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Anorexia Nervosa: The Diagnosis

Linda Smithuis, Nienke Kool-Goudzwaard, Janneke M de Man-van Ginkel, Harmieke van Os-Medendorp, Tamara Berends, Alexandra Dingemans, Laurence Claes, Annemarie A van Elburg, Berno van Meijel
Background: Many patients with an eating disorder report difficulties in regulating their emotions and show a high prevalence of self-injurious behaviour. Several studies have stated that both eating disorder and self-injurious behaviour help emotion regulation, and are thus used as coping mechanisms for these patients. We aimed to determine the prevalence of self-injurious behaviour, its characteristics and its emotion-regulation function in patients with anorexia nervosa or an eating disorder not otherwise specified ( n  = 136)...
2018: Journal of Eating Disorders
Cheri A Levinson, Irina Vanzhula, Leigh C Brosof
INTRODUCTION: Despite the high mortality and significant societal and personal costs associated with eating disorders (EDs) there are few evidence-based treatments. Part of the difficulty developing and implementing evidence-based treatments in EDs is due to the extremely high heterogeneity (e.g., variability in treatment outcome, symptom presentation etc) present. METHODS: To begin to identify specific symptom heterogeneity within persons, the current study used novel within and between group and intra-individual network analyses to create longitudinal and within-person networks of ED cognitions and behaviors (N = 66 individuals diagnosed with an ED)...
October 6, 2018: International Journal of Eating Disorders
Laura M Thornton, Melissa A Munn-Chernoff, Jessica H Baker, Anders Juréus, Richard Parker, Anjali K Henders, Janne T Larsen, Liselotte Petersen, Hunna J Watson, Zeynep Yilmaz, Katherine M Kirk, Scott Gordon, Virpi M Leppä, Felicity C Martin, David C Whiteman, Catherine M Olsen, Thomas M Werge, Nancy L Pedersen, Walter Kaye, Andrew W Bergen, Katherine A Halmi, Michael Strober, Allan S Kaplan, D Blake Woodside, James Mitchell, Craig L Johnson, Harry Brandt, Steven Crawford, L John Horwood, Joseph M Boden, John F Pearson, Laramie E Duncan, Jakob Grove, Manuel Mattheisen, Jennifer Jordan, Martin A Kennedy, Andreas Birgegård, Paul Lichtenstein, Claes Norring, Tracey D Wade, Grant W Montgomery, Nicholas G Martin, Mikael Landén, Preben Bo Mortensen, Patrick F Sullivan, Cynthia M Bulik
BACKGROUND: Genetic factors contribute to anorexia nervosa (AN); and the first genome-wide significant locus has been identified. We describe methods and procedures for the Anorexia Nervosa Genetics Initiative (ANGI), an international collaboration designed to rapidly recruit 13,000 individuals with AN and ancestrally matched controls. We present sample characteristics and the utility of an online eating disorder diagnostic questionnaire suitable for large-scale genetic and population research...
October 1, 2018: Contemporary Clinical Trials
Ana Margarida Cruz, Manuel Gonçalves-Pinho, João Vasco Santos, Francisco Coutinho, Isabel Brandão, Alberto Freitas
INTRODUCTION: Recent evidence suggests that incidence of Anorexia nervosa (AN) has remained stable over the last decades in Western Europe, while decreasing for Bulimia nervosa (BN). It is well-known that most individuals with an ED (Eating disorder) do not seek medical treatment. OBJECTIVE: The present study analyses hospitalizations related with EDs held in mainland Portuguese public hospitals between 2000 and 2014. METHOD: A retrospective observational study was performed gathering all inpatient episodes with primary or secondary diagnosis of ED...
September 28, 2018: International Journal of Eating Disorders
Mima Simic, Catherine S Stewart, Ivan Eisler, Julian Baudinet, Katrina Hunt, Jayne O'Brien, Beth McDermott
OBJECTIVE: Family Therapy for Anorexia Nervosa (FT-AN) is the first line treatment for adolescents with anorexia nervosa in the UK. However, research suggests between 10 and 40% of young people have a poor outcome. For those for whom FT-AN alone is not effective there is a clear need to develop additional treatments. This paper describes the effectiveness of an additional treatment for adolescents who had not responded to FT-AN, the Intensive Day Treatment Program (ITP) embedded within a comprehensive outpatient service at the Maudsley Hospital...
September 28, 2018: International Journal of Eating Disorders
Lenka Kučerová, Jiří Dolina, Milan Dastych, Daniel Bartušek, Tomáš Honzík, Jan Mazanec, Lumír Kunovský
Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disease caused by a mutation in the TYMP gene encoding thymidine phosphorylase. MNGIE causes gastrointestinal and neurological symptoms in homozygous individuals and is often misdiagnosed as anorexia nervosa, inflammatory bowel disease, or celiac disease. We present the case of a 26-year-old female with MNGIE, who was initially diagnosed with anorexia nervosa and Crohn's disease. The diagnosis of MNGIE was established by biochemical confirmation of elevated serum and urine thymidine and deoxyuridine levels after multiple examinations and several years of disease progression and ineffective treatment...
