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anorexia nervosa treatment

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https://www.readbyqxmd.com/read/29334934/factors-influencing-the-length-of-hospital-stay-of-patients-with-anorexia-nervosa-results-of-a-prospective-multi-center-study
#1
D Kästner, B Löwe, A Weigel, B Osen, U Voderholzer, A Gumz
BACKGROUND: The length of stay (LOS) strongly influences anorexia nervosa (AN) inpatient weight outcomes. Hence, understanding the predictors of LOS is highly relevant. However, the existing evidence is inconsistent and to draw conclusions, additional evidence is required. METHODS: We conducted a prospective, multi-center study including adult female inpatients with AN. Using stepwise linear regression, the following demographic and clinical variables were examined as potential predictors for LOS: admission BMI, AN-subtype, age, age of onset, living situation, partnership status, education, previous hospitalization, self-rated depression, anxiety and somatic symptoms (PHQ-9, PHQ-15, GAD-7), self-rated therapy motivation (FEVER) and eating disorder psychopathology (EDI-2 subscale scores)...
January 15, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29331075/an-examination-of-the-clinical-outcomes-of-adolescents-and-young-adults-with-broad-autism-spectrum-traits-and-autism-spectrum-disorder-and-anorexia-nervosa-a-multi-centre-study
#2
Bruno Palazzo Nazar, Vanessa Peynenburg, Charlotte Rhind, Rebecca Hibbs, Ulrike Schmidt, Simon Gowers, Pamela Macdonald, Elizabeth Goddard, Gillian Todd, Nadia Micali, Janet Treasure
OBJECTIVES: To compare the clinical outcomes of adolescents and young adults with anorexia nervosa (AN) comorbid with broad autism spectrum disorder (ASD) or ASD traits. METHOD: The developmental and well-being assessment and social aptitude scale were used to categorize adolescents and young adults with AN (N = 149) into those with ASD traits (N = 23), and those who also fulfilled diagnostic criteria for a possible/probable ASD (N = 6). We compared both eating disorders specific measures and broader outcome measures at intake and 12 months follow-up...
January 13, 2018: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29325236/treatment-with-a-ghrelin-agonist-in-outpatient-women-with-anorexia-nervosa-a-randomized-clinical-trial
#3
Pouneh K Fazeli, Elizabeth A Lawson, Alexander T Faje, Kamryn T Eddy, Hang Lee, Fred T Fiedorek, Anne Breggia, Ildiko M Gaal, Rebecca DeSanti, Anne Klibanski
OBJECTIVE: To assess the effects of relamorelin-an agonist of the appetite-stimulating hormone ghrelin, which has effects on gastric emptying-on (1) weight gain and (2) gastric emptying in women with anorexia nervosa. METHODS: In a randomized, double-blind, placebo-controlled design, the effects of the ghrelin agonist relamorelin were studied in 22 outpatient women with anorexia nervosa, diagnosed using DSM-5 criteria. The study was conducted at the Massachusetts General Hospital Clinical Research Center between March 11, 2013, and February 26, 2015...
January 2, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29321971/processing-and-regulation-of-negative-emotions-in-anorexia-nervosa-an-fmri-study
#4
Maria Seidel, Joseph A King, Franziska Ritschel, Ilka Boehm, Daniel Geisler, Fabio Bernardoni, Matthias Beck, Sophie Pauligk, Ronald Biemann, Alexander Strobel, Thomas Goschke, Henrik Walter, Veit Roessner, Stefan Ehrlich
Theoretical models and recent advances in the treatment of anorexia nervosa (AN) have increasingly focused on the role of alterations in the processing and regulation of emotions. To date, however, our understanding of these changes is still limited and reports of emotional dysregulation in AN have been based largely on self-report data, and there is a relative lack of objective experimental evidence or neurobiological data. The current functional magnetic resonance imaging (fMRI) study investigated the hemodynamic correlates of passive viewing and voluntary downregulation of negative emotions by means of the reappraisal strategy detachment in AN patients...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29314160/are-parental-self-efficacy-and-family-flexibility-mediators-of-treatment-for-anorexia-nervosa
#5
Shiri Sadeh-Sharvit, Katherine D Arnow, Lilya Osipov, James D Lock, Booil Jo, Sarah Pajarito, Harry Brandt, Elizabeth Dodge, Katherine A Halmi, Craig Johnson, Walter Kaye, Denise Wilfley, W Stewart Agras
OBJECTIVE: Family-based treatment (FBT) for adolescent anorexia nervosa (AN) promotes faster weight restoration when compared to other treatments. However, the mechanisms through which this occurs are not clarified. This study explored the trajectories of parental self-efficacy and perceived family flexibility during FBT and systemic family therapy (SyFT). We also explored whether parental self-efficacy mediates the effects of treatment on weight gain early in treatment. METHOD: 158 adolescents (12-18 years old; 89% girls) and their parents were randomized to FBT or SyFT...
