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1.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451453

RESUMO

This report discusses a case of superior mesenteric artery (SMA) syndrome in a previously healthy 15-year-old boy with no weight loss or other common risk factors. The patient presented to the emergency department with acute bilious vomiting and epigastric pain after acute consumption of a meal and excessive quantities of water. The patient was diagnosed with SMA syndrome based on the findings of contrasted CT of the abdomen. In early puberty, boys have a significant increase in lean body mass and a concomitant loss of adipose tissues. These pubertal changes lead to a narrowing of the aortomesenteric space. The acute consumption of food and water caused a transient obstruction at the already-narrowed space, which resulted in the manifestation of SMA syndrome. This case demonstrates that pubertal growth spurt is a risk factor for SMA syndrome, and acute excessive ingestion can trigger SMA syndrome among those in puberty.


Assuntos
Bulimia/complicações , Puberdade/fisiologia , Síndrome da Artéria Mesentérica Superior , Tomografia Computadorizada por Raios X/métodos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Adolescente , Bulimia/fisiopatologia , Diagnóstico Diferencial , Humanos , Masculino , Intensificação de Imagem Radiográfica/métodos , Radiografia Abdominal/métodos , Síndrome da Artéria Mesentérica Superior/diagnóstico , Síndrome da Artéria Mesentérica Superior/etiologia , Síndrome da Artéria Mesentérica Superior/fisiopatologia , Síndrome da Artéria Mesentérica Superior/prevenção & controle , Vômito/diagnóstico , Vômito/etiologia
3.
Eat Weight Disord ; 24(5): 799-814, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31119586

RESUMO

PURPOSE: To evaluate and understand the genetic and epigenetic basis of bulimia nervosa/bulimia spectrum disorder and comorbid borderline personality disorder (BN/BSD-BPD). METHODS: The present systematic review was conducted in accordance to PRISMA guidelines. Advanced systematic searches of Medline, EMBASE, PsychINFO, Web of Science, Scopus, CINHAL plus, and the Cochrane Library were conducted using the search terms 'bulimia nervosa', 'bulimia spectrum disorder', 'borderline personality disorder', 'genes', and 'genetics'. The search strategy garnered seven studies for inclusion in the present review. RESULTS: Women with BN/BSD-BPD had significantly lower serotonin and monoamine oxidise activity compared to women with BN/BSD or healthy controls (HC). As well, women with BN/BSD-BPD displayed elevated methylation of the dopamine receptor gene promoter, brain-derived neurotrophic factor, and changes in the methylation of the glucocorticoid receptor gene promoter (NR3C1) compared to women with BN/BSD and HC. The results also demonstrated that rates of childhood sexual abuse and childhood physical abuse are higher in those with BN/BSD-BPD than those with BN/BSD and HC, and that these types of abuse are often correlated with the methylation differences seen in BN/BSD-BPD women. CONCLUSION: Due to the differences observed between individuals with BN/BSD-BPD and those with BN/BSD and HC a genetic/epigenetic aetiological model of BN/BSD-BPD was developed and is proposed in this review. This evidence-based model visually illustrates the current state of the field and draws attention to the need for subsequent research.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis , Transtorno da Personalidade Borderline/genética , Bulimia Nervosa/genética , Bulimia/genética , Epigênese Genética , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/psicologia , Bulimia/complicações , Bulimia/psicologia , Bulimia Nervosa/complicações , Bulimia Nervosa/psicologia , Humanos
4.
PLoS One ; 14(4): e0215506, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31017971

