over a period of 3 months. After the institution of zinc, weight loss was not registered in any of our patients. In 13 subjects the menstruation returned 1-17 months after the initiation of zinc therapy. None of our patients developed bulimia. The design of an ongoing multicenter placebo-controlled clinical trial of zinc supplementation to patients with AN is described. PMID:2291418

  9. Family cognitive remediation therapy for anorexia nervosa.

    Science.gov (United States)

    Lask, Bryan; Roberts, Alice

    2015-04-01

    Anorexia nervosa (AN) in childhood and adolescence has a poor prognosis. It is possible that this may in part be due to the fact that cognitive weaknesses that appear to be risk factors for its development and maintenance are not being targeted in treatment. Through its focus on these deficits, cognitive remediation therapy (CRT) has been shown to be a promising intervention for AN. Furthermore, family interventions are widely recommended for this patient population, but to date no studies have reported the use of CRT in a family setting. This paper presents a case series in which family-based CRT was a significant component of the management. It was well received by patients and their families and previously treatment resistant patients became more engaged with the entire treatment process. In addition, all patients receiving family-based CRT went on to make progress towards recovery. These initial clinical observations suggest family-based CRT is likely to be a useful addition to treatment for child and adolescent AN and justifies formal evaluation. PMID:24096368

  10. Resting state functional connectivity in anorexia nervosa.

    Science.gov (United States)

    Phillipou, Andrea; Abel, Larry Allen; Castle, David Jonathan; Hughes, Matthew Edward; Nibbs, Richard Grant; Gurvich, Caroline; Rossell, Susan Lee

    2016-05-30

    Anorexia Nervosa (AN) is a serious psychiatric illness characterised by a disturbance in body image, a fear of weight gain and significantly low body weight. The factors involved in the genesis and maintenance of AN are unclear, though the potential neurobiological underpinnings of the condition are of increasing interest. Through the investigation of functional connectivity of the brain at rest, information relating to neuronal communication and integration of information that may relate to behaviours and cognitive symptoms can be explored. The aim of this study was to investigate functional connectivity of the default mode network, and sensorimotor and visual networks in AN. 26 females with AN and 27 healthy control participants matched for age, gender and premorbid intelligence underwent a resting state functional magnetic resonance imaging scan. Default mode network functional connectivity did not differ between groups. AN participants displayed reduced functional connectivity between the sensorimotor and visual networks, in comparison to healthy controls. This finding is discussed in terms of differences in visuospatial processing in AN and the distortion of body image experienced by these individuals. Overall, the findings suggest that sensorimotor and visual network connectivity may be related to visuospatial processing in AN, though, further research is required. PMID:27111812

  11. Compulsivity in Anorexia Nervosa: a transdiagnostic concept

    Directory of Open Access Journals (Sweden)

    LaurenRoseGodier

    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.

  12. Physical activity and cortisol in anorexia nervosa.

    Science.gov (United States)

    Klein, Diane Alix; Mayer, Laurel E S; Schebendach, Janet Ellen; Walsh, B Timothy

    2007-06-01

    Elevated physical activity is commonly observed among patients with Anorexia Nervosa (AN) and can manifest in several forms. While elevated physical activity may play a key role in the pathophysiology of this disorder, much remains unknown about it, including the relationship among its various manifestations, and their underlying mechanism(s). The purposes of the current study were to (1) quantify locomotor activity in inpatients with AN using an accelerometer, (2) determine the association between locomotor activity and exercise history and (3) determine the association between urinary cortisol and physical activity. Thirty-six women hospitalized with AN wore activity armbands for 48 h during the first 2 weeks of hospitalization, collected 24-h urine to measure cortisol, and completed rating forms. Activity counts varied more than four-fold among individuals but were consistent within individuals over the 2 monitoring days (pactivity counts were positively correlated with pre-hospitalization attitude towards exercise as measured by the Commitment to Exercise Scale (CES; p=0.032). Forty-two percent of women reported "high" exercise in the 3 months before hospitalization; compared to non-high-exercising patients, these women demonstrated a higher CES score (pactivity counts (p=0.059). Urinary cortisol was positively associated with activity counts (p=0.044) and CES score (p=0.018). These data suggest that some women with AN have a higher "drive" for physical activity that persists into early hospitalization. HPA axis abnormalities may be associated with this state. PMID:17462830

  13. Saccadic Eye Movements in Anorexia Nervosa

    Science.gov (United States)

    Phillipou, Andrea; Rossell, Susan Lee; Gurvich, Caroline; Hughes, Matthew Edward; Castle, David Jonathan; Nibbs, Richard Grant; Abel, Larry Allen

    2016-01-01

    Background Anorexia Nervosa (AN) has a mortality rate among the highest of any mental illness, though the factors involved in the condition remain unclear. Recently, the potential neurobiological underpinnings of the condition have become of increasing interest. Saccadic eye movement tasks have proven useful in our understanding of the neurobiology of some other psychiatric illnesses as they utilise known brain regions, but to date have not been examined in AN. The aim of this study was to investigate whether individuals with AN differ from healthy individuals in performance on a range of saccadic eye movements tasks. Methods 24 females with AN and 25 healthy individuals matched for age, gender and premorbid intelligence participated in the study. Participants were required to undergo memory-guided and self-paced saccade tasks, and an interleaved prosaccade/antisaccade/no-go saccade task while undergoing functional magnetic resonance imaging (fMRI). Results AN participants were found to make prosaccades of significantly shorter latency than healthy controls. AN participants also made an increased number of inhibitory errors on the memory-guided saccade task. Groups did not significantly differ in antisaccade, no-go saccade or self-paced saccade performance, or fMRI findings. Discussion The results suggest a potential role of GABA in the superior colliculus in the psychopathology of AN. PMID:27010196

  14. [Bone health in patients with anorexia nervosa].

    Science.gov (United States)

    Suzuki, Mari Hotta

    2013-02-01

    Osteoporosis associated with anorexia nervosa (AN) is common, and tends to be severe, slow to recover from, and sometimes irreversible. The abnormal bone metabolism in severely emaciated AN patients involves both a reduction in bone formation and an increase in bone resorption. The annual change in lumbar bone mineral density (BMD) is significantly correlated with BMI at the entry. The critical BMI for a positive increase in BMD was 16.4±0.3 kg/m(2). Nutritional improvement with body weight gain is the most important goal of treatment for AN-related osteoporosis since it increases both serum levels of insulin-like growth factor-I, a potent osteogenic factor, and estradiol, a powerful bone resorption inhibitor. However, it is difficult for AN patients to accept weight gain. About 50% of AN patients are insufficient of vitamin D and 43% show an increase in plasma undercalboxylated osteocalcin, indicating a deficiency state of the vitamin K(2). Vitamin D(3) or vitamin K(2) (menatetrenone) can prevent further bone loss in severely emaciated AN patients. Recently, bone strength has been evaluated by both BMD and bone quality. Plasma levels of homocysteine, a marker of degradation of bone quality, have significantly positive correlation with their ages of AN patients. We must evaluate bone density as well as bone quality in AN patients. PMID:23354095

  15. Bone Metabolism in Adolescents with Anorexia Nervosa

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2013-01-01

    Adolescents with anorexia nervosa (AN) are at risk for low bone mass at multiple sites, associated with decreased bone turnover. Bone microarchitecture is also affected, with a decrease in bone trabecular volume and trabecular thickness, and an increase in trabecular separation. The adolescent years are typically the time when marked increases occur in bone mass accrual towards the attainment of peak bone mass, an important determinant of bone health and fracture risk in later life. AN often begins in the adolescent years, and decreased rates of bone mass accrual at this critical time are therefore also concerning for deficits in peak bone mass. Factors contributing to low bone density and decreased rates of bone accrual include alterations in body composition such as low BMI and lean body mass, and hormonal alterations such as hypogonadism, a nutritionally acquired resistance to growth hormone and low levels of IGF-1, relative hypercortisolemia, low levels of leptin, and increased adiponectin (for fat mass) and peptide YY. Therapeutic strategies include optimizing weight and menstrual recovery, and adequate calcium and vitamin D replacement. Oral estrogen-progesterone combination pills are not effective in increasing bone density in adolescents with AN. RhIGF-1 increases levels of bone formation markers in the short-term, while long-term effects remain to be determined. Bisphosphonates act by decreasing bone resorption, and are not optimal for use in adolescents with AN, in whom the primary defect is low bone formation. PMID:21301203

  16. Eye movement abnormalities in anorexia nervosa.

    Science.gov (United States)

    Pallanti, S; Quercioli, L; Zaccara, G; Ramacciotti, A B; Arnetoli, G

    1998-03-20

    The aim of the present study is to investigate smooth pursuit eye movement and saccadic performance in anorexia nervosa during a restored weight period and to determine if functional links can be made between eye movement performance and clinical features. SPEM parameters were recorded for 28 female anorectic out-patients (DSM IV), who had a body weight loss of up to 20% of ideal body weight. Twenty-eight comparison subjects were also tested. Clinically, each patient was assessed using the Eating Disorder Inventory (EDI), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Structured Interview for Personality Disorders (SCID II), the Symptom Checklist-90-Revised (SCL-90-R) and the Hamilton Scale for Depression (HRSD). The anorectic patients performed slightly worse than the comparison subjects on a number of SPEM measures. No relationship was found between SPEM impairment and a global severity index of psychopathology (SCL 90-R GSI) or depressive symptoms. Moreover, OCD symptoms and scores on some EDI scales (such as perfectionism) appear related to the severity of the eye movement alterations. The evidence of SPEM abnormalities in a subgroup of anorectic patients during the remitted state and the relationship of the abnormalities to obsessive-compulsive symptoms are discussed. Results are in agreement with the hypothesis regarding the persistence of neurophysiological as well as psychopathological traits of disorder in anorectic patients. PMID:9579703

  17. 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.

  18. Vegetarianism in anorexia nervosa? A review of 116 consecutive cases.

    Science.gov (United States)

    O'Connor, M A; Touyz, S W; Dunn, S M; Beumont, P J

    A retrospective study was carried out of 116 consecutive patients with anorexia nervosa to ascertain the extent and nature of vegetarianism in this population. Sixty-three (54.3%) patients were found to be avoiding red meat. In only four (6.3%) of these did meat avoidance predate the onset of their anorexia nervosa. Of the remaining 59 patients (best termed pseudovegetarians), 25 (42.4%) patients continued to avoid red meat by the end of treatment. Pseudovegetarianism was associated with a longer duration of anorexia nervosa, a lower weight during the course of their illness, and living away from the parental home. The reintroduction of red meat into the diet was more likely if vegetarianism were of a short duration. PMID:3696039

  19. 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. PMID:22699719

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

    OpenAIRE

    Andony, Louise Julia; Tay, Elaine; Allen, Karina L; Wade, Tracey D.; Hay, Phillipa; Touyz, Stephen; McIntosh, Virginia V W; 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 Psychother...

  1. Psychopathology and psychotherapy in adolescents with anorexia and bulimia nervosa

    OpenAIRE

    Salbach-Andrae, Harriet

    2010-01-01

    Anorexia nervosa (AN) and bulimia nervosa (BN) are multifactorial diseases, which are among the most prevalent disorders in child and adolescent psychiatry. Aesthetic sports are often considered as a risk factor for the development of an eating disorder. The present professorial dissertation for the first time demonstrates no higher risk for competitive athletes aged 12 to 18 years to develop an eating disorder. Research shows that psychiatric comorbidity is a very unfavorable prognostic ...

  2. 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. PMID:25879137

  3. 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

  4. Anorexia nervosa: treatment expectations – a qualitative study

    OpenAIRE

    Paulson-Karlsson, Gunilla

    2012-01-01

    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 ...

  5. Anorexia nervosa: discourses of gender, subjectivity and the body

    OpenAIRE

    Malson, H. M.

    1995-01-01

    This thesis investigates how anorexia nervosa is constructed and deployed as a discursive social and psychological category, drawing critically on feminist psychoanalytic and Foucauldian theories of gender, subjectivity and discourse. The introduction provides a brief discussion of diagnostic criteria and the epidemiology of anorexia. It outlines the thesis as a whole, providing a brief explanation of the approach adopted in the thesis. Chapter 2 critically reviews rec...

  6. Gelatinous Degeneration of the Bone Marrow in Anorexia Nervosa.

    OpenAIRE

    Shih-Hsiang Chen; Iou-Jih Hung; Tang-Her Jaing; Chien-Feng Sun

    2004-01-01

    Anorexia nervosa is a chronic psychiatric process characterized by a restrictive disorderin alimentary habits. Hematologic alterations in the peripheral blood include cytopeniasinvolving one or more hematopoietic lineages. Morphologic changes in the bone marrowand stereologic alterations in bone marrow adiopocytes may also be observed in anorexianervosa. We present a 12-year-old girl who had chronic anorexia and one third of bodyweight loss during an 8-month period. She was apathetic and had ...

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

    International Nuclear Information System (INIS)

    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

  8. 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.

  9. Long-term consequences of anorexia nervosa.

    Science.gov (United States)

    Meczekalski, Blazej; Podfigurna-Stopa, Agnieszka; Katulski, Krzysztof

    2013-07-01

    Anorexia nervosa (AN) is a psychiatric disorder that occurs mainly in female adolescents and young women. The obsessive fear of weight gain, critically limited food intake and neuroendocrine aberrations characteristic of AN have both short- and long-term consequences for the reproductive, cardiovascular, gastrointestinal and skeletal systems. Neuroendocrine changes include impairment of gonadotropin releasing-hormone (GnRH) pulsatile secretion and changes in neuropeptide activity at the hypothalamic level, which cause profound hypoestrogenism. AN is related to a decrease in bone mass density, which can lead to osteopenia and osteoporosis and a significant increase in fracture risk in later life. Rates of birth complications and low birth weight may be higher in women with previous AN. The condition is associated with fertility problems, unplanned pregnancies and generally negative attitudes to pregnancy. During pregnancy, women with the condition have higher rates of hyperemesis gravidarum, anaemia and obstetric complications, as well as impaired weight gain and compromised intrauterine foetal growth. It is reported that 80% of AN patients are affected by a cardiac complications such as sinus bradycardia, a prolonged QT interval on electrocardiography, arrythmias, myocardial mass modification and hypotension. A decrease in bone mineral density (BMD) is one of the most important medical consequences of AN. Reduced BMD may subsequently lead to a three- to seven-fold increased risk of spontaneous fractures. Untreated AN is associated with a significant increase in the risk of death. Better detection and sophisticated therapy should prevent the long-term consequences of this disorder. The aims of treatment are not only recovery but also prophylaxis and relief of the long-term effects of this disorder. Further investigations of the long-term disease risk are needed. PMID:23706279

  10. 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

  11. Fast psychomotor functioning in underweight anorexia nervosa patients.

    NARCIS (Netherlands)

    Pieters, G.F.F.M.; Sabbe, B.G.C.C.; Hulstijn, W.; Probst, M.; Eycken, W. van der; Peuskens, J.

    2003-01-01

    To explore whether underweight anorexia nervosa patients show psychomotor differences relative to normal controls, 32 female hospitalised patients, aged between 14 and 25 years, were compared with 32 healthy, normal weight controls, matched for sex, age and educational level. Using computerised anal

  12. 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)

  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. PMID:27157194

  14. Depression and Anorexia Nervosa of Persons with Down Syndrome.

    Science.gov (United States)

    Szymanski, Ludwik S.; Biederman, Joseph

    1984-01-01

    Manifestations of depression in three adults wth Down syndrome, one of whom also exhibited anorexia nervosa, are described. Overall findings indicate that major depression in Down syndrome may be more frequent than previously assumed and that it can be diagnosed with standard diagnostic criteria, modified according to the patient's developmental…

  15. Predictive factors of length of inpatient treatment in anorexia nervosa

    OpenAIRE

    Strik Lievers, Luisa; Curt, Florence; Wallier, Jenny; Perdereau, Fabienne; Rein, Zoé; Jeammet, Philippe; Godart, Nathalie

    2008-01-01

    Abstract Objective To identify clinical variables influencing the length of stay (LOS) of inpatient treatment for anorexia nervosa (AN). Method We analyzed structured clinical charts of 300 consecutive hospitalizations for AN in a specialized eating disorder unit. The sample included patients from 12 to 22 years ...

  16. Psychoneuroendocrinological aspects of anorexia nervosa: predictors of recovery

    NARCIS (Netherlands)

    Elburg, A.A. van

    2007-01-01

    Anorexia Nervosa (AN) is a psychosomatic eating disorder of unknown aetiology, which primarily affects adolescent girls and young women and is characterized by aberrant patterns of eating behaviour and weight regulation which result in weight loss and endocrine abnormalities such as amenorrhea, dist

  17. 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

  18. 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)

  19. Anorexia Nervosa: Family Characteristics and Family Interaction Patterns.

    Science.gov (United States)

    Geer, Susan Fellerman

    This literature review examines research issues in anorexia nervosa, including conceptual issues and methodological considerations. Research on the family's contribution to the disorder is reviewed. The demographic characteristics of social class, birth order, history of sexual abuse, and biological and genetic factors are examined. Individual…

  20. 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

  1. [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. PMID:26953548

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

    OpenAIRE

    Lechin, Fuad; van der Dijs, Bertha; Pardey-Maldonado, Betty; Baez, Scarlet; Lechin, Marcel E.

    2011-01-01

    Background: 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 disor...

  3. 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)

  4. 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 on...

  5. [Somatic care and complications of anorexia nervosa in adolescent girls].

