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1.
PLoS One ; 15(7): e0235346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667951

RESUMO

Several studies have recently suggested that an abnormal processing of respiratory interoceptive and nociceptive (painful) stimuli may contribute to eating disorder (ED) pathophysiology. Mood and anxiety disorders (MA) are also characterized by abnormal respiratory symptoms, and show substantial comorbidity with ED. However, no studies have examined both respiratory and pain processing simultaneously within ED and MA. The present study systematically evaluated responses to perturbations of respiratory and nociceptive signals across the levels of physiology, behavior, and symptom report in a transdiagnostic ED sample (n = 51) that was individually matched to MA individuals (n = 51) and healthy comparisons (HC; n = 51). Participants underwent an inspiratory breath-holding challenge as a probe of respiratory interoception and a cold pressor challenge as a probe of pain processing. We expected both clinical groups to report greater stress and fear in response to respiratory and nociceptive perturbation than HCs, in the absence of differential physiological and behavioral responses. During breath-holding, both the ED and MA groups reported significantly more stress, feelings of suffocation, and suffocation fear than HC, with the ED group reporting the most severe symptoms. Moreover, anxiety sensitivity was related to suffocation fear only in the ED group. The heightened affective responses in the current study occurred in the absence of group differences in behavioral (breath hold duration, cold pressor duration) and physiological (end-tidal carbon dioxide, end-tidal oxygen, heart rate, skin conductance) responses. Against our expectations, there were no group differences in the response to cold pain stimulation. A matched-subgroup analysis focusing on individuals with anorexia nervosa (n = 30) produced similar results. These findings underscore the presence of abnormal respiratory interoception in MA and suggest that hyperreactivity to respiratory signals may be a potentially overlooked clinical feature of ED.


Assuntos
Anorexia Nervosa/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Dor Nociceptiva/fisiopatologia , Adolescente , Adulto , Afeto/fisiologia , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Asfixia/fisiopatologia , Asfixia/terapia , Comorbidade , Medo/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia , Transtornos do Humor/fisiopatologia , Dor Nociceptiva/complicações , Dor Nociceptiva/epidemiologia , Dor/complicações , Dor/epidemiologia , Dor/fisiopatologia , Sistema Respiratório/fisiopatologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-32481615

RESUMO

Background: Anorexia nervosa (AN) among the general population is a rare but often fatal illness. Objective: To summarize the incidence of AN using a systematic review and meta-analysis. Methods: Four online databases (PubMed, Scopus, WoS and Embase) were consulted. The review was conducted according to with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was limited to women. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale (NOS). Results: A total of 31 articles were included in the study. The incidence rate of AN ranged from 0.5 to 318.0 cases per 100,000 women-years. The incidence in studies based on outpatient healthcare services (OHS) was higher than those based on hospital admissions (HA) (8.8 95% CI: 7.83-9.80 vs. 5.0 95% CI: 4.87-5.05). In young women, the incidence in OHS was higher than HA (63.7, 95% CI 61.21-66.12 vs. 8.1 95% CI 7.60-8.53). The linear trend in the incidence of AN was increasing in all ages of women and young women, both in studies with hospital admission records, and in those based on outpatient healthcare services. Conclusion: The incidence of AN depends on the methodology, the type of population and the diagnostic criteria used.


Assuntos
Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Assistência Ambulatorial , Anorexia Nervosa/epidemiologia , Feminino , Hospitalização , Humanos , Incidência , Gravidez
5.
Pediatr. aten. prim ; 22(85): e13-e19, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193435