RESUMO

OBJECTIVE: To investigate whether binge-eating in patients with eating disorders (EDs) is associated with attentional deficits. METHODS: We studied ED patients with binge-eating (n = 51), no binge-eating (n = 59) and controls (n = 58). ED patients were assessed following the stabilization of weight and ED pathology. Attention assessment included evaluation of attention deficit hyperactivity disorder (ADHD) diagnosis, the Adult ADHD Self-Report (ASRS) and ADHD Rating Scale-IV-Home Version (ADHD-RS) questionnaires, and attention functioning assessed with neuropsychological tools. The severity of eating-related pathology, depression, anxiety and obsessionality was also monitored. RESULTS: Patients with binge-eating showed more ADHD symptomatology on the ADHD-RS compared with non-binge-eating patients. No differences were found between binge-eating and non-binge-eating patients in ADHD diagnosis and neuropsychological functioning. Among the specific ED subtypes, patients with anorexia nervosa binge/purge type (AN-B/P) showed the highest rates of ADHD symptomatology on the ADHD-RS, and were characterized with sustained attention deficits. CONCLUSION: Binge-eating is not associated with attention deficits as measured by objective neuropsychological tools. Nonetheless, it is associated with attentional difficulties as measured with the self-reported ADHD-RS. AN-B/P patients are the only ED category showing objective sustained attention deficits.


Assuntos
Atenção , Bulimia/psicologia , Adolescente , Adulto , Ansiedade/complicações , Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/psicologia , Bulimia/complicações , Estudos de Casos e Controles , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Israel , Testes de Estado Mental e Demência , Modelos Psicológicos , Autorrelato , Inquéritos e Questionários , Adulto Jovem
5.
Obes Surg ; 29(7): 2071-2077, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30847764

RESUMO

OBJECTIVE: Food addiction and binge eating share overlapping and non-overlapping features; the presence of both may represent a more severe obesity subgroup among treatment-seeking samples. Loss-of-control (LOC) eating, a key marker of binge eating, is one of the few consistent predictors of suboptimal weight outcomes post-bariatric surgery. This study examined whether co-occurring LOC eating and food addiction represent a more severe variant post-bariatric surgery. METHODS: One hundred thirty-one adults sought treatment for weight/eating concerns approximately 6 months post-sleeve gastrectomy surgery. The Eating Disorder Examination-Bariatric Surgery Version assessed LOC eating, picking/nibbling, and eating disorder psychopathology. Participants completed the Yale Food Addiction Scale (YFAS), the Beck Depression Inventory-Second Edition (BDI-II), and the Short-Form Health Survey-36 (SF-36). RESULTS: 17.6% met food addiction criteria on the YFAS. Compared to those without food addiction, the LOC group with food addiction reported significantly greater eating disorder and depression scores, more frequent nibbling/picking and LOC eating, and lower SF-36 functioning. CONCLUSION: Nearly 18% of post-operative patients with LOC eating met food addiction criteria on the YFAS. Co-occurrence of LOC and food addiction following sleeve gastrectomy signals a more severe subgroup with elevated eating disorder psychopathology, problematic eating behaviors, greater depressive symptoms, and diminished functioning. Future research should examine whether this combination impacts long-term bariatric surgery outcomes.


Assuntos
Transtorno da Compulsão Alimentar/epidemiologia , Dependência de Alimentos/epidemiologia , Gastrectomia/estatística & dados numéricos , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Adolescente , Adulto , Idoso , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/psicologia , Transtorno da Compulsão Alimentar/cirurgia , Bulimia/complicações , Bulimia/epidemiologia , Bulimia/psicologia , Bulimia/cirurgia , Depressão/complicações , Depressão/epidemiologia , Depressão/cirurgia , Comportamento Alimentar/psicologia , Feminino , Dependência de Alimentos/complicações , Dependência de Alimentos/psicologia , Dependência de Alimentos/cirurgia , Gastrectomia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/psicologia , Período Pós-Operatório , Escalas de Graduação Psiquiátrica , Autocontrole/psicologia , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
6.
Obesity (Silver Spring) ; 27(4): 629-635, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30900406