September 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Nadine Riesco, Zaida Agüera, Roser Granero, Susana Jiménez-Murcia, José M Menchón, Fernando Fernández-Aranda
BACKGROUND: with the DSM-5 new eating disorders (EDs) diagnostic subtypes were identified within the Other Specified Feeding or Eating Disorders (OSFED) category, which have so far been under-researched. Objectives of this study were to examine differential features among OSFED subtypes, exploring short-term cognitive-behavioral therapy (CBT) response and identifying clinical predictors of therapy outcome. METHODS: the sample included 176 female patients diagnosed with OSFED [82 atypical anorexia nervosa (atypical-AN), 57 purging disorder (PD), and 37 subthreshold bulimia nervosa (sub-BN)]...
October 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Savannah R Roberts, Anna C Ciao, Alexander M Czopp
A stereotype exists that anorexia nervosa (AN) is a "female" disorder. As a result, men with AN may face harsher stigmatization from their peers or go undiagnosed. The shifting standards model provides a framework to explore how gender stereotypes impact perceptions of AN. Participants (N = 438) were given a vignette of a person with symptoms of AN labeled as either male or female. Assessments were experimentally manipulated according to the shifting standards perspective: participants were asked if they were concerned (or convinced) that the target had AN and then indicated the severity of behavioral symptoms (calorie reduction, pounds lost per week, and hours of exercise) needed to make them concerned (or convinced) of AN...
September 6, 2018: International Journal of Eating Disorders
Trine Tetlie Eik-Nes, Julie Horn, Susanne Strohmaier, Turid L Holmen, Nadia Micali, Sigrid Bjørnelv
OBJECTIVE: Current evidence from clinical studies suggests that having an active eating disorder (ED) during pregnancy is associated with unfavorable obstetric outcomes. However, the role of a lifetime diagnosis of ED is not fully understood. Variations in findings suggest a need for additional studies of maternal ED. This study aims to identify associations between a lifetime ED and obstetric outcomes. METHOD: Data from a hospital patient register and a population-based study (The HUNT Study) were linked to the Medical Birth Registry in Norway...
September 6, 2018: International Journal of Eating Disorders
Anna Hedman, Lauren Breithaupt, Christopher Hübel, Laura M Thornton, Annika Tillander, Claes Norring, Andreas Birgegård, Henrik Larsson, Jonas F Ludvigsson, Lars Sävendahl, Catarina Almqvist, Cynthia M Bulik
BACKGROUND: Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases. METHODS: In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2...
September 3, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Jeanne Sansfaçon, Lise Gauvin, Émilie Fletcher, Danaëlle Cottier, Erika Rossi, Esther Kahan, Mimi Israël, Howard Steiger
According to Self-Determination Theory, when motivation to reach an objective is fully internal, it is said to be "autonomous"; when driven by external incentives, it is said to be "controlled". Previous research has indicated that autonomously motivated individuals show better response to treatments for eating disorders. OBJECTIVE: In individuals undergoing different intensities of outpatient treatment for an eating disorder, we sought to assess associations between autonomous and controlled motivations and response to treatment on the one hand, and likelihood of dropping out of treatment, on the other...
September 1, 2018: International Journal of Eating Disorders
Montserrat Graell, Patricia de Andrés, Ana Rosa Sepúlveda, Alba Moreno, Ángel Villaseñor, Mar Faya, Carmen Martínez-Cantarero, Sonia Gómez-Martínez, Ascensión Marcos, Gonzalo Morandé, Esther Nova
The anorexia nervosa adolescent longitudinal biomarker assessment study (ANABEL) is a 2-year longitudinal study. OBJECTIVE: Evaluate several clinical, biochemical, immunological, psychological, and family variables and their interactions in adolescent onset eating disorders (EDs) patients and their 2-year clinical and biological outcome. This article illustrates the framework and the methodology behind the research questions, as well as describing general features of the sample. METHODS: A longitudinal study of 114 adolescents with EDs seeking treatment was performed...
September 2018: International Journal of Methods in Psychiatric Research
Katarzyna Górowska-Kowolik, Agata Chobot, Jarosław Kwiecień
BACKGROUND: Anorexia nervosa (AN) concerns approximately up to 1.8% of the pediatric female population. One of the complications that can occur in the course of this disease is acute liver failure. This study's objective was to assess the usefulness of the 13 C labeled Methacetin Breath Test (MBT) in the diagnostics of the liver function in girls with eating disorders. METHODS: For the study 81 girls aged 12 to 17 years were recruited, including 41 patients with confirmed diagnosis of AN (mean age 14...