January 4, 2018: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29313281/eating-disorders-substance-use-disorders-and-multiple-symptoms-three-clinical-vignettes
#6
Graziella Fava Vizziello, Laura Bellin
During the longitudinal study of three patients, referred to services at 3, 13, 15 years for eating disorders, reduced food intake and anorexia nervosa, other symptoms appeared depending on difficult development, relational and personality problems. The patients showed the interweaving of symptoms at different times: they were dealing with modified developmental needs and contexts, included new possibilities of attachment that might produce different internal organizations. These changes required different treatments...
January 8, 2018: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/29289966/intestinal-microbiota-a-key-to-understanding-the-pathophysiology-of-anorexia-nervosa
#7
REVIEW
Hanna Karakuła-Juchnowicz, Hanna Pankowicz, Dariusz Juchnowicz, Jose Luis Valverde Piedra, Teresa Małecka-Massalska
Anorexia nervosa (AN) is a psychiatric disorder related to very serious consequences for physical and mental health of patients. Due to a complex clinical picture, which consists of anumber of somatic and mental symptoms, AN remains a serious problem of modern medicine and encourages the search for possible causes of the illness and new, more effective therapies. The recent reports emphasize the role of the intestinal microbiota in regulation of body weight. In this light, the hypothesis that in AN patients there is a significant imbalance of the intestinal microbiota, which contributes to the pathogenesis of the illness, seems interesting...
October 29, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/29288794/role-of-central-neurotensin-in-regulating-feeding-implications-for-the-development-and-treatment-of-body-weight-disorders
#8
REVIEW
Laura E Schroeder, Gina M Leinninger
The peptide neurotensin (Nts) was discovered within the brain over 40 years ago and is implicated in regulating analgesia, body temperature, blood pressure, locomotor activity and feeding. Recent evidence suggests, however, that these disparate processes may be controlled via specific populations of Nts neurons and receptors. The neuronal mediators of Nts anorectic action are now beginning to be understood, and, as such, modulating specific Nts pathways might be useful in treating feeding and body weight disorders...
December 27, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29288690/mifepristone-reduces-hypothalamo-pituitary-adrenal-axis-activation-and-restores-weight-loss-in-rats-subjected-to-dietary-restriction-and-methylphenidate-administration
#9
Rami Bou Khalil, Viviane Smayra, Youakim Saliba, Joelle Hajal, Jules-Joël Bakhos, Lama Souaiby, Sami Richa, Jean Tamraz, Nassim Farès
This study evaluates the efficacy of mifepristone on weight restoration in rats subjected to dietary restriction and methylphenidate administration. 25 female rats aged between 9 and 12 months were divided into 2 groups: 5 controls (exposed only to dietary restriction) and 20 rats that were administered 5 mg/kg/d of methylphenidate before meal exposure, for 36 days. Among rats who responded to methylphenidate (weight loss of 15-25%) weeks after its administration, a group of 6 rats continued to receive only methylphenidate ("Met" group), and another group received 10 mg/kg/d of mifepristone in addition to methylphenidate for 18 days ("Met+Mif" group; n = 6)...
