Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Anorexia nervosa [keywords]
- Recovering from anorexia nervosa by machine. [Journal Article]
- J Neuroendocrinol 2014 Oct; 26(10):750-1.
Any healthy person can develop anorexia nervosa. Prolonged dieting causes reversible endocrine changes that emerge to combat starvation, the main threat to survival. Animals have evolved to develop strategies to cope with this challenge, assisted by hormonal systems that facilitate food hoarding but which can also inhibit eating, reinforcing the anorexic state. However, a simple machine that provides feedback on how to eat can allow patients to escape from anorexia and restore their health.
- A review of eating disorders in males. [JOURNAL ARTICLE]
- Curr Opin Psychiatry 2014 Sep 15.
Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males.Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males.Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.
- The outcome of treatment for anorexia nervosa inpatients who required urgent hospitalization. [Journal Article]
- Biopsychosoc Med 2014.:20.
This study was done to determine which psychosocial factors are related to the urgent hospitalization of anorexia nervosa patients (AN) due to extremely poor physical condition and to evaluate their outcome after inpatient treatment.133 hospitalized AN patients were classified into an urgent hospitalization (n = 24) or a planned hospitalization (n = 109) group. Multiple regression analysis was done of clinical features, body mass index (BMI), psychological tests [The Minnesota Multiphasic Personality Inventory (MMPI), alexithymia, relationship with parents, and the Eating Disorder Inventory (EDI)]. The effectiveness of treatment was prospectively determined two years after discharge by the Global Clinical Score (GCS). The hospitalized weight gain and the frequency of outpatient visits were evaluated.Of the factors assessed, only BMI at admission was related to the necessity of urgent hospitalization (β = - 1.063, P = 0.00). The urgent group had significantly more weight loss after discharge and poorer social adaptation on the GCS, even when the patient had a sufficient increase in body weight during inpatient treatment and an equivalent number of outpatient consultations.None of the parameters of the psychosocial tests studied were significantly different between the groups. The outcome of the urgent group was poor. Two years after discharge they had difficulty maintaining weight and continued to have poor social adaptation.
- P-69harm reduction approaches for a patient with anorexia nervosa. [Journal Article]
- Alcohol Alcohol 2014 Sep.:i67.
The correlation between anorexia nervosa and substance use disorder can be well characterized with the psychopathological analogs. Harm reduction approaches for substance use disorder have been accepted successfully, while those for anorexia nervosa haven't been established enough yet. Since we experienced a treatment with harm reduction approaches for anorexia nervosa, we'll report it.Ms A is 28 years old, 161cm tall, 39kg in weight (BMI 15.0). She was diagnosed with anorexia nervosa binge-eating/purging type. We've introduced harm reduction approaches that don't compel patients to regain weight as we don't recommend alcoholics to be abstinent at first. We've supported her to handle with her difficulties for three years. She has gradually accepted her appropriate weight with her own will.This case may suggest the availability of harm reduction approaches for anorexia nervosa. It could be useful to set an interim goal which let patients keep their weight not as low as fatal. In addition, the interim goal has to be followed by the real goals which aim to not only regain weight but also strengthen their self-esteem. Harm reduction approaches may reinforce the self determination that contributes to the recovery from anorexia nervosa.
- Obese patients have higher circulating protein levels of dipeptidyl peptidase IV. [JOURNAL ARTICLE]
- Peptides 2014 Sep 8.
Dipeptidyl peptidase IV (DPPIV) is a protease with broad distribution involved in various homeostatic processes such as immune defense, psychoneuroendocrine functions and nutrition. While DPPIV protein levels were investigated in patients with hyporectic disorders, less is known under conditions of obesity. Therefore, we investigated DPPIV across a broad range of body mass index (BMI). Blood samples from hospitalized patients with normal weight (BMI 18.5-25kg/m(2)), anorexia nervosa (BMI <17.5kg/m(2)) and obesity (BMI 30-40, 40-50 and >50kg/m(2), n=15/group) were tested cross-sectionally and DPPIV concentration and total enzyme activity and the DPPIV targets, pancreatic polypeptide (PP) and glucagon-like peptide (GLP-1) were measured. DPPIV protein expression was detected in human plasma indicated by a strong band at the expected size of 110kDa and another major band at 50kDa, likely representing a fragment comprised of two heavy chains. Obese patients had higher DPPIV protein levels compared to normal weight and anorexics (+50%, p<0.05) resulting in a positive correlation with BMI (r=0.34, p=0.004). DPPIV serum activity was similar in all groups (p>0.05), while the concentration/activity ratio was higher in obese patients (p<0.05). Plasma PP levels were highest in anorexic patients (∼2-fold increase compared to other groups, p<0.05), whereas GLP-1 did not differ among groups (p<0.05). Taken together, circulating DPPIV protein levels depend on body weight with increased levels in obese resulting in an increased concentration/activity ratio. Since DPPIV deactivates food intake-inhibitory hormones like PP, an increased DPPIV concentration/activity ratio might contribute to reduced food intake-inhibitory signaling under conditions of obesity.
- Body checking as a behavioral link: A preliminary study assessing inhibition and its association to idiosyncratic body checking in anorexia nervosa. [JOURNAL ARTICLE]
- Eat Behav 2014 Aug 23; 15(4):591-594.
