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anorexia nervosa treatment

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https://www.readbyqxmd.com/read/28060579/a-comparison-of-the-metabolic-complications-and-hospital-course-of-severe-anorexia-nervosa-by-binge-purge-and-restricting-subtypes
#1
Melanie Rylander, John T Brinton, Allison L Sabel, Philip S Mehler, Jennifer L Gaudiani
This study examines adult patients with severe, life-threatening anorexia nervosa who were admitted to an inpatient, medical stabilization unit between October 1, 2008 and December 31, 2014. Specifically, the study compares anorexia nervosa, binge purge subtype (AN-BP) and anorexia nervosa, restricting subtype (AN-R) on admission measures, hospital course, and outcomes. Of the 232 patients, 46% (N = 108) had AN-BP. Patients with AN-R manifested a higher frequency of underweight-mediated medical complications, including bone marrow dysfunction, hepatic dysfunction, and hypoglycemia...
January 6, 2017: Eating Disorders
https://www.readbyqxmd.com/read/28058799/impact-of-asd-traits-on-treatment-outcomes-of-eating-disorders-in-girls
#2
Catherine S Stewart, Fiona S McEwen, Anna Konstantellou, Ivan Eisler, Mima Simic
Evidence links high levels of Autism Spectrum Disorder Traits in women with chronicity of anorexia nervosa. This study reports through clinical audit the impact of ASD traits on treatment outcomes of girls who were referred for treatment in a specialist eating disorder service. Presence of current, but not early childhood, ASD traits was elevated in comparison with previously reported community samples. Current ASD traits were correlated with emotional disorders and with need for treatment augmentation (psychiatric inpatient or day patient admission), but this relationship was not significant after the contribution of depression had been controlled for...
January 6, 2017: European Eating Disorders Review: the Journal of the Eating Disorders Association
https://www.readbyqxmd.com/read/28056106/metasynthesis-of-the-views-about-treatment-of-anorexia-nervosa-in-adolescents-perspectives-of-adolescents-parents-and-professionals
#3
Jordan Sibeoni, Massimiliano Orri, Marie Valentin, Marc-Antoine Podlipski, Stephanie Colin, Jerome Pradere, Anne Revah-Levy
BACKGROUND: Anorexia nervosa in adolescents can be a difficult-to-treat disease. Because qualitative research is a well-established method for deepening our understanding of subjective experiences, such as eating disorders and their treatment, we sought to perform a systematic review of qualitative studies to synthesize the views of adolescents with this disease, their parents, and their healthcare providers about its treatment. METHODS: We performed a thematic synthesis to develop the central themes that summarize all of the topics raised in the articles included in our review...
2017: PloS One
https://www.readbyqxmd.com/read/28030575/time-course-of-leptin-in-patients-with-anorexia-nervosa-during-inpatient-treatment-longitudinal-relationships-to-bmi-and-psychological-factors
#4
Esther Stroe-Kunold, Magdalena Buckert, Hans-Christoph Friederich, Daniela Wesche, Stefan Kopf, Wolfgang Herzog, Beate Wild
BACKGROUND: Leptin, a hormone secreted by adipose tissue, appears to play a major role in the homeostasis of body weight and psychobiological processes associated with anorexia nervosa (AN). However, there is scarce data on its exact influence on this disorder, in particular data over time. OBJECTIVE: The present study addresses whether leptin changes during inpatient treatment play a role for treatment outcome and psychological factors in underweight AN patients...
