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anorexia nervosa treatment

Amy Harrison, Pamela Stavri, Lynn Ormond, Francine McEnemy, Dilan Akyol, Annum Qureshi, Hind Al-Khairulla
Cognitive remediation therapy (CRT) is a low-intensity treatment adjunct for individuals with severe and complex anorexia nervosa (AN) with difficulties in globally oriented, flexible thinking. Previously trialled in adults, this study investigated whether individual and group CRT was a feasible, acceptable, and beneficial treatment for 125 adolescent inpatients with severe and complex AN. Seventy patients (mean age = 15.22, SD = 1.44) received 10 sessions of individual CRT, and 55 patients (mean age = 14...
March 15, 2018: European Eating Disorders Review: the Journal of the Eating Disorders Association
Tiffany A Brown, Anne Cusack, Leslie K Anderson, Julie Trim, Tiffany Nakamura, Mary Ellen Trunko, Walter H Kaye
Partial hospital programmes (PHPs) have demonstrated efficacy in the treatment of eating disorders (EDs); however, few programmes have examined long-term outcomes across diagnoses, including subtypes of anorexia nervosa (AN). The present study examined the effectiveness of PHP for adult patients (n = 243) with AN-restricting subtype (n = 79), AN binge/purge subtype (n = 46), and bulimia nervosa (n = 118). These patients tended to have long-standing courses of illness (43%, illness duration >7 years) and high levels of psychiatric comorbidity (92...
March 14, 2018: European Eating Disorders Review: the Journal of the Eating Disorders Association
Valentina Cardi, Núria Mallorqui-Bague, Gaia Albano, Alessio Maria Monteleone, Fernando Fernandez-Aranda, Janet Treasure
Anorexia nervosa (AN) is a serious psychiatric disorder characterized by severe restriction of energy intake and dangerously low body weight. Other domains of functioning are affected, including social functioning. Although difficulties within this domain have started to be acknowledged by the literature, some important gaps remain to be filled. Do social difficulties predate the onset of the illness? What difficulties in particular are relevant for the development and maintenance of the illness? The aim of this study is to combine the use of quantitative and qualitative methods to answer these questions...
2018: Frontiers in Psychiatry
Can Sarica, Mazhar Ozkan, Husniye Hacioglu Bay, Umit Sehirli, Filiz Onat, M Ibrahim Ziyal
BACKGROUND: Binge eating (BE) involves the consumption of a large amount of food in a short period of time and a loss of control during the binge episode. It is a key feature of the major subtypes of eating disorders like bulimia nervosa, BE disorder, anorexia nervosa binge/purge type. Alterations in the mesocorticolimbic pathway play a crucial role in its pathophysiology. OBJECTIVES: We hypothesized that BE rats receiving deep brain stimulation (DBS) in the prelimbic cortex, a functional analog of the dorsolateral prefrontal cortex in humans, would have a reduced binge size compared with those receiving sham stimulation...
March 13, 2018: Stereotactic and Functional Neurosurgery
Andrea B Goldschmidt, Ross D Crosby, Li Cao, Markus Moessner, Kelsie T Forbush, Erin C Accurso, Daniel Le Grange
Classifying eating disorders in youth is challenging in light of developmental considerations and high rates of diagnostic migration. Understanding the transactional relationships among eating disorder symptoms, both across the transdiagnostic spectrum and within specific diagnostic categories, may clarify which core eating disorder symptoms contribute to, and maintain, eating-related psychopathology in youth. We utilized network analysis to investigate interrelationships among eating disorder symptoms in 636 treatment-seeking children and adolescents (90...
February 2018: Journal of Abnormal Psychology
Jake Linardon, Andrea Phillipou, David Castle, Richard Newton, Philippa Harrison, Leonardo L Cistullo, Scott Griffiths, Annemarie Hindle, Leah Brennan
Recent research has demonstrated that certain components of body image (i.e., shape and weight over-evaluation, preoccupation, and dissatisfaction) in secondary school students shared a distinct clinical significance because of their differential relation to measures of psychopathology. The present study aimed to replicate and extend on these findings by examining the distinctiveness of these body image constructs, in addition to a fear of weight gain, in individuals with anorexia nervosa (AN)-a disorder this is facilitated and maintained by extreme body image concerns...
March 2, 2018: Eating Behaviors
S Zaami, A Di Luca, N M Di Luca, G Montanari Vergallo
This review illustrates some brief considerations of the medical use of cannabis recently issued in Italy. History and uses of cannabis throughout centuries and different countries are illustrated together with a description of botany and active phytocannabinoids. Then, medical use of cannabis anti-pain treatment for patients resistant to conventional therapies is described in case of chronic neuropathic pain, spasticity, for anticinetosic and antiemetic effect in nausea and vomiting caused by chemotherapy, for appetite stimulating effect in cachexia, anorexia, loss of appetite in cancer patients or patients with AIDS and in anorexia nervosa, hypotensive effect in glaucoma resistant to conventional therapies and for reduction of involuntary body and facial movements in Gilles de la Tourette syndrome...