December 27, 2017: Neuroscience Research
https://www.readbyqxmd.com/read/29282232/the-competency-paradox-in-somatic-disease
#10
Barry W Wall
Westmoreland et al. have reviewed factors associated with provider reluctance to initiate and judicial reluctance to authorize civil commitment and involuntary treatment for persons with severe anorexia nervosa. Their analysis of the legal, medical, and psychiatric elements that affect treatment outcomes contributes to professional understanding of a complex topic. Although their proposal to create guidelines for involuntary treatment for persons with eating disorders may be of clinical utility, guidelines should not be promulgated for the purposes of reaching judicial findings of law...
December 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/29282231/involuntary-treatment-of-patients-with-life-threatening-anorexia-nervosa
#11
Patricia Westmoreland, Craig Johnson, Michael Stafford, Richard Martinez, Philip S Mehler
Anorexia nervosa has the highest mortality rate of any psychiatric illness. Predictors of mortality include chronicity of the illness, critically low body weight, and binging and purging behavior. Delusional beliefs body image, coupled with impaired judgment and cognition caused by starvation, often result in these patients adamantly resisting efforts to treat them. Guardianship, although useful in assisting with medical treatment decisions for patients with anorexia nervosa who are critically medically ill, is usually an inadequate intervention with respect to psychiatric treatment for these patients...
December 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/29261731/time-course-of-adiponectin-and-its-relationship-to-psychological-aspects-in-patients-with-anorexia-nervosa-during-inpatient-treatment
#12
Magdalena Buckert, Esther Stroe-Kunold, Hans-Christoph Friederich, Daniela Wesche, Christiane Walter, Stefan Kopf, Joe J Simon, Wolfgang Herzog, Beate Wild
OBJECTIVE: The protein hormone adiponectin promotes metabolic and psychological health. The aim of the study was to track changes in adiponectin levels in response to weight gain and to assess associations between adiponectin and psychological aspects in patients with anorexia nervosa (AN). METHODS: To investigate if adiponectin levels depend on AN severity, data were assessed from 11 inpatients with a very low body mass index (BMI) and a high chronicity (high severity group; HSS), and nine with less severe symptoms (LSS)...
2017: PloS One
https://www.readbyqxmd.com/read/29250146/advanced-research-on-deep-brain-stimulation-in-treating-mental-disorders
#13
Dongxin Wang, Xuejun Liu, Bin Zhou, Weiping Kuang, Tiansheng Guo
Deep brain stimulation is a method that involves using an electric stimulus on a specific target in the brain with stereotaxis. It is a minimally invasive, safe, adjustable and reversible nerve involvement technology. At present, this technique is widely applied to treat movement disorders and has produced promising effects on mental symptoms, including combined anxiety and depression. Deep brain stimulation has therefore been employed as a novel treatment for depression, obsessive-compulsive disorder, habituation, Tourette's syndrome, presenile dementia, anorexia nervosa and other refractory mental illnesses...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29239739/endophenotypes-a-conceptual-link-between-anorexia-nervosa-and-autism-spectrum-disorder
#14
Z C Zhou, D B McAdam, D R Donnelly
The paper, by translating the concept and the two models of endophenotype (EP), strengthens the hypothesis that there exists a linkage between anorexia nervosa (AN) and autism spectrum disorder (ASD). Specifically, the paper synthesizes empirical research that supported the idea that individuals with AN and individuals with ASD share similarities with respect to their neurocognitive EPs and temperament EPs. The paper then introduces an innovative structure to emphasize the subtle difference between neurocognitive EPs and temperament EPs in relation to AN and ASD...
November 24, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/29218761/naturalistic-outcome-of-family-based-inpatient-treatment-for-adolescents-with-anorexia-nervosa
#15
Inger Halvorsen, Deborah Lynn Reas, Jan-Vegard Nilsen, Øyvind Rø
BACKGROUND: Outpatient family-based treatment (FBT) is the best-documented treatment for adolescent anorexia nervosa (AN), but research is scarce on FBT adapted to inpatient settings. AIM: The naturalistic outcome of inpatient FBT for adolescent AN was investigated. METHODS: Thirty-seven (65%) of 57 patients who received inpatient FBT at a tertiary adolescent eating disorders (ED) unit participated in a follow-up interview (mean 4.5 ± 1...