August 13, 2018: BMC Gastroenterology
Mariana Santos, Eva Osório, Sarah Finnegan, Matt Clarkson, Sertório Timóteo, Isabel Brandão, António Roma-Torres, Nick C Fox, António J Bastos-Leite
We aimed to determine whether variation in the body mass index (BMI)-a marker of anorexia nervosa (AN) severity-is associated with brain volume changes longitudinally estimated using registration-based methods on serial high-resolution T1-weighted magnetic resonance images (MRI). Fifteen female patients (mean age = 21 years; standard deviation [SD] = 5.7; range: 15-33 years) with the diagnosis of AN of the restricting type (AN-r)-according to the Diagnostic and Statistic Manual of Mental Disorders, 5th edition criteria-underwent T1-weighted MRI at baseline and after a mean follow-up period of 11 months (SD = 6...
September 30, 2018: Psychiatry research. Neuroimaging
Johnny Berona, Rebekah Richmond, Renee D Rienecke
Early response to treatment has been shown to predict good outcome in family-based treatment, but little is known about who responds quickly. OBJECTIVE: The purpose of the current study was to examine the short-term weight gain trajectories among youth receiving partial hospitalization program services for anorexia nervosa (AN), and to identify predictors of these trajectories. METHOD: Adolescent and young adults (n = 102) with AN or subthreshold AN completed semi-structured interviews and self-report measures on admission to a family-based partial hospitalization program...
July 29, 2018: International Journal of Eating Disorders
Neda Razaz, Sven Cnattingius
BACKGROUND: The etiology of anorexia nervosa is poorly understood. Although genetic factors play a major role, maternal factors, and obstetric complications are possible environmental causes. We investigated the association between maternal overweight and obesity in early pregnancy and risk of anorexia nervosa in daughters. METHODS: A retrospective cohort study including all live singleton females born in Sweden from 1992 through 2002. Anorexia nervosa diagnosis was identified by using the nation-wide Swedish Patient and Cause of Death Registers...
July 26, 2018: International Journal of Eating Disorders
Bronwyn C Raykos, David M Erceg-Hurn, Peter M McEvoy, Anthea Fursland, Glenn Waller
OBJECTIVE: The present study aimed to examine whether Anorexia Nervosa (AN) illness severity or duration is associated with retention or treatment response in outpatient, enhanced cognitive-behavioral therapy (CBT-E). METHOD: Patients with a confirmed AN diagnosis (N = 134) completed measures of eating disorder symptoms and quality of life, and had their BMI objectively measured before, during, and after treatment. We evaluated whether illness severity or duration predicted treatment outcomes, using longitudinal regression models...
August 2018: Journal of Consulting and Clinical Psychology
Mauro Bozzola, Elena Bozzola, Chiara Montalbano, Filomena Andreina Stamati, Pietro Ferrara, Alberto Villani
Constitutional delay of growth and puberty (CDGP) is the most common cause of delayed puberty (DP), is mainly found in males, and is characterized by short stature and delayed skeletal maturation. A family history of the subject comprising the timing of puberty in the parents and physical examination may provide clues regarding the cause of DP. Delayed onset of puberty is rarely considered a disease in either sex. In fact, DP usually represents a common normal variant in pubertal timing, with favorable outcomes for final height and future reproductive capacity...
June 2018: Annals of Pediatric Endocrinology & Metabolism
Jason M Nagata, Jennifer L Carlson, Neville H Golden, Stuart B Murray, Jin Long, Mary B Leonard, Rebecka Peebles
OBJECTIVE: To identify the effect of duration of weight-bearing exercise and team sports participation on bone mineral density (BMD) and body composition among adolescents with anorexia nervosa (AN). METHOD: We retrospectively reviewed electronic medical records of all patients 9-20 years old with a DSM-5 diagnosis of AN evaluated by the Stanford Eating Disorders Program (1997-2011) who underwent dual-energy X-ray absorptiometry. RESULTS: A total of 188 adolescents with AN were included (178 females and 10 males)...
June 8, 2018: Eating and Weight Disorders: EWD
Bethan Dalton, Savani Bartholdy, Lauren Robinson, Marco Solmi, Mohammad A A Ibrahim, Gerome Breen, Ulrike Schmidt, Hubertus Himmerich
Cytokines are signalling molecules, which play an important role in both immune system function and brain development and function, and subsequently mental states and behaviour. Cytokines have been implicated in eating disorders (EDs) due to their role in psychological health, body weight and appetite regulation. This meta-analysis examined cross-sectional and longitudinal studies measuring concentrations of cytokines in individuals with EDs. Using PRISMA guidelines, we systematically reviewed relevant articles in PubMed, Web of Science, and MEDLINE...
August 2018: Journal of Psychiatric Research
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