February 2018: European Review for Medical and Pharmacological Sciences
Shian Ming Tan, Kah Foo Victor Kwok, Kelly A Zainal, Huei Yen Lee
OBJECTIVE: The incidence of cases of older onset anorexia nervosa (AN) has increased in recent years. However, the literature on late-onset AN has been inconclusive. The goal of this study was to compare late-onset with early-onset cases of AN. METHODS: Cases of AN presenting to an eating disorders treatment service were identified and the associated medical records were studied retrospectively. RESULTS: Of the 577 cases of AN that were studied, 7...
March 2018: Journal of Psychiatric Practice
Olaia Carrera, Emilio Gutiérrez
In the Editorial 'Is the neglect of exercise in anorexia nervosa research a case of "running out" of ideas or do we need to take a "LEAP" of faith into the future?' these authors express their doubts concerning the suitability of keeping patients warm as a beneficial treatment option in managing excessive activity in anorexia nervosa (AN) patients. The case for warming as an adjunctive treatment for AN patients is based on strong experimental evidence gathered from research on animals with Activity-Based Anorexia (ABA)...
2018: Journal of Eating Disorders
Sridhar Vajapeyam, Kirsten Ecklund, Robert V Mulkern, Henry A Feldman, Jennifer M O'Donnell, Amy D DiVasta, Clifford J Rosen, Catherine M Gordon
PURPOSE: Dehydroepiandrosterone (DHEA)+estrogen/progestin therapy for adolescent girls with anorexia nervosa (AN) has the potential to arrest bone loss. The primary aim of this study was to test the effects of DHEA+estrogen/progestin therapy in adolescent girls with AN on bone marrow in the distal femur using magnetic resonance imaging (MRI) and spectroscopy. METHODS: Seventy adolescent girls with AN were enrolled in a double blind, randomized, placebo-controlled trial at two urban hospital-based programs...
February 26, 2018: Bone
Amanda E Bryson, Anna M Scipioni, Jamal H Essayli, Johnna R Mahoney, Rollyn M Ornstein
OBJECTIVE: To assess long-term outcomes of patients with avoidant/restrictive food intake disorder (ARFID) treated in a partial hospitalization program (PHP) for eating disorders (ED). METHOD: A cross-sectional study comparing patients with ARFID to those with anorexia nervosa (AN) who had been discharged from a PHP for at least 12 months was performed. Percent median body mass index (%MBMI), scores on the Children's Eating Attitudes Test (ChEAT), and treatment utilization were assessed, with intake and discharge data collected via retrospective chart review...
March 1, 2018: International Journal of Eating Disorders
Joanne L Gusella, Anna G Campbell, Kristin Lalji
Family-based treatment (FBT) has emerged as a promising approach for medically stable youth with anorexia nervosa (AN). While there is evidence that therapists embrace the core principles of FBT, most face barriers in implementing the model with fidelity. Little research has been conducted to determine whether adhering to the core methods of placing parents in charge are sufficient in restoring weight in youth with AN. This study involved a chart review of youth under 16 years of age, treated by a Canadian tertiary care health centre-based eating disorders team (EDT)...
August 2017: Paediatrics & Child Health
Therese Fostervold Mathisen, Jan H Rosenvinge, Oddgeir Friborg, Gunn Pettersen, Trine Stensrud, Bjørge Herman Hansen, Karoline E Underhaug, Elisabeth Teinung, KariAnne Vrabel, Mette Svendsen, Solfrid Bratland-Sanda, Jorunn Sundgot-Borgen
OBJECTIVE: Knowledge about physical fitness in women with bulimia nervosa (BN) or binge-eating disorder (BED) is sparse. Previous studies have measured physical activity largely through self-report, and physical fitness variables are mainly restricted to body mass index (BMI) and bone mineral density. We expanded the current knowledge in these groups by including a wider range of physical fitness indicators and objective measures of physical activity, assessed the influence of a history of anorexia nervosa (AN), and evaluated predictive variables for physical fitness...
February 23, 2018: International Journal of Eating Disorders
April R Smith, Lauren N Forrest, Elizabeth A Velkoff, Jessica D Ribeiro, Joseph Franklin
OBJECTIVE: The current study tested whether people with and without eating disorders (EDs) varied in their implicit attitudes toward ED-relevant stimuli. Additionally, the study tested whether implicit evaluations of ED-relevant stimuli predicted ED symptoms and behaviors over a 4-week interval. METHOD: Participants were people without EDs (N = 85) and people seeking treatment for EDs (N = 92). All participants completed self-report questionnaires and a version of the affect misattribution procedure (AMP) at baseline...