    Science.gov (United States)

    Helfer, Jennifer; Favaro, Alexandra; Ambresin, Anne-Emmanuelle

    2016-06-01

    Anorexia nervosa is a frequent condition that appears mainly during adolescence and may persist until adulthood. It can have serious consequences, which is why it must be quickly detected and treated. In this article, we describe the parameters to be followed in outpatient clinic, complications not to be missed and when a hospital treatment becomes necessary. PMID:27451511

  6. 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…

  7. Humanistic Approaches to the Understanding and Treatment of Anorexia Nervosa.

    Science.gov (United States)

    Dittmar, Helga; Bates, Brian

    1987-01-01

    Summarizes some attempts to understand the causes and consequent treatments of anorexia nervosa from the viewpoints of psychoanalytically informed, family, existential and feminist psychology. These perspectives, which focus on the individual experience of the anorexic, leave many questions unanswered, but provide fresh frameworks from which to…

  8. Total daily energy expenditure and activity level in anorexia nervosa.

    Science.gov (United States)

    Casper, R C; Schoeller, D A; Kushner, R; Hnilicka, J; Gold, S T

    1991-05-01

    Clinical reports consistently comment on high physical activity for anorexia nervosa patients but provide few quantitative measurements. To assess activity, total daily energy expenditure (TDEE) by doubly labeled water, basal metabolic rate (BMR), and thermic effect of meals (TEM) were measured in six female outpatients with anorexia nervosa (67% of ideal body weight) and age-, sex-, and height-matched to six control subjects. Anorexia nervosa patients expended more energy as physical activity than did control subjects [0.084 +/- 0.012 vs 0.044 +/- 0.008 MJ/kg body wt, respectively (20.1 +/- 3.0 vs 10.5 +/- 1.9 kcal/kg body wt, respectively), P less than 0.04], although they had a lower BMR [4.17 +/- 0.37 vs 5.52 +/- 0.15 MJ/d, respectively (997 +/- 89 vs 1319 +/- 37 kcal/d, respectively), P less than 0.01]. TDEE and TEM were similar in both groups. There was a reduction in serum triiodothyronine (T3; 1.20 +/- 0.15 vs 2.04 +/- 0.13 nmol/L, respectively; P less than 0.003) and a slight reduction in serum thyroxine (T4); reverse T3, thyrotropin, free T4, serum cortisol, and adrenocorticotropin values were normal. BMR correlated with total body weight and fat-free mass. These results provide quantitative evidence for increased physical activity in anorexia nervosa despite profound underweight and hypometabolism. PMID:1850575

  9. 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…

  10. 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…

  11. The role of pharmacotherapy in anorexia nervosa and bulimia.

    Science.gov (United States)

    Tolstoi, L G

    1989-11-01

    The purpose of this article is to review the basic pharmacology and the role of drugs that are used to treat anorexia nervosa and bulimia. The pharmacological treatment of eating disorders is based upon theoretical principles. The theoretical models include: (a) an illness secondary to other psychiatric disorders, (b) a disorder in the hypothalamic control of food intake, (c) a disorder of hypothalamic endocrine regulation, (d) a syndrome secondary to depressive illness, and (e) a disorder in the hypothalamic regulation of food intake. Theoretical models a, b, and c govern the choice of drug therapy for anorexia nervosa, and models d and e govern the choice of drug therapy for bulimia. Drugs used to treat anorexia nervosa and bulimia include tricyclic antidepressants and lithium carbonate. Chlorpromazine, metoclopramide, cyproheptadine, and clomiphene citrate have also been prescribed for the treatment of anorexia nervosa. Monoamine oxidase inhibitors are commonly prescribed to treat bulimia. Fenfluramine has the potential to be of therapeutic value in patients with bulimia. Although drug therapy plays a limited role in the treatment of eating disorders, drugs are commonly prescribed. Therefore, the nutritionist should be familiar with the basic pharmacology and the side effects related to drug therapy. PMID:2572619

  12. Premenopausal osteoporosis, an overlooked consequence of anorexia nervosa.

    Science.gov (United States)

    Teng, Kathryn

    2011-01-01

    Many young women with anorexia nervosa develop premenopausal osteoporosis. In particular, female athletes have a much higher incidence of disordered eating than their peers and therefore are at a much higher risk of stress fractures and other traumatic bone pathology. This review summarizes factors affecting the development of premenopausal osteoporosis in these patients and identifies potential targets for intervention. PMID:21199907

  13. [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. PMID:25594270

  14. 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...

  15. 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...

  16. 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…

  17. 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…

  18. 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…

  19. Bone Metabolism in Adolescent Boys with Anorexia Nervosa

    OpenAIRE

    Misra, Madhusmita; Katzman, Debra K.; Cord, Jennalee; Manning, Stephanie J; Mendes, Nara; Herzog, David B.; Miller, Karen K.; Klibanski, Anne

    2008-01-01

    Background: Anorexia nervosa (AN) is a condition of severe undernutrition associated with low bone mineral density (BMD) in adolescent females with this disorder. Although primarily a disease in females, AN is increasingly being recognized in males. However, there are few or no data regarding BMD, bone turnover markers or their predictors in adolescent AN boys.

  20. Drive for activity in patients with anorexia nervosa

    NARCIS (Netherlands)

    Sternheim, Lot; Danner, Unna; Adan, Roger; Van Elburg, Annemarie

    2015-01-01

    Method Two hundred and forty female patients with AN completed measures for DFA, eating disorder (ED) pathology, anxiety, and clinical parameters. Objective Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a

  1. Drive for activity in patients with anorexia nervosa

    NARCIS (Netherlands)

    Sternheim, Lot; Danner, Unna; Adan, Roger; van Elburg, Annemarie

    2014-01-01

    OBJECTIVE: Hyperactivity and elevated physical activity are both considered symptom characteristics of anorexia nervosa (AN). It has been suggested that a drive for activity (DFA) may underlie these expressions, yet research into DFA in AN remains scant. This study investigated DFA levels in patient

  2. Anorexia nervosa e bulimia nervosa: abordagem cognitivo-construtivista de psicoterapia Anorexia nervosa and bulimia nervosa: a psychotherapeutic cognitive-constructivist approach

    OpenAIRE

    Cristiano Nabuco de Abreu; Raphael Cangelli Filho

    2004-01-01

    Dos transtornos alimentares, a anorexia nervosa e a bulimia nervosa são os que mais têm levado pacientes adolescentes, geralmente do sexo feminino e cada vez mais jovens, a buscar ajuda. Essa ajuda se dá através de um tratamento multidisciplinar envolvendo médicos psiquiatras, psicólogos e nutricionistas. A psicoterapia tem se mostrado um componente eficaz para a melhora dessas pacientes. O presente artigo tem por objetivo expor uma proposta de tratamento psicoterápico a partir da abordagem c...

  3. Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

    2016-01-01

    The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa. PMID:26467107

  4. 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…

  5. A psychological typology of females diagnosed with anorexia nervosa, bulimia nervosa or binge eating disorder

    OpenAIRE

    Bernadetta Izydorczyk

    2015-01-01

    Background The present paper reports the results of research aimed at identifying intra-group differences among females suffering from different eating disorders (anorexia nervosa, bulimia nervosa or binge eating disorder) in terms of the subjects’ psychological traits, adoption of socio-cultural norms (through media pressure, internationalization of norms, and exposure to information concerning body image standards), and the level of body dissatisfaction. The following research question...

  6. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa

    OpenAIRE

    Anna Tasegian; Francesco Curcio; Laura Dalla Ragione; Francesca Rossetti; Samuela Cataldi; Michela Codini; Francesco Saverio Ambesi-Impiombato; Tommaso Beccari; Elisabetta Albi

    2016-01-01

    Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical an...

  7. A comparison of neuropsychological test performance on the Ravello Profile between bulimia nervosa and anorexia nervosa

    OpenAIRE

    MacDonald, Kirsty

    2011-01-01

    Background The Ravello Profile is a battery of standardised neuropsychological measures of areas of functioning that evidence indicates are impaired in Anorexia Nervosa (AN), namely visuo-spatial functioning, central coherence and executive functioning. The neuropsychological profile of individuals with Bulimia Nervosa (BN) is less well established. The current study aimed to examine differences in cognitive performance between people with BN, AN and non-eating disordered controls on the Rave...

  8. A polysomnographic study in young psychiatric inpatients: major depression, anorexia nervosa, bulimia nervosa

    OpenAIRE

    Lauer, C J; Krieg, J. C.; Riemann, D; Zulley, Jürgen; Berger, M.

    1990-01-01

    The baseline EEG sleep patterns of 10 young depressed patients, 20 patients with anorexia nervosa, 10 patients with bulimia nervosa, and 10 healthy subjects were found to be indistinguishable, except for an increased REM density in the depressed patients. In eating disorder patients, a concomitant major depressive episode had no influence on EEG sleep. The results of the cholinergic REM sleep induction test revealed a significantly faster induction of REM sleep in the depressed patients when ...

  9. ТHE PRESENT STATE OF THE PROBLEM OF ANOREXIA NERVOSA AND BULIMIA NERVOSA

    OpenAIRE

    Shebanova, Vitaliya

    2014-01-01

    The article describes the analysis of scientific sources on the study of clinical forms of eating disorders (anorexia nervosa and bulimia nervosa). Close relationship of pathological patterns of eating behavior to bulimic and anorectic type is determined. There is a lack of accurate data on the therapeutic methods of treatment for people using pathological forms of eating behavior to correct their figures (anorexic and bulimic strategies).

  10. Fat Attenuation at CT in Anorexia Nervosa.

    Science.gov (United States)

    Gill, Corey M; Torriani, Martin; Murphy, Rachel; Harris, Tamara B; Miller, Karen K; Klibanski, Anne; Bredella, Miriam A

    2016-04-01

    Purpose To investigate the composition, cross-sectional area (CSA), and hormonal correlates of different fat depots in women with anorexia nervosa (AN) and control subjects with normal weights to find out whether patients with AN have lower fat CSA but higher attenuation than did control subjects and whether these changes may be mediated by gonadal steroids, cortisol, and thyroid hormones. Materials and Methods This study was institutional review board approved and HIPAA compliant. Written informed consent was obtained. Forty premenopausal women with AN and 40 normal-weight women of comparable age (mean age ± standard deviation, 26 years ± 5) were studied. All individuals underwent computed tomography of the abdomen and thigh with a calibration phantom. Abdominal subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), thigh SAT, and thigh intermuscular adipose tissue CSA and attenuation were quantified. Serum estradiol, thyroid hormones, and urinary free cortisol levels were assessed. Variables were compared by using analysis of variance. Associations were examined by using linear regression analysis. Results Women with AN had higher fat attenuation than did control subjects (-100.1 to -46.7 HU vs -117.6 to -61.8 HU, P < .0001), despite lower fat CSA (2.0-62.8 cm(2) vs 5.5-185.9 cm(2), P < .0001). VAT attenuation but not CSA was inversely associated with lowest prior lifetime body mass index in AN (r = -0.71, P = .006). Serum estradiol levels were inversely associated with fat attenuation (r = -0.34 to -0.61, P = .03 to <.0001) and were positively associated with fat CSA of all compartments (r = 0.42-0.64, P = .007 to <.0001). Thyroxine levels and urinary free cortisol levels were positively associated with thigh SAT attenuation (r = 0.64 [P = .006] and r = 0.68 [P = .0004], respectively) and were inversely associated with abdominal SAT and VAT CSA (r = -0.44 to -0.58, P = .04 to .02). Conclusion Women with AN have differences in fat composition, with

  11. Increased Bone Marrow Fat in Anorexia Nervosa

    Science.gov (United States)

    Bredella, Miriam A.; Fazeli, Pouneh K.; Miller, Karen K.; Misra, Madhusmita; Torriani, Martin; Thomas, Bijoy J.; Ghomi, Reza Hosseini; Rosen, Clifford J.; Klibanski, Anne

    2009-01-01

    Context: Although women with anorexia nervosa (AN) have severe depletion of body fat, a paradoxical increase in bone marrow fat has been described. Recent data suggest that marrow fat measured by 1H-magnetic resonance spectroscopy (MRS) in combination with bone mineral density (BMD) may be more valuable than either parameter alone in detecting bone weakness. Objective: The objective of the study was to investigate the effect of AN on accumulation of marrow fat in spine and femur using 1H-MRS and the relationship between marrow fat, BMD, and body composition in subjects with AN and normal-weight controls. Design: This was a cross-sectional study. Setting: The study was conducted at a referral center. Patients: Patients included 10 women with AN (29.8 ± 7.6 yr) and 10 normal-weight age-matched women (29.2 ± 5.2 yr). Interventions: There were no interventions. Main Outcomes Measure: Marrow fat content of the fourth lumbar vertebra and femur measured by 1H-MRS. BMD of spine and hip measured by dual-energy x-ray absorptiometry. Results: Subjects with AN had higher marrow fat at the fourth lumbar vertebra and femur compared with controls (P = 0.004–0.01). There was an inverse correlation between marrow fat of L4 and femur and BMD of the spine and hip (r = −0.56 to −0.71, P = 0.01–0.0002) and body mass index and sc adipose tissue of the thigh (r = −0.49 to −0.71, P = 0.03–0.0007). There was an inverse correlation between femur marrow fat and sc and total abdominal adipose tissue (r = −0.53 to −0.67, P = 0.003–0.03). Conclusion: Women with AN have greater lumbar and femoral marrow fat than controls, and marrow fat correlates inversely with BMD. This paradoxical increase in marrow fat at a time when sc and visceral fat are markedly reduced raises important questions about functional consequences of this process. PMID:19318450

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

    OpenAIRE

    Bárbara C. Machado; Óscar F. Gonçalves; 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...

  13. Acquired zinc deficiency in association with anorexia nervosa: case report and review of the literature.

    Science.gov (United States)

    Van Voorhees, A S; Riba, M

    1992-09-01

    Zinc deficiency, whether a result of an acquired or inherited abnormality of zinc metabolism, is associated with characteristic cutaneous findings. The inherited variety is known as acrodermatitis enteropathica. We present a case of zinc deficiency secondary to starvation induced by anorexia nervosa. Since the cutaneous stigmata of zinc deficiency and anorexia nervosa can initially be subtle and occasionally overlap, we believe that screening zinc levels in patients with anorexia nervosa with prominent cutaneous findings should be considered. PMID:1488378

  14. Anorexia nervosa and dialysis: we have no time when the body is so damaged!

    OpenAIRE

    Osório, Eva; Milheiro, Isabel; Brandão, Isabel; Roma Torres, António

    2013-01-01

    Anorexia nervosa remains challenging to treat and difficult to prevent. Nearly 5% of affected individuals die of this disease and 20% develop a chronic eating disorder. Anorexia nervosa may be associated with several medical complications of varying severity, including dysfunction of the renal system. Though there are some reports of renal failure in patients with anorexia nervosa, few reports are available concerning patients who required maintenance dialysis. We report a case of a patient w...

  15. Translational neuroscience of anorexia nervosa: A genetic and environmental interplay underlying behavioural hyperactivity in mice

    OpenAIRE

    Pjetri, E.

    2012-01-01

    Anorexia Nervosa is a severe mental illness, affecting young females more than males. Anorexia nervosa runs a chronic, relapsing course and is associated with high disability and mortality rates. The hallmark of the disease is keeping a low body weight, less than 85% of what is expected. The etiology of anorexia nervosa is complex (unknown), with risks involving environmental, temperamental, developmental and genetic factors. Though not specified in the diagnosis criteria, excessive physical ...

  16. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa

    OpenAIRE

    Sheng, Min; Lu, Hanzhang; Liu, Peiying; Thomas, Binu P.; McAdams, Carrie J.

    2015-01-01

    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...

  17. Two diagnoses become one? Rare case report of anorexia nervosa and Cushing’s syndrome

    OpenAIRE

    Sawicka, Nadia; Gryczyńska, Maria; Sowiński, Jerzy; Tamborska-Zedlewska, Monika; RUCHAŁA, MAREK

    2013-01-01

    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 Int...

  18. Oesophageal and gastric motility disorders in patients categorised as having primary anorexia nervosa.

    OpenAIRE

    Stacher, G; Kiss, A; Wiesnagrotzki, S; Bergmann, H; Höbart, J; Schneider, C

    1986-01-01

    Gastrointestinal motor function in patients with primary anorexia nervosa has rarely been investigated. We studied oesophageal motor activity in 30 consecutive patients meeting standard diagnostic criteria for primary anorexia nervosa (Feighner et al; DSM III). Seven were found to suffer from achalasia instead of primary anorexia nervosa, one from diffuse oesophageal spasm and one from severe gastro-oesophageal reflux and upper oesophageal sphincter hypertonicity, while partly non-propulsive ...

  19. Anoreksija nervoza s prikazom primera: Anorexia nervosa with a case study:

    OpenAIRE

    Arzenšek, Pia; Lahe, Milica; Turčin, Zlatan

    2005-01-01

    The article presents the summary of the diploma work Anorexia nervosa with a case study. Anorexia nervosa (AN) is presented together with its causes, specific symptoms and complications and the fact that their understanding is of crucial importance for the choice of relevant mode of treatment. The article stresses the importance of the role of the nurse in hospital treatment of patients with anorexia nervosa, and presents the measure called involuntary hospitalization which can prevent vital ...

  20. 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

  1. 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

  2. Pneumococcal sepsis associated with adrenal apoplexy in a young woman with anorexia nervosa

    OpenAIRE

    Nicola Maria Vitola; Dante Lo Pardo; Romualdo Cirillo; Matteo De Roberto; Pier Giovanni Crocco; Dario Caputo

    2013-01-01

    BACKGROUND A crude rate of mortality of 5% has been quoted for anorexia nervosa in recent studies. Nowadays the mechanism of death is unclear and various authors recommend that any anorexia nervosa death be reported and that, where possible, an autopsy be performed. METHODS In this work we present a case of sudden death in anorexia nervosa with unexpected autopsy findings. A 21-years-old woman with long-standing anorexia nervosa, severely underweight with a body mass index of 14.47 kg/m2, has...

  3. 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

  4. 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...

  5. MRI demonstration of orbital lipolysis in anorexia nervosa

    International Nuclear Information System (INIS)

    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.)