RESUMO

OBJECTIVE: Potential mechanisms of abnormal food intake, such as dysregulation of meal-related appetite hormones, including acyl ghrelin (AG) and des-acyl ghrelin (DAG), were investigated among men and women with obesity, with and without binge eating (BE). METHODS: Participants (n = 42: 19 female, 23 male) were assigned to a liquid meal and water condition in counterbalanced order, and blood samples for measuring hormones were obtained before and after these conditions. RESULTS: Participants with BE had significantly lower fasting and postingestive AG concentrations than participants without BE in both conditions. During the meal condition, postprandial decreases in AG concentrations were significantly smaller for the BE group than for the non-BE group. There were no significant differences in DAG by BE group. Leptin increased significantly less after meals for those with BE compared with those without BE. There were no differences in other hormones by BE group. Fasting and postmeal hunger ratings were significantly higher for those with BE than for those without BE. CONCLUSIONS: In individuals with BE, lower fasting AG may be due to downregulation by habitual overeating, and a smaller postmeal decline in AG may contribute to overeating. Lower postmeal leptin concentrations may also contribute to overeating.


Assuntos
Apetite/fisiologia , Bulimia/sangue , Ingestão de Alimentos/fisiologia , Grelina/sangue , Obesidade/sangue , Adulto , Transtorno da Compulsão Alimentar/sangue , Transtorno da Compulsão Alimentar/complicações , Bulimia/complicações , Colecistocinina/sangue , Feminino , Peptídeo 1 Semelhante ao Glucagon/sangue , Humanos , Hiperfagia/sangue , Hiperfagia/complicações , Insulina/sangue , Leptina/sangue , Masculino , Refeições , Pessoa de Meia-Idade , Obesidade/complicações , Peptídeo YY/sangue , Período Pós-Prandial/fisiologia , Adulto Jovem
7.
Can J Diet Pract Res ; 80(3): 131-136, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-30724093

RESUMO

At least 5% of women have an eating disorder (ED) during pregnancy. These EDs affect prepregnancy body mass index (BMI) and weight gain during pregnancy, factors associated with birth complications and adverse neonatal outcomes. This review contributes to the literature by examining several adverse birth outcomes associated with EDs and differentiates between past and present EDs. Of the 18 articles reviewed, EDs were associated with preterm birth in 5/14 (36%) and small-for-gestational-age in 5/8 (63%) studies. Anorexia Nervosa increases the odds of a low birth weight baby, particularly when women enter pregnancy with a low BMI. Binge Eating Disorder is positively associated with having a large-for-gestational-age infant, and Bulimia Nervosa is associated with miscarriage when symptomatic during pregnancy. Having a current ED increases the risk for adverse birth outcomes more than a past ED. Since the aetiology of adverse birth outcomes is multi-factorial, drawing conclusions about causal relationships between EDs and birth outcomes is problematic given the small number of studies reporting these outcomes. Resources should target preconception interventions that put EDs into remission and help women achieve a healthier BMI prior to pregnancy, as these have been consistently shown to improve birth outcomes.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Complicações na Gravidez/fisiopatologia , Resultado da Gravidez/epidemiologia , Aborto Espontâneo/epidemiologia , Adolescente , Adulto , Anorexia Nervosa/complicações , Peso ao Nascer , Índice de Massa Corporal , Bulimia/complicações , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Gravidez , Nascimento Prematuro/epidemiologia , Adulto Jovem
8.
Riv Psichiatr ; 54(1): 8-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30760932

