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1.
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
2.
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
3.
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 , Américas/epidemiologia , Anorexia Nervosa/epidemiologia , Ásia/epidemiologia , Transtorno da Compulsão Alimentar/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Prevalência
4.
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
5.
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
6.
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
7.
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
8.
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
9.
Psychiatry Res ; 272: 349-358, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30599438

RESUMO

Checking behavior (CB) occurs in a variety of disorders such as obsessive-compulsive (OCD), body dysmorphic (BDD), illness anxiety (IA), and panic disorder (PD), as well as anorexia (AN) and bulimia nervosa (BN). Etiological models of these disorders - with the exception of those for PD - postulate that CB mainly occurs in situations characterized by negative affect and serves to regulate it. We aimed to test these assumptions: N = 386 individuals with a self-reported diagnosis of one of the disorders rated their affect at baseline, directly before a remembered CB episode, during, immediately afterwards, and 15 and 60 minutes afterwards, and rated their endorsement of different functions of CB. The results show that transdiagnostically negative affect is significantly higher before CB compared to baseline, and is significantly reduced from before CB to all post-CB assessments. Reduction of negative affect and Attainment of certainty were the sole functions predicting the affective course during CB, and most prominently reported transdiagnostically. Assumptions of the etiological models were confirmed, suggesting that exposure and ritual prevention should be examined across disorders. As attainment of certainty seems to be predictive for the course of CB, this might be targeted in cognitive interventions.


Assuntos
Anorexia Nervosa/psicologia , Transtornos Dismórficos Corporais/psicologia , Bulimia Nervosa/psicologia , Hipocondríase/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno de Pânico/psicologia , Adulto , Afeto/fisiologia , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/epidemiologia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Comorbidade , Feminino , Humanos , Hipocondríase/diagnóstico , Hipocondríase/epidemiologia , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/epidemiologia , Autorrelato/normas
10.
Encephale ; 45(2): 121-126, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-29673720

RESUMO

INTRODUCTION: Anorexia nervosa constitutes a severe and complex eating disorder occurring principally in adolescence. It is one of the most deadly psychiatric disorders. Considering the multifactorial nature of anorexia nervosa, the important place of the family and the growing interest in the theory of attachment in eating disorders, parental bonding is questioned in anorexia nervosa. The main study goal is to analyze parental bonding in a population of children and adolescents with anorexia nervosa. The secondary objective is to study differences according to the age group. METHOD: We realized an observational pilot study in Bordeaux over a period from June 2015 to April 2017. Twenty five young girls with anorexia nervosa, aged 10 to 17 years, hospitalized in the department of child and adolescent psychiatry and department of eating disorders have been included and divided into two groups: peripubertal for children under 14 and pubertal for children aged 14 to 17 years. We met them individually to complete a series of questionnaires including the Parental Bonding Instrument (for assessing attachment), the Mini International Neuropsychiatry Interview for Children and Adolescent (for detecting the presence of comorbidity) and a structured questionnaire for collecting general information on anorexia nervosa. RESULTS: Results revealed high parental care, high maternal and paternal overprotection with predominantly "optimal" parenting style followed by "affectionate constraint" style. Significant differences were observed in anorexia nervosa patients with maternal (P=0.011) and paternal (P=0.085) overprotection in pubes compared to peripubertal. In correlation analysis, there was a positive correlation between maternal protection and age of diagnosis and a negative correlation between parental care and duration of illness. Furthermore, the maternal overprotection tended to be correlated significantly and positively with the age of the diagnosis and the paternal overprotection with the body mass index. CONCLUSION: Our study shows a rating by the parents of warm and understanding parents, an over-protective mother and a father encouraging autonomy. There is maternal and paternal overprotection in pubertal anorexia nervosa compared with peripubertals. Our results suggest the importance of analyzing parenting style in addition to Parental Bonding Instruments results and of supporting the importance of the development of family therapy in the anorexia nervosa.