2016: PloS One
https://www.readbyqxmd.com/read/28018879/cost-evaluation-of-out-of-country-care-for-patients-with-eating-disorders-in-ontario-a-population-based-study
#5
Claire de Oliveira, Erin M Macdonald, Diane Green, Patricia Colton, Marion Olmsted, Susan Bondy, Paul Kurdyak
BACKGROUND: Eating disorders, specifically anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified, represent a substantial burden to the health care system. Our goal was to estimate the economic burden of patients who received specialized inpatient care for an eating disorder out of country. METHOD: We conducted a cost-of-illness study evaluating health care costs among patients in Ontario who received specialized inpatient care for an eating disorder out of country from 2003 to 2011, from the public third-party payer perspective...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28018595/outcomes-of-an-inpatient-refeeding-protocol-in-youth-with-anorexia-nervosa-and-atypical-anorexia-nervosa-at-children-s-hospitals-and-clinics-of-minnesota
#6
Kathryn Smith, Julie Lesser, Beth Brandenburg, Andrew Lesser, Jessica Cici, Robert Juenneman, Amy Beadle, Sarah Eckhardt, Elin Lantz, James Lock, Daniel Le Grange
BACKGROUND: Historically, inpatient protocols have adopted relatively conservative approaches to refeeding in Anorexia Nervosa (AN) in order to reduce the risk of refeeding syndrome, a potentially fatal constellation of symptoms. However, increasing evidence suggests that patients with AN can tolerate higher caloric prescriptions during treatment, which may result in prevention of initial weight loss, shorter hospital stays, and less exposure to the effects of severe malnutrition. Therefore the present study sought to examine the effectiveness of a more accelerated refeeding protocol in an inpatient AN and atypical AN sample...
2016: Journal of Eating Disorders
https://www.readbyqxmd.com/read/27991694/characterizing-severe-and-enduring-anorexia-nervosa-an-empirical-approach
#7
Jennifer E Wildes, Kelsie T Forbush, Kelsey E Hagan, Marsha D Marcus, Evelyn Attia, Loren M Gianini, Wei Wu
Targeted approaches for the treatment of severe and enduring anorexia nervosa (SE-AN) have been recommended, but there is no consensus definition of SE-AN to inform research and clinical practice. This study aimed to take initial steps toward developing an empirically based definition of SE-AN by characterizing associations among putative indicators of severity and chronicity in eating disorders. Patients with AN (N = 355) completed interviews and questionnaires at treatment admission and discharge; height and weight were assessed to calculate body mass index (BMI)...
December 19, 2016: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/27989453/the-transition-from-thinness-oriented-to-muscularity-oriented-disordered-eating-in-adolescent-males-a-clinical-observation
#8
Stuart B Murray, Scott Griffiths, Deborah Mitchison, Jonathan M Mond
PURPOSE: Robust empirical evidence has illustrated a rising prevalence of body dissatisfaction and disordered eating among males, noting that both may be oriented more toward muscularity-as opposed to thinness-oriented concerns. While an elevated prevalence of premorbid anorexia nervosa (AN) has been noted among those with muscle dysmorphia, little evidence has examined the process of this transition from thinness-oriented to muscularity-oriented disordered eating. METHODS: This clinical observation presents a case of AN in an adolescent male, whose symptom presentation transitioned during the course of treatment for AN, into more muscularity-oriented disordered eating...
December 15, 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27943533/expressed-emotions-and-depressive-symptoms-in-caregivers-of-adolescents-with-first-onset-anorexia-nervosa-a-long-term-investigation-over-2-5%C3%A2-years
#9
Reinhild Schwarte, Nina Timmesfeld, Astrid Dempfle, Melanie Krei, Karin Egberts, Charlotte Jaite, Christian Fleischhaker, Christoph Wewetzer, Beate Herpertz-Dahlmann, Jochen Seitz, Katharina Bühren
OBJECTIVE: High levels of expressed emotions (EE) and depressive symptoms (DS) are often found in caregivers of patients with anorexia nervosa (AN). Both parameters are considered to influence AN symptoms of the patient. METHODS: One hundred seventy adolescent women with AN and their caregivers were assessed at admission, discharge, at 1-year and 2.5-year follow up to evaluate AN symptoms of the patient and EE and DS of caregivers. RESULTS: The EE and DS were elevated at admission and decreased during treatment, criticism (as part of EE) exhibited again at the 2...
January 2017: European Eating Disorders Review: the Journal of the Eating Disorders Association
https://www.readbyqxmd.com/read/27933021/dimensions-of-compulsive-exercise-across-eating-disorder-diagnostic-subtypes-and-the-validation-of-the-spanish-version-of-the-compulsive-exercise-test
#10
Sarah Sauchelli, Jon Arcelus, Roser Granero, Susana Jiménez-Murcia, Zaida Agüera, Amparo Del Pino-Gutiérrez, Fernando Fernández-Aranda
Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: (1) to validate the Spanish version of the CET; (2) to compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; (3) to explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology...