RESUMO

INTRODUCTION: For bariatric surgery candidates body image dissatisfaction (BID) may influence both psychological well-being and motivation to obtain surgery. This study aims to examine possible psychiatric predictors of BID. In particular, we explored the burden of new associated factors such as early trauma and attachment style (AS), which have not been assessed in previous literature. METHODS: In this study, 536 patients with extreme obesity (mean Body Mass Index, BMI=43 kg/m2, SD=6.62) undergoing presurgical psychiatric evaluations as part of a mandatory workup before surgery were chosen as participants. A semi-structured clinical interview was performed to assess psychiatric diagnosis and patients' history of early trauma. BID was assessed using the Body Shape Questionnaire (BSQ). Depression, binge eating, and AS were assessed using self-report instruments. RESULTS: Binge eating behavior (p<0.0001), depression severity (p<0.0001), female gender (p<0.0001), and the "need for approval" dimension of insecure AS (p<0.0001) were found to be independent and significant predictors of BSQ score. However, early trauma and BMI were not included in the significant regression model (F4,442=90.784, p<0.0001, adjR2=0.446). DISCUSSION: Our results increased the understanding of BID among individuals with extreme obesity. Similar to previous studies, we reported that binge-eating, depressive symptoms, and gender influenced BID. Neither early trauma nor BMI were associated with BID. Our novel finding was the significance of insecure AS. Implications for multidisciplinary approaches to obesity treatment are discussed. Identifying critical features of BID to be targeted in pre- and post-operative behavioral interventions may open new possibilities for providing effective support for individuals over the course of their therapy. CONCLUSIONS: For some individuals living with obesity, developmental and relational processes such as insecure AS may play a substantial role in the development of BID.


Assuntos
Cirurgia Bariátrica/psicologia , Imagem Corporal , Obesidade Mórbida/psicologia , Adulto , Experiências Adversas da Infância/estatística & dados numéricos , Índice de Massa Corporal , Bulimia/complicações , Bulimia/psicologia , Estudos Transversais , Depressão/complicações , Depressão/psicologia , Dieta Redutora/psicologia , Feminino , Seguimentos , Humanos , Entrevista Psicológica , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Obesidade Mórbida/complicações , Obesidade Mórbida/dietoterapia , Obesidade Mórbida/cirurgia , Cooperação do Paciente , Cuidados Pré-Operatórios , Escalas de Graduação Psiquiátrica , Trauma Psicológico/psicologia , Inquéritos e Questionários
9.
Alcohol Clin Exp Res ; 42(11): 2214-2223, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30252141

RESUMO

BACKGROUND: Alcohol involvement has familial associations with bulimic symptoms (i.e., binge eating, inappropriate compensatory behaviors), with several studies indicating a genetic overlap between the two. It is unclear whether overlapping familial risk with alcohol involvement extends to other eating disorder symptoms. Understanding the genetic overlap between alcohol involvement and other eating disorder symptoms may aid in more targeted interventions for comorbid alcohol use-eating disorder symptoms. Thus, we investigated associations between alcohol involvement and 2 core eating disorder symptoms: drive for thinness and body dissatisfaction in adolescent female and male twins. METHODS: We assessed 3 levels of alcohol involvement: alcohol use in the last month, having ever been intoxicated, and alcohol intoxication frequency via self-report. The Eating Disorder Inventory-II assessed drive for thinness and body dissatisfaction. Sex-specific biometrical twin modeling examined the genetic overlap between alcohol involvement and eating disorder symptoms. RESULTS: Phenotypic associations between alcohol involvement, drive for thinness, and body dissatisfaction were significantly greater in girls compared with boys. A majority of the associations between alcohol involvement, drive for thinness, and body dissatisfaction in girls, but not boys, met our threshold for twin modeling (phenotypic r > 0.20). Moderate genetic correlations were observed between the 3 aspects of alcohol involvement and drive for thinness. Moderate genetic correlations were observed between alcohol use and intoxication frequency and body dissatisfaction. CONCLUSIONS: Together with the literature on alcohol involvement and bulimic symptoms, these findings suggest a generalized association between alcohol involvement and eating disorder symptoms in girls, whereas this association may be symptom specific in boys. Genetic correlations indicate that the amount and direction of this genetic overlap differs across specific symptoms. When intervening on comorbid alcohol involvement and eating disorder symptoms, it may be important to target-specific eating disorder symptoms.