Assuntos
Anorexia Nervosa/psicologia , Apego ao Objeto , Relações Pais-Filho , Poder Familiar/psicologia , Pais/psicologia , Adolescente , Adulto , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/terapia , Criança , Feminino , França , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Projetos Piloto , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos
11.
Encephale ; 45(1): 60-73, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29983177

RESUMO

OBJECTIVE: To assess the association between sub-types of bipolar disorder (BD) (types I and II) and sub-types of eating disorders (EDs) (Anorexia Nervosa, Bulimia Nervosa, Binge-eating disorders) as well as their relative order of occurrence. METHODOLOGY: A systematic review of articles estimating prevalence rates for BD among patients with ED and vice versa. We also analysed all articles assessing their relative order of occurrence. RESULTS: Comorbid BD is common among patients with an ED. From 0.6 to 33.3% of bipolar subjects have an eating disorder. Conversely, from 0 to 35.8% of subjects with an ED can present a BD. This co-occurrence has mostly been observed among patients with anorexia of the bulimic/purging type, with bulimia or with binge-eating disorders. The association is less frequent in cases of anorexia of the restrictive type. In contrast, the BD sub-type does not seem to have an impact on the association with EDs. Whilst age at BD onset is earlier in case of a comorbid ED, age at ED onset does not seem to be impacted by the presence of an associated BD. There has been little data on the relative order of occurrence of the two disorders or on the impact of the thymic phase on the expression of EDs. CONCLUSIONS: EDs and BD are frequently comorbid, suggesting the need for crossed screening of these pathologies, in particular for EDs with purging behaviours and for patients with early BD onset.


Assuntos
Transtorno Bipolar/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adulto , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/psicologia , Transtorno Bipolar/classificação , Transtorno Bipolar/psicologia , Bulimia Nervosa/epidemiologia , Bulimia Nervosa/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/classificação , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Prevalência
12.
Eur Arch Psychiatry Clin Neurosci ; 269(3): 351-359, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30120534

RESUMO

Anorexia nervosa (AN) is found associated with increased mortality. Frequent comorbidities of AN include substance use disorders (SUD), affective disorders (AD) and personality disorders (PD). We investigated the influence of these psychiatric comorbidities on all-cause mortality with demographic and socioeconomic factors considered as confounders in the observation window between January 2007 and March 2016 for 1970 people with AN, using data from the case register of the South London and Maudsley (SLaM) NHS Foundation Trust, an almost monopoly-secondary mental healthcare service provider in southeast London. We retrieved data from its Clinical Records Interactive Search (CRIS) system as data source. Mortality was ascertained through nationwide tracing by the UK Office for National Statistics (ONS) linked to CRIS database on a monthly basis. A total of 43 people with AN died during the observation period. Standardized Mortality Ratio (SMR) with England and Wales population in 2012 as standard population for our study cohort was 5.21 (95% CI 3.77, 7.02). In univariate analyses, the comorbidity of SUD or PD was found to significantly increase the relative risks of mortality (HRs = 3.10, 95% CI 1.21, 7.92; and 2.58, 95% CI 1.23, 5.40, respectively). After adjustment for demographic and socioeconomic covariates as confounders, moderately but not significantly elevated risks were identified for SUD (adjusted HR = 1.39, 95% CI 0.53, 3.65) and PD (adjusted HR = 1.58, 95% CI 0.70, 3.56). These results suggest an elevated mortality in people with AN, which might be, at least partially, explained by the existence of the comorbidities SUD or PD.