Body checking (BC) is a behavioral feature of anorexia nervosa (AN), which is also present in obsessive-compulsive (OC) disorders. This study assessed whether increased body checking in AN patients correlated with deficits in cognitive inhibition. A battery of neuropsychological tests (the Ravello Profile), OC disorder measures, and the Body Checking Questionnaire (BCQ) were administered to nine adolescent females being treated for AN at an in-patient hospital in Scotland, UK. Neuropsychological measures were assessed using composite variables. Body Checking prevalence was split into high and low category to compare across groups. A negative relationship between cognitive inhibition and idiosyncratic body checking was evident. Clinically, increased body-checking symptoms were related to OC symptoms. These findings provide preliminary evidence that idiosyncratic body checking in AN patients may indicate a similar neuropsychological profile found in those with checking behaviors in OCD patients.
- Attentional biases to body shape images in adolescents with anorexia nervosa: An exploratory eye-tracking study. [JOURNAL ARTICLE]
- Psychiatry Res 2014 Aug 14.
Body image distortion (BID) plays an important role in the etiology and maintenance of anorexia nervosa (AN). Previous studies of BID in AN showed small biases in visual scanning behavior (VSB) towards images of body shapes. The aim of this study is to investigate biases in VSB when body shape images compete with images with a different theme (social interactions) for subjects׳ attention. When images of thin body shapes (TBS) were presented alongside images of social interactions, AN patients (n=13) spent significantly more time looking at TBSs rather than at social interactions, but controls (n=20) did not. When images of fat body shapes (FBS) were presented alongside images of social interactions, AN patients spent significantly more time looking at FBSs rather than at social interactions, but controls did not. When images of TBSs, FBSs and social interactions were presented alongside each other, AN patients demonstrated a hierarchy in their attention allocation, choosing to spend the most viewing time on TBS images, followed by FBS images and then images with social interactions. Under the three experimental conditions, AN patients demonstrated large biases in their visual scanning behavior (VSB). Biases in VSB may provide physiologically objective measures that characterize patients with AN.
- Re-examining premature mortality in anorexia nervosa: A meta-analysis redux. [REVIEW]
- Compr Psychiatry 2014 Jul 22.
Anorexia nervosa (AN) is reported to have the highest premature mortality of any psychiatric disorder, but recent meta-analyses may have inflated estimates. We sought to re-estimate mortality after methodological corrections and to identify predictors of mortality. We included 41 cohorts from 40 peer-reviewed studies published between 1966 and 2010. Methods included double data extraction, log-linear regression with an over-dispersed Poisson model, and all-cause and suicide-specific standardized mortality ratios (SMRs), with 95% Poisson confidence intervals. Participants with AN were 5.2 [3.7-7.5] times more likely to die prematurely from any cause, and 18.1 [11.5-28.7] times more likely to die by suicide than 15-34year old females in the general population. Our estimates were 10% and 49% lower, respectively, than previously reported SMRs. Risk of premature mortality was highest in studies with older participants, although confounding by treatment was present. Gender, ascertainment, and diagnostic criteria also impacted risk.
- Cultural trends and eating disorders. [JOURNAL ARTICLE]
- Curr Opin Psychiatry 2014 Sep 10.
Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures.While historically, eating disorders were conceptualized as primarily afflicting Caucasian adolescent or young adult women within high-income, industrialized Western Europe and North America, eating disorders are increasingly documented in diverse countries and cultures worldwide. This study highlights recent trends that reflect the changing landscape of culture and eating disorders: stabilization of the incidence of anorexia nervosa and possibly lower incidence rates of bulimia nervosa in Caucasian North American and Northern European groups; increasing rates of eating disorders in Asia; increasing rates of eating disorders in the Arab region; and increasing rates of binge eating and bulimia nervosa in Hispanic and Black American minority groups in North America.The changing face of eating disorders calls for a new conceptualization of culture in both the emergence and spread of eating disorders across the globe.
- Between difference and belonging: configuring self and others in inpatient treatment for eating disorders. [Journal Article]
- PLoS One 2014; 9(9):e105452.
Dedicated inpatient care for eating disorders has profound impact on patients' embodied practices and lived realities. Analyses of inpatients' accounts have shown that participants endorse complex and conflicting attitudes toward their experiences in eating disorders wards, yet the apparent ambivalence that characterizes inpatient experiences has not been subject to critical examination. This paper examines the narrated experiences of 13 participants (12 women and one man; age 18-38 years at first interview) with past or present anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified, who had been hospitalized in an inpatient eating disorders ward for adults in central Israel. The interviews, which took place in 2005-2006, and again in 2011, were part of a larger longitudinal study exploring the subjective experiences of eating disorders and recovery among Israeli adults. Employing qualitative analysis, this study finds that the participants' accounts were concerned with dynamics of difference and belonging, as they played out in various aspects of inpatient care, including diagnosis, treatment, relationships with fellow patients and staff, and everyday life in hospital. Notably, participants simultaneously defined themselves as connected to, but also distinct from, the eating disordered others who formed their reference group at the ward. Through negotiating a protectively ambivalent positioning, participants recognized their eating disordered identities and connected with others on the ward, while also asserting their non-disordered individuality and distancing themselves from the potential dangers posed by 'excessive' belonging. The paper suggests that this ambivalent positioning can usefully be understood through the anthropological concept of liminality: being both a part of and apart from one's community.