Assuntos
Transtornos Relacionados ao Uso de Álcool/psicologia , Transtornos Dismórficos Corporais/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Magreza , Adolescente , Consumo de Bebidas Alcoólicas/genética , Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/complicações , Transtornos Relacionados ao Uso de Álcool/genética , Intoxicação Alcoólica/genética , Intoxicação Alcoólica/psicologia , Animais , Transtornos Dismórficos Corporais/complicações , Transtornos Dismórficos Corporais/genética , Imagem Corporal , Bulimia/complicações , Bulimia/genética , Bulimia/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/genética , Feminino , Humanos , Masculino , Fatores Sexuais , Gêmeos
10.
Eat Weight Disord ; 23(4): 469-478, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29947017

RESUMO

Food addiction (FA) has recently emerged as a new field in the study of obesity. Previous studies have contributed to identifying psychological correlates of FA. However, few researchers have examined the cognitive profile related to this condition; up until now, attentional biases related to food cues and a poorer performance monitoring have been observed. The present study aimed to examine the psychological profile and executive functioning related to FA in individuals with severe obesity and awaiting bariatric surgery. Participants (N = 86) were split into two groups, according to their level of FA symptoms (low FA vs high FA). Groups were compared on questionnaires measuring binge eating, depression and anxiety symptoms, and impulsivity as well as on measures reflecting executive functioning (D-KEFS and BRIEF-A). The relationship between FA groups and patterns of errors during the D-KEFS' Color-Word Interference Test was further analyzed. Individuals within the high FA group reported significantly more binge eating, depressive and anxiety symptoms, and more metacognitive difficulties. They also tended to show a poorer inhibition/cognitive flexibility score and a typical pattern of errors, characterized by an increased number of errors as the tasks' difficulty rose as opposed to a decreased number of errors, which characterizes an atypical pattern of errors. The present results show that the inability to learn from errors or past experiences is related to the severity of FA and overall impairments.Level of evidence Level V, descriptive study.


Assuntos
Bulimia/psicologia , Função Executiva/fisiologia , Comportamento Alimentar/psicologia , Dependência de Alimentos/psicologia , Obesidade/psicologia , Adolescente , Adulto , Ansiedade/complicações , Ansiedade/psicologia , Bulimia/complicações , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Obesidade/complicações , Adulto Jovem
11.
BMC Endocr Disord ; 18(1): 18, 2018 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-29530008

RESUMO

BACKGROUND: Here, we report a case of central pontine demyelinization in a type-2 diabetes patient with hyperglycemia after a binge-eating attack in the absence of a relevant hyponatremia. CASE PRESENTATION: A 55-year-old, male type-2 diabetic patient with liver cirrhosis stage Child-Pugh B was admitted due to dysmetria of his right arm, gait disturbance, dizziness, vertigo, and polyuria, polydipsia after a binge-eating attack of sweets (a whole fruit cake and 2 Liters of soft drinks). A recently initiated insulin therapy had been discontinued for 8 months. A serum glucose measurement obtained 5 days prior to hospitalisation was 38.5 mmol/l (694 mg/dl). The patient graved for sweets since stopping alcohol consumption 8 months earlier. On admission, venous-blood glucose was 29.1 mmol/l (523.8 mg/dl), glycated hemoglobin was 168.0 mmol/mol or 17.6%. No supplementation of sodium chloride was reported. Laboratory exams revealed an elevated serum ammonia level (127.1 µmol/l), rendering a hepatic encephalopathy very likely. After initiation of insulin therapy, capillary glucose normalized, and serum sodium rose from 133 on admission to 144 mmol/l during the hospital stay. In retrospect, the mild hyponatremia on admission was classified as pseudohyponatremia due to hyperglycemia. The patient had an insulin resistance (HOMA-IR 7.8 (normal range < 2.5)). A T2-weighted magnetic resonance imaging (MRI) of the head and a cranial computed tomography scan were obtained demonstrating a symmetric central pontine demyelinization. After 26 days in hospital, the patient was discharged with an inkretin-mimetic therapy (dulaglutide SC, 1.5 mg/week) and an intensified conventional insulin therapy (insulin aspart: 14 units/d in euglycemia, insulin glargin 20 units/d). CONCLUSIONS: Central pontine and/or cerebellar myelinolysis can be caused by sudden, severe, and sustained hyperglycemia, especially when another risk factor (in this case, liver cirrhosis) is present. Functional neurological deficits in the context of hyperglycemia should prompt for the consideration of this differential diagnosis in all diabetes patients.