RESUMO

INTRODUCCIÓN: el objetivo del estudio es describir los hallazgos electrocardiográficos y ecocardiográficos en mujeres adolescentes con anorexia nerviosa y correlacionarlos con parámetros clínicos. PACIENTES Y MÉTODOS: estudio observacional, retrospectivo, de casos y controles. Se estudiaron 98 mujeres adolescentes ingresadas en un hospital terciario por anorexia nerviosa restrictiva (ANR) durante los últimos 15 años, en las que se realizó valoración electrocardiográfica y ecocardiográfica al ingreso. RESULTADOS: la edad media fue similar en ambos grupos (14,6 ± 2,0 frente a 14,7 ± 2,0 años). Las pacientes con ANR presentaban menor frecuencia cardiaca (57 ± 12 frente a 72 ± 13 lpm), voltajes más bajos (rV5 = 1,1 ± 0,5 frente a 1,6 ± 0,4 mV) y menor masa ventricular izquierda (65,7 ± 14,8 frente a 90 ± 15,3 g/m2) que las pacientes controles. No se encontraron diferencias en la medición del QTc. En las pacientes con ANR, la bradicardia no se correlacionó con el peso (r = -0,20; p = 0,05), ni con el índice de masa corporal (IMC) (r = 0,02; p = 0,22) al ingreso. El grosor del septo interventricular y la masa del ventrículo izquierdo fueron significativamente menores en los pacientes con ANR (5,7 mm frente a 6,8 mm, p <0,001; 65,7 frente a 90 g/m2; p <0,001). La masa ventricular izquierda se correlacionó de forma significativa con el IMC (r = 0,21; p <0,001) y con la frecuencia cardiaca (FC) (r = -0,225; p <0,001). CONCLUSIONES: las alteraciones cardiacas fueron más prevalentes en pacientes con ANR. La bradicardia, los trastornos de la repolarización ventricular y la disminución de la masa cardiaca fueron los más frecuentemente identificados


INTRODUCTION: the aim of the study was to describe the electrocardiographic and echocardiographic findings in female adolescents with anorexia nervosa and to assess their correlation with clinical variables. PATIENTS AND METHODS: we conducted a retrospective observational case-control study. The analysis included 98 female adolescents admitted to a tertiary hospital due to anorexia nervosa over the last 15 years, all of who underwent an electrocardiographic and echocardiographic evaluation. RESULTS: the mean age was similar in both groups: 14.6 ± 2.0 years in cases vs. 14.7 ± 2.0 years in controls. Patients with anorexia had significantly lower heart rates (57 ± 12 vs. 72 ± 13 bpm), a smaller R-wave in V5 (1.1 ± 0.5 vs 1.6 ± 0.4 mV) and a lesser left ventricular mass (65.7 ± 14.8 vs 90 ± 15.3 g/m2) compared to controls. We found no differences in the QTc interval. In patients with anorexia, the presence of bradycardia was not correlated to weight (r = -0.20, p = 0.05) or body mass index (r = 0.02, p = 0.22) at admission. We found that the left ventricular mass was significantly correlated to the body mass index (r = 0.21, p <0.001,) and the heart rate (r = -0.225, p <0.001). CONCLUSIONS: cardiac abnormalities were more prevalent in patients with anorexia nervosa. Bradycardia, changes in ventricular repolarization, and a lesser left ventricular mass were the most frequent abnormalities in our sample


Assuntos
Humanos , Feminino , Adolescente , Anorexia Nervosa/complicações , Eletrocardiografia/estatística & dados numéricos , Ecocardiografia/estatística & dados numéricos , Bradicardia/epidemiologia , Disfunção Ventricular Esquerda/epidemiologia , Anorexia Nervosa/epidemiologia , Estudos Retrospectivos , Estudos de Casos e Controles , Pesos e Medidas Corporais/estatística & dados numéricos
6.
BMC Psychiatry ; 20(1): 36, 2020 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-32000754