Assuntos
Anorexia Nervosa/epidemiologia , Transtornos do Humor/epidemiologia , Transtornos da Personalidade/epidemiologia , Sistema de Registros/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anorexia Nervosa/mortalidade , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
13.
Eur Eat Disord Rev ; 27(1): 24-33, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30062717

RESUMO

BACKGROUND: Network analysis is increasingly applied to psychiatric populations to understand relationships among symptoms. METHODS: Network analysis was applied on 955 patients with anorexia nervosa (AN; 631 restricting-type [ANR] and 324 binge eating-/purging-type [ANBP]), assessed with Symptom Check-List 90 (SCL-90), Eating Disorder Inventory (EDI), and Tridimensional Personality Questionnaire. RESULTS: Depression, anxiety, interpersonal sensitivity (SCL-90), and ineffectiveness (EDI) had the highest centrality (strength from 1.19 to 1.35 in ANBP, and from 1.15 to 1.51 in ANR). Body mass index (BMI) had low centrality (0.14 ANBP and 0.41 ANR). Drive for thinness showed the strongest correlation with central nodes in ANBP (correlation around 0.44) and ANR (correlation range 0.38-0.47), and drive for thinness had higher centrality in ANR (1.15) than in ANBP (0.81), whereas body dissatisfaction in ANBP (0.73) than in ANR (0.61). DISCUSSION: In addition to ED-core symptoms, psychiatric comorbid symptoms should be the focus of specific treatments in patients with AN, independently from BMI.


Assuntos
Anorexia Nervosa/psicologia , Adolescente , Adulto , Anorexia Nervosa/epidemiologia , Comorbidade , Humanos , Psicopatologia , Adulto Jovem
14.
Eur Eat Disord Rev ; 27(2): 161-172, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30136346

RESUMO

OBJECTIVE: Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are highly comorbid. However, the factors that account for this comorbidity are poorly understood. We examined the core dimensions of AN and OCD and psychological and personality factors shared by both disorders. METHOD: In path analyses (N = 732 women with either current AN or recovered from AN), we examined which factors were uniquely and independently associated with the core dimensions of AN and OCD. We also examined recovery from AN as a moderator. RESULTS: When individuals with AN reported greater concern over mistakes, they endorsed more severity in both AN and OCD core dimensions. These unique associations existed above and beyond all other transdiagnostic personality and psychological factors and regardless of AN recovery status. CONCLUSIONS: Concern over mistakes partially accounts for severity in the core dimensions of both AN and OCD. Concern over mistakes may represent an important target in the aetiology of AN and OCD.


Assuntos
Anorexia Nervosa/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Adolescente , Adulto , Anorexia Nervosa/epidemiologia , Comorbidade , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/epidemiologia , Personalidade , Psicologia , Adulto Jovem
15.
Encephale ; 45(1): 27-33, 2019 Feb.
Artigo em Francês | MEDLINE | ID: mdl-29935928

RESUMO

PURPOSE: Anorexia nervosa is often accompanied by comorbid mood disorders, in particular depression, but individual or family history of bipolar disorders has not frequently been explored in anorexia nervosa. The objectives of the present study were: (1) to assess the frequency of bipolar disorders in patients with anorexia nervosa hospitalized in adolescence and in their parents, (2) to determine whether the patients with a personal or family history of bipolar disorders present particular characteristics in the way in which anorexia nervosa manifests itself, in their medical history, in the secondary diagnoses established, and in the treatments prescribed. METHOD: Overall, 97 female patients aged 13 to 20 hospitalized for anorexia nervosa and their parents were assessed. The diagnoses of anorexia nervosa and bipolar disorders were established on the basis of DSM-IV-TR criteria. RESULTS: A high frequency of type II and type V bipolar disorders was observed. The patients with anorexia nervosa and presenting personal or family histories of bipolar disorder had an earlier onset of anorexia nervosa, more numerous hospitalizations, a longer time-lapse between anorexia nervosa onset and hospitalization, more suicide attempts and more psychiatric comorbidities. CONCLUSION: The occurrence of anorexia nervosa-bipolar disorders comorbidity appears to be considerable and linked to the severity of anorexia nervosa, raising the issue of the relationship between anorexia nervosa and bipolar disorders.