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

    International Nuclear Information System (INIS)

    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

  7. A case of anorexia nervosa with multiple medical complications.

    Science.gov (United States)

    Akgül, Sinem; Derman, Orhan

    2014-01-01

    Anorexia nervosa (AN) is a potentially life-threatening eating disorder characterized by an intense fear of gaining weight and a distorted body image. Although AN is a psychiatric illness, it is also very important from a pediatric perspective, as it can cause major medical complications in every organ system in the growing and developing body. The medical complications of anorexia nervosa may endanger the patient in several ways, and the severity of medical complications may be underestimated. Pediatricians should be aware of the possibility of medical complications in adolescent patients who have an eating disorder and understand that, if not managed correctly, such complications may be fatal. This case report describes the vast number of medical complications that can be observed in an adolescent due to an eating disorder. PMID:26022596

  8. Gelatinous Degeneration of the Bone Marrow in Anorexia Nervosa.

    Directory of Open Access Journals (Sweden)

    Shih-Hsiang Chen

    2004-11-01

    Full Text Available Anorexia nervosa is a chronic psychiatric process characterized by a restrictive disorderin alimentary habits. Hematologic alterations in the peripheral blood include cytopeniasinvolving one or more hematopoietic lineages. Morphologic changes in the bone marrowand stereologic alterations in bone marrow adiopocytes may also be observed in anorexianervosa. We present a 12-year-old girl who had chronic anorexia and one third of bodyweight loss during an 8-month period. She was apathetic and had missed several menstrualcycles. The sex maturity rating was Tanner stage IV. There was no lymphadenopathy, nohepatosplenomegaly, and no identifiable tumor mass. She was not anemic, but was found tohave leukopenia, neutropenia and a low level of triiodothyronine. Sections of the bone marrowbiopsy showed almost complete serous atrophy (gelatinous degeneration of the bonemarrow. In this patient, the bone marrow alteration is related to nutritional deprivation ofanorexia nervosa.

  9. EEG neurofeedback effects in the treatment of adolescent anorexia nervosa.

    Science.gov (United States)

    Lackner, Nina; Unterrainer, Human-Friedrich; Skliris, Dimitris; Shaheen, Sandra; Dunitz-Scheer, Marguerite; Wood, Guilherme; Scheer, Peter Jaron Zwi; Wallner-Liebmann, Sandra Johanna; Neuper, Christa

    2016-01-01

    A pre-post design including 22 females was used to evaluate the effectiveness of neurofeedback in the treatment of adolescent anorexia nervosa. Resting EEG measures and a psychological test-battery assessing eating behavior traits, clinical symptoms, emotionality, and mood were obtained. While both the experimental (n = 10) and control group (n = 12) received their usual maintenance treatment, the experimental group received 10 sessions of individual alpha frequency training over a period of 5 weeks as additional treatment. Significant training effects were shown in eating behavior traits, emotion regulation, and in relative theta power in the eyes closed condition. Although the results are limited due to the small sample size, these are the first empirical data demonstrating the benefits of neurofeedback as a treatment adjunct in individuals with anorexia nervosa. PMID:27027700

  10. 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

  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. 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. PMID:26769199

  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. 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...

  15. Kwashiorkor-like zinc deficiency syndrome in anorexia nervosa.

    Science.gov (United States)

    Esca, S A; Brenner, W; Mach, K; Gschnait, F

    1979-01-01

    This report deals with a 26-year-old white woman exhibiting signs of both Kwashiorkor (marasmus, pallor, hypopigmentation of hair and hepatomegaly) and acrodermatitis enteropathica (eczematous dermatitis predominantly on acral areas). Clinical and laboratory examinations excluded malabsorption syndrome and glucagonoma syndrome and revealed hypoproteinemia and marked zinc deficiency. Psychiatric examination disclosed anorexia nervosa. Substitution therapy led to rapid clearing of the skin lesions. PMID:92154

  16. Anorexia nervosa: a multifactorial disease of nutritional origin?

    Science.gov (United States)

    Tannhauser, Pia P

    2002-01-01

    Nutrition in general, with infant and child nutrition in particular, have changed in the past century through altered farming practices and eating habits. Food intake in childhood can influence the expression of the genetic potential. In this paper it is attempted to show how childhood zinc deficiency, aggravated in puberty by high energy/low zinc ratio of the diet and stresses of various kinds, can influence both mental and physical development and ultimately lead to the development of anorexia nervosa. PMID:12467193

  17. 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. PMID:26170676

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

    OpenAIRE

    Dudova I; Kocourkova J; Koutek J

    2015-01-01

    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 ...

  19. Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings

    OpenAIRE

    Campbell Iain C; Davies Helen; Tchanturia Kate

    2007-01-01

    Abstract Background Anorexia nervosa (AN) is a severe mental illness. Drug treatments are not effective and there is no established first choice psychological treatment for adults with AN. Neuropsychological studies have shown that patients with AN have difficulties in cognitive flexibility: these laboratory based findings have been used to develop a clinical intervention based on Cognitive Remediation Therapy (CRT) which aims to use cognitive exercises to strengthen thinking skills. Aims 1) ...

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

    OpenAIRE

    Lindsay P Bodell; Keel, Pamela K.

    2010-01-01

    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 review...

  1. Psychoneuroendocrinological aspects of anorexia nervosa: predictors of recovery

    OpenAIRE

    van Elburg, A A

    2007-01-01

    Anorexia Nervosa (AN) is a psychosomatic eating disorder of unknown aetiology, which primarily affects adolescent girls and young women and is characterized by aberrant patterns of eating behaviour and weight regulation which result in weight loss and endocrine abnormalities such as amenorrhea, disturbances in attitude and perception about weight and shape, and an intense fear of gaining weight. This thesis is based upon a follow up cohort study of 61 young girls and women consecutively refer...

  2. Time course of bone loss in patients with anorexia nervosa

    OpenAIRE

    Olmos Martínez, José Manuel; Valero Díaz de Lamadrid, Carmen; Gómez del Barrio, José Andrés; Amado Señarís, José Antonio; Hernández Hernández, José Luis; Menéndez Arango, José; González Macías, Jesús

    2010-01-01

    Objective: To evaluate the time course of bone mineral density (BMD) in women with anorexia nervosa (AN) during two years of follow-up. Methods: We prospectively studied 51 female with AN aged 18-38 years, and forty age-matched healthy women (19-34 years). BMD was measured in lumbar spine (LS), femoral neck (FN) and total hip (TH) by DXA. Results: At baseline, weight, body mass index, and lumbar and hip BMD were significantly (p

  3. Serum glutamine, set-shifting ability and anorexia nervosa

    OpenAIRE

    Collier David A; Campbell Iain C; Tchanturia Kate; Schmidt Ulrike; Hashimoto Kenji; Nakazato Michiko; Iyo Masaomi; Treasure Janet

    2010-01-01

    Abstract Background Set-shifting is impaired in people with anorexia nervosa (AN), but the underlying physiological and biochemical processes are unclear. Animal studies have established that glutamatergic pathways in the prefrontal cortex play an important role in set-shifting ability. However, it is not yet understood whether levels of serum glutamatergic amino acids are associated with set-shifting performance in humans. The aim of this study was to determine whether serum concentrations o...

  4. Mirroring voices of mother, daughter and therapist in Anorexia Nervosa

    OpenAIRE

    Weaver, Kathryn; Martin-McDonald, Kristine; Spiers, Judith

    2012-01-01

    "Die Erfahrungen von Frauen mit Essstörungen und die Deutungen, die Frauen aufgrund dieser Erfahrungen vollziehen, werden meist vor Professionellen im Gesundheitswesen zurückgehalten und sind deshalb in klinischen und akademischen Diskursen nur schlecht repräsentiert. In der hier vorgestellten Studie haben die Autorinnen sich - ausgehend von persönlichen Reflexionen, Tagebüchern und Briefen - mit der Beziehung zwischen einer Mutter, deren an Anorexia Nervosa leidender Tochter sowie einer Ther...

  5. Predictors of the resumption of menses in adolescent anorexia nervosa

    OpenAIRE

    Dempfle, Astrid; Herpertz-Dahlmann, Beate; Timmesfeld, Nina; Schwarte, Reinhild; Egberts, Karin M; Pfeiffer, Ernst; Fleischhaker, Christian; Wewetzer, Christoph; Bühren, Katharina

    2013-01-01

    Background: The resumption of menses is an important indicator of recovery in anorexia nervosa (AN). Patients with early-onset AN are at particularly great risk of suffering from the long-term physical and psychological consequences of persistent gonadal dysfunction. However, the clinical variables that predict the recovery of menstrual function during weight gain in AN remain poorly understood. The aim of this study was to investigate the impact of several clinical parameters on the resumpti...

  6. Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

    OpenAIRE

    Mathieu eMéquinion; Fanny eLanglet; Sara eZgheib; Suzanne eDickson; Bénédicte eDehouck; Christophe eChauveau; Odile eViltart

    2013-01-01

    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 condition...

  7. The Maudsley family-based treatment for adolescent anorexia nervosa

    OpenAIRE

    Le Grange, Daniel

    2005-01-01

    Anorexia nervosa (AN) usually onsets in mid-adolescence and presents with serious psychiatric and medical morbidities. Yet, few psychological treatments for this debilitating disorder have been studied. One intervention which involves the parents of the adolescent has proved to be promising, especially in patients with a short duration of illness, i.e., less than three years. The benefits of this family-based treatment have also been shown to be enduring at five-year follow-...

  8. Refeeding low weight hospitalised Adolescents with Anorexia Nervosa

    OpenAIRE

    O'Connor, G

    2014-01-01

    Refeeding adolescents with anorexia nervosa (AN) carries risks, the extent of which have been much debated but subject to little research. As such, the optimal nutritional management of such patients is unknown, and the lack of evidence from interventional studies has led to worldwide disparities in clinical management recommendations. In this first randomised controlled trial in this area, we tested the hypothesis that refeeding with a higher energy intake than that currently recommended in ...

  9. Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

    OpenAIRE

    Méquinion, Mathieu; Langlet, Fanny; Zgheib, Sara; Dickson, Suzanne; Dehouck, Bénédicte; Chauveau, Christophe; Viltart, Odile

    2013-01-01

    Increasing clinical and therapeutic interest in the neurobiology of eating disorders reflects their dramatic impact on health. Chronic food restriction resulting in severe weight loss is a major symptom described in restrictive anorexia nervosa (AN) patients, and they also suffer from metabolic disturbances, infertility, osteopenia, and osteoporosis. Restrictive AN, mostly observed in young women, is the third largest cause of chronic illness in teenagers of industrialized countries. From a n...

  10. Prolonged QT interval in a man with anorexia nervosa

    OpenAIRE

    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 wh...

  11. Constitutional Thinness and Anorexia Nervosa: A Possible Misdiagnosis?

    OpenAIRE

    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 p...

  12. Late Onset Anorexia Nervosa Treated With Olanzapine: A Case Report

    OpenAIRE

    Paolo Santonastaso; Arianna Camporese; Lorenza Caregaro; Angela Favaro

    2008-01-01

    A case of late onset anorexia nervosa (AN) treated with olanzapine is reported. The patient suffered AN onset at the age of 53 and was brought to our attention four years later in a very poor state of health due to extreme starvation and laxative abuse. She presented severe obsessions about food, a very disturbed body image, and “ascetic” rituals of self-punishment. There was no improvement of her symptoms with cognitive behavioural therapy, antidepressant drugs and inpatient nutritional ther...

  13. A genome-wide association study of anorexia nervosa

    OpenAIRE

    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 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...

  14. Impact of Broadening Definitions of Anorexia Nervosa on Sample Characteristics

    OpenAIRE

    Dellava, Jocilyn E.; Thornton, Laura M.; Lichtenstein, Paul; Pedersen, Nancy L; Bulik, Cynthia M

    2010-01-01

    Practical limitations and sample size considerations often lead to broadening of diagnostic criteria for anorexia nervosa (AN) in research. The current study sought to elucidate the effects of this practice on resultant sample characteristics in terms of eating disorder behaviors, psychiatric comorbidities, temperament and personality characteristics, and heritability point estimates. Three definitions of AN were created: meeting all Diagnostic and Statistical Manual of Mental Disorders-IV (D...

  15. Perspectives on the Prevention of Anorexia Nervosa and Bulimia

    OpenAIRE

    Steiger, Howard; Leichner, Pierre; Ghadirian, A. Missagh

    1987-01-01

    Ample evidence suggests a rising incidence of anorexia nervosa and bulimia over the past few decades. Correspondingly, medical knowledge about the etiology, symptomatology and treatment of these eating disorders has increased. Often the front line health-care workers who treat these disorders, family physicians are in a key position for early detection and prevention of these eating disorders. An adequate understanding of relevant risk factors, symptoms and signs may allow the physician to pr...

  16. Erythema Ab Igne in Three Girls with Anorexia Nervosa.

    Science.gov (United States)

    Dessinioti, Clio; Katsambas, Andreas; Tzavela, Eleni; Karountzos, Vasileios; Tsitsika, Artemis K

    2016-03-01

    We present three girls with the eating disorder anorexia nervosa (AN) presenting with erythema ab igne (EAI), a benign, reticular, erythematous dermatosis caused by repeated prolonged skin exposure to mild heat. AN has been associated with abnormal peripheral vascular response to cold, vasoconstriction of the limbs, low hand blood flow, exaggerated response to cold stimuli, subnormal core temperature, and a general feeling of cold that may encourage prolonged heat exposure and induce EAI. PMID:26822102

  17. Abnormal white matter properties in adolescent girls with anorexia nervosa

    OpenAIRE

    Travis, Katherine E.; Neville H. Golden; FELDMAN, HEIDI M.; Murray Solomon; Jenny Nguyen; Aviv Mezer; 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 ...

  18. Neurocognitive and social cognition deficits in patients with anorexia nervosa

    OpenAIRE

    Kułakowska, Dorota; Biernacka, Katarzyna; Wilkos, Ewelina; Rybakowski, Filip; Kucharska-Pietura, Katarzyna

    2014-01-01

    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 in...

  19. 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...

  20. Body Image Disturbance and Emotional Regulation in Anorexia Nervosa

    OpenAIRE

    2011-01-01

    Anorexia nervosa (AN) is a severe mental illness with a number of physical, psychological and social conditions. In spite of the severity of the disorder, we still lack empirical evidence to choose one treatment over another. The failure to show scientific evidence of effective treatment and prevention might rely on the complex psychological mechanisms involved in the disorder. To further improve our ability to help patients with AN, a better understanding of the specific mechanisms involved ...

  1. Anorexia nervosa: from purgative behaviour to nephropathy. a case report

    OpenAIRE

    Manzato, Emilia; Mazzullo, Maria; Gualandi, Malvina; Zanetti, Tatiana; Scanelli, Giovanni

    2009-01-01

    Background Individuals who suffer from Anorexia Nervosa refuse to maintain a minimally normal body weight, are intensely afraid of gaining weight and exhibit a significant disturbance in the perception of the shape and size of their body. Postmenarchal females with this disorder are amenorrohic. In the Binge-Eating/Purging subtype individuals regularly engage in binge eating and purging behaviour (i.e self-induced vomiting or misuse of laxatives, diuretics, or enemas). Hypokalaemia is often s...

  2. Anorexia nervosa and body fat distribution: a systematic review.

    Science.gov (United States)

    El Ghoch, Marwan; Calugi, Simona; Lamburghini, Silvia; Dalle Grave, Riccardo

    2014-09-01

    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). PMID:25251296

  3. 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.

  4. Participatory action research for women with anorexia nervosa.

    Science.gov (United States)

    Nicholls, Daniel; Fogarty, Sarah; Hay, Phillipa; Ramjan, Lucie Michelle

    2016-05-01

    Aim To discuss the application of the principles of participatory action research (PAR) in a project that developed and evaluated a mentor-mentee support programme for women with anorexia nervosa. Background A programme was developed and implemented in which mentors and mentees participated in workshops, social activities and focus groups that sought to support and develop resilience for those experiencing anorexia nervosa. Discussion PAR principles were mirrored in the programme, paying respect to the views and needs of each participant, an open trajectory to possible conclusions and a continuous feedback cycle. Mentees had a sense of empowerment, ownership of the programme and hope that recovery was possible. It allowed their voices to be heard and provided them with belief they could begin new relationships and friendships. Conclusion The principles of PAR suited a project aimed at developing self-determination and resilience in women with anorexia nervosa. Implications for research/practice PAR would be readily transferable to a number of mental health settings where empowerment is of paramount concern. PMID:27188570

  5. 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...

  6. Autism and anorexia nervosa: Two facets of the same disease?

    Science.gov (United States)

    Odent, Michel

    2010-07-01

    We compiled data included in the Primal Health Research Database (www.primalhealthresearch.com) to test the hypothesis that when two pathological conditions or personality traits share the same critical period for gene-environment interaction, we should expect further similarities, particularly from clinical and pathophysiological perspectives. The keywords 'autism' and 'anorexia nervosa' (but not bulimia nervosa) lead to studies suggesting that for both conditions the perinatal period is critical. We take this example to look at other possible links between these pathological entities. From a clinical perspective, several teams have independently emphasized the importance of autistic traits in anorexia nervosa. Deficits in the processing of oxytocin have been demonstrated in both cases. Autistic groups have significantly lower blood oxytocin levels than normal groups, and oxytocin levels increase with age in the normal group only. In autistic groups there is a high ratio of intermediates of oxytocin synthesis (OX-T) to the nonapeptide oxytocin (OT). On the other hand, it has been reported that the level of oxytocin in the cerebrospinal fluid of anorexic women is significantly lower than the level of oxytocin in bulimic and control subjects. Scanning data reveal similar asymmetric functions with left hemisphere preponderance in autistic spectrum disorders and anorexia. A comparative study of the mirror neurons systems is another promising avenue for research. Such an accumulation of similarities from a great diversity of perspectives suggests that anorexia nervosa might be considered a female variant of the autistic spectrum. A plausible interpretation is that prenatal exposure to male hormones might protect against the expression of this disease: girls who have a twin brother are at low risk for anorexia nervosa, compared with girls who have a twin sister, and with controls; furthermore genetic linkage analyses do not detect change on the X chromosome. From an

  7. A Developmental View of Anorexia Nervosa.

    Science.gov (United States)

    Akeroyd-Guillory, Denise

    1988-01-01

    Conducted research, based on Erikson's theory of identity development, to examine anorexic's progression through early stages of development. Results support the view that the negative aspects of development are clearly present in the anorexic. Findings have implications for school counselors. Introductory questionnaire on anorexia is appended.…

  8. 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…

  9. Recovery of Normal Body Weight in Adolescents with Anorexia Nervosa: The Nurses’ Perspective on Effective Interventions

    NARCIS (Netherlands)

    Bakker, René; Meijel, Berno van; Beukers, Laura; Ommen, Joyce van; Meerwijk, Esther; Elburg, Annemarie van

    2011-01-01

    Little is known about effective nursing interventions for adolescents with anorexia nervosa. The purpose of this study was to discover which aspects of nursing care are most effective, according to nurses, in recovery of normal body weight in adolescents with anorexia nervosa. METHODS: A qualitative

  10. 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

  11. Einfluss von Mirtazapin auf die Cortisolsekretion und die klinischen Parameter bei Patientinnen mit Anorexia nervosa

    OpenAIRE

    Sighart, Christian

    2006-01-01

    Das Antidepressivum Mirtazapin senkt Cortisolsekretion im Speichel bei Patientinnen mit Anorexia nervosa statistisch signifikant über die Zeit. Es wurden bei 5 Patientinnen in einem Zeitraum von 21 Tagen Speichelproben genommen. Der Schluß lautet, dass eine Mirtazapintherapie sinnvoll sein könnte, Hypercortisolismus bei Anorexia nervosa zu behandeln und HPA-Achsendysfunktion wieder herzustellen.