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) is common in patients with eating disorders (EDs). There is a lack of research investigating the presence of ED symptoms among patients with OCD, despite concerns that many of these patients may be at high risk for EDs. Our objective was to assess the presence of ED symptoms in patients receiving treatment for OCD. METHODS: Adult patients with OCD (n = 132, 71% females) and controls (n = 260, 90% females) completed the Eating Disorder Examination-Questionnaire (EDE-Q) at admission to a specialized OCD outpatient unit. A small subset of patients (n = 22) also completed the EDE-Q 3-months after end of treatment. RESULTS: At the group-level, mean EDE-Q scores did not differ significantly between female patients and controls. However, female patients compared to controls were significantly more likely to score above the EDE-Q cut-off (23% vs. 11%) and have a probable ED (9% vs. 1%), indicating elevated rates of ED symptoms in the clinical range. There was no evidence of elevated rates of ED symptoms in male patients, though sample sizes were small. Preliminary follow-up data showed that certain ED symptoms improved significantly from admission to 3-month follow-up. CONCLUSIONS: Our findings suggest that while ED symptoms are not generally elevated in female patients with OCD, a considerable subset of female patients may have a clinical ED or be at high risk of developing one. Clinicians should be alert to ED symptoms in female patients with OCD, and our findings raise the issue of whether ED screening of female patients with OCD is warranted.


Assuntos
Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Transtorno Obsessivo-Compulsivo , Adulto , Anorexia Nervosa/epidemiologia , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Hospitalização , Humanos , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia
7.
Psychiatry Res ; 284: 112768, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31931274

RESUMO

Anorexia nervosa (AN) is a multifactorial illness. Although several studies have determined which factors could predispose AN, few studies have determined which factors could precipitate it. What is more, it has been suggested that having experienced stressful life events (SLE) could be related to the onset of AN. The aim of this study was to explore specific psychosocial and familial correlates and the impact of SLE in the onset of AN. Following a case-control design, 40 adolescents diagnosed with AN were matched to three control groups, 40 healthy adolescents, 40 adolescents with affective disorders, 40 adolescents with asthma and their families by sex, age and socioeconomic status. Diagnostic interviews K-DSADS and questionnaires were used. The results empathised that no specific predisposing correlates were found for AN. Similarly, the increase of the amount of SLE prior to the onset is an overall characteristic for psychiatric disorders, which in AN it is only specifically related to psychological correlates, but no to cortisol. In terms of specific SLE, those related to interpersonal problems were frequent at the onset of AN. The results highlight the consequences of SLEs in the emotional well-being of the AN adolescents, that could be specific for this psychopathology.


Assuntos
Anorexia Nervosa/psicologia , Relações Familiares/psicologia , Relações Interpessoais , Acontecimentos que Mudam a Vida , Estresse Psicológico/psicologia , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Estudos de Casos e Controles , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Inquéritos e Questionários
8.
Med. leg. Costa Rica ; 36(2): 46-55, sep.-dic. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1040444

RESUMO

Resumen La anorexia nerviosa se caracteriza por una sobreestimación del volumen y forma del cuerpo, que conlleva a una búsqueda de la delgadez mediante dietas rígidas. Esta se presenta en 0.6% de la población mundial, siendo las mujeres adolescentes quienes más la padecen y ocurriendo en pacientes cada vez más jóvenes. Con respecto a los criterios diagnósticos, actualmente no se cuenta con rubros o guías específicas para la población pediátrica, lo que dificulta su valoración. En cuanto al tratamiento, se recomienda la realimentación progresiva alcanzar el peso esperado para el sexo y edad del paciente, en conjunto con terapia psicológica individual y familiar. Se concluye que es fundamental para el abordaje de la anorexia nerviosa ampliar la investigación para asegurar que las particularidades de esta en la población pediátrica, en su diagnóstico, tratamiento y prevención, sean contempladas. Asimismo, se insiste en la necesidad del trabajo interdisciplinario para lograr una recuperación integral.