Assuntos
Anorexia Nervosa/complicações , Transtorno Bipolar/complicações , Adolescente , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/psicologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Hospitalização , Humanos , Pais , Ideação Suicida , Adulto Jovem
16.
Med Sci Monit ; 24: 9204-9212, 2018 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-30562336

RESUMO

BACKGROUND Little has been reported regarding the epidemiology of eating disorders (EDs) in type 2 diabetes (T2DM). We examined the Polish National Health Fund-NFZ database estimates of all medical visits from 2008 to 2017 to determine the trend and the epidemiology of EDs in T2DM patients. MATERIAL AND METHODS The NFZ database were used. We defined the T2DM group diagnosed with both T2DM and EDs according to the ICD-10 codes. Demographic data were collected from the webpage of Statistics Poland (GUS). The annual prevalence of EDs was estimated according to the T2DM diagnosis status, and the age groups were stratified into 8 groups. RESULTS The prevalence of EDs in T2DM patients in the whole patient population with diagnosed T2DM ranged from 0.059% (in 2017) to 0.086% patients (in 2010). Differences in subcategories of EDs were noted. In the case of anorexia nervosa, a decreasing trend of coexistence with T2DM was noted. However, in the case of atypical anorexia nervosa, an increasing trend was observed. Both in the case of bulimia nervosa and atypical bulimia nervosa, an increasing trend of coexistence with T2DM was noted. As patients with T2DM age, the prevalence of EDs in T2DM decreased. CONCLUSIONS A relatively stable trend of prevalence of EDs in T2DM patients benefiting from state medical care indicated the need to develop effective screening methods and adequate procedures for therapeutic interventions with this group of patients using a multidisciplinary therapeutic team.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adolescente , Adulto , Fatores Etários , Anorexia Nervosa/epidemiologia , Bulimia Nervosa/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Polônia , Prevalência , Fatores Sexuais
17.
Psychiatry Res Neuroimaging ; 282: 24-30, 2018 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-30384147

RESUMO

Patients with anorexia nervosa (AN) exhibit volume reduction in cerebral gray matter (GM), and several studies report reduced hippocampus volume. The hippocampal subfields (HS) are functionally and structurally distinct, and appear to respond differently to neuropathology. The aim of this study was to investigate HS volumes in adolescent females with restrictive AN compared to a healthy age-matched control group (HC). The FreeSurfer v6.0 package was used to extract brain volumes, and segment HS in 58 female adolescents (AN = 30, HC = 28). We investigated group differences in GM, white matter (WM), whole hippocampus and 12 HS volumes. AN patients had significantly lower total GM and total hippocampal volume. No group difference was found in WM. Volume reduction was found in 11 of the 12 HS, and most results remained significant when adjusting for global brain volume reduction. Investigations of clinical covariates revealed statistically significant relationships between the whole hippocampus, several HS and scores on depression and anxiety scales in AN. Results from this study show that young AN patients exhibit reduced volume in most subfields of the hippocampus, and that this reduction may be more extensive than the observed global cerebral volume loss.


Assuntos
Comportamento do Adolescente/psicologia , Anorexia Nervosa/diagnóstico por imagem , Anorexia Nervosa/psicologia , Hipocampo/diagnóstico por imagem , Adolescente , Anorexia Nervosa/epidemiologia , Córtex Cerebral/diagnóstico por imagem , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Noruega/epidemiologia , Tamanho do Órgão , Lobo Temporal/diagnóstico por imagem , Substância Branca/diagnóstico por imagem
18.
Int J Eat Disord ; 51(10): 1144-1152, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30265747

