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1.
Rev Esp Med Nucl ; 26(1): 11-8, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17286944

RESUMO

OBJECTIVE: To evaluate cortical brain blood flow by 99mTc-HMPAO SPECT in patients with Eating Disorders (ED): restrictive anorexia (RA) and purgative bulimia (PB). MATERIAL AND METHOD: The study included 7 women with diagnostic criteria of RA and 12 with PB. The control group was made up of 12 healthy women. All subjects underwent brain 99mTc-HMPAO SPECT. The SPECT studies were quantified, yielding semiquantitative indexes relating to cerebellar activity in different regions. Body dissatisfaction was assessed by means of the BSQ (Body Shape Questionnaire). The results were analyzed with the ANOVA variance and had a statistical significance of p < 0.05. RESULTS: Mean BSQ scores were 98.28 (range 71-159) in the RA group, 145.05 (range 73-191) in the PB group, and 57.4 (range 37-88) in the control group. All patients in the sample (i.e., both RA and PB) showed global cerebral hypoperfusion versus the controls, although the difference only reached statistical significance in the RA group in the left parietal lobe (p = 0.02) and in the right (p = 0.004) and left temporal lobes (p = 0.015). In the PB group, the significantly hypoperfused regions were the right (p < 0.001) and left (p = 0.008) superior frontal lobe, the right inferior frontal lobe (p = 0.042), the right (p = 0.042) and left (p = 0.002) parietal lobes, and the right temporal lobe (p = 0.002). CONCLUSION: The results obtained showed that patients with ED had cerebral hypoperfusion compared with healthy subjects. This pattern is common in parietotemporal regions for both PB and AR although with temporal and parietal predominance in RA and PB, respectively. In addition, patients with PB had frontal region involvement.


Assuntos
Anorexia/diagnóstico por imagem , Bulimia/diagnóstico por imagem , Córtex Cerebral/irrigação sanguínea , Córtex Cerebral/diagnóstico por imagem , Circulação Cerebrovascular , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton Único , Adulto , Feminino , Humanos , Estudos Prospectivos
2.
Actas Esp Psiquiatr ; 34(4): 245-50, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-16823685

RESUMO

INTRODUCTION: Our aim was to assess if the degree of motivation at the beginning of the treatment for eating disorders (ED) might have an influence on the clinical outcome at one year of follow-up. METHODS: 102 patients diagnosed of ED, following ED DSM-IV criteria, who initiated treatment at the hospital eating disorders unit, were included in the study. All the patients were examined with the structured interview SCID-I and numerous clinical and demographic variables were recorded. Before beginning eating disorders treatment, patients completed one questionnaire that assessed attitudes towards change in eating disorders (ACTA) and other questionnaires measuring eating and general psychopathology. RESULTS: At one year of follow-up, initial low scores on the "relapse" subscale predicted a greater weight recovery in patients with anorexia nervosa and a lower number of weekly binges in bulimic patients. CONCLUSIONS: Attitude towards treatment at the beginning of a therapeutic program, mainly feeling of relapse, is a significant prognostic factor for the therapeutic response.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Motivação , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Anorexia Nervosa/terapia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/psicologia , Bulimia Nervosa/terapia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Humanos , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento
3.
Actas Esp Psiquiatr ; 33(6): 352-8, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16292717

RESUMO

INTRODUCTION: The aim of the present study was to identify possible risk and protective factors for the development of problems with the use of drugs in adolescents. METHODS: A two years follow-up was carried out (from the 2nd to the 4th year of the Compulsory Secondary Education). Sociodemographic variables, general and eating psychopathology, family functioning and patterns of drugs use were assessed in 1,076 students. RESULTS: After controlling the effect of having problems with the use of drugs at the beginning, cigarettes smoking at the age of 13 years predicted the consumption of alcohol 2 years later and vice versa. Independently of the effect of this association, general psychopathology, body image dissatisfaction and self-harm at the beginning were risk factors for alcohol consumption 2 years later. Moreover, besides female gender and high academic achievements, normal family functioning was a protective factor against the fact of suffering problems with drugs later on. CONCLUSIONS: These present findings might have relevance in the development of preventive strategies for the use of drugs in adolescent population.


