THE CHILD-ADULT TRANSITION FOR PATIENTS SUFFERING FROM EATING DISORDERS.: Eating disorders are chronic and evolutive psychiatric conditions which develop on a continuum between childhood and adulthood. The transition between child, adolescent and then adult care is a period of great vulnerability which may induce drop-out and aggravation of symptoms. In the case of eating disorders in particular, personalised transition programmes have been implemented in order to provide this support.
Anorexia must not be considered as a syndrome specific to a culture but as being linked to fast-moving sociocultural changes. Its occurrence can be favoured by certain transcultural phenomena, such as globalisation and the process of acculturation. The analysis of a clinical case of a young migrant with anorexia illustrates the complexity and need for complementary transcultural psychotherapy, to improve understanding and the future.
Acculturation , Anorexia Nervosa/ethnology , Anorexia Nervosa/nursing , Emigrants and Immigrants/psychology , Transcultural Nursing/methods , Adolescent , Anorexia Nervosa/psychology , Anorexia Nervosa/therapy , Child , China/ethnology , Female , France , Humans , Sibling Relations/ethnology , Social Change , Social Values
Anorexia nervosa (AN) is classically defined as a condition in which an abnormally low body weight is associated with an intense fear of gaining weight and distorted cognitions regarding weight, shape, and drive for thinness. This article reviews recent evidences from physiology, genetics, epigenetics, and brain imaging which allow to consider AN as an abnormality of reward pathways or an attempt to preserve mental homeostasis. Special emphasis is put on ghrelino-resistance and the importance of orexigenic peptides of the lateral hypothalamus, the gut microbiota and a dysimmune disorder of neuropeptide signaling. Physiological processes, secondary to underlying, and premorbid vulnerability factors-the "pondero-nutritional-feeding basements"- are also discussed.
Anorexia is a complex, multifactorial disease, emerging during puberty and requiring cross-disciplinary care. The body, taken hostage, expresses psychological suffering and the patient's developmental impasse. Compassionate treatment and the care given to this mistreated and undernourished body facilitate the access to the psychological care and are an essential step towards recovery.
Anorexia/psychology , Anorexia/therapy , Adolescent , Complementary Therapies , Enteral Nutrition/methods , Humans
Bulimia nervosa is an eating disorder associating binge eating with inappropriate compensatory methods. Patients suffer from multiple organic, psychological and social complications. Of these, the somatic consequences are numerous and of varying degrees of seriousness. Regular monitoring is therefore essential in order to identify them and treat them.
Bulimia Nervosa/complications , Bulimia Nervosa/diagnosis , Endocrine System Diseases/etiology , Female , Gastrointestinal Diseases/etiology , Humans , Hypokalemia/etiology , Kidney Diseases/etiology , Menstruation Disturbances/etiology
The increased prevalence of anorexia nervosa reported in non-Western societies inevitably raises the issue of the influence of cultural factors in the genesis and the patterns of this disorder. Anorexia nervosa is not a straightforward Western culture-bound syndrome, although an influence of Western ideals of thinness does exist. The illness seems more related to rapid cultural shifts, either societal or individual, such as those occurring in the migratory process. Migrants and their children have to face the acculturation process and may experience a culture-clash. The pathology can also fulfil a positive acculturative function. This is a case study concerning a second-generation Chinese girl born in France presenting with anorexia nervosa. This case leads us to raise the issue of the choice of diagnostic criteria in relation to cultural background. We will also discuss the impact of the family's migratory history on the construction of identity in adolescence. Finally we will explore the specific features of care provision for anorexia nervosa in a transcultural setting.
Acculturation , Anorexia Nervosa/diagnosis , Body Image , Culture , Adolescent , Anorexia Nervosa/ethnology , Anorexia Nervosa/psychology , Asian People , Female , Humans