2016: Frontiers in Psychology
https://www.readbyqxmd.com/read/27928853/early-response-to-treatment-in-eating-disorders-a-systematic-review-and-a-diagnostic-test-accuracy-meta-analysis
#11
REVIEW
Bruno Palazzo Nazar, Louise Kathrine Gregor, Gaia Albano, Angelo Marchica, Gianluca Lo Coco, Valentina Cardi, Janet Treasure
OBJECTIVE: Early response to eating disorders treatment is thought to predict a later favourable outcome. A systematic review of the literature and meta-analyses examined the robustness of this concept. METHOD: The criteria used across studies to define early response were summarised following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Diagnostic Test Accuracy methodology was used to estimate the size of the effect. RESULTS: Findings from 24 studies were synthesized and data from 14 studies were included in the meta-analysis...
December 7, 2016: European Eating Disorders Review: the Journal of the Eating Disorders Association
https://www.readbyqxmd.com/read/27924450/neurobiochemical-and-psychological-factors-influencing-the-eating-behaviors-and-attitudes-in-anorexia-nervosa
#12
REVIEW
Teresa Grzelak, Agata Dutkiewicz, Elzbieta Paszynska, Monika Dmitrzak-Weglarz, Agnieszka Slopien, Marta Tyszkiewicz-Nwafor
The aim of this study was to determine the characteristic features which contribute to inappropriate eating attitudes in people suffering from anorexia nervosa, based on an analysis of recent data. Factors influencing these attitudes have a genetic, neurobiological, biochemical, affective-motivational, cognitive, and behavioral background. Another important issue addressed in the paper is a description of the mechanism leading to continuous dietary restrictions. The altered activity of neurotransmitters modulating patients' moods after the consumption of food and a disturbed responsiveness to enterohormones enhance affective-motivational and cognitive aspects which, in turn, impede the improvement of eating behaviors...
December 6, 2016: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/27923148/patient-and-clinician-reported-outcome-in-eating-disorders
#13
Laura Al-Dakhiel Winkler, Jacob Stampe Frølich, Claire Gudex, Kirsten Hørder, Niels Bilenberg, René Klinkby Støving
Patient-reported outcome is increasingly applied in health sciences. Patients with eating disorders (EDs) characteristically have a different opinion of their needs to that of the health professionals, which can lead to ambivalence towards treatment and immense compliance difficulties. This cross-sectional study compared data assessed by the clinician to patient-reported measures in patients with a history of EDs. We included data from a cohort of patients with EDs (n=544) referred to a specialized ED unit in Denmark...
January 2017: Psychiatry Research
https://www.readbyqxmd.com/read/27909746/brain-glutamate-in-anorexia-nervosa-a-magnetic-resonance-spectroscopy-case-control-study-at-7-tesla
#14
Beata R Godlewska, Alexandra Pike, Ann L Sharpley, Agnes Ayton, Rebecca J Park, Philip J Cowen, Uzay E Emir
RATIONALE: Anorexia nervosa (AN) is a serious psychiatric disorder with high morbidity and mortality. There are no established pharmacological treatments and the neurobiology of the condition is poorly understood. Previous studies using magnetic resonance spectroscopy (MRS) have shown that AN may be associated with reductions in indices of brain glutamate; however, at conventional field strengths (≤3 T), it is difficult to separate glutamate from its precursor and metabolite, glutamine...
December 1, 2016: Psychopharmacology
https://www.readbyqxmd.com/read/27895913/listening-in-the-dark-why-we-need-stories-of-people-living-with-severe-and-enduring-anorexia-nervosa
#15
EDITORIAL
Janet Conti, Paul Rhodes, Heather Adams
A bold step forward in our approach to Severe and Enduring Anorexia Nervosa invites new paradigms for research and practice. It provides an opportunity for us to explore fault lines, both in our communities of practice and the social structures that inform them. This paper serves to question the medical metaphors on which treatment has been based, in favour of alternative perspectives that resonate more clearly with the lived experience of those for whom it has failed. We invite the consideration of alternative metaphors, which can disrupt the notion of heroic patients (and therapists), mediate against acts of self-silencing and sensitising us to more radical acts of listening...