February 22, 2018: International Journal of Eating Disorders
Jessica McClelland, John Hodsoll, Amy Brown, Katie Lang, Elena Boysen, Michaela Flynn, Victoria A Mountford, Danielle Glennon, Ulrike Schmidt
This pilot study assesses the impact of FREED (First Episode Rapid Early Intervention for Eating Disorders [ED]), a novel transdiagnostic service for emerging adults with recent ED onset, on clinical outcomes. Data were collected from 56 patients and 19 carers for 12 months following enrolment. FREED patients showed significant improvements in ED and other symptoms across time. Carers also showed psychological improvements. For FREED anorexia nervosa (AN) patients, body mass index (BMI) at initial clinical assessment was similar to that of comparable patients (audit cohort) seen in our service before (16...
March 2018: European Eating Disorders Review: the Journal of the Eating Disorders Association
Joanna E Steinglass, Deborah R Glasofer, Emily Walsh, Gabby Guzman, Carol B Peterson, B Timothy Walsh, Evelyn Attia, Stephen A Wonderlich
BACKGROUND: Habits are behavioral routines that are automatic and frequent, relatively independent of any desired outcome, and have potent antecedent cues. Among individuals with anorexia nervosa (AN), behaviors that promote the starved state appear habitual, and this is the foundation of a recent neurobiological model of AN. In this proof-of-concept study, we tested the habit model of AN by examining the impact of an intervention focused on antecedent cues for eating disorder routines...
February 19, 2018: Psychological Medicine
Sarah Young, Stephen Touyz, Caroline Meyer, Jon Arcelus, Paul Rhodes, Sloane Madden, Kathleen Pike, Evelyn Attia, Ross D Crosby, Phillipa Hay
Background: For people with anorexia nervosa (AN), compulsive exercise is characterized by extreme concerns about the perceived negative consequences of stopping/reducing exercise, dysregulation of affect, and inflexible exercise routines. It is associated with increased eating disorder psychopathology and poor clinical outcome. However, its relationships with two important clinical issues, quality of life (QoL) and motivation to change, are currently unknown. This study aimed to assess the cross-sectional relationships between compulsive exercise, QoL, psychological distress (anxiety and depressive symptoms, and obsessive-compulsive traits) and motivation to change in patients with AN...
2018: Journal of Eating Disorders
Simonetta Marucci, Laura Dalla Ragione, Giulia De Iaco, Tania Mococci, Maria Vicini, Edoardo Guastamacchia, Vincenzo Triggiani
There is great interest, supported by clinical experience, in the relationship between Eating Disorders (EDs) and psychiatric symptoms and diseases. The psychopathology of EDs is also referred to many risk and protective factors, and there is some evidence in the literature, also about genetic and neurobiological factors involved. EDs are often associated with pre-morbid psychiatric disorders, personality disorders, substance abuse, mood and anxiety disorders. The great amount of scientific articles dealing with the relationship between EDs and psychopathology confirms the complexity of these problems and the difficulties in diagnosis and treatment...
February 12, 2018: Endocrine, Metabolic & Immune Disorders Drug Targets
Teresa Małecka-Massalska, Joanna Popiołek, Mariusz Teter, Iwona Homa-Mlak, Mariola Dec, Agata Makarewicz, Hanna Karakuła-Juchnowicz
The evaluation of the nutrition status of patients has been the subject of interest of many scientific disciplines. Any deviation from normal values is a serious clinical problem. There are multiple nutrition status evaluation methods used including diet history, scales and questionnaires, physical examination, anthropometric measurements, biochemical measurements, function tests, as well as bioelectric impedance analysis or adipometry. Phase angle, obtained by means of bioelectric impedance analysis, is another parameter that is being more and more frequently applied in nutrition status monitoring...
December 30, 2017: Psychiatria Polska
Antonios Dakanalis, C Alix Timko, Fabrizia Colmegna, Giuseppe Riva, Massimo Clerici
We examined the validity and utility of the DSM-5 severity ratings for anorexia nervosa (AN) in a clinical (treatment-seeking) sample (N = 273; 95.6% women). Participants classified with mild, moderate, severe, and extreme severity of AN based on their measured body mass index, differed significantly from each other in eating disorder features, putative maintenance factors, and illness-specific functional impairment (medium effect sizes). However, they were statistically indistinguishable in psychiatric-disorder comorbidity and distress, demographics, and age-of-AN onset...
February 5, 2018: Psychiatry Research
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