December 8, 2017: European Eating Disorders Review: the Journal of the Eating Disorders Association
https://www.readbyqxmd.com/read/29215743/driven-exercise-in-the-absence-of-binge-eating-implications-for-purging-disorder
#16
Janet A Lydecker, Megan Shea, Carlos M Grilo
OBJECTIVE: Purging disorder (PD) is characterized by recurrent purging without objectively large binge-eating episodes. PD has received relatively little attention, and questions remain about the clinical significance of "purging" by exercise that is driven or compulsive (i.e., as extreme compensatory or weight-control behavior). The little available research suggests that individuals who use exercise as a compensatory behavior might have less eating-disorder psychopathology than those who purge by vomiting or laxatives, but those studies have had smaller sample sizes, defined PD using low-frequency thresholds, and defined exercise without weight-compensatory or driven elements...
December 7, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/29214022/advancing-our-understanding-of-the-neurobiology-of-anorexia-nervosa-translation-into-treatment
#17
Lasse Bang, Janet Treasure, Øyvind Rø, Andreas Joos
A wealth of studies has investigated the neurobiological underpinnings of anorexia nervosa. In our letter to the editor, we point to a number of ways in which the advances in our understanding of the neurobiology of anorexia nervosa - focusing on neuroimaging studies of brain structure and function - can be translated into treatment. We point to how such advances can: inform psychological treatment, be implemented in psychoeducation, point to novel therapeutic targets, lead to the identification of biomarkers, and expand our vocabulary for how we think and talk about anorexia nervosa...
2017: Journal of Eating Disorders
https://www.readbyqxmd.com/read/29209500/examining-a-staging-model-for-anorexia-nervosa-empirical-exploration-of-a-four-stage-model-of-severity
#18
Sarah Maguire, Lois J Surgenor, Daniel Le Grange, Hubert Lacey, Ross D Crosby, Scott G Engel, Kirsty M Fromholtz, Bryony Bamford, Stephen Touyz
Background: An illness staging model for anorexia nervosa (AN) has received increasing attention, but assessing the merits of this concept is dependent on empirically examining a model in clinical samples. Building on preliminary findings regarding the reliability and validity of the Clinician Administered Staging Instrument for Anorexia Nervosa (CASIAN), the current study explores operationalising CASIAN severity scores into stages and assesses their relationship with other clinical features...
2017: Journal of Eating Disorders
https://www.readbyqxmd.com/read/29209435/diseases-potentially-related-to-flammer-syndrome
#19
REVIEW
Katarzyna Konieczka, Carl Erb
Flammer syndrome (FS) is a prevalent and mostly benign condition. Subjects with FS seem to have a good life expectancy. Nevertheless, FS subjects are at increased risk for certain diseases, mainly when they are challenged by psychological stress or other stimuli such as coldness. FS is related to ocular diseases, such as normal-tension glaucoma, retinitis pigmentosa, central serous chorioretinopathy, optic nerve compartment syndrome, Leber's hereditary optic neuropathy, arterial or venous occlusions in the retina, and choroid and optic nerve head, despite the absence of classical vascular risk factors...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/29205410/eating-pathology-in-midlife-women-similar-or-different-to-younger-counterparts
#20
Paul E Jenkins, Tom Price
OBJECTIVE: This study examined potential similarities and differences between women with eating disorders (EDs) in midlife and their younger counterparts. METHOD: Seven hundred and three women assessed by a specialist eating disorder service were divided into three groups based on age (18-25, 25-40, and 40+) and compared on a number of clinical and demographic measures. Distribution of ED diagnoses was also examined between groups. RESULTS: Midlife women were less likely to receive a diagnosis of anorexia nervosa and more likely to receive a diagnosis of binge-eating disorder than their younger counterparts...
December 4, 2017: International Journal of Eating Disorders
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