  12. Locus of Control, Psychopathology, and Weight Gain in Juvenile Anorexia Nervosa.

    Science.gov (United States)

    Strober, Michael

    1982-01-01

    Based on a hypothesized disturbance in personal control and efficacy in anorexia nervosa, locus of control score in female adolescents with anorexia nervosa was compared to scores obtained from depressed and conduct-disordered controls and to adolescent female standardization norms. (Author/CL)

  13. 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…

  14. 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…

  15. 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…

  16. 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…

  17. 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

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

    OpenAIRE

    Senay Akbay

    2014-01-01

    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 nervos...

  19. Fractures in patients with anorexia nervosa, bulimia nervosa, and other eating disorders--a nationwide register study

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Emborg, Charlotte; Støving, René K;

    2002-01-01

    OBJECTIVE: To study fracture risk in patients with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorders not otherwise specified (EDNOS). METHOD: Cohort study including all Danes diagnosed with AN (n = 2,149), BN (n = 1,294), or EDNOS (n = 942) between 1977 and 1998. Each patient...

  20. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa.

    Science.gov (United States)

    Tasegian, Anna; Curcio, Francesco; Dalla Ragione, Laura; Rossetti, Francesca; Cataldi, Samuela; Codini, Michela; Ambesi-Impiombato, Francesco Saverio; Beccari, Tommaso; Albi, Elisabetta

    2016-01-01

    Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders. PMID:26903713

  1. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa

    Directory of Open Access Journals (Sweden)

    Anna Tasegian

    2016-01-01

    Full Text Available Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders.

  2. Hypovitaminosis D3, Leukopenia, and Human Serotonin Transporter Polymorphism in Anorexia Nervosa and Bulimia Nervosa

    Science.gov (United States)

    Tasegian, Anna; Curcio, Francesco; Dalla Ragione, Laura; Rossetti, Francesca; Cataldi, Samuela; Codini, Michela; Ambesi-Impiombato, Francesco Saverio; Beccari, Tommaso; Albi, Elisabetta

    2016-01-01

    Vitamin D3 has been described to have different extraskeletal roles by acting as parahormone in obesity, diabetes, cancer, cognitive impairment, and dementia and to have important regulatory functions in innate immunity. There are no studies showing extraskeletal changes associated with hypovitaminosis D3 in eating disorders. Methods. We have analyzed the blood of 18 patients affected by anorexia nervosa and bulimia nervosa collected over a 15-month period. We performed a panel of chemical and clinical analyses: the assay of vitamin D3, the immunoblotting of vitamin D receptor and peroxisome proliferator-activated receptor gamma, and the genotyping of 5-hydroxytryptamine transporter linked polymorphic region. Results. We choose 18 patients with a normal blood test profile such as thyroid hormones, hepatic and renal parameters, triglycerides, proteins, vitamin B12, and folic acid. Among these emerged the case of a woman with long-term anorexia nervosa and the case of a woman with long-term bulimia nervosa both complicated by anxiety and depression, severe hypovitaminosis D3, decrease of vitamin D receptor, leukopenia, and 5-hydroxytryptamine transporter linked polymorphic region short allele. Conclusion. The results induce hypothesising that the severe hypovitaminosis D3 might be responsible for the lack of the inflammatory response and the depressive symptoms in patients with long-term eating disorders. PMID:26903713

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Radionuclide study of gastric emptying in anorexia nervosa patients

    International Nuclear Information System (INIS)

    To evaluate gastric emptying, 20 patients with anorexia nervosa were given 150 μCi of Tc-99m triethylene tetraamine polystyrene resin in cereal and were imaged in the supine position. Data were accumulated at 5-minute intervals to determine the gastric emptying time (GET). The GET results were divided into three categories: prolonged (10 patients); rapid (eight); and normal (two). Although all patients had symptoms of gastric dysfunction, only 50% had prolonged GET. This study allows the objective documentation of gastric emptying and the separation of patients with rapid or normal GET from those with prolonged GET, who might benefit from metoclopramide

  5. Spontaneous Pneumomediastinum: An Unusual Pulmonary Complication in Anorexia Nervosa.

    Science.gov (United States)

    Lee, Kyung-Jin; Yum, Ho-Kee; Park, I-Nae

    2015-10-01

    Spontaneous pneumomediastinum (PM) is an uncommon condition in which free air enters the mediastinum. This usually occurs either through esophageal tears after vigorous vomiting, or after alveolar rupture subsequent to a rapid increase in intra-alveolar pressure. Spontaneous PM is a rare entity in anorexia nervosa (AN) and self-induced vomiting is often the cause of PM in patients with AN. We experienced a case of spontaneous PM in an anorexic adolescent, in whom vomiting was not the cause of PM. PMID:26508924

  6. Bone Marrow Changes in Adolescent Girls With Anorexia Nervosa

    OpenAIRE

    Ecklund, Kirsten; Vajapeyam, Sridhar; Feldman, Henry A.; Buzney, Catherine D.; Mulkern, Robert V.; Kleinman, Paul K.; Rosen, Clifford J; Gordon, Catherine M.

    2009-01-01

    Early osteoporosis is common among adolescent girls with anorexia nervosa (AN) and may result from premature conversion of red (RM) to yellow bone marrow. We performed right knee magnetic resonance imaging (MRI) on a 1.0 T extremity scanner in 20 patients and 20 healthy controls, aged 16.2 ± 1.6 years (mean ± SD). Coronal T1-weighted (T1W) images and T1 maps were generated from T1 relaxometry images. Blinded radiologists visually assessed RM in the distal femoral and proximal tibial metaphyse...

  7. [Anorexia nervosa is frequently associated with psychiatric co-morbidity].

    Science.gov (United States)

    Panchenko, Anna; Arnfred, Sidse Marie Hemmingsen

    2015-09-21

    Recent literature is explored focusing on the relationship between symptoms of anorexia nervosa (AN) and other psychiatric disorders and lines of treatment. In AN, restrictive subtype, anxiety and obsessive-compulsive disorders are the most frequent co-morbidities. In AN, bulimic subtype, depression, emotional instability/borderline and dependency disorders are most frequent. Psychopharmacological treatment could be tried in cases with AN and co-morbid depression, but otherwise the evidence base is lacking and pharmacological treatment relies on case stories and experience. PMID:26418641

  8. Late Onset Anorexia Nervosa Treated With Olanzapine: A Case Report

    Directory of Open Access Journals (Sweden)

    Paolo Santonastaso

    2008-12-01

    Full Text Available A case of late onset anorexia nervosa (AN treated with olanzapine is reported. The patient suffered AN onset at the age of 53 and was brought to our attention four years later in a very poor state of health due to extreme starvation and laxative abuse. She presented severe obsessions about food, a very disturbed body image, and “ascetic” rituals of self-punishment. There was no improvement of her symptoms with cognitive behavioural therapy, antidepressant drugs and inpatient nutritional therapy. After the prescription of olanzapine, the patient was more cooperative and able to maintain a stable acceptable weight, although her psychiatric and anorexic symptoms only improved partially.

  9. [Anorexia nervosa and obsessive-compulsive disorder in a young Russian immigrant].

    Science.gov (United States)

    Iancu, I; Kikenzon, L; Ratzoni, G; Apter, A

    1993-04-15

    Anorexia nervosa is a psychiatric disorder characterized by excessive dieting, severe weight loss, disturbed body image and inexplicable fear of gaining weight. It afflicts mainly upper class women of developed countries. We present a 16-year-old recent immigrant from Russia, where she had developed anorexia nervosa, obsessive-compulsive disorder and depression. The management of this patient is presented in the light of the sociocultural theory of the pathogenesis of anorexia nervosa and the clinical link between eating disorders and depression and obsessive-compulsive disorders. PMID:8335272

  10. Dietary zinc intake of vegetarian and nonvegetarian patients with anorexia nervosa.

    Science.gov (United States)

    Bakan, R; Birmingham, C L; Aeberhardt, L; Goldner, E M

    1993-03-01

    Anorexia nervosa (AN) and zinc deficiency, found most frequently in young females, have a number of symptoms in common. These include weight loss, alterations in taste and appetite, depression, and amenorrhea. Approximately half of anorexia nervosa patients (ANs) are vegetarian (VANs), a practice that may increase their risk for zinc deficiency. This study compared the dietary intake of zinc and related nutrients in 9 outpatient VANs with that of 11 outpatient nonvegetarian patients with anorexia nervosa (NVANs). VANs reported significantly lower (p zinc, fat, and protein, and a significantly higher (p zinc intake should be routinely assessed in VANs and that zinc supplementation of their diets may be indicated. PMID:8477292

  11. 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

  12. Infantile anorexia nervosa: a developmental disorder or separation and individuation.

    Science.gov (United States)

    Chatoor, I

    1989-01-01

    Infantile anorexia nervosa is an eating disorder that has its onset during the early developmental stage of separation and individuation between the ages of six months and three years. Infantile anorexia nervosa is characterized by food refusal and leads to failure to thrive. The infant refuses to eat in an attempt to achieve autonomy and control with regard to the mother, a maneuver that serves to involve the mother more deeply in the infant's eating behavior and to meet the infant's need for attention. Mother and infant become embroiled in a battle of wills over the infant's food intake. The infant's feeding is directed by his emotional needs instead of physiological sensations of hunger and satiety, and he fails to develop somatopsychological differentiation. The infant's temperament and maternal conflicts over control, autonomy, and dependency appear to contribute to this eating disorder. Treatment is aimed toward helping the parents understand and promote the developmental process of somatopsychological differentiation. Initially, a behavioral-cognitive approach is used; however, parents who struggle with unresolved issues around dependency and control require further psychotherapy. PMID:2470708

  13. 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. PMID:21070808

  14. Cardiovascular disorders in anorexia nervosa and potential therapeutic targets.

    Science.gov (United States)

    Di Cola, Giovanni; Jacoangeli, Francesca; Jacoangeli, Fabrizio; Lombardo, Mauro; Iellamo, Ferdinando

    2014-10-01

    Anorexia nervosa (AN) is an eating disorder in which a distorted self-perception of body image and an excessive fear of gaining weight result in extreme restrictions in eating habits. AN may be divided into two types: a "binge-eating/purging type" during which the individual regularly engages in overeating and then purging behavior, and a "restricting type", in which she does not. AN is a serious medical problem in young people in Western societies. It is widely reported that patients with AN exhibit an enhanced mortality rate as compared with age-matched healthy subjects, which has been mainly ascribed to cardiac complications. At least one-third of all deaths in patients with anorexia nervosa are estimated to be due to cardiac causes, mainly sudden death. Cardiovascular complications of AN can be present in up to 80% of cases, and among them alterations in cardiac electrical activity, structure and hemodynamics have been reported as causes of morbidity and mortality. The objective of this brief review is to summarize current knowledge on the main cardiovascular complications of AN, their underlying mechanisms and the possible therapeutic approaches. PMID:25056404

  15. Processo de Enfermagem para pacientes com Anorexia Nervosa

    Directory of Open Access Journals (Sweden)

    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 mesma

  16. Eßstörungen bei Männern - Charakteristika des Verlaufs von Anorexia nervosa und Bulimia nervosa bei Männern und Vergleich mit einer weiblichen Stichprobe

    OpenAIRE

    Heidelinde Krenn

    2004-01-01

    Der kurz-, mittel- und langfristige Verlauf der Anorexia nervosa und Bulimia nervosa in einer parallelisierten klinischen Stichprobe von N=62 Männern und Frauen mit Anorexia nervosa und N=55 Männern und Frauen mit Bulimia nervosa wird beschrieben. Ergebnisse zu komorbiden psychiatrischen Erkrankungen (Achse I und Achse II; DSM-IV) werden ebenso berichtet wie Ergebnisse zu Homosexualität. Trendanalysen erlauben Aussagen zum Verlauf...

  17. Anorexia nervosa: some connections with the religious attitude.

    Science.gov (United States)

    Huline-Dickens, S

    2000-03-01

    This paper examines the religious and ascetic features of anorexia nervosa. The concept of asceticism in the Judeo-Christian culture and the many connections between the ascetic religious attitude and the anorexic are described. Whilst empirical evidence for religious themes in anorexia is not strong, in the family therapy literature there are indications of ethical codes of sacrifice, loyalty and sexual denial in the families of anorexics. The themes of sin, denial and self-punishment in the Judeo-Christian tradition are then discussed and the significance of the original sin with respect to both eating and sex emphasized. The psychological features of the ascetic mode are then described. It is argued that there exist many connections between the religious ascetic and the anorexic and that there are many psychopathological features common to both. Both anorexia and asceticism are considered to be connected conceptually in the process of idealization. It is suggested that this line of enquiry can enrich clinical approaches to the understanding and treatment of this neurotic disorder and stimulate further research. PMID:10759051

  18. Investigation of Oxytocin Secretion in Anorexia Nervosa and Bulimia Nervosa: Relationships to Temperament Personality Dimensions.

    Science.gov (United States)

    Monteleone, Alessio Maria; Scognamiglio, Pasquale; Volpe, Umberto; Di Maso, Virginia; Monteleone, Palmiero

    2016-01-01

    Published studies suggested an implication of oxytocin in some temperament characteristics of personality. Therefore, we measured oxytocin secretion in 23 women with anorexia nervosa (AN), 27 with bulimia nervosa (BN) and 19 healthy controls and explored the relationships between circulating oxytocin and patients' personality traits. Plasma oxytocin levels were significantly reduced in AN women but not in BN ones. In healthy women, the attachment subscale scores of the reward dependence temperament and the harm avoidance (HA) scores explained 82% of the variability in circulating oxytocin. In BN patients, plasma oxytocin resulted to be negatively correlated with HA, whereas no significant correlations emerged in AN patients. These findings confirm a dysregulation of oxytocin production in AN but not in BN and show, for the first time, a disruption of the associations between hormone levels and patients' temperament traits, which may have a role in certain deranged behaviours of eating disorder patients. PMID:26259495

  19. 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.

  20. Anorexia nervosa in pregnancy: a case report and review of the literature

    Science.gov (United States)

    Dinas, K; Daniilidis, A; Sikou, K; Tantanasis, T; Kasmas, S; Tzafettas, J

    2008-01-01

    Anorexia nervosa is a complex illness rarely encountered in pregnant women. It is a disorder characterized by markedly decreased food intake accompanied by a distorted body image, resulting in an inability to maintain the body weight within 85% of ideal body weight. We describe a case of a pregnant woman diagnosed with anorexia nervosa at 28 weeks of gestation. Her body mass index was 17 kg/m2. A live male infant weighing 2,08 kg was delivered prematurely via vaginal delivery at 35 weeks of gestation. Pregnant women with anorexia nervosa may have a higher risk of hypertension, miscarriage, difficult labour, premature delivery and intrauterine growth restriction. Management of pregnancy complicated with anorexia nervosa requires involvement of a multidisciplinary team and hospitalization in severe cases.

  1. Bilateral superficial peroneal nerve entrapment secondary to anorexia nervosa: a case report

    OpenAIRE

    Doğramacı Yunus; Kalacı Aydıner; Sevinç Teoman; Yanat Ahmet

    2008-01-01

    Abstract We report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression.

  2. Mirtazapine in the treatment of adolescent anorexia nervosa. Case-control study

    Czech Academy of Sciences Publication Activity Database

    Hrdlička, M.; Beranová, I.; Zámečníková, R.; Urbánek, Tomáš

    2008-01-01

    Roč. 17, č. 3 (2008), s. 187-189. ISSN 1018-8827 Institutional research plan: CEZ:AV0Z70250504 Keywords : anorexia nervosa * treatment * antidepressants Subject RIV: AN - Psychology Impact factor: 1.769, year: 2008

  3. Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: An alternative to family therapy?

    OpenAIRE

    Dalle Grave, Riccardo; Calugi, Simona; Doll, Helen A.; Fairburn, Christopher G.

    2013-01-01

    A specific form of family therapy (family-based treatment) is the leading treatment for adolescents with anorexia nervosa. As this treatment has certain limitations, alternative approaches are needed. “Enhanced” cognitive behaviour therapy (CBT-E) is a potential candidate given its utility as a treatment for adults with eating disorder psychopathology. The aim of the present study was to establish, in a representative cohort of patients with marked anorexia nervosa, the immediate and longer t...

  4. Recovery of Normal Body Weight in Adolescents with Anorexia Nervosa: The Nurses’ Perspective on Effective Interventions

    OpenAIRE

    Bakker, René; van Meijel, Berno; Beukers, Laura; Ommen, Joyce van; Meerwijk, Esther; van Elburg, Annemarie

    2011-01-01

    Little is known about effective nursing interventions for adolescents with anorexia nervosa. The purpose of this study was to discover which aspects of nursing care are most effective, according to nurses, in recovery of normal body weight in adolescents with anorexia nervosa. METHODS: A qualitative descriptive research design was applied with individual in-depth interviews and a focus group. Thematic analysis was used to analyze the data. FINDINGS: Nurses state that they are in a key positio...

  5. ‘Feelings stronger than reason’: conflicting experiences of exercise in women with anorexia nervosa

    OpenAIRE

    Kolnes, Liv-Jorunn

    2016-01-01

    Background Individuals with anorexia nervosa frequently feel ambivalent about treatment and weight restoration, and drop out and relapse rates in treatment are high. Increased insight into the function of the eating disorder is considered essential for achieving long-lasting, meaningful change. However, research investigating the functions of anorexia nervosa tends to focus on the role of the disease per se. Distinctions are rarely made across features. In particular, the subjective experienc...