Abstract Anorexia nervosa is a disorder characterized by an overestimation of the volume and shape of the body, which leads them to seek excessive thinness through rigid diets. It occurs in 0.6% of the world population, mostly affecting teenage girls and increasingly occurring in young patients. Nowadays, there are no specific guidelines for anorexia nervosa in pediatric patients which complicates its assessment. The recommended treatment is progressive feeding until the patient gains the expected weight for the patient, according to his sex and age, alongside individual and family therapy. It is concluded that further research is key to assure that the particularities of diagnosis, treatment and prevention of the disorder in pediatric patients are contemplated. Likewise, interdisciplinary work is necessary to achieve an integral approach.


Assuntos
Humanos , Pediatria , Imagem Corporal , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/fisiopatologia , Anorexia Nervosa/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Alimentar , Transtornos Dismórficos Corporais
9.
J Pediatr Endocrinol Metab ; 32(12): 1377-1384, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31714887

RESUMO

Background Anorexia nervosa (AN) is a serious eating disorder that is associated with decreased bone mineral density (BMD) and greater lifetime risk for fractures. The aim of this study was to determine the correlation between BMD and genetic polymorphisms in AN. Methods This case-control study analyzed vitamin D receptor (VDR) (VDRBsml, VDRFokl) and estrogen receptor (ESR) (ESR1Xbal, ESR1Pvull) polymorphisms in 45 adolescents diagnosed with AN and 46 age-matched healthy controls. BMD values of the AN group were classified as low or normal, and polymorphisms were compared between cases and controls. The effects of body mass index (BMI), duration of disease and amenorrhea on BMD were also evaluated. Results In girls with AN, a positive effect of the bb genotype of VDRBsmI polymorphism on femur Z-scores (p = 0.103) and of the Ff genotype of VDRFokI polymorphism on vertebra Z-scores (p = 0.097) was observed. In boys with AN, a positive effect of the Ff genotype of VDRFokI polymorphism on vertebra BMD (g/cm2) was detected (p = 0.061). No association was detected between ESR polymorphisms. An inverse relationship was observed between BMD and duration of illness and amenorrhea. A direct relationship was detected between BMD and BMI. Conclusions Specific VDR gene polymorphism genotypes may have positive effects on BMD in patients with AN. Additionally, the lack of association between ESR gene polymorphisms on BMD could be attributed to the low estrogen status of the patient.


Assuntos
Anorexia Nervosa/genética , Biomarcadores/análise , Densidade Óssea , Polimorfismo Genético , Receptores de Calcitriol/genética , Receptores Estrogênicos/genética , Adolescente , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/patologia , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Genótipo , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Turquia/epidemiologia
10.
Nursing ; 49(10): 24-30, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31568077

RESUMO

Anorexia nervosa (AN) is an eating disorder that is difficult to treat, and relapse is common. This article addresses management strategies and nursing interventions for adolescents diagnosed with AN.


Assuntos
Anorexia Nervosa/enfermagem , Adolescente , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/fisiopatologia , Comorbidade , Humanos , Transtornos Mentais/epidemiologia , Diagnóstico de Enfermagem , Fatores de Risco
11.
Nutrients ; 11(8)2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31426409

RESUMO

Knowledge of anorexia nervosa (AN) in childhood is scarce. This review gives a state-of-the-art overview on the definition, classification, epidemiology and etiology of this serious disorder. The typical features of childhood AN in comparison to adolescent AN and avoidant restrictive eating disorder (ARFID) are described. Other important issues discussed in this article are somatic and psychiatric comorbidity, differential diagnoses and medical and psychological assessment of young patients with AN. Special problems in the medical and psychological treatment of AN in children are listed, although very few studies have investigated age-specific treatment strategies. The physical and mental outcomes of childhood AN appear to be worse than those of adolescent AN, although the causes for these outcomes are unclear. There is an urgent need for ongoing intensive research to reduce the consequences of this debilitating disorder of childhood and to help patients recover.