Assuntos
Bulimia/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Hiperglicemia/etiologia , Mielinólise Central da Ponte/etiologia , Humanos , Hiperglicemia/patologia , Masculino , Pessoa de Meia-Idade , Mielinólise Central da Ponte/patologia , Prognóstico
12.
J Abnorm Psychol ; 127(1): 30-42, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29369666

RESUMO

Despite wide recognition of the importance of interpersonal problems in binge eating disorder (BED), the nature of this association remains unclear. Examining the direction of this longitudinal relationship is necessary to clarify the role that interpersonal problems play in the course of binge eating problems, and thus to specify treatment targets and mechanisms. This study aimed to articulate the bidirectional, longitudinal associations between BED and both the general severity of interpersonal problems as well as warm and dominant interpersonal styles. Severity and styles of interpersonal problems and BED symptoms were measured at baseline, 12 weeks, 24 weeks, and 36 weeks in a sample of 107 women in treatment for BED. Results from bivariate latent change score models indicated that interpersonal problem severity and BED symptoms are associated longitudinally but do not directly influence each other. The results indicated a bidirectional interrelation between binge eating symptoms and dominance such that less dominance predicted greater decreases in binge eating problems, and less binge eating symptoms predicted greater increases in dominance. We also found that binge eating symptoms positively predicted changes in warmth (i.e., less binge eating symptoms predicted less increases or more decreases in warmth). These findings highlight the importance of using dynamic models to examine directionality and delineate the distinct roles of interpersonal severity and styles in BED trajectories. (PsycINFO Database Record


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia/psicologia , Relações Interpessoais , Adulto , Idoso , Transtorno da Compulsão Alimentar/complicações , Bulimia/complicações , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Modelos Psicológicos , Índice de Gravidade de Doença , Predomínio Social , Adulto Jovem
13.
J Psychiatr Res ; 96: 183-188, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29078155

RESUMO

OBJECTIVE: The objective of this study was to investigate predictors of long-term recovery from eating disorders 22 years after entry into a longitudinal study. METHOD: One hundred and seventy-six of the 228 surviving participants (77.2%) were re-interviewed 20-25 years after study entry using the Longitudinal Interval Follow-up Evaluation to assess ED recovery. The sample consisted of 100 women diagnosed with anorexia nervosa (AN) and 76 with bulimia nervosa (BN) at study entry. RESULTS: A comorbid diagnosis of major depression at the start of the study strongly predicted having a diagnosis of AN-Restricting type at the 22-year assessment. A higher body mass index (BMI) at study intake decreased the odds of being diagnosed with AN-Binge Purge type, relative to being recovered, 22 years later. The only predictor that increased the likelihood of having a diagnosis of BN at the 22-year assessment was the length of time during the study when the diagnostic criteria for BN were met. CONCLUSIONS: Together, these results indicate that the presence and persistence of binge eating and purging behaviors were poor prognostic indicators and that comorbidity with depression is particularly pernicious in AN. Treatment providers might pay particular attention to these issues in an effort to positively influence recovery over the long-term.