  6. Experiences of specialist inpatient treatment for anorexia nervosa: a qualitative study from adult patients’ perspectives

    OpenAIRE

    Smith, Vivien

    2012-01-01

    Background: Response to treatment in anorexia nervosa entails various challenges, including an increased risk of relapse and re-admission in those treated as inpatients. A better understanding of patients’ experiences is paramount to improve treatment acceptability and outcome. This qualitative study aimed to explore the lived experiences of adult female inpatients undergoing a specialist inpatient treatment programme for anorexia nervosa. Methods: Semi-structured interviews...

  7. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions

    OpenAIRE

    Rizk, Melissa; Lalanne, Christophe; Berthoz, Sylvie; Kern, Laurence; ,; Godart, Nathalie

    2015-01-01

    “Hyperactivity” has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1) To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2) To examine how core eating disorder symptoms and the dimensions of emotional ...

  8. Inpatient Cognitive Behavior Therapy for Adolescents with Anorexia Nervosa: Immediate and Longer-Term Effects

    OpenAIRE

    RiccardoDalle Grave; Christofer G.Fairburn

    2014-01-01

    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 ...

  9. Seven years’ experience with etidronate in a woman with anorexia nervosa and vertebral fractures

    OpenAIRE

    Iwamoto J; Sato Y; Uzawa M; Takeda T; Matsumoto H

    2011-01-01

    Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Tsuyoshi Takeda1, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Department of Neurology, Mitate Hospital, Fukuoka, Japan; 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the case of a 30-year-old Japanese woman with anorexia nervosa and vertebral fractures who was treated with etidronate. She had a history of anorexia nervosa, chroni...

  10. Effect of Management of Patients with Anorexia and Bulimia nervosa on Symptoms and Impulsive Behavior

    OpenAIRE

    Sernec, Karin; Tomori, Martina; Zalar, Bojan

    2010-01-01

    The aim of the study was to provide further and up to date information on the evaluation of the management of Anorexia and Bulimia nervosa at the Eating Disorders Unit (EDU) of the Ljubljana Psychiatric Clinic, based upon detailed assessment of the eating disorders specific and non specific symptoms of impulsive behaviors, highly correlated with these entities. 34 female patients with anorexia (restrictive or purgative type) and 38 female patients with Bulimia nervosa (purgative or non-purgat...

  11. Kognitive Funktionen bei adoleszenten Patienten mit Anorexia nervosa und unipolaren Affektiven Störungen

    OpenAIRE

    Sarrar, Lea

    2014-01-01

    Anorexia nervosa und unipolare Affektive Störungen stellen häufige und schwerwiegende kinder- und jugendpsychiatrische Störungsbilder dar, deren Pathogenese bislang nicht vollständig entschlüsselt ist. Verschiedene Studien zeigen bei erwachsenen Patienten gravierende Auffälligkeiten in den kognitiven Funktionen. Dahingegen scheinen bei adoleszenten Patienten lediglich leichtere Einschränkungen in den kognitiven Funktionen vorzuliegen. Die Prävalenz der Anorexia nervosa und unipolaren Affektiv...

  12. Endocrine Alterations Are the Main Determinants of Cardiac Remodelling in Restrictive Anorexia Nervosa

    OpenAIRE

    Guido Carlomagno; Valentina Mercurio; Antonio Ruvolo; Ignazio Senatore; Irina Halinskaya; Valeria Fazio; Flora Affuso; Serafino Fazio

    2011-01-01

    Objective. Anorexia nervosa is a condition of reduced hemodynamic load, characterized by varying degrees of cardiac remodelling, only in part related to reduced body mass; the mechanism for such variability, as well as its clinical significance, remains unknown. Aim of the study was to assess the possible influence of a great number of clinical, biochemical, and endocrine factors on cardiovascular parameters in restrictive anorexia nervosa. Method. Twenty-five female patients hospitalized for...

  13. 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. PMID:26066296

  14. Acute gastric dilatation with infarction and perforation: Report of fatal outcome in patient with anorexia nervosa

    OpenAIRE

    Saul, S. H.; Dekker, A.; Watson, C G

    1981-01-01

    This is a report of a 22-year-old woman with treated anorexia nervosa who died of complications of acute gastric dilatation—that is, infarction and perforation with severe and irreversible shock. Binge eating and drinking, precipitated by emotional crises, contributed to her acute gastric dilatation. This complication of anorexia nervosa has been previously reported, but, unlike the others, this case ended fatally. The literature is reviewed.

  15. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions

    OpenAIRE

    Melissa Rizk; Christophe Lalanne; Sylvie Berthoz; Laurence Kern; Nathalie Godart

    2015-01-01

    "Hyperactivity" has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1) To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2) To examine how core eating disorder symptoms and the dimensions of emotional ...

  16. Psychiatry in the flesh. Embodiment of troubled lives. Studies of anorexia nervosa and eating disorders.

    OpenAIRE

    2007-01-01

    Body and mind – new perspectives on eating disorders In this doctoral dissertation the author focuses on models of understanding of how body and mind might interact in eating disorders, with particular emphasis on anorexia nervosa. The thesis ”Psychiatry in the flesh. Embodiment of troubled lives. Studies of anorexia nervosa and eating disorders” is based on six scientific articles which all have been published in referee-based psychiatric journals. Three of these scientific papers d...

  17. Olfaktorische Sensitivität und Geruchsperzeption bei Patientinnen mit Anorexia nervosa

    OpenAIRE

    Kleehaupt, Eva

    2011-01-01

    Hintergrund und Ziele Die Pathogenese der Anorexia nervosa ist komplex und beinhaltet sowohl psychologische und soziologische, als auch neurobiologische Komponenten (Bulik et al. 2005; Bulik et al. 2006; Lask & Bryant-Waugh 1992). Dabei ist die Rolle des Geruchssinns in der Pathobiologie der Anorexia nervosa wenig erforscht, obwohl - wie im „Diagnostischen und Statistischen Manual Psychischer Störungen“ und in der „Internationalen Klassifikation psychischer Störungen“ beschrieben - eine gestö...

  18. The possibility or coercion treatment? Anorexia nervosa – legal regulations. A case report

    OpenAIRE

    Tylec, Aneta; Olajossy, Marcin; Dubas-Ślemp, Halina; Spychalska, Katarzyna

    2013-01-01

    Anorexia nervosa is diagnosed on the basis of well-defined diagnostic criteria and requires treatment, as it is associated with the highest mortality rate of all mental illnesses. In Poland, anorexia nervosa is not considered a mental illness, although the opinion of researchers and clinicians are divided. To reduce the death rate of AN correct and early diagnosis, appropriate treatment starting immediately and the appropriate regulations to allow people to take the AN treatment against their...

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

    OpenAIRE

    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 c...

  20. ANOREXIA NERVOSA AS AN ADVERSE EFFECT OF MEDICATION IN A CASE OF CHRONIC SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    Mary C.

    2015-01-01

    Full Text Available INTRODUCTION: A 24 year old male patient presented to our department with anorexia nervosa in a long standing case of schizophrenia on treatment with resperidone and sodium valproate . The excessive weight gain due to side effect of medications resulted in development of anorexia nervosa in the patient. RESULT & CONCLUSION: We present this interesting case for its rarity and also to demonstrate how the use of the side effect of another medication can prove beneficial for therapeutic purpose.

  1. Treatment of anorexia nervosa with long-term risperidone in an outpatient setting: case study

    OpenAIRE

    Kracke, Elsa J; Tosh, Aneesh K.

    2014-01-01

    Introduction There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population. Case description This case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved an...

  2. [Personality disorders and psychiatric comorbidity in obsessive-compulsive disorder and anorexia nervosa].

    Science.gov (United States)

    Müller, B; Wewetzer, C; Jans, T; Holtkamp, K; Herpertz, S C; Warnke, A; Remschmidt, H; Herpertz-Dahlmann, B

    2001-08-01

    The aim of this prospective longitudinal study was to examine the course of adolescent anorexia nervosa and obsessive-compulsive disorder (OCD) (fulfilling DSM-III-R criteria) to compare psychiatric comorbidity and personality disorders of both groups. Because anorexia nervosa patients are mainly female, we compared them only with female OCD patients. Ten years after discharge the whole sample (32 female patients; 100%) of a group of 39 (32 female; 7 male) anorexia nervosa patients could be reexamined personally. 25 (61%) female patients of a group of 116 patients (41 female; 75 male) with obsessive-compulsive disorder were also reexamined. The anorexia nervosa patients were interviewed using the Structured Interview for Anorexia and Bulimia nervosa (SIAB [39]) to assess eating disorder symptomatology. To examine comorbid psychiatric disorders we used the Composite International Diagnostic Interview, WHO [44] and SCID-II [45] for personality disorders. One fourth of the patients with anorexia nervosa (AN) and 20% of the patients with obsessive-compulsive disorder had a personality disorder according to DSM-III-R. Most of them were "Cluster C"-personality disorders (AN: 28%; OCD: 20%). In the group of the female OCD patients 8% schizoid, 4% schizotype and 12% paranoid personality disorders were observed. The most prevalent psychiatric disorders were anxiety (AN: 28%; OCD: 20%) and affective disorders (AN: 16%; OCD: 16%). Our results support the view that in the course of anorexia nervosa and in obsessive-compulsive disorder there is a high prevalence of psychiatric comorbidity and "Cluster C"-personality disorders according to DSM-III-R. These results might confirm a model of a high vulnerability of the serotonergic neurotransmitter system in patients with anorexia nervosa or OCD. PMID:11584688

  3. 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...

  4. Pneumococcal sepsis associated with adrenal apoplexy in a young woman with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Nicola Maria Vitola

    2013-05-01

    Full Text Available BACKGROUND A crude rate of mortality of 5% has been quoted for anorexia nervosa in recent studies. Nowadays the mechanism of death is unclear and various authors recommend that any anorexia nervosa death be reported and that, where possible, an autopsy be performed. METHODS In this work we present a case of sudden death in anorexia nervosa with unexpected autopsy findings. A 21-years-old woman with long-standing anorexia nervosa, severely underweight with a body mass index of 14.47 kg/m2, has been taken to the Emergency Department in very critical conditions. Despite the attempts of resuscitation, she died shortly afterwards. Therefore an autopsy has been requested in order to clarify the causes of death. RESULTS The clinical picture, laboratory parameters, histology and microbiological investigations were consistent with pneumococcal sepsis associated adrenal apoplexy. CONCLUSIONS The cause of death in anorexia nervosa cannot reliably be established from antemortem clinical features. All anorexia nervosa deaths should be reported together with description of necropsy. This may lead to advances in the knowledge and treatment practices.

  5. 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. PMID:25985103

  6. Process evaluation of the MOSAIC trial: treatment experience of two psychological therapies for out-patient treatment of Anorexia Nervosa

    OpenAIRE

    Zainal, K. A.; Renwick, B.; Keyes, A.; Lose, A.; Kenyon, M.; DeJong, H; Broadbent, H.; Serpell, L; Richards, L.; Johnson-Sabine, E.; Boughton, N.; Whitehead, L.; Treasure, J; Schmidt, U.; MOSAIC trial group

    2016-01-01

    BACKGROUND: This study is part of a series of process evaluations within the MOSAIC Trial (Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions). This randomised controlled trial (RCT) compared two psychological treatments, the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM) for adult outpatients with Anorexia Nervosa. The present process study integrates quantitative (treatment acceptabi...

  7. Zusammenhang von Angst mit dem Schweregrad der Anorexia nervosa - Komorbidität am Beispiel einer klinischen Studie

    OpenAIRE

    Calame, Silke

    2005-01-01

    In der Literatur wird eine hohe Komorbidität zwischen Anorexia nervosa und Angststörungen beschrieben. Die Dissertation beinhaltet eine klinische Studie anhand von 29 anorektischen Patientinnen, in der der Zusammenhang zwischen der Ausprägung der Angst und dem Schweregrad der Anorexia nervosa untersucht wurde. Als Testverfahren kamen zur Anwendung State-Trait-Angstinventar (Stai), Sozialphobie und -angstinventar für Kinder (SPAIK), Anorexia nervosa Inventar zur Selbstbeobachtung (ANIS), Frage...

  8. 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. PMID:24963430

  9. Dialectical Behavior Therapy of Anorexia and Bulimia Nervosa among Adolescents: A Case Series

    Science.gov (United States)

    Salbach-Andrae, Harriet; Bohnekamp, Inga; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Miller, Alec L.

    2008-01-01

    The aim of this study was to describe a case series of adolescents (mean age = 16.5 years, SD = 1.0) with anorexia nervosa (AN) and bulimia nervosa (BN) who received dialectical behavior therapy (DBT). Twelve outpatients with AN and BN took part in 25 weeks of twice weekly therapy consisting of individual therapy and a skills training group.…

  10. Anorexia nervosa responding to zinc supplementation: a case report.

    Science.gov (United States)

    Yamaguchi, H; Arita, Y; Hara, Y; Kimura, T; Nawata, H

    1992-08-01

    An emaciated 16-year-old female with anorexia nervosa was hospitalized for treatment of vomiting, epigastralgia and diarrhea. The finding of a taste disorder, low serum alkaline phosphatase activity and relatively low serum zinc level strongly suggested a zinc deficiency. Zinc was initially administered intravenously (40 mumol/day) for 7 days, then orally (15 mg elemental zinc/day) for about 60 days. Her digestive symptoms disappeared after the second day of intravenous treatment and she began to gain weight. She rapidly regained her normal weight after one month of receiving the oral zinc supplementation. Both exocrine pancreatic function and intestinal absorption were improved by the prolonged oral administration of zinc. In such cases zinc supplementation may be a therapeutic option in addition to psychologic and other approaches to management. PMID:1526438

  11. Psychopharmacological options for adult patients with anorexia nervosa.

    Science.gov (United States)

    Miniati, Mario; Mauri, Mauro; Ciberti, Agnese; Mariani, Michela Giorgi; Marazziti, Donatella; Dell'Osso, Liliana

    2016-04-01

    The aim of this review was to summarize evidence from research on psychopharmacological options for adult patients with anorexia nervosa (AN). Database searches of MEDLINE and PsycINFO (from January 1966 to January 2014) were performed, and original articles published as full papers, brief reports, case reports, or case series were included. Forty-one papers were screened in detail, and salient characteristics of pharmacological options for AN were summarized for drug classes. The body of evidence for the efficacy of pharmacotherapy in AN was unsatisfactory, the quality of observations was questionable (eg, the majority were not blinded), and sample size was often small. More trials are needed, while considering that nonresponse and nonremission are typical of patients with AN. PMID:26145463

  12. 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. PMID:26689208

  13. Identical twins concordant for anorexia nervosa. A preliminary case report.

    Science.gov (United States)

    Debow, S L

    1975-04-01

    This case described the symptoms of anorexia nervosa occurring in identical twins. The problems of twinship, especially the failure to establish separate identities, complicated the more general psychological issues facing these adolescents in a disturbed family. In therapy the core issues of the anorexic patient persist--disturbance of body image, misinterpretation of body stimuli and a sense of ineffectiveness. Up to now therapy seems to have improved family function, making it easier for them to coexist and decreasing the feelings of hostility and negativism felt between the parents and the twins. Eating behaviour presently focuses on the twins' need to have equal amounts of food but less emphasis is placed on the food as an area of conflict for the family. PMID:1168539

  14. Anorexia nervosa and gender dysphoria in two adolescents.

    Science.gov (United States)

    Couturier, Jennifer; Pindiprolu, Bharadwaj; Findlay, Sheri; Johnson, Natasha

    2015-01-01

    Little has been published about the co-occurrence of gender dysphoria (GD) and eating disorders (ED) in adults, with no cases described in the adolescent population. The emphasis on body shape in both conditions suggests that there may be some overlap in symptomatology. We report two adolescent cases initially diagnosed with anorexia nervosa who later met criteria for GD. The drive for thinness for the 16-year-old male was associated with a wish to achieve a feminine physique whereas there was an emphasis for stunted breast growth and a desire for muscularity in the 13-year-old female. Complexities in presentation, evolution of symptoms over time, and the treatment of the two cases are discussed. Clinicians should inquire about sexual issues in the presentation of ED and should monitor for symptoms of GD, not only at initial presentation, but throughout treatment, especially as weight gain progresses. PMID:25421316

  15. 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. PMID:25368605

  16. Teriparatide treatment of osteoporosis in a patient with anorexia nervosa.

    Science.gov (United States)

    Shibli-Rahhal, Amal; McCormick, Laurie

    2013-06-01

    Osteoporosis commonly occurs in patients with anorexia nervosa (AN) and is often irreversible even after weight restoration. We describe a 52-year-old woman with AN and severe osteoporosis, discovered after she sustained multiple fractures from a fall. She had low weight for most of her life, but was only formally diagnosed with AN 6 years prior to her presentation. She received therapy for her eating disorder and was able to restore weight, which led to a 4.1 % improvement in her bone density. We then treated her with teriparatide for 2 years, which lead to a further 21 % increase in bone density and she has had no recurrence of fractures. Since AN-associated osteoporosis is characterized by low bone formation, teriparatide may be a useful treatment option. PMID:23760852

  17. [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. PMID:24440724

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

    Science.gov (United States)

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

    2016-03-01

    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. PMID:26757948

  19. 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.

  20. Purtscher-Like Retinopathy Associated with Anorexia Nervosa

    Science.gov (United States)

    Karasu, Bugra; Gunay, Betul Onal; Erdogan, Gurkan; Kardes, Esra; Gunay, Murat

    2016-01-01

    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. PMID:27069703

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

    Science.gov (United States)

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

    2016-01-01

    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. PMID:26757948

  2. 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.