Assuntos
Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Adolescente , Anorexia Nervosa/terapia , Criança , Humanos , Resultado do Tratamento
12.
Int J Eat Disord ; 52(8): 885-894, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31215675

RESUMO

OBJECTIVE: Despite known associations between eating disorders and obesity, little is known about the current prevalence of symptoms of eating disorders across the weight spectrum. This study therefore aimed to estimate the population prevalence of eating disorder symptoms in relation to weight status in adolescents. METHOD: The sample comprised 3,270 participants (14-15 years; 52% boys) drawn from Wave 6 of the Longitudinal Study of Australian Children. Symptoms of anorexia nervosa (AN) and bulimia nervosa (BN) were assessed using self-report on the Branched Eating Disorder Test. This measure identifies clinically significant symptoms in the past 3 months according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Using study-derived cross-sectional population weights, the prevalence of each symptom was estimated for the total population and by sex and weight status. RESULTS: The estimated population prevalence was high (14.3-25.7%) for body image symptoms such as fear of weight gain and overvaluation of body weight but lower (0.5-3.7%) for behavioral symptoms such as binge eating and compensatory behaviors. Symptoms were more prevalent among adolescents with overweight or obesity. Although most symptoms tended to have higher prevalence among girls than boys, boys with obesity had higher prevalence of binge eating and excessive exercise than girls with obesity. The overall estimated population prevalence for AN and BN was 0.20% and 0.10%, respectively. DISCUSSION: The study highlights a need for clinicians to be cognizant of disordered eating behaviors regardless of weight status and has implications for both eating disorder and obesity prevention and intervention.


Assuntos
Anorexia Nervosa/diagnóstico , Imagem Corporal/psicologia , Bulimia Nervosa/diagnóstico , Comportamento Alimentar/psicologia , Adolescente , Anorexia Nervosa/epidemiologia , Austrália/epidemiologia , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/epidemiologia , Peso Corporal , Bulimia Nervosa/epidemiologia , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/psicologia , Sobrepeso/psicologia , Prevalência , Autorrelato , Fatores Sexuais
13.
Am J Clin Nutr ; 109(5): 1402-1413, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31051507

RESUMO

BACKGROUND: Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern. OBJECTIVES: The aim of this study was to give an exhaustive view of the studies reporting the prevalence of the different EDs or total EDs and to study their evolution. METHODS: A literature search following PRISMA Guidelines and limited to studies in English or French published between 2000 and 2018 was performed and relevant studies were included in this systematic review on the prevalence of EDs. The literature search revealed 94 studies with accurate ED diagnosis and 27 with broad ED diagnosis. RESULTS: In 94 studies with accurate ED diagnosis, the weighted means (ranges) of lifetime ED were 8.4% (3.3-18.6%) for women and 2.2% (0.8-6.5%) for men. The weighted means (ranges) of 12-month ED prevalence were 2.2% (0.8-13.1%) for women and 0.7% (0.3-0.9%) for men. The weighted means (ranges) of point prevalence were 5.7% (0.9-13.5%) for women and 2.2% (0.2-7.3%) for men. According to continents, the weighted means (ranges) of point prevalence were 4.6% (2.0-13.5%) in America, 2.2% (0.2-13.1%) in Europe, and 3.5% (0.6-7.8%) in Asia.In addition to the former, 27 other studies reported the prevalence of EDs as broad categories resulting in weighted means (ranges) of total point prevalence of any EDs of 19.4% (6.5-36.0%) for women and 13.8% (3.6-27.1%) for men. CONCLUSIONS: Despite the complexity of integrating all ED prevalence data, the most recent studies confirm that EDs are highly prevalent worldwide, especially in women. Moreover, the weighted means of point ED prevalence increased over the study period from 3.5% for the 2000-2006 period to 7.8% for the 2013-2018 period. This highlights a real challenge for public health and healthcare providers.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , América/epidemiologia , Anorexia Nervosa/epidemiologia , Ásia/epidemiologia , Transtorno da Compulsão Alimentar/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Prevalência
14.
Psychiatr Clin North Am ; 42(2): 309-318, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31046932

RESUMO

Thirteen percent of girls and women experience an eating disorder, yet most do not receive treatment. Thus, broad implementation of eating disorder prevention programs that reduce eating disorder symptoms and future eating disorder onset is a critical priority. This article (1) reviews risk factors that have been shown to predict future onset of eating disorders, because this should guide the content of prevention programs and high-risk subgroups to target with selective prevention programs; (2) reviews the evidence base for eating disorder prevention programs that have reduced eating disorder symptoms or future onset of eating disorders; and (3) discusses directions for future research.