Assuntos
Anorexia Nervosa/diagnóstico , Bulimia Nervosa/diagnóstico , Adolescente , Adulto , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Bulimia/complicações , Bulimia/diagnóstico , Bulimia/epidemiologia , Bulimia Nervosa/complicações , Bulimia Nervosa/epidemiologia , Comorbidade , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/epidemiologia , Feminino , Seguimentos , Humanos , Modelos Logísticos , Estudos Longitudinais , Pessoa de Meia-Idade , Prognóstico , Recuperação de Função Fisiológica , Fatores de Tempo , Adulto Jovem
15.
J Affect Disord ; 225: 482-488, 2018 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-28865369

RESUMO

BACKGROUND: Recent research, especially from the USA, suggests that comorbid binge eating (BE) behaviour and BE disorder are frequent in individuals with Bipolar Disorder (BD). Although basic clinical associations between BD and BE have been investigated, less is known about psychological or temperamental dimensions and qualitative aspects of eating habits. In a French cohort of patients with BD, we investigated the prevalence of BE behaviour and any associations with illness characteristics, anxiety, impulsivity, emotional regulation and eating habits. METHODS: 145 outpatients with BD (I and II) were assessed for the presence of BE behaviour using the Binge Eating Scale (BES). Characteristics identified in univariate analyses as differentiating BD cases with and without BE behaviour were then included in a backward stepwise logistic regression (BSLR) model. RESULTS: In this sample, 18.6% of BD patients met criteria for BE behaviour. Multivariate analysis (BSLR) indicated that shorter duration of BD, and higher levels of anxiety and emotional reactivity were observed in BD with compared to BD without BE behaviour. LIMITATIONS: Relatively small sample referred to specialist BD clinics and cross-sectional evaluation meant that it was not possible to differentiate between state and trait levels of impulsivity, emotional instability and disinhibition. These dimensions may also overlap with mood symptoms. CONCLUSION: BE behaviour is common in females and males with BD. Emotional dysregulation and anxiety may represent important shared vulnerability factors for worse outcome of BD and increased likelihood of BE behaviour.


Assuntos
Transtorno Bipolar/psicologia , Bulimia/psicologia , Comportamento Alimentar , Comportamento Impulsivo , Adulto , Transtornos de Ansiedade/psicologia , Transtorno Bipolar/complicações , Bulimia/complicações , Comorbidade , Estudos Transversais , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
16.
Poiésis (En línea) ; (34): 73-87, 2018.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-987233

RESUMO

El estilo de personalidad tendiente a los trastornos alimentarios se refiere a una lucha de sentido con el propio cuerpo, que regula la dialéctica entre la co-percepción del otro y el sentido de sí mismo, el problema alimentario va comprendido como un problema con la dialéctica del cuerpo, no con la imagen del cuerpo. El punto fundamental para comprender el trastorno alimentario es en relación a la imagen corporal, la mujer y los medios de información. Adicionalmente, se ha encontrado que la tecnología juega un papel importante al afectar no sólo la experiencia de la percepción, a través de acelerar el cambio en contextos específicos, sino la introducción de nuevos recursos de signi- ficado; nuevos puntos de referencia que proporcionan el anclaje para crear y mantener la identidad propia. Esto sitúa al hombre en una nueva forma de orientarse emocional- mente en relación a su contexto.


The eating disorder-prone style of personality refers to a feeling struggle with the same body, which regulates the dialectic between the other co-perception and the sense of self, the eating disorder is understood as a problem related to the dialectic of the body itself but not to the image of the body. The main point in order to understand the eating disorder is associated with the body image, the female gender and media. On the other hand, it has been found that technology plays a vital role not only by afecting the experience perception by accelerating the change in specific contexts but also by introducing new resources of meaning; new points of reference which provide the basis to create and keep the own identity. Thus, it sets the human in a new way of emotional orientation in relationship with his context.