  3. Resumption of menses after 32 years in anorexia nervosa.

    Science.gov (United States)

    Gentile, M G; Manna, G M; Pastorelli, P; Oltolini, A

    2011-09-01

    In anorexia nervosa estrogen deficient amenorrhea is associated with reduced bone mineral density and increased fracture risk. We report a case of a 53 years old female patient affected with AN since the age of 17 years when also amenorrhea started. During the subsequent 31 years she refused to modify her body weight, she always remained with a BMI below 17, and amenorrhea persisted throughout all the period. In November 2005, when she was 48 years old (BMI 15.6 kg/m²), she came to the Eating Disorder Unit of Niguarda Hospital to treat surgical complication of lower limb wound persisting after two operation; she also presented a marked reduction of bone density. After 6 months of intensive day hospital treatment she got a normal body weight and resumption of menses; in the following four years she has still been well and with normal menses, and bone density showed an improvement. PMID:21606666

  4. Selective cognitive empathy deficit in adolescents with restrictive anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Calderoni S

    2013-10-01

    Full Text Available Sara Calderoni,1 Pamela Fantozzi,1 Sandra Maestro,1 Elena Brunori,1 Antonio Narzisi,1 Giulia Balboni,2 Filippo Muratori1,31Department of Child Neurology and Psychiatry, IRCCS Stella Maris Foundation, 2Department of Surgery, Medical, Molecular and Critical Area Pathology, University of Pisa, 3Department of Developmental Medicine, University of Pisa, Pisa, ItalyBackground: A growing, but conflicting body of literature suggests altered empathic abilities in subjects with anorexia nervosa-restricting type (AN-R. This study aims to characterize the cognitive and affective empathic profiles of adolescents with purely AN-R.Methods: As part of a standardized clinical and research protocol, the Interpersonal Reactivity Index (IRI, a valid and reliable self-reported instrument to measure empathy, was administered to 32 female adolescents with AN-R and in 41 healthy controls (HC comparisons, matched for age and gender. Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures.Results: Patients scored significantly lower than HC on cognitive empathy (CE, while they did not differ from controls on affective empathy (AE. The deficit in CE was not related to either disease severity nor was it related to associated psychopathology.Conclusion: These results, albeit preliminary, suggest that a dysfunctional pattern of CE capacity may be a stable trait of AN-R that should be taken into account not only for the clinical management, but also in preventive and therapeutic intervention.Keywords: anorexia nervosa-restricting type, cognitive empathy, affective empathy, female adolescents, Interpersonal Reactivity Index

  5. Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa

    OpenAIRE

    Nagata Katsutaro; Ohkuma Kazuyoshi; Saito Satoshi; Yamaguchi Chikara; Koide Masanori; Okabe Kenjiro; Nishizono Aya; Okamoto Yuri; Nagata Toshihiko; Kawai Keisuke; Oka Takakazu; Nakahara Toshihiro; Ando Tetsuya; Komaki Gen; Nishimura Hiroki

    2008-01-01

    Abstract Background Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes. Method All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80...

  6. [Association of anorexia nervosa and mitral valve prolapse].

    Science.gov (United States)

    Amano, K; Sakamoto, T; Hada, Y; Hasegawa, I; Takahashi, T; Suzuki, J; Takahashi, H

    1986-01-01

    Four cases of anorexia nervosa recently encountered were reported in respect to their cardiovascular manifestations including prolapse of the cardiac valves and other poorly recognized cardiac findings. All four patients, aged 13 to 32 years, were women and had marked emaciation (35 to 44% weight loss of the ideal body weight) with typical hormone abnormalities. Chest radiographs showed a small cardiac shadow, and sinus bradycardia with low voltage was present in their electrocardiograms. One case, 13-year-old, had a mid-systolic click and occasionally a late systolic murmur, and also an abdominal continuous hum. Echocardiography including two-dimensional color flow-mapping disclosed mitral valve prolapse in all, and tricuspid valve prolapse in two. Mild to moderate pericardial effusion was noted in all between the right ventricle and diaphragm, and pericardiocentesis in one case had no effect on the valve movements. No inflammatory changes were observed in the specimen of the pericardium and also of the fluid. An association of mitral valve prolapse and anerexia nervosa was discussed based on the previous studies, but the final conclusion remains unknown. PMID:3681005

  7. The impact of hyperactivity and leptin on recovery from anorexia nervosa

    NARCIS (Netherlands)

    Elburg, A.A. van; Kas, M.J.H.; Hillebrand, J.J.G.; Eijkemans, R.J.C.; Engeland, H. van

    2007-01-01

    In anorexia nervosa (AN), hyperactivity is observed in about 80% of patients and has been associated with low leptin levels in the acute stage of AN and in anorexia animal models. To further understand the importance of this correlation in AN, we investigated the relationship between hypoleptinaemia

  8. 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. PMID:26059633

  9. Anorexia nervosa: the diagnosis. A postmodern ethics contribution to the bioethics debate on involuntary treatment for anorexia nervosa.

    Science.gov (United States)

    Kendall, Sacha

    2014-03-01

    This paper argues that there is a relationship between understandings of anorexia nervosa (AN) and how the ethical issues associated with involuntary treatment for AN are identified, framed, and addressed. By positioning AN as a construct/discourse (hereinafter "AN: the diagnosis") several ethical issues are revealed. Firstly, "AN: the diagnosis" influences how the autonomy and competence of persons diagnosed with AN are understood by decision-makers in the treatment environment. Secondly, "AN: the diagnosis" impacts on how treatment and treatment efficacy are defined and the ethical justifiability of paternalism. Thirdly, "AN: the diagnosis" can limit the opportunity for persons with AN to construct an identity that casts them as a competent person. "AN: the diagnosis" can thus inherently affirm professional knowledge and values. Postmodern professional ethics can support professionals in managing these issues by highlighting the importance of taking responsibility for professional knowledge, values, and power and embracing moral uncertainty. PMID:24366443

  10. Massa óssea em pacientes com anorexia nervosa

    Directory of Open Access Journals (Sweden)

    Santos Evaldo dos

    2004-01-01

    Full Text Available OBJETIVO: avaliar a ingestão diária de cálcio e estabelecer sua correlação com a densidade óssea de pacientes com anorexia nervos. PACIENTES E MÉTODOS: quatorze mulheres com anorexia nervosa registraram, em diário alimentar padronizado, sua ingestão em 24 horas e foram submetidas ao exame de densitometria óssea. A análise estatística foi feita pelos testes do c² e correlação de Pearson, adotando-se como significância estatística p<0,05. RESULTADOS: a média da densidade óssea na coluna lombar foi de 0,95 ± 0,15 e no colo do fêmur foi de 0,88 ± 0,26. Houve correlação significativa entre o tempo de amenorréia e a perda de massa óssea, tanto na coluna lombar (r=-0,65; p=0,01 como no fêmur (r=-0,71; (p=0,0068. Com exceção de uma paciente, todas apresentavam ingestão de cálcio inferior ao recomendado pelo RDA, com média de 554,5 mg/dia (variando de 120 a 840 mg/dia. Observou-se que 64% das pacientes apresentavam algum grau de perda de massa óssea (osteopenia ou osteoporose na coluna e 57% no fêmur. Das seis pacientes com déficit na ingestão de cálcio inferior a 60%, nenhuma apresentou osteoporose, ao passo que das oito pacientes com déficit superior a 60% na ingestão de cálcio, três tinham osteoporose. CONCLUSÃO: Pacientes com anorexia nervosa têm baixa ingestão de cálcio e perda significativa de massa óssea, que estão diretamente relacionadas entre si. A baixa densidade óssea está, também, correlacionada com o tempo de amenorréia.

  11. Hypothalamic tumor associated with atypical forms of anorexia nervosa and diencephalic syndrome

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    Eugenio Chipkevitch

    1993-06-01

    Full Text Available We report the case of a 10-year-old girl with a mature teratoma in the hypothalamic region. The patient presented a 2-month history of anorexia, psychic disturbances and a 37% loss of body weight. These symptoms had led initially to a diagnosis of major depression and atypical anorexia nervosa. She also presented some signs and symptoms of diencephalic syndrome. This case illustrates the importance of considering a slow-growing mass as a rare but real possibility in the differential diagnosis of anorexia nervosa, mainly in atypical cases.

  12. 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. PMID:26106053

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

    OpenAIRE

    Vanessa Pellegrino Toledo; Natália Amorim Ramos; Flávia Wopereis

    2011-01-01

    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...

  14. 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

    2015-01-01

    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. PMID:26555618

  15. 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.

  16. 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. PMID:26195537

  17. 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…

  18. 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

  19. Definition of a gastric emptying abnormality in patients with anorexia nervosa

    International Nuclear Information System (INIS)

    Upper gastrointestinal symptoms may be prominent in anorexia nervosa. This study is an investigation of the gastric emptying of solid and liquid meal components in 16 female patients who met accepted psychiatric diagnostic criteria for anorexia nervosa. The results were compared with those of gastric emptying studies in 10 normal females of ideal body weight, 13 normal persons (12 males), and six patients with weight loss secondary to Crohn's disease with no psychiatric symptoms. A dual-isotope technique using chicken liver intracellularly labeled with technetium-/sup 99m/ (/sup 99m/Tc) bound to sulfur colloid as the solid-phase marker, and indium-111 (111In) -labeled water as the liquid-phase marker was used. In 13 of the 16 anorexia nervosa patients (80%), gastric emptying of solids was slower than the range in the two groups of normal subjects, and mean gastric emptying was significantly slower than in the weight-loss patients. Liquid emptying (water) in anorexia nervosa was normal and similar to the control groups studied. In 11 of the anorexia nervosa patients with delayed gastric emptying, intramuscular metoclopramide, 10 mg, significantly accelerated the mean gastric emptying from 60 through 120 min after the meal. The authors conclude that these data are consistent with an antral motility disturbance, either primary or secondary; and metoclopramide, a gastric prokinetic agent, accelerates (delayed) gastric emptying

  20. Two diagnoses become one? Rare case report of anorexia nervosa and Cushing’s syndrome

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    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

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

    Directory of Open Access Journals (Sweden)

    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

  2. Average total energy expenditure in anorexia nervosa, bulimia nervosa, and healthy young women.

    Science.gov (United States)

    Pirke, K M; Trimborn, P; Platte, P; Fichter, M

    1991-10-01

    The double-labeled water method was used to measure average daily total energy expenditure (EE) in 11 healthy normal-weight women classified as unrestrained eaters, in 8 patients with anorexia nervosa, and in 8 patients with bulimia nervosa. The body mass index was 20.0 +/- 1.3 kg/m2 in the control group, 15.2 +/- 5.6 kg/m2 in the anorectic groups, and 19.7 +/- 1.9 kg/m2 in the bulimic group. EE was measured over a 2-week period during which weight remained constant in all groups and was 2357 +/- 504 kcal/day for the controls, 2510 +/- 920 kcal/day for the bulimics, and 2899 +/- 656 kcal/day for the anorectics. Differences were not significant among groups. Physical activity was recorded in diaries by all subjects. Anorectic patients showed significantly more activity than all other groups. The data suggest that EE is high in anorectic patients as a consequence of physical activity. PMID:1958768

  3. A case series investigation of association between co-morbid psychiatric disorder and the improvement in body mass index among patients with anorexia nervosa and eating disorder not otherwise specified of the anorexia nervosa type

    OpenAIRE

    Goh, Robin

    2015-01-01

    Background Anorexia nervosa and eating disorder not otherwise specified* (not fulfilling Anorexia Nervosa DSM IV criteria) are increasing in Singapore. Patients with eating disorders may also present with other psychiatric disorders such as depression and anxiety. The paper aims to investigate the association of co-morbid psychiatric disorders with the improvement of body mass index (BMI) in these patients. Methods A retrospective cohort analysis of 182 patients with anorexia and eating disor...

  4. A abordagem familiar no tratamento da anorexia e bulimia nervosa Family assessment in the treatment of anorexia and bulimia nervosa

    Directory of Open Access Journals (Sweden)

    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.

  5. A qualitative investigation into anorexia nervosa: The inner perspective

    Directory of Open Access Journals (Sweden)

    Enrica Marzola

    2015-12-01

    Full Text Available The ego-syntonic nature of anorexia nervosa (AN emphasizes how some aspects of this disorder can be highly valuable to patients. To understand the different perspectives that patients with AN hold about their condition, we explored the meanings they attribute to it. Thirty-four AN patients were asked to write a letter to their condition describing what it represents and means to them. Letters were then evaluated using a standardized coding scheme. Three pro-codes resulted to be mostly represented: difference (i.e. feeling different from others because of AN, company (i.e. being protected by the disorder, and identity (i.e. being totally represented by the illness. Some anti-codes were also particularly used: anger/hate, expressing anger toward AN, fear/distress, betrayal/pretend (i.e. feeling cheated by the disorder, and loss/waste (i.e. describing a feeling of life being wasted. In addition to pro- and anti-codes, the ambivalence theme was also well represented. Given the complex adaptive function of this disorder, this study may provide a framework of different perspectives that therapists could refer to and patients could identify with during the therapeutic process toward discovering individual meanings of the disorder.

  6. Radionuclide gastric emptying studies in patients with anorexia nervosa

    International Nuclear Information System (INIS)

    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

  7. Radionuclide gastric emptying studies in patients with anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Anorexia Nervosa and Its Associated Endocrinopathy in Young People.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2016-01-01

    Anorexia nervosa (AN) is a condition of severe undernutrition associated with adaptive changes in many endocrine axes. These changes include hypogonadotropic hypogonadism, acquired growth hormone resistance with low insulin-like growth factor 1 (IGF-1) levels, hypercortisolemia, altered secretion of adipokines and appetite-regulating hormones, and low bone mineral density (BMD). Bone health is impaired subsequent to a low body mass index, decreased lean mass, and the endocrine changes described above. In addition to low areal BMD, AN is characterized by a decrease in volumetric BMD, changes in bone geometry, and reductions in strength estimates, leading to an increased risk for fracture. Weight restoration is essential for restoration of normal endocrine function; however, hypercortisolemia, high peptide YY levels, and ghrelin dynamics may not completely normalize. In some patients, hypogonadotropic hypogonadism persists despite weight restoration. Weight gain and menstrual recovery are critical for improving bone health in AN; however, residual deficits may persist. Physiologic estrogen replacement using transdermal, but not oral, estrogen increases bone accrual in adolescents with AN, while bisphosphonates improve BMD in adults. Recombinant human IGF-1 and teriparatide have been used in a few studies as bone anabolic therapies. More data are necessary to determine the optimal therapeutic strategies for low BMD in AN. PMID:26863308

  9. Neurocognitive and social cognition deficits in patients with anorexia nervosa

    Directory of Open Access Journals (Sweden)

    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.

  10. Liver autophagy in anorexia nervosa and acute liver injury.

    Science.gov (United States)

    Kheloufi, Marouane; Boulanger, Chantal M; Durand, François; Rautou, Pierre-Emmanuel

    2014-01-01

    Autophagy, a lysosomal catabolic pathway for long-lived proteins and damaged organelles, is crucial for cell homeostasis, and survival under stressful conditions. During starvation, autophagy is induced in numerous organisms ranging from yeast to mammals, and promotes survival by supplying nutrients and energy. In the early neonatal period, when transplacental nutrients supply is interrupted, starvation-induced autophagy is crucial for neonates' survival. In adult animals, autophagy provides amino acids and participates in glucose metabolism following starvation. In patients with anorexia nervosa, autophagy appears initially protective, allowing cells to copes with nutrient deprivation. However, when starvation is critically prolonged and when body mass index reaches 13 kg/m(2) or lower, acute liver insufficiency occurs with features of autophagic cell death, which can be observed by electron microscopy analysis of liver biopsy samples. In acetaminophen overdose, a classic cause of severe liver injury, autophagy is induced as a protective mechanism. Pharmacological enhancement of autophagy protects against acetaminophen-induced necrosis. Autophagy is also activated as a rescue mechanism in response to Efavirenz-induced mitochondrial dysfunction. However, Efavirenz overdose blocks autophagy leading to liver cell death. In conclusion, in acute liver injury, autophagy appears as a protective mechanism that can be however blocked or overwhelmed. PMID:25250330

  11. The functional significance of shyness in anorexia nervosa.

    Science.gov (United States)

    Winecoff, Amy A; Ngo, Lawrence; Moskovich, Ashley; Merwin, Rhonda; Zucker, Nancy

    2015-07-01

    The defining features of anorexia nervosa (AN) include disordered eating and disturbance in the experience of their bodies; however, many women with AN also demonstrate higher harm avoidance (HA), lower novelty seeking, and challenges with interpersonal functioning. The current study explored whether HA and novelty seeking could explain variation in disordered eating and social functioning in healthy control women ( n = 18), weight-restored women with a history of AN (n = 17), and women currently-ill with AN (AN; n = 17). Our results indicated that clinical participants (AN + weight-restored women) reported poorer social skills than healthy control participants. Moreover, the relationship between eating disorder symptoms and social skill deficits was mediated by HA. Follow-up analyses indicated that only the 'shyness with strangers' factor of HA independently mediated this relationship. Collectively, our results suggest a better understanding of shyness in many individuals with eating disorders could inform models of interpersonal functioning in AN. PMID:25959923

  12. [Fever and lung abscesses in anorexia nervosa after infusion therapy].

    Science.gov (United States)

    Hoffmann, J; Herzum, M; Maisch, B

    1994-06-01

    A 26 year old female patient was admitted to our hospital because of septic temperatures and chills. In the patient's history renal insufficiency has been known for several years due to agenesia of the right and pyelonephritic renal congestion of the left kidney. Long lasting anorexia nervosa had been treated by psychotherapeutical interventions for years and when failing it necessitated repeated intravenous nutrition by central venous lines. The prominent symptom of the intravenously treated young woman was fever up to 39.7 degrees C and pneumonia, which was considered by the first treating clinic to be caused directly by diminished immunoreactivity in malnutrition and preuremia. The chest X-ray confirmed pneumonia and revealed multiple abscesses in both lungs (Figure 1). After being transferred to our intensive care unit the pathophysiological context became obvious. From inspection (positive jugular pulsation), from auscultation (holosystolic murmur at the left parasternal border) tricuspid incompetence due to infective endocarditis was suspected. This was confirmed immediately by TM and two-dimensional transthoracic echocardiography, which showed a large vegetation on the anterior tricuspid valve leaflet (Figures 2a and 2b). Tricuspid regurgitation was also ascertained by color flow echocardiography (Figure 2c). Several blood cultures were positive for staphylococcus aureus. Clinical and laboratory recovery was achieved by antibiotic therapy with vancomycin and cephtazidim for 3 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7927123

  13. [Neurocognitive and social cognition deficits in patients with anorexia nervosa].