2016: Journal of Eating Disorders
https://www.readbyqxmd.com/read/27891176/a-series-of-patients-with-purging-type-anorexia-nervosa-who-do-tube-vomiting
#16
Takeshi Horie, Saki Harashima, Ryo Yoneda, Maiko Hiraide, Shuji Inada, Makoto Otani, Kazuhiro Yoshiuchi
BACKGROUND: It is important for clinicians to assess their patients' purging behavior. Various methods of purging, such as self-induced vomiting are well-known. Because patients do not always report their purging behavior, knowing the clinical signs that indicate the behavior is useful. However, we have experienced patients who did not have the reported physical signs of self-induced vomiting because they used hoses instead of their fingers to purge their stomach contents, which they call "tube vomiting"...
2016: BioPsychoSocial Medicine
https://www.readbyqxmd.com/read/27889099/eating-disorders-in-the-context-of-preconception-care-fertility-specialists-knowledge-attitudes-and-clinical-practices
#17
Iolanda S Rodino, Susan M Byrne, Katherine A Sanders
OBJECTIVE(S): To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. DESIGN: Cross-sectional study. SETTINGS: Fertility clinics. PARTICIPANTS: Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. INTERVENTION(S): None. MAIN OUTCOME MEASURES(S): Responses to an anonymously completed online questionnaire...
November 23, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27887708/pulsatile-gonadotropin-releasing-hormone-therapy-in-persistent-amenorrheic-weight-recovered-anorexia-nervosa-patients
#18
Natacha Germain, Anaïs Fauconnier, Jean-Philippe Klein, Amélie Wargny, Yadh Khalfallah, Chrysoula Papastathi-Boureau, Bruno Estour, Bogdan Galusca
OBJECTIVE: To compare hormonal and clinical responses to GnRH pulsatile treatment in weight-recovered anorexia nervosa patients (Rec-AN) with persistent functional hypothalamic amenorrhea (HA) vs. in patients with secondary and primary HA. DESIGN: Retrospective, observational, ambulatory study. SETTING: University hospital. PATIENT(S): Forty-one women: 19 Rec-AN (body mass index >18.5 kg/m(2) without menses recovery), 15 secondary HA without any eating disorders patients (SHA), and 7 primary HA patients (PHA)...
November 22, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27881106/a-pragmatic-randomised-multi-centre-trial-of-multifamily-and-single-family-therapy-for-adolescent-anorexia-nervosa
#19
Ivan Eisler, Mima Simic, John Hodsoll, Eia Asen, Mark Berelowitz, Frances Connan, Gladys Ellis, Pippa Hugo, Ulrike Schmidt, Janet Treasure, Irene Yi, Sabine Landau
BACKGROUND: Considerable progress has been made in recent years in developing effective treatments for child and adolescent anorexia nervosa, with a general consensus in the field that eating disorders focussed family therapy (often referred to as Maudsley Family Therapy or Family Based Treatment) currently offers the most promising outcomes. Nevertheless, a significant number do not respond well and additional treatment developments are needed to improve outcomes. Multifamily therapy is a promising treatment that has attracted considerable interest and we report the results of the first randomised controlled trial of multifamily therapy for adolescent anorexia nervosa...
November 24, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27869569/change-in-expressed-emotion-and-treatment-outcome-in-adolescent-anorexia-nervosa
#20
Ashley A Moskovich, C Alix Timko, Lisa K Honeycutt, Nancy L Zucker, Rhonda M Merwin
Expressed emotion (EE) has been associated with poor outcomes in anorexia nervosa (AN); however, whether changes in EE predict superior treatment outcomes is unknown. The current study examined whether decreases in EE during an open trial of a novel family-based treatment for AN predicted symptoms at end of treatment. Forty-seven adolescents (12-18 years of age) with AN or sub-threshold AN and their parents (mothers: n = 47, fathers: n = 39) participated in 6 months of family treatment. Measures of AN symptomatology (Eating Disorder Examination completed by adolescent and end of treatment recovery status) and parental EE (Family Questionnaire completed by parents which measures two facets of EE: critical communication [CC] and emotional over-involvement [EOI]) were collected at baseline and end of treatment...
January 2017: Eating Disorders
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