RESUMO

OBJECTIVE: Few studies have investigated temporal trends in the incidence of eating disorders (EDs). This study investigated time trends in the age- and sex-specific incidence of healthcare-detected anorexia nervosa (AN) and bulimia nervosa (BN) from 2010 to 2016. METHODS: Data were retrieved from the Norwegian National Patient Register as defined by the International Classification of Diseases (ICD-10): narrowly defined AN (F50.0), broadly defined AN (F50.0 + 50.1), narrowly defined BN (F50.2), and broadly defined BN (F50.2 + 50.3). The average annual percent changes (AAPCs) in incidence rates (IRs) were examined by Joinpoint regression analyses. RESULTS: The overall (i.e., both genders, ages 10-49) rates of AN were stable across the 7-year period, with IRs ranging from 18.8 to 20.4 per 100,000 for narrowly defined AN and 33.2 to 39.5 per 100,000 for broadly defined AN, whereas overall rates of BN declined. Age- and gender-stratification revealed a significant average annual increase in AN (narrow and broad) among 10- to 14-year-old girls. The incidence of broadly defined AN also increased significantly among females aged 15-19 years between 2010 and 2012, before leveling off. Nearly universal declines in the incidence of narrowly and broadly defined BN among females occurred. IRs among males were stable and comparatively low, with no significant trends toward increasing or decreasing rates of AN or BN over time. DISCUSSION: Although register-based studies provide an underestimate of the true incidence and may not accurately reflect population-level changes in true ED occurrence, this study extends our knowledge regarding trends in the detected incidence of EDs into the second decade of the 21st century.


Assuntos
Anorexia Nervosa/epidemiologia , Bulimia Nervosa/epidemiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Noruega , Sistema de Registros , Fatores de Tempo , Adulto Jovem
19.
Int J Eat Disord ; 51(9): 1098-1102, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30193008

RESUMO

OBJECTIVE: This study examined whether patterns of eating-disorder (ED) psychopathology differed by gender across DSM-5 severity specifiers in anorexia nervosa (AN) and bulimia nervosa (BN). METHOD: We tested whether ED psychopathology differed across DSM-5 severity specifiers among 532 adults (76% female) in a residential treatment center with AN or BN. We hypothesized that severity of ED psychopathology would increase in tandem with increasing severity classifications for both males and females with AN and BN. RESULTS: Among females with BN, DSM-5 severity categories were significantly associated with increasing ED psychopathology, including Eating Disorder Examination-Questionnaire dietary restraint, eating concern, shape concern, and weight concern; and Eating Disorder Inventory drive for thinness and bulimia. ED psychopathology did not differ across DSM-5 severity levels for males with BN. For both males and females with AN, there were no differences in ED psychopathology across severity levels. DISCUSSION: Results demonstrate that DSM-5 severity specifiers may function differently for males versus females with BN. Taken together, data suggest DSM-5 severity specifiers may not adequately capture severity, as intended, for males with BN and all with AN. Future research should evaluate additional clinical validators of DSM-5 severity categories (e.g., chronicity, treatment non-response), and consider alternate classification schemes.


Assuntos
Anorexia Nervosa/epidemiologia , Bulimia Nervosa/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Psicopatologia/métodos , Adulto , Feminino , Identidade de Gênero , Humanos , Masculino , Adulto Jovem
20.
Int J Eat Disord ; 51(10): 1162-1167, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30189122

RESUMO

A stereotype exists that anorexia nervosa (AN) is a "female" disorder. As a result, men with AN may face harsher stigmatization from their peers or go undiagnosed. The shifting standards model provides a framework to explore how gender stereotypes impact perceptions of AN. Participants (N = 438) were given a vignette of a person with symptoms of AN labeled as either male or female. Assessments were experimentally manipulated according to the shifting standards perspective: participants were asked if they were concerned (or convinced) that the target had AN and then indicated the severity of behavioral symptoms (calorie reduction, pounds lost per week, and hours of exercise) needed to make them concerned (or convinced) of AN. Participants were more likely to state that the male target had AN compared to the female target (p = .036) whereas women were more likely to believe an individual had AN than men, regardless of the target gender (p < .001). In addition, men required that the male target have more severe symptoms to assign an AN diagnosis than women (p = .005). In general, severity ratings for symptoms were quite high, indicating a normalization of unhealthy weight loss practices. These results confirm that gender affects the perception of AN, though they do not conform to expectations within the shifting standards model. Instead, they suggest that a male target is more readily identified as having AN than a female target with AN when exhibiting identical symptoms.


Assuntos
Anorexia Nervosa/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Identidade de Gênero , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
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