    Science.gov (United States)

    Kułakowska, Dorota; Biernacka, Katarzyna; Wilkos, Ewelina; Rybakowski, Filip; Kucharska-Pietura, Katarzyna

    2014-01-01

    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--neurocognitive 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. PMID:25204093

  14. Therapeutic potential of ghrelin in restricting-type anorexia nervosa.

    Science.gov (United States)

    Hotta, Mari; Ohwada, Rina; Akamizu, Takashi; Shibasaki, Tamotsu; Kangawa, Kenji

    2012-01-01

    Anorexia nervosa (AN) is an eating disorder characterized by a decrease in caloric intake and malnutrition. It is associated with a variety of medical morbidities as well as significant mortality. Nutritional support is of paramount importance to prevent impaired quality of life later in life in affected patients. Some patients with restricting-type AN who are fully motivated to gain body weight cannot increase their food intake because of malnutrition-induced gastrointestinal dysfunction. Chronicity of AN prevents participation in social activities and leads to increased medical expenses. Therefore, there is a pressing need for effective appetite-stimulating therapies for patients with AN. Ghrelin is the only orexigenic hormone that can be given intravenously. Intravenous infusion of ghrelin is reported to increase food intake and body weight in healthy subjects as well as in patients with poor nutritional status. Here, we introduce the results of a pilot study that investigated the effects of ghrelin on appetite, energy intake, and nutritional parameters in five patients with restricting-type AN, who are fully motivated to gain body weight but could not increase their food intake because of malnutrition-induced gastrointestinal dysfunction. PMID:22975066

  15. Role of the evolutionarily conserved starvation response in anorexia nervosa.

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    Dwyer, D S; Horton, R Y; Aamodt, E J

    2011-06-01

    This review will summarize recent findings concerning the biological regulation of starvation as it relates to anorexia nervosa (AN), a serious eating disorder that mainly affects female adolescents and young adults. AN is generally viewed as a psychosomatic disorder mediated by obsessive concerns about weight, perfectionism and an overwhelming desire to be thin. By contrast, the thesis that will be developed here is that, AN is primarily a metabolic disorder caused by defective regulation of the starvation response, which leads to ambivalence towards food, decreased food consumption and characteristic psychopathology. We will trace the starvation response from yeast to man and describe the central role of insulin (and insulin-like growth factor-1 (IGF-1))/Akt/ F-box transcription factor (FOXO) signaling in this response. Akt is a serine/threonine kinase downstream of the insulin and IGF-1 receptors, whereas FOXO refers to the subfamily of Forkhead box O transcription factors, which are regulated by Akt. We will also discuss how initial bouts of caloric restriction may alter the production of neurotransmitters that regulate appetite and food-seeking behavior and thus, set in motion a vicious cycle. Finally, an integrated approach to treatment will be outlined that addresses the biological aspects of AN. PMID:20838399

  16. 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.

  17. Altered social attention in anorexia nervosa during real social interaction.

    Science.gov (United States)

    Dalmaso, Mario; Castelli, Luigi; Scatturin, Pietro; Carli, Lorenza; Todisco, Patrizia; Palomba, Daniela; Galfano, Giovanni

    2016-01-01

    The capacity to devote attentional resources in response to body-related signals provided by others is still largely unexplored in individuals with Anorexia Nervosa (AN). Here, we tested this capacity through a novel paradigm that mimics a social interaction with a real partner. Healthy individuals (Experiment 1) and individuals with AN (Experiment 2) completed a task with another person which consisted in performing, alternatively, rapid aiming movements to lateralised targets. Generally, this task leads to a form of Inhibition of Return (IOR), which consists of longer reaction times when an individual has to respond to a location previously searched by either himself (individual IOR) or by the partner (social IOR) as compared to previously unexplored locations. IOR is considered as an important attentional mechanism that promotes an effective exploration of the environment during social interaction. Here, healthy individuals displayed both individual and social IOR that were both reliable and of the same magnitude. Individuals with AN displayed a non-significant individual IOR but a reliable social IOR that was also significantly stronger than individual IOR. These results suggest the presence of a reduced sensitivity in processing body-related stimuli conveyed by oneself in individuals with AN which is reflected in action-based attentional processes. PMID:26984784

  18. 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.

  19. Liver Autophagy in Anorexia Nervosa and Acute Liver Injury

    Directory of Open Access Journals (Sweden)

    Marouane Kheloufi

    2014-01-01

    Full Text Available Autophagy, a lysosomal catabolic pathway for long-lived proteins and damaged organelles, is crucial for cell homeostasis, and survival under stressful conditions. During starvation, autophagy is induced in numerous organisms ranging from yeast to mammals, and promotes survival by supplying nutrients and energy. In the early neonatal period, when transplacental nutrients supply is interrupted, starvation-induced autophagy is crucial for neonates’ survival. In adult animals, autophagy provides amino acids and participates in glucose metabolism following starvation. In patients with anorexia nervosa, autophagy appears initially protective, allowing cells to copes with nutrient deprivation. However, when starvation is critically prolonged and when body mass index reaches 13 kg/m2 or lower, acute liver insufficiency occurs with features of autophagic cell death, which can be observed by electron microscopy analysis of liver biopsy samples. In acetaminophen overdose, a classic cause of severe liver injury, autophagy is induced as a protective mechanism. Pharmacological enhancement of autophagy protects against acetaminophen-induced necrosis. Autophagy is also activated as a rescue mechanism in response to Efavirenz-induced mitochondrial dysfunction. However, Efavirenz overdose blocks autophagy leading to liver cell death. In conclusion, in acute liver injury, autophagy appears as a protective mechanism that can be however blocked or overwhelmed.

  20. Altered social attention in anorexia nervosa during real social interaction

    Science.gov (United States)

    Dalmaso, Mario; Castelli, Luigi; Scatturin, Pietro; Carli, Lorenza; Todisco, Patrizia; Palomba, Daniela; Galfano, Giovanni

    2016-01-01

    The capacity to devote attentional resources in response to body-related signals provided by others is still largely unexplored in individuals with Anorexia Nervosa (AN). Here, we tested this capacity through a novel paradigm that mimics a social interaction with a real partner. Healthy individuals (Experiment 1) and individuals with AN (Experiment 2) completed a task with another person which consisted in performing, alternatively, rapid aiming movements to lateralised targets. Generally, this task leads to a form of Inhibition of Return (IOR), which consists of longer reaction times when an individual has to respond to a location previously searched by either himself (individual IOR) or by the partner (social IOR) as compared to previously unexplored locations. IOR is considered as an important attentional mechanism that promotes an effective exploration of the environment during social interaction. Here, healthy individuals displayed both individual and social IOR that were both reliable and of the same magnitude. Individuals with AN displayed a non-significant individual IOR but a reliable social IOR that was also significantly stronger than individual IOR. These results suggest the presence of a reduced sensitivity in processing body-related stimuli conveyed by oneself in individuals with AN which is reflected in action-based attentional processes. PMID:26984784

  1. Contemporary views on the genetics of anorexia nervosa.

    Science.gov (United States)

    Shih, Pei-An Betty; Woodside, D Blake

    2016-04-01

    Anorexia nervosa (AN) is a serious mental illness characterized by severe dietary restriction that leads to high rates of morbidity, chronicity, and mortality. Unfortunately, effective treatment is lacking and few options are available. High rates of familial aggregation and significant heritability suggested that the complex etiology of AN is affected by both genetic and environmental factors. In this paper, we review studies that reported common and rare genetic variation that influence susceptibility of AN through candidate gene studies, genome-wide association studies, and sequencing-based studies. We also discuss gene expression, methylation, imaging genetics, and pharmacogenetics to demonstrate that these studies have collectively advanced our knowledge of how genetic variation contributes to AN susceptibility and clinical course. Lastly, we highlight the importance of gene by environment interactions (G×E) and share our enthusiasm for the use of nutritional genomic approaches to elucidate the interaction among nutrients, metabolic intermediates, and genetic variation in AN. A deeper understanding of how nutrition alters genome stability, how genetic variation influences uptake and metabolism of nutrients, and how response to food components affects disordered eating, will lead to personalized dietary interventions and effective nutraceutical and pharmacological treatments for AN. PMID:26944296

  2. Radionuclide gastric emptying studies in patients with anorexia nervosa.

    Science.gov (United States)

    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 [99mTc]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. PMID:3572544

  3. Defective in vitro granulopoiesis in patients with anorexia nervosa.

    Science.gov (United States)

    Vaisman, N; Barak, Y; Hahn, T; Karov, Y; Malach, L; Barak, V

    1996-07-01

    Patients with anorexia nervosa (AN) frequently suffer from a mild degree of anemia and from moderate leukopenia on top of their undernourished state and metabolic disarrangements. To evaluate in vitro granulopoiesis and its relationship to cytokine production and undernutrition, we have studied 10 adolescent girls with moderate AN (age range, 13.5-18.0). Study methods included assessment of peripheral blood (PB) granulocyte-macrophage colony-forming cells (GM-CFC) of the patients and age-matched controls, and determination of plasma and conditioned medium (CM) of mononuclear cells levels of IL-1, IL-3, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF) and tumor necrosis factor (TNF), all of which may play a role in GM-CFC growth regulation. GM-CFC numbers were significantly lower in AN patients compared with the normal controls (13.09 +/- 11.15 versus 39.33 +/- 26.61 colonies/5 x 10(5) cells, p bone marrow GM-CFC targets, the number of colonies stimulated by the CM of patients with AN was significantly lower than those stimulated by the CM of the controls (73.5 +/- 20.1 versus 113.0 +/- 11.6, p changes are the result of the basic disease process or are they due to malnutrition. PMID:8798255

  4. Leptin, ghrelin, and endocannabinoids: potential therapeutic targets in anorexia nervosa.

    Science.gov (United States)

    Støving, René Klinkby; Andries, Alin; Brixen, Kim; Flyvbjerg, Allan; Hørder, Kirsten; Frystyk, Jan

    2009-04-01

    Anorexia nervosa (AN) has the highest mortality rate between psychiatric disorders, and evidence for managing it is still very limited. So far, pharmacological treatment has focused on a narrow range of drugs and only a few controlled studies have been performed. Furthermore, the studies have been of short duration and included a limited number of subjects, often heterogenic with regard to stage and acute nutritive status. Thus, novel approaches are urgently needed. Body weight homeostasis is tightly regulated throughout life. With the discovery of orexigenic and anorectic signals, an array of new molecular targets to control eating behavior has emerged. This review focuses on recent advances in three important signal systems: leptin, ghrelin, and endocannabinoids toward the identification of potential therapeutical breakthroughs in AN. Our review of the current literature shows that leptin may have therapeutic potentials in promoting restoration of menstrual cycles in weight restored patients, reducing motor restlessness in severely hyperactive patients, and preventing osteoporosis in chronic patients. Ghrelin and endocannabinoids exert orexigenic effects which may facilitate nutritional restoration. Leptin and endocannabinoids may exert antidepressive and anxiolytic effects. Finally, monitoring serum concentration of leptin may be useful in order to prevent refeeding syndrome. PMID:18926548

  5. Impaired processing of self-face recognition in anorexia nervosa.

    Science.gov (United States)

    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 eating disorders could play a part in impaired self-face recognition. PMID:26420298

  6. The perception of affective touch in anorexia nervosa.

    Science.gov (United States)

    Crucianelli, Laura; Cardi, Valentina; Treasure, Janet; Jenkinson, Paul M; Fotopoulou, Aikaterini

    2016-05-30

    Anorexia nervosa (AN) is a disorder characterized by restricted eating, fears of gaining weight, and body image distortions. The etiology remains unknown; however impairments in social cognition and reward circuits contribute to the onset and maintenance of the disorder. One possibility is that AN is associated with reduced perceived pleasantness during social interactions. We therefore examined the perception of interpersonal, 'affective touch' and its social modulation in AN. We measured the perceived pleasantness of light, dynamic stroking touches applied to the forearm of 25 AN patients and 30 healthy controls using C Tactile (CT) afferents-optimal (3cm/s) and non-optimal (18cm/s) velocities, while simultaneously displaying images of faces showing rejecting, neutral and accepting expressions. CT-optimal touch, but not CT non-optimal touch, elicited significantly lower pleasantness ratings in AN patients compared with healthy controls. Pleasantness ratings were modulated by facial expressions in both groups in a similar fashion; namely, presenting socially accepting faces increased the perception of touch pleasantness more than neutral and rejecting faces. Our findings suggest that individuals with AN have a disordered, CT-based affective touch system. This impairment may be linked to their weakened interoceptive perception and distorted body representation. PMID:27137964

  7. First do no harm: iatrogenic maintaining factors in anorexia nervosa.

    Science.gov (United States)

    Treasure, Janet; Crane, Anna; McKnight, Rebecca; Buchanan, Emmakate; Wolfe, Melissa

    2011-01-01

    The aim of this paper is to reflect on the way that we as clinicians may play an inadvertent role in perpetuating eating disordered behaviour. This is considered within the theoretical framework of Schmidt and Treasures' maintenance model of anorexia nervosa (AN). The model includes four main domains; interpersonal factors, pro-AN beliefs, emotional style and thinking style. Interpersonal reactions are of particular relevance as clinicians (as with family members) may react with high expressed emotion and unknowingly encourage eating disorder behaviours to continue. Hostility in the form of coercive refeeding in either a hospital or outpatient setting may strengthen conditioned food avoidance and pessimism may hamper motivation to change. Negative schema common to eating disorders, for example low self-esteem, perfectionism and striving for social value may augment existing or initiate new eating disorder behaviour. Services can become a reinforcing influence by providing an overly protective, palliating environment which ensures safety, security and acceptance whilst reducing loneliness and isolation. This stifles the need for an individual to develop their own sense of responsibility, autonomy and independence allowing avoidance to dominate. Furthermore, the highly structured environment of inpatient care supports the rigid attention to detail and inflexibility that is characteristic of people with eating disorders, and allows these negative behaviours to thrive. Careful planning of service provision, reflective practice, supervision and regular team feedback is essential to prevent iatrogenic harm. PMID:21714039

  8. Self-esteem in patients treated for anorexia nervosa.

    Science.gov (United States)

    Karpowicz, Ewa; Skärsäter, Ingela; Nevonen, Lauri

    2009-10-01

    Anorexia nervosa (AN) mainly affects girls or women between 13 and 45 years of age. According to previous studies, one of the reasons for the desire to be thin is low self-esteem. The purpose of the study was to examine the self-esteem of 38 female patients with AN between 16 and 25 years of age, before and after 3 months of treatment at a specialist ward for eating disorders in Göteborg, Sweden. A quantitative pre- and post-assessment based on two self-rating questionnaires, the Rosenberg Self-Esteem Scale (RSE-S) and three subscales (weight phobia, body dissatisfaction, and ineffectiveness) of Eating Disorder Inventory-2 (EDI-2), together with body mass index (BMI), were used in the study, which was conducted between June 2005 and March 2008. The results reveal that self-esteem, BMI, weight phobia, and body dissatisfaction improved significantly between pre- and post-treatment. The RSE-S and EDI-2 ineffectiveness correlate highly with one another, which lends support to convergent validity, and the internal consistency was high for both the RSE-S and EDI-2 ineffectiveness. The results indicate that the treatment was effective, as both patients' self-esteem and BMI increased after completed treatment, which was the primary goal of the treatment at this ward. Future studies should focus on follow up and the way self-esteem manifests itself at different points in time within an individual. PMID:19740141

  9. 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.

  10. Increased reverse T/sub 3/ concentration in patients with anorexia nervosa

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    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.

  11. Refining behavioral dysregulation in borderline personality disorder using a sample of women with anorexia nervosa.

    Science.gov (United States)

    Selby, Edward A; Bulik, Cynthia M; Thornton, Laura; Brandt, Harry A; Crawford, Steve; Fichter, Manfred M; Halmi, Katherine A; Jacoby, Georg E; Johnson, Craig L; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Nutzinger, Detlev O; Strober, Michael; Treasure, Janet; Woodside, D Blake; Kaye, Walter H; Joiner, Thomas E

    2010-10-01

    One of the primary facets of borderline personality disorder (BPD) is behavioral dysregulation, a wide array of behaviors that are difficult to control and harmful to the individual. The purpose of this study was to explore the association between BPD and a variety of dysregulated behaviors, some of which have received little empirical attention. Using a large sample of individuals diagnosed with anorexia nervosa, 41 individuals diagnosed with BPD were compared to the rest of the sample on the presence of dysregulated behaviors using logistic regression analyses. Anorexia nervosa subtypes, age, and other Cluster B personality disorders were used as covariates. Results support an association between BPD and alcohol misuse, hitting someone/breaking things, provoking fights/arguments, self-injury, overdosing, street drug use, binge-eating, impulsive spending, shoplifting/stealing, and risky sexual behaviors. Differences between dichotomous and continuous measures of BPD yielded somewhat different results. Information on co-occurring anorexia nervosa and BPD was generated. PMID:22448667

  12. [Dietotherapy of patients with anorexia nervosa and eating disorders in inpatient clinic].