Assuntos
Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Tabagismo/prevenção & controle , Adolescente , Comportamento do Adolescente , Demografia , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabagismo/epidemiologia
4.
Eat Weight Disord ; 10(1): 59-65, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15943173

RESUMO

OBJECTIVE: To investigate the influence of the stage of change on treatment outcome among patients suffering from eating disorders. METHOD: Sixty-seven women receiving free outpatient treatment for eating disorders initially participated in this study. Their demographic, lifetime and clinical characteristics, eating disorder symptoms and general distress were assesssed at baseline and after one year, together with the results of self-report questionnaire on Attitudes towards Change in Eating Disorders (ACTA). RESULTS: High scores on the Maintenance subscale were protective for eating psychopathology as measured by the Eating Attitudes Test (EAT-40), Eating Disorders Inventory (EDI-2) and the frequency of purging. Action was predictive of weight changes. Precontemplation and Relapse respectively predicted little change in EAT and the Bulimic Inventory Test Edinburgh (BITE). High Preparation scores were predictive of the level of EDI-2 Interoceptive Awareness, Maturity Fears, and Ascetism. DISCUSSION: Our results suggest considering the stage of change as a useful outcome predictor.


Assuntos
Atitude Frente a Saúde , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Adolescente , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Previsões , Humanos , Motivação , Psicometria , Espanha/epidemiologia , Inquéritos e Questionários
5.
Actas Esp Psiquiatr ; 33(1): 33-40, 2005.
Artigo em Espanhol | MEDLINE | ID: mdl-15704029

RESUMO

INTRODUCTION: The use of antipsychotic drugs in the treatment of eating disorders (ED) patients is a controversial issue. Although a few studies support the systematic use of antipsychotics, they are frequently used, mainly in severe disorders with other associated psychopathological symptoms. METHODS: 27 ED patients were included in the study, 7 dropped-out prematurely or did not complete the pharmacological treatment. All the patients were interviewed and diagnosed according to the Structured Clinical Interview for the DSM-IV (SCID-I) and the personality diagnosis was carried out with the Spanish version of the International Personality Disorders Examination (IPDE). The clinical assessment was performed with the Clinical Global Impression (CGI) scale and the Change Severity Assessment (CSA) at baseline and three months after the beginning of the treatment with risperidone. RESULTS: A significant proportion of patients showed clear clinical and general state improvement in areas like physical state, eating behavior, family and social relationships and work ability. CONCLUSIONS: Risperidone associated to the previous therapeutic treatment in patient with a severe ED, with comorbid disorders and where other pharmacological treatments have not been effective, could be a useful option.


Assuntos
Antipsicóticos/uso terapêutico , Transtornos da Alimentação e da Ingestão de Alimentos/tratamento farmacológico , Risperidona/uso terapêutico , Adulto , Feminino , Humanos , Estudos Prospectivos
6.
Actas Esp Psiquiatr ; 31(3): 111-9, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-12772038

RESUMO

INTRODUCTION: The aim of the present study was the development of a self-reported instrument in Spanish to assess attitudes towa rds change in eating disord e rs (AC TA ) and to analyze its reliability and validity. METHODS: The questionnaire was elaborated following the transtheoretical approach of stages of changes, proposed by Prochaska and DiClemente and using the clinical records systematically registered regarding patients cognitions, behaviors and emotions related to the disorder. It was administered to 186 patients who where diagnosed an eating disorder according DSM-IV criteria. Subsequently, the process of refinement and validation of the scale was initiated. Moreover, a set of self-reported instruments was used to assess the eating disorder psychopathology: the Eating Attitudes Test (EAT), the Bulimic Investigatory Test Edinburgh (BITE), the Eating Disorders Inventory (EDI-2) and the Body Shape Questionnaire (BSQ). RESULTS: The final version consisted of 59 items divided into six subscales: precontemplation, contemplation, determination, action, maintenance and relapse. All of them s h owed an internal consistency over 0.70 which corresponded to the six factor obtained after the factorial analysis. Furthermore, the subscales were logically correlated to each other and to the questionnaires measuring eating psychopathology. CONCLUSIONS: The present results suggest that the ACTA be an easily administered, reliable and valid questionnaire, which could be used withinthe motivational approach. This could provide interesting information regarding the knowledge of the therapeutical process.


Assuntos
Atitude Frente a Saúde , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Inquéritos e Questionários , Humanos , Motivação , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes
7.
Actas Esp Psiquiatr ; 31(2): 59-64, 2003.
Artigo em Espanhol | MEDLINE | ID: mdl-12677468

RESUMO

This study reports the Spanish version of a new scale for the assessment of body image, developed by Gardner, Stark, Jackson and Friedman (1999). A silhouette method was used as a self-evaluation measure of schematic ideal body size within three groups of women: anorexia nervosa (n= 57), bulimia nervosa (n=57) and normal control (n=168). The results showed that, considering the body mass index as covariant of the results, the clinical groups formed by anorexic and bulimic patients judged their current body size as significantly greater than the control group. In the same way, the clinical groups judged their ideal body size significantly thinner than that considered by the control group. We can conclude that this scale for assessment is a sensitive psychometrical measure of the body image.


Assuntos
Anorexia Nervosa/etiologia , Bulimia/etiologia , Idioma , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Feminino , Humanos , Reprodutibilidade dos Testes
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