Assuntos
Humanos , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Personalidade , Autoimagem , Anorexia/complicações , Bulimia/complicações , Interocepção
17.
Medicine (Baltimore) ; 96(40): e8251, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28984784

RESUMO

RATIONALE: Severe hypokalemia can be a potentially life-threatening disorder and is associated with variable degrees of skeletal muscle weakness. PATIENT CONCERNS: We report a case of severe hypokalemic paralysis and rhabdomyolysis in a 28-year-old bodybuilder. He was admitted to the emergency room due to progressive paralysis in both lower extremities, which had begun 12 hours earlier. He was a bodybuilder trainer and had participated in a regional competition 5 days earlier. He went on a binge, consuming large amounts of carbohydrates over 4 days, resulting in a gain of 10 kg in weight. DIAGNOSES: He had no family history of paralysis and this was his first attack. He strongly denied drug abuse, such as anabolic steroids, thyroid and growth hormone, and diuretics. Neurological examinations revealed symmetrical flaccid paralysis in his lower extremities, but the patient was alert and his sensory system was intact. His initial serum potassium and phosphate level was 1.8 mmol/L and 1.4 mg/dL, respectively. The calculated transtubular potassium gradient (TTKG) was 2.02. His thyroid function was normal. INTERVENTIONS AND OUTCOMES: Serum potassium levels increased to 3.8 mmol/L with intravenous infusion of about 50 mmol of potassium chloride over 20 hours. OUTCOMES: His muscular symptoms improved progressively and he was discharged from the hospital 7 days after admission on foot. He was followed in our outpatient clinic, without recurrence. LESSONS: Physicians should keep in mind that large intakes of food during short periods can provoke hypokalemic paralysis and rhabdomyolysis, especially in bodybuilders.


Assuntos
Bulimia/complicações , Paralisia Periódica Hiperpotassêmica/etiologia , Rabdomiólise/etiologia , Levantamento de Peso , Adulto , Humanos , Masculino
19.
Rev Esp Enferm Dig ; 109(12): 877, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29082742

RESUMO

Acute gastric dilatation is a rare disease for which an early diagnosis and treatment are crucial in order to avoid potential serious complications. We present the case report of a woman with acute gastric dilatation after dietary violation.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico por imagem , Dilatação Gástrica/diagnóstico por imagem , Estômago/diagnóstico por imagem , Adulto , Bulimia/complicações , Bulimia/diagnóstico por imagem , Dilatação , Feminino , Humanos , Tomografia Computadorizada por Raios X
20.
Int J Eat Disord ; 50(10): 1183-1193, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28856699

RESUMO

OBJECTIVE: To examine gender differences in disordered eating behaviors (DEB) and body dissatisfaction in adolescents with type 1 diabetes. While evidence shows that female youth with type 1 diabetes are more prone to DEB compared to their peers without diabetes, little is known about male adolescents. METHOD: In a national online survey, adolescents (13-19 years) with type 1 diabetes for ≥1 year completed the Diabetes Eating Problem Survey-Revised (DEPS-R), and the Body Mass Index Silhouette Matching Test (BMI-SMT) and items on binge eating and insulin omission. RESULTS: About 477 adolescents (mean age 16 years; 62% females) completed the DEPS-R and 431 the BMI-SMT. The DEPS-R total score was higher for females than males, with scores for females increasing with age. BMI, HbA1c , insulin omission, and binge-eating frequency were associated moderately with DEPS-R for both genders. On the BMI-SMT, 88% of females wanted to be thinner. Of the males, 76% reported body dissatisfaction; however, only 43% expressed a desire for thinness with the remainder desiring a larger body size. DEPS-R was positively associated with the discrepancy between perceived actual and ideal body size for both genders. DISCUSSION: A large proportion of adolescents with type 1 diabetes, particularly females reported engaging in DEB. Similarly, high rates of body dissatisfaction were reported, though ideal body shape preferences differed by gender. Given the high levels of self-reported DEB and gender-based patterns of body dissatisfaction, future research needs to examine the effectiveness of routine screening of DEB and consider implementation of stepped care approaches.


Assuntos
Transtornos Dismórficos Corporais/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adolescente , Adulto , Austrália , Bulimia/complicações , Feminino , Identidade de Gênero , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
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