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Anorexia Nervosa: The Diagnosis

Meng-Che Tsai, Shu-Ting Gan, Chih-Ting Lee, Yi-Lin Liang, Lan-Ting Lee, Sheng-Hsiang Lin
OBJECTIVE: Nationwide data on eating disorders (EDs) among East Asian populations are scarce. This study aimed to estimate the prevalence, incidence, and psychiatric comorbidities of EDs in Taiwan. METHOD: Drawing from the National Health Research Institute database, we identified the study subjects aged 11-34 years who received an ED diagnosis during ambulatory visits or hospitalization from 2001 to 2012. We analyzed the subjects by age and gender. Diagnoses for comorbid psychiatric disorders were entered in the analysis only if they occurred within 1 year before or after the ED diagnosis date...
November 28, 2018: International Journal of Eating Disorders
Margarita Sala, Irina A Vanzhula, Cheri A Levinson
Mindfulness-based treatments for eating disorders could be improved by understanding how facets of mindfulness predict eating disorder symptoms over time. We examined whether facets of mindfulness predict eating disorder symptoms over time and vice versa. Individuals with an eating disorder diagnosis (N = 124; 87.9% diagnosed with anorexia nervosa) and an undergraduate sample (N = 290) completed measures of mindfulness at baseline. The clinical sample also completed these measures 1 month later. Individuals in the clinical sample had lower acting with awareness and higher observing than individuals in the undergraduate sample (ps < 0...
November 22, 2018: European Eating Disorders Review: the Journal of the Eating Disorders Association
Karel Kostev, Franka Teichgräber, Marcel Konrad, Louis Jacob
AIMS: The goal of this study was to analyze the association between chronic somatic conditions and depression diagnosis in children and adolescents. METHODS: The present case-control study included 13,326 children and adolescents with depression as well as controls without depression followed in 243 pediatric practices between 2010 and 2015. Cases and controls were matched by age, gender, index year, and physician. The effect of several chronic disorders in terms of the risk of developing depression was estimated using logistic regression models...
November 5, 2018: Journal of Affective Disorders
Klara Meierer, Alexandre Hudon, Marc Sznajder, Marie-France Leduc, Danielle Taddeo, Olivier Jamoulle, Jean-Yves Frappier, Chantal Stheneur
The purpose of our study is to establish if the proportion of patients diagnosed with anorexia nervosa that have a history of excess weight has increased over a 10-year period and to study how different premorbid weight groups vary in terms of clinical characteristics. We performed a single-center, retrospective cohort study of all new patients presenting with anorexia nervosa, restrictive and binge/purge subtypes, in 2004 and 2014 at the Adolescent Medicine Clinic of Sainte-Justine University Health Centre (n = 172)...
November 5, 2018: European Journal of Pediatrics
Chao-Ying Tu, Mei-Chih Meg Tseng, Chin-Hao Chang
BACKGROUND/PURPOSE: Night eating syndrome (NES) is a diagnosis newly introduced in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders. This study investigated the characteristics of NES in individuals with eating disorders and the clinical significance of NES in individuals with bulimia nervosa (BN). METHODS: We recruited participants with eating problems at psychiatric outpatient clinics and from Internet referrals and age, sex, and educational level-comparable controls from September 2013 to April 2017...
November 2, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Urszula Tokarska, Dorota Ryżanowska
OBJECTIVES: Deepening understanding of the experience of patients with anorexia nervosa in the light of a narrative-constructivist approach and Dialogic Self Theory. Exploring the phenomenon of internal dialogues, which occur in patients'minds as an interchange between two competing (healthy and disordered) aspects of their Selves. Describing diagnostic and applicative possibilities of narrative stimuli in the form of "Letters to anorexia". METHODS: As was assumed the process of developing/ regaining a relative detachment from the internal voice of anorexia, which itself is indicative of progressing recovery, can be both diagnosed and fostered with externalisation techniques...
August 24, 2018: Psychiatria Polska
Aedin Collins, Elizabeth Nolan, Michelle Hurley, Antoinette D'Alton, Séamus Hussey
Crohn disease and anorexia nervosa share common symptoms of weight loss and reduced oral intake. The prevalence of both disorders has increased over time. Symptoms of Crohn disease and anorexia nervosa can mimic each other leading to a delayed diagnosis and requiring complex, multidisciplinary management. Here we present a case of a 15 year old girl with Crohn disease who subsequently developed anorexia nervosa, and review the published literature on the occurrence of both diagnoses.
2018: Frontiers in Pediatrics
Katherine Schaumberg, Stephanie Zerwas, Erica Goodman, Zeynep Yilmaz, Cynthia M Bulik, Nadia Micali
BACKGROUND: Cross-sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent-reported anxiety in mid-childhood (age 10) and child-reported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population-based sample...
October 24, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Nazish Imran, Fatima Rumesa, Farhat Jamil
Schizophrenia is serious illness with high comorbidity of other psychiatric illnesses such as substance abuse disorders, depression and anxiety disorder. The dual diagnosis of schizophrenia and anorexia nervosa in an adolescent male is a rare occurrence and is understudied. The case presented is of a 12-year-old boy with complaints of auditory hallucinations, odd behaviors, paranoid delusions and suicidal attempt along with body image distortion, dread of fatness, food restriction and very low Body mass Index...
September 2018: Pakistan Journal of Medical Sciences Quarterly
Yu Yoshida, Jun Maeda, Hiroyuki Fukushima, Natsuko Tokita, Hiroyuki Yamagishi, Mitsuaki Tokumura
Resting bradycardia is an important symptom for early diagnosis of anorexia nervosa (AN) during weight loss, and it improves with body-weight recovery. However, chronotropic incompetence (CI) in exercise is observed in some patients with AN despite amelioration of resting bradycardia in the recovery phase. We examined the relationship between CI in exercise and other parameters in patients with AN during the recovery phase. Ninety-two girls with AN (aged 13-20 years, median 15 years) performed cardiopulmonary exercise tolerance tests with a bicycle ergometer in the post-treatment recovery phase...
October 19, 2018: Heart and Vessels
José H Marco, Maria Pilar Tormo-Irun, Alba Galán-Escalante, Carmen Gonzalez-García
Studies carried out in nonclinical samples have found an association between cyberbullying victimization and eating disorder (ED) psychopathology (negative emotions, low self-esteem, unhealthy eating behaviors, and body dissatisfaction); however, these previous studies were carried out with participants without an ED diagnosis. To extend the knowledge in this area of research, we aim to confirm these associations in two different samples: on the one hand, a sample composed of participants with ED diagnoses and, on the other hand, a sample composed of participants at high risk of ED...
October 2018: Cyberpsychology, Behavior and Social Networking
Caroline A Fisher, Sonja Skocic, Kathleen A Rutherford, Sarah E Hetrick
BACKGROUND: Anorexia nervosa (AN) is characterised by a failure to maintain a normal body weight due to a paucity of nutrition, an intense fear of gaining weight or behaviour that prevents the individual from gaining weight, or both. The long-term prognosis is often poor, with severe developmental, medical and psychosocial complications, high rates of relapse and mortality. 'Family therapy approaches' indicate a range of approaches, derived from different theories, that involve the family in treatment...
October 15, 2018: Cochrane Database of Systematic Reviews
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...
November 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
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