    Science.gov (United States)

    Gladyshev, O A; Isakov, V A; Shakhovskaia, A K

    2011-01-01

    We assessed a nutritional status of patients with anorexia nervosa, theirs metabolical indicators and body structure with the use of bioimpedometry. Also we assessed a basal metabolic rate patients with anorexia nervosa with the use of indirect calorimethry method. We developed an algorithm of dietotherapy of patients with anorexia nervosa. In dependence of expressiveness degree of metabolical disorders of patients we suggested three different food allowance with different caloric content and different chemical compound of the food. The results show us the improvement of status of patients: their activity have risen up, mood have stabilized, anxiety have decreased, appetite have taken a turn for the better and their weight have stabilized too. PMID:21574467

  13. Definition of a gastric emptying abnormality in patients with anorexia nervosa.

    Science.gov (United States)

    McCallum, R W; Grill, B B; Lange, R; Planky, M; Glass, E E; Greenfeld, D G

    1985-08-01

    Upper gastrointestinal symptoms may be prominent in anorexia nervosa. This study is an investigation of the gastric emptying of solid and liquid meal components in 16 female patients (mean age 20.0 years, range 14-40 years) who met accepted psychiatric diagnostic criteria for anorexia nervosa. The results were compared with those of gastric emptying studies in 10 normal females of ideal body weight (mean age 25.4 years, range 20-35), 13 normal persons (12 males), and six patients (mean age 12 years, range 9-14 years) with weight loss (less than 90 percent ideal body weight) secondary to Crohn's disease with no psychiatric symptoms. A dual-isotope technique using chicken liver intracellularly labeled with technetium-99m (99mTc) bound to sulfur colloid as the solid-phase marker, and indium-111 (111In) -labeled water as the liquid-phase marker was used. Gastric emptying was monitored for 2 hr by gamma camera. In 13 of the 16 anorexia nervosa patients (80%), gastric emptying of solids was slower than the range in the two groups of normal subjects, and mean gastric emptying was significantly slower (P less than 0.05) than in the weight-loss patients. Liquid emptying (water) in anorexia nervosa was normal and similar to the control groups studied. In 11 of the anorexia nervosa patients with delayed gastric emptying, intramuscular metoclopramide, 10 mg, significantly (P less than 0.05) accelerated the mean gastric emptying from 60 through 120 min after the meal. We conclude that in anorexia nervosa patients who are symptomatic and seeking medical care: gastric emptying of solids is significantly delayed when compared with female subjects of similar age and normal body weight and with patients of less than 90% ideal body weight but without psychiatric disorder; these data are consistent with an antral motility disturbance, either primary or secondary; and metoclopramide, a gastric prokinetic agent, accelerates (delayed) gastric emptying. PMID:4017831

  14. Cancer Incidence among Patients with Anorexia Nervosa from Sweden, Denmark and Finland.

    Directory of Open Access Journals (Sweden)

    Lene Mellemkjaer

    Full Text Available 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.

  15. Reduced Amylin Levels Are Associated with Low Bone Mineral Density in Women with Anorexia Nervosa

    Science.gov (United States)

    Wojcik, Monica H; Meenaghan, Erinne; Lawson, Elizabeth A; Misra, Madhusmita; Klibanski, Anne; Miller, Karen K

    2009-01-01

    Context Anorexia nervosa, characterized by extreme low body weight due to reduced nutrient intake, is associated with severe bone loss. Peptide hormones, including amylin, GIP, and GLP2, are released immediately after nutrient intake and may be involved in the regulation of bone turnover. Objective To investigate fasting levels of amylin, GIP, and GLP2 and their relationships with bone mineral density (BMD) in women with anorexia nervosa compared to healthy controls. Design Cross-sectional Setting Clinical Research Center Study Participants 15 women with anorexia nervosa and 16 healthy controls Intervention None Main Outcome Measures Fasting serum amylin, GIP, and GLP2, and BMD Results Women with anorexia nervosa had significantly lower fasting serum amylin and GIP levels than healthy controls. Fasting serum GLP2 levels were not significantly different between groups. Fasting amylin levels were positively associated with BMD and Z-score at the PA spine, total hip, and femoral neck. Fasting amylin levels were also positively associated with weight and percent fat; after controlling for these variables, amylin was still a significant predictor of BMD and Z-score at the femoral neck and of Z-score at the total hip. In the anorexia nervosa group, there was a trend toward an inverse association between amylin and C-terminal telopeptide (CTX) levels (R = −0.47, p = 0.08). GIP and GLP2 levels did not predict BMD at any site. Conclusion Decreased secretion of amylin may be a mechanism through which reduced nutrient intake adversely affects BMD in anorexia nervosa. PMID:19931436

  16. Neuropathy and myopathy in two patients with anorexia and bulimia nervosa.

    OpenAIRE

    Alloway, R; Reynolds, E H; Spargo, E; Russell, G F

    1985-01-01

    Two adolescent patients with eating disorders and severe weight loss presented with neuromyopathy. The first was female and had a twenty months' history of bulimia nervosa with weight loss and episodic gorging and vomiting. The second was male with a two-year history of anorexia nervosa characterised by vegetarianism and increasing food restriction. Both had severe wasting and asymmetrical weakness of proximal limb muscles. The first patient deteriorated on refeeding and became temporarily pa...

  17. Autoantibodies against α-MSH, ACTH, and LHRH in anorexia and bulimia nervosa patients

    OpenAIRE

    Fetissov, Sergueï O.; Hallman, Jarmila; Oreland, Lars; af Klinteberg, Britt; Grenbäck, Eva; Hulting, Anna-Lena; Hökfelt, Tomas

    2002-01-01

    The hypothalamic arcuate nucleus is involved in the control of energy intake and expenditure and may participate in the pathogenesis of eating disorders such as anorexia nervosa (AN) and bulimia nervosa (BN). Two systems are of particular interest in this respect, synthesizing α-melanocyte-stimulating hormone (α-MSH) and synthesizing neuropeptide Y, respectively. We report here that 42 of 57 (74%) AN and/or BN patients studied had in their plasma Abs that bind to melanotropes and/or corticotr...

  18. Management of anorexia and bulimia nervosa: An evidence-based review

    OpenAIRE

    Chakraborty, Kaustav; Basu, Debasish

    2010-01-01

    Anorexia nervosa and bulimia nervosa are primarily psychiatric disorders characterized by severe disturbances of eating behavior. Eating disorders are most prevalent in the Western culture where food is in abundance and female attractiveness is equated with thinness. Eating disorders are rare in countries like India. Despite a plethora of management options available to the mental health professionals, no major breakthrough has been achieved in recent years. Nutritional rehabilitation along w...

  19. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa.

    Science.gov (United States)

    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. PMID:25795596

  20. Enhanced cognitive behaviour therapy for adults with anorexia nervosa: A UK–Italy study

    OpenAIRE

    Fairburn, Christopher G.; Cooper, Zafra; Doll, Helen A.; O'Connor, Marianne E.; Palmer, Robert L.; Dalle Grave, Riccardo

    2013-01-01

    Anorexia nervosa is difficult to treat and no treatment is supported by robust evidence. As it is uncommon, it has been recommended that new treatments should undergo extensive preliminary testing before being evaluated in randomized controlled trials. The aim of the present study was to establish the immediate and longer-term outcome following “enhanced” cognitive behaviour therapy (CBT-E). Ninety-nine adult patients with marked anorexia nervosa (body mass index ≤ 17.5) were recruited from c...

  1. 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. PMID:24505059

  2. Zu Verlauf und Prognose der Anorexia nervosa: Katamnese von 41 Patienten

    OpenAIRE

    Finzer, Patrick; Haffner, Johann; Müller-Küppers, Manfred

    1998-01-01

    Ziel der vorliegenden Studie war es, eine mehrdimensionale Betrachtung des Verlaufs der Anorexia nervosa durchzuführen. In der vorgestellten Katamnese konnten von 51 Patienten unserer Klinik, bei denen die Diagnose einer Anorexia nervosa - gemäß dem DSM-III R - gestellt wurde, 41 nach im Mittel 5;3 Jahren nachuntersucht werden. Die Ausgangsstichprobe zeigte einen frühen Krankheitsbeginn (im Mittel 14;2 Jahre), keine oder wenige psychiatrische Vorbehandlungen und restriktives Eßverhalten (72,5...

  3. Seven years’ experience with etidronate in a woman with anorexia nervosa and vertebral fractures

    OpenAIRE

    Iwamoto, Jun; Sato, Yoshihiro; Uzawa, Mitsuyoshi; Takeda, Tsuyoshi; Matsumoto, Hideo

    2011-01-01

    We report the case of a 30-year-old Japanese woman with anorexia nervosa and vertebral fractures who was treated with etidronate. She had a history of anorexia nervosa, chronic back pain, osteoporosis, and multiple vertebral fractures (morphometric fractures) that responded poorly to treatment with alfacalcidol (1 μg daily) for 1 year and was treated with cyclical etidronate (200 mg for 2 weeks every 3 months) for 7 years. The lumbar spine bone mineral density (BMD) increased, and the serum a...

  4. Reexpansion pulmonary edema after surgery for spontaneous pneumothorax in a patient with anorexia nervosa

    OpenAIRE

    Ozawa, Yuichiro; ICHIMURA, HIDEO; Sakai, Mitsuaki

    2016-01-01

    Introduction Several adverse effects on the pulmonary system in patients with anorexia nervosa (AN) have been reported. We present a case of AN who presented with a complicated reexpansion pulmonary edema (RPE) after video-assisted thoracic surgery (VATS) for spontaneous pneumothorax. Presentation of case A 23-year-old woman with severe anorexia nervosa (weight: 25 kg, body mass index: 8.96 kg/m2) underwent VATS for spontaneous pneumothorax. Five hours after the surgery, she immediately prese...

  5. Resistance training enhances muscular performance in patients with anorexia nervosa: A randomized controlled trial

    OpenAIRE

    Fernández del Valle, María; Larumbe Zabala, Eneko; Villaseñor Montarroso, Ángel; Cardona González, Claudia Andrea; Díez Vega, Ignacio; López Mojares, Luis Miguel; Pérez Ruiz, Margarita

    2014-01-01

    OBJECTIVE: Low-intensity exercise applied in anorexia nervosa patients has been shown to have a harmless effect on body composition and to effect short-term improvements in muscular strength and agility. The aim of this study was to determine the effects of a high-intensity resistance training program designed for adolescents to improve strength and agility in anorexia nervosa restricting-type patients (AN-R). METHODS: From a total of 36 female patients with AN-R, one group (interven...

  6. Neuromyopathic complications in a patient with anorexia nervosa and vitamin C deficiency.

    Science.gov (United States)

    Woodruff, P W; Morton, J; Russell, G F

    1994-09-01

    A 19-year-old female patient with anorexia nervosa developed profound weight loss over 1 year associated with vegetarianism and excessive exercise. There was severe wasting and proximal muscle weakness in the legs and bilateral weakness of eye closure. A purpuric rash developed due to vitamin C deficiency. This case demonstrates a new neurological sign in anorexia nervosa indicating a weakness of the orbicularis oculi muscles as part of a more general myopathy. The myopathic and scorbutic features may have a common pathogenesis. PMID:7987355

  7. [Brain metabolism alterations in patients with anorexia nervosa observed in 1H-MRS

    OpenAIRE

    Grzelak, P.; Gajewicz, W.; Wyszogrodzka-Kucharska, A.; Rotkiewicz, A.; Stefanczyk, L.; Goraj, B.M.; Rabe-Jablonska, J.

    2005-01-01

    The causes of metabolic brain changes in patients with anorexia nervosa are still not fully explained. The purpose of this study was to use the 1H-MRS method in investigating metabolic changes in the brain of patients with anorexia nervosa. We studied 10 patients for visible alternations in brain metabolism and compared the results to healthy controls. 1H-MRS was acquired by the method of single voxels in white and grey matter. Proton MRS was performed after image guided localization using st...

  8. Cancer Incidence among Patients with Anorexia Nervosa from Sweden, Denmark and Finland

    OpenAIRE

    Lene Mellemkjaer; Papadopoulos, Fotios C.; Eero Pukkala; Anders Ekbom; Mika Gissler; Jane Christensen; 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 a...

  9. 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. PMID:27236605

  10. The impact of hyperactivity and leptin on recovery from anorexia nervosa

    OpenAIRE

    van Elburg, A A; Kas, M. J. H.; Hillebrand, J.J.G.; Eijkemans, R.J.C.; van Engeland, H

    2007-01-01

    Summary In anorexia nervosa (AN), hyperactivity is observed in about 80% of patients and has been associated with low leptin levels in the acute stage of AN and in anorexia animal models. To further understand the importance of this correlation in AN, we investigated the relationship between hypoleptinaemia and hyperactivity in AN patients longitudinally and assessed their predictive value for recovery. Body weight, activity levels, and serum leptin levels were assessed in adolescents and adu...

  11. Focus on anorexia nervosa: modern psychological treatment and guidelines for the adolescent patient

    OpenAIRE

    Espie J; Eisler I

    2015-01-01

    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 r...

  12. Altered Mitochondrial Function and Oxidative Stress in Leukocytes of Anorexia Nervosa Patients

    OpenAIRE

    Victor, Victor M.; Rovira-Llopis, Susana; Saiz-Alarcon, Vanessa; Sangüesa, Maria C.; Rojo-Bofill, Luis; Bañuls, Celia; Falcón, Rosa; Castelló, Raquel; Rojo, Luis; Rocha, Milagros; Hernández-Mijares, Antonio

    2014-01-01

    Context Anorexia nervosa is a common illness among adolescents and is characterised by oxidative stress. Objective The effects of anorexia on mitochondrial function and redox state in leukocytes from anorexic subjects were evaluated. Design and setting A multi-centre, cross-sectional case-control study was performed. Patients Our study population consisted of 20 anorexic patients and 20 age-matched controls, all of which were Caucasian women. Main outcome measures Anthropometric and metabolic...

  13. Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings

    Directory of Open Access Journals (Sweden)

    Campbell Iain C

    2007-06-01

    Full Text Available Abstract Background Anorexia nervosa (AN is a severe mental illness. Drug treatments are not effective and there is no established first choice psychological treatment for adults with AN. Neuropsychological studies have shown that patients with AN have difficulties in cognitive flexibility: these laboratory based findings have been used to develop a clinical intervention based on Cognitive Remediation Therapy (CRT which aims to use cognitive exercises to strengthen thinking skills. Aims 1 To conduct a preliminary investigation of CRT in patients with AN 2 to explore whether cognitive training improves performance in set shifting tasks 3 to explore whether CRT exercises are appropriate and acceptable to AN patients 4 to use the data to improve a CRT module for AN patients. Methods Intervention was comprised of ten 45 minute sessions of CRT. Four patients with AN were assessed before and after the ten sessions using five set shifting tests and clinical assessments. At the end, each patient wrote a letter providing feedback on the intervention. Results Post intervention, three of the five set shifting assessments showed a moderate to large effect size in performance and two showed a large effect size in performance, both indicative of improved flexibility. Patients were aware of an improvement in their cognitive flexibility qualitative feedback was generally positive towards CRT. Discussion This preliminary study suggests that CRT changed performance on flexibility tasks and may be beneficial for acute, treatment resistant patients with AN. Feedback gathered from this small case series has enabled modification of the intervention for a future larger study, for example, by linking exercises with real life behavioural tasks and including exercises that encourage global thinking. Conclusion This exploratory study has produced encouraging data supporting the use of CRT in patients with AN: it has also provided insight into how the module should be

  14. Atypical Antipsychotics as Augmentation Therapy in Anorexia Nervosa

    Science.gov (United States)

    Marzola, Enrica; Desedime, Nadia; Giovannone, Cristina; Amianto, Federico; Fassino, Secondo; Abbate-Daga, Giovanni

    2015-01-01

    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. PMID:25922939

  15. Gyrification brain abnormalities as predictors of outcome in anorexia nervosa.

    Science.gov (United States)

    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. PMID:26374960

  16. 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

  17. 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.

  18. Bone histomorphometric analysis in a patient with anorexia nervosa.

    Science.gov (United States)

    Hiramatsu, Rikako; Ubara, Yoshifumi; Suwabe, Tatsuya; Hoshino, Junichi; Sumida, Keiichi; Hasegawa, Eiko; Yamanouchi, Masayuki; Hayami, Noriko; Sawa, Naoki; Takaichi, Kenmei

    2013-09-01

    A 34-year-old Japanese woman with anorexia nervosa (AN) of a body mass index (BMI) of 11.0 kg/cm(2) was admitted to our hospital for assessment of renal dysfunction with a serum creatinine of 1.8 mg/dL and hypokalemia (3.0 mEq/L). Renal biopsy showed chronic interstitial fibrosis with hypertrophy of the juxtaglomerular apparatus. Iliac crest biopsy was performed because of a severe decrease in bone mineral density. It showed active resorption at the periosteal and endosteal surfaces of cortical bone by numerous osteoclasts, as well as bone island formation in cancellous bone due to marked decrease of trabecular connections. A dynamic study using double labeling showed that mineralization of cancellous bone adjacent to cortical bone occurred between the first and second labelings, but did not occur between the second labeling and osteoid formation during the 28-day period before biopsy, which implied that the mineralization was related to promotion of food intake after hospitalization, while the lack of mineralization was due to poor food intake outside hospital. Empty lacunae that indicated the death of osteocytes were seen. Because her bone mass and kidney injury improved after weight gain and normokalemia were achieved by a highly nutritious diet, malnutrition with hypokalemia may have a negative influence on bone formation due to impaired mineralization and may activate bone resorption by osteoclasts secondary to the formation of empty lacunae. This is the first report about the histological features of premenopausal osteoporosis in a patient with AN and kidney injury. PMID:23726962

  19. Ghrelin: central and peripheral implications in anorexia nervosa.

    Science.gov (United States)

    Méquinion, Mathieu; Langlet, Fanny; Zgheib, Sara; Dickson, Suzanne; Dehouck, Bénédicte; Chauveau, Christophe; Viltart, Odile

    2013-01-01

    Increasing clinical and therapeutic interest in the neurobiology of eating disorders reflects their dramatic impact on health. Chronic food restriction resulting in severe weight loss is a major symptom described in restrictive anorexia nervosa (AN) patients, and they also suffer from metabolic disturbances, infertility, osteopenia, and osteoporosis. Restrictive AN, mostly observed in young women, is the third largest cause of chronic illness in teenagers of industrialized countries. From a neurobiological perspective, AN-linked behaviors can be considered an adaptation that permits the endurance of reduced energy supply, involving central and/or peripheral reprograming. The severe weight loss observed in AN patients is accompanied by significant changes in hormones involved in energy balance, feeding behavior, and bone formation, all of which can be replicated in animals models. Increasing evidence suggests that AN could be an addictive behavior disorder, potentially linking defects in the reward mechanism with suppressed food intake, heightened physical activity, and mood disorder. Surprisingly, the plasma levels of ghrelin, an orexigenic hormone that drives food-motivated behavior, are increased. This increase in plasma ghrelin levels seems paradoxical in light of the restrained eating adopted by AN patients, and may rather result from an adaptation to the disease. The aim of this review is to describe the role played by ghrelin in AN focusing on its central vs. peripheral actions. In AN patients and in rodent AN models, chronic food restriction induces profound alterations in the « ghrelin » signaling that leads to the development of inappropriate behaviors 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 reprograming is discussed in regard of new clinical treatments currently investigated. PMID:23549309

  20. 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.