Assuntos
Anorexia Nervosa/epidemiologia , Anorexia Nervosa/prevenção & controle , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/prevenção & controle , Bulimia Nervosa/prevenção & controle , Imagem Corporal , Bulimia Nervosa/epidemiologia , Medicina Baseada em Evidências , Humanos , Fatores de Risco
15.
Metas enferm ; 22(3): 12-19, abr. 2019.
Artigo em Espanhol | IBECS | ID: ibc-183525

RESUMO

Objetivo: explorar las características y comportamientos que comparten las chicas pro-ANA (anorexia nerviosa en entornos virtuales), así como identificar sus necesidades de salud. Método: investigación cualitativa basada en el análisis en profundidad de cuatro blogs pro-ANA, que se llevó a cabo en dos fases. En una primera fase exploratoria se desarrolló la selección, vaciado y análisis de los blogs pro-ANA; posteriormente se elaboró un blog propio, "Un cambio de rumbo", para interaccionar y acercarse a las participantes de estudio. En la segunda fase se hizo un análisis intensivo sobre la transcripción de los blogs y se elaboró un diario de campo de cada uno, que fue utilizado como herramienta para efectuar la codificación y categorización. Resultados: fueron obtenidas las siguientes categorías: búsqueda de la perfección y preocupación por el peso y la imagen; fotografías thinspiration autoestima baja y búsqueda de reconocimiento social; meta de peso, autoinsultos, sentimientos de culpa, vacío, soledad e incomprensión; autocontrol sobre el cuerpo; autoexigencia, conflicto familiar y humor lábil; autolesiones; mentiras y doble personalidad; TCA como estilo de vida; contradicciones conciencia de enfermedad; y evasión y búsqueda de apoyo en el mundo de los blogs. Conclusiones: a pesar del intento por parte de las participantes de alcanzar el éxito en todas las esferas de la vida diaria a través de la delgadez se establece en ellas un sentimiento de insatisfacción personal y de baja autoestima, que aumenta paralelamente junto con la instauración del trastorno. La autoestima se convierte en el eje vertebrador de todos los aspectos que giran en torno a dicho trastorno


Objective: to explore the characteristics and behaviors shared by Pro-ANA girls (anorexia nervosa in virtual settings), as well as to identify their health needs. Method: a qualitative research based on the in-depth analysis of Pro-ANA blogs, conducted in two stages. The first exploratory stage consisted in the selection, data collection and analysis of the Pro-ANA blogs; subsequently, a specific blog was prepared, called "A change in direction", in order to interact with and get close to the study participants. In the second stage, an intensive analysis was conducted on the blog transcription, and a field journal was prepared for each one, which was used as a tool for coding and classification. Results: the following categories were retrieved: the search for perfection and concern with weight and image; "thinspiration" photos, low self-esteem and search for social acknowledgement; weight goals, self-insults; feelings of guilt, emptiness, loneliness and incomprehension; self-control over the body; self-demand, family conflicts and labile mood; self-lesions; lies and double personality; eating disorders as a lifestyle; contradictions, disease awareness; and escape and search for support in the world of blogs. Conclusions: regardless of the attempt by the participants to reach success in all daily life areas through thinness, a feeling of personal dissatisfaction and low self-esteem gets hold of them, which increases in parallel with the implementation of the disorder. Self-esteem becomes the main axis for all aspects revolving around said disorder


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Estilo de Vida , Anorexia Nervosa/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Pesquisa Qualitativa , Blogging , Autoimagem , Autocontrole , Comportamento Autodestrutivo
16.
Fertil Steril ; 111(5): 1020-1029.e2, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30922647

RESUMO

OBJECTIVE: To evaluate the potentially protective effects of oral contraceptives (OC) on bone loss in a large population of young women with anorexia nervosa (AN). DESIGN: Cross-sectional study. SETTING: University hospital. PATIENT(S): Three hundred and five patients with AN (99 of them using OC) and 121 age-matched controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Areal bone mineral density (aBMD) evaluated by dual-energy X-ray absorptiometry and bone turnover markers, with leptin evaluated concomitantly. RESULT(S): Although the AN patients taking OC presented lower aBMD compared with the controls at all bone sites, the whole body excepted, their aBMD values were systematically higher than those of AN patients who were not taking OC for the whole body and the lumbar spine, femoral neck, hip, and radius. These differences persisted after multiple adjustments. Preservation of aBMD improved with longer durations of OC use and shorter delays between disease onset and the start of OC. Moreover, patients with the lowest body mass index showed the best bone tissue responses to OC. Bone formation markers were systematically lower in the two groups of patients with AN compared with the controls. The markers of bone resorption were normalized in AN patients using OC. CONCLUSION(S): Although OC use does not provide total protection of aBMD, our data suggest that OC might be prescribed for young women with AN to limit their bone loss.


Assuntos
Anorexia Nervosa/tratamento farmacológico , Anorexia Nervosa/epidemiologia , Densidade Óssea/efeitos dos fármacos , Reabsorção Óssea/epidemiologia , Reabsorção Óssea/prevenção & controle , Anticoncepcionais Orais/administração & dosagem , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Densidade Óssea/fisiologia , Reabsorção Óssea/diagnóstico , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Adulto Jovem
17.
Eat Behav ; 33: 30-33, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30852343

RESUMO

PURPOSE: To examine the potential factor structure of the Eating Disorder Diagnostic Scale (EDDS) in a sample of individuals with bipolar disorder. METHOD: Exploratory common factor analyses were conducted in a sample of 1031 people with bipolar disorder as defined by the Structured Clinical Interview for DSM-IV-TR. RESULTS: Approximately 27% of participants had a comorbid eating disorder. Exploratory factor analysis yielded a 3 factor solution (i.e., shape/weight concerns; binge eating behaviors, compensatory behavior). CONCLUSIONS: The 3-factor solution of the EDDS in a bipolar disorder sample is consistent with major eating disorder symptom domains. Future research is necessary to replicate these findings in eating disorder samples with diverse comorbid psychopathology.


Assuntos
Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/psicologia , Transtorno Bipolar/psicologia , Bulimia Nervosa/psicologia , Comportamento Alimentar/psicologia , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno Bipolar/complicações , Bulimia Nervosa/complicações , Bulimia Nervosa/epidemiologia , Comorbidade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicopatologia
18.
Int Rev Psychiatry ; 31(4): 308-317, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30821179

RESUMO

Research suggests that up to one in four individuals with anorexia nervosa (AN) may be on the autistic spectrum, and that these autistic traits may not have been recognized or diagnosed prior to eating disorder (ED) treatment. Significantly, these heightened autistic traits are associated with poorer treatment outcomes, suggesting that treatment may need to be adapted for this population. The purpose of this study was to explore with people with AN on the autistic spectrum their experiences of ED treatment, and their views on what needs to be changed. Women with AN (n= 13), either with an autism diagnosis or presenting with clinically significant levels of autistic traits, were interviewed on their experiences of treatment and potential improvements. Interviews were analysed using thematic analysis. The findings suggest that this population experience unique needs associated with their autism that are not being met by standard ED treatments, and recommendations are made for potential future adaptations. Future research into a more systematic approach for treatment adaptations for this population, including education programmes for clinicians, could potentially lead to better treatment experiences.


Assuntos
Anorexia Nervosa/terapia , Transtorno do Espectro Autista/fisiopatologia , Acesso aos Serviços de Saúde , Preferência do Paciente , Adulto , Anorexia Nervosa/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Comorbidade , Feminino , Humanos , Pesquisa Qualitativa , Adulto Jovem
19.
Psychiatry Res ; 274: 20-26, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30776708

RESUMO

The correct functioning of the chemosensory pathway is pivotal for the attitude towards feeding. In some neuropsychiatric disorders, abnormalities of the sensory processing dramatically affect feeding behavior; however, evidences for an olfactory involvement in Anorexia Nervosa (AN) are still controversial. We administered a complete olfactory testing battery, the Sniffin' Sticks Extended Test, to a cohort of 19 girls with Restrictive Anorexia Nervosa (AN-R) and 19 healthy controls. A battery of questionnaires aiming to evaluate eating attitude, psychopathologic disorders and autistic traits was also administered. No difference was found between the two groups in any of the olfactory tasks. Despite the lack of correlation between olfaction and disease severity, however, olfactory performances were related to autistic traits in anorectic girls (r = -0.489, p = 0.039). Girls with AN-R do not appear to have an impaired olfactory function with respect to controls. However, a possible correlation between olfactory ability and autistic traits was discovered. In light of such findings, the role of possible relations between social functioning-related features and olfactory processing in AN-R is discussed.


Assuntos
Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Transtorno Autístico/diagnóstico , Transtorno Autístico/psicologia , Olfato/fisiologia , Adolescente , Comportamento do Adolescente/fisiologia , Comportamento do Adolescente/psicologia , Anorexia Nervosa/epidemiologia , Transtorno Autístico/epidemiologia , Criança , Estudos Transversais , Comportamento Alimentar/fisiologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/psicologia , Autorrelato , Inquéritos e Questionários , Adulto Jovem
20.
J Affect Disord ; 245: 1149-1167, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30699859

RESUMO

OBJECTIVE: Suicide is the second leading cause of death among individuals with anorexia nervosa (AN) and is also elevated in bulimia nervosa (BN). We carried out a systematic review in which we analyzed the relationship between AN and/or BN and suicidality (i.e. suicidal ideation or attempted and/or death by suicide) and the major risk factors for suicidal behavior among AN and BN patients by synthesizing the qualitative data from relevant studies. EVIDENCE ACQUISITION: According to PRISMA guidelines, we conducted a systematic search of the literature on PsycNET, PubMed, Google Scholar, and ScienceDirect. Search terms were "eating disorders" "OR" "anorexia" "OR" "bulimia" combined with the Boolean "AND" operator with "suicide." EVIDENCE SYNTHESIS: The initial search identified 8,590 records, of which 38 research reports met the predefined inclusion criteria and were analyzed. Eating disorders (EDs) were found to be associated with a marked increase in suicidal behaviors and ideation. ED type, impulsivity, and specific interpersonal features were associated with suicidal behavior. CONCLUSIONS: Our findings highlight the importance of the combined role of socio-demographic and psychological factors to the co-occurrence of EDs and suicidal behavior. It is imperative that a thorough suicide assessment be conducted routinely for individuals with past and current EDs, and that clinicians be aware that this risk may be ongoing and occur throughout treatment, even after ED symptoms appear to be remitting. LIMITATIONS: Study limitations include diagnostic definitions of and criteria for EDs, and the different terminology used by researchers to define suicide, including non-suicidal behaviors, which weakens the ability to draw conclusions regarding actual suicidal behaviors versus other self-harm behaviors.


Assuntos
Anorexia Nervosa/epidemiologia , Bulimia Nervosa/epidemiologia , Suicídio/estatística & dados numéricos , Fatores Etários , Anorexia Nervosa/psicologia , Bulimia Nervosa/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Humanos , Relações Interpessoais , Personalidade , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Suicídio/psicologia , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos
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