151
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Solstrand Dahlberg L, Wiemerslage L, Swenne I, Larsen A, Stark J, Rask-Andersen M, Salonen-Ros H, Larsson EM, Schiöth HB, Brooks SJ. Adolescents newly diagnosed with eating disorders have structural differences in brain regions linked with eating disorder symptoms. Nord J Psychiatry 2017; 71:188-196. [PMID: 27844498 DOI: 10.1080/08039488.2016.1250948] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Adults with eating disorders (ED) show brain volume reductions in the frontal, insular, cingulate, and parietal cortices, as well as differences in subcortical regions associated with reward processing. However, little is known about the structural differences in adolescents with behavioural indications of early stage ED. AIM This is the first study to investigate structural brain changes in adolescents newly diagnosed with ED compared to healthy controls (HC), and to study whether ED cognitions correlate with structural changes in adolescents with ED of short duration. METHODS Fifteen adolescent females recently diagnosed with ED, and 28 age-matched HC individuals, were scanned with structural magnetic resonance imaging (MRI). Whole-brain and region-of-interest analyses were conducted using voxel-based morphometry (VBM). ED cognitions were measured with self-report questionnaires and working memory performance was measured with a neuropsychological computerized test. RESULTS AND CONCLUSIONS The left superior temporal gyrus had a smaller volume in adolescents with ED than in HC, which correlated with ED cognitions (concerns about eating, weight, and shape). Working memory reaction time correlated positively with insula volumes in ED participants, but not HC. In ED, measurements of restraint and obsession was negatively correlated with temporal gyrus volumes, and positively correlated with cerebellar and striatal volumes. Thus, adolescents with a recent diagnosis of ED had volumetric variations in brain areas linked to ED cognitions, obsessions, and working memory. The findings emphasize the importance of early identification of illness, before potential long-term effects on structure and behaviour occur.
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Affiliation(s)
| | - Lyle Wiemerslage
- a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden
| | - Ingemar Swenne
- b Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Anna Larsen
- a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden
| | - Julia Stark
- a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden
| | - Mathias Rask-Andersen
- a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden
| | - Helena Salonen-Ros
- c Department of Neuroscience, Child and Adolescent Psychiatry , Uppsala University , Sweden
| | - Elna-Marie Larsson
- d Department of Surgical Sciences , Uppsala University , Uppsala , Sweden
| | - Helgi B Schiöth
- a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden
| | - Samantha J Brooks
- a Department of Neuroscience, Functional Pharmacology , Uppsala University , Uppsala , Sweden.,e Department of Psychiatry and Mental Health , University of Cape Town , Cape Town , South Africa
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152
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Abstract
Bulimia nervosa was first described in 1979 by British psychiatrist Gerald Russell as a "chronic phase of anorexia nervosa" in which patients overeat and then use compensatory mechanisms, such as self-induced vomiting, laxatives, or prolonged periods of starvation. The characterization of bulimia nervosa continues to evolve with the introduction of the DSM-5 in 2013. In this article, the epidemiology and risk factors of bulimia nervosa are identified and reviewed, along with the medical complications and psychiatric comorbidities. The evaluation of a patient with suspected bulimia nervosa is addressed, with an emphasis on acquiring a complete and thorough history as well as discovering any comorbidities that are present. Management of the patient involves both medical interventions and behavioral counseling in order to address physical, psychological, and social needs. Lastly, a new diagnosis introduced in the DSM-5, purging disorder, is described and discussed.
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Affiliation(s)
- Marigold Castillo
- Division of Adolescent Medicine, Cohen Children׳s Medical Center, Northwell Health, New Hyde Park, New York, Hofstra-Northwell School of Medicine, Hempstead, New York
| | - Eric Weiselberg
- Division of Adolescent Medicine, Cohen Children׳s Medical Center, Northwell Health, New Hyde Park, New York, Hofstra-Northwell School of Medicine, Hempstead, New York
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153
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Abstract
Anorexia nervosa has the highest mortality rate among all psychiatric illnesses, as it can result in significant psychopathology along with life-threatening medical complications. Atypical anorexia nervosa is a new variant described in the latest DSM edition, which has much in common with anorexia nervosa and also can result in significant morbidity and mortality. The evolution of the criteria for these illnesses is reviewed, and the two are compared and contrasted in this article. Important labs to monitor for in those with these illnesses, along with an emphasis on the monitoring of vital signs and weight, are reviewed here. The necessity for close psychiatric monitoring of safety concerns, including suicidal thoughts, is also stressed. The etiology and the treatment of these illnesses are reviewed from a biopsychosocial approach; and lastly, the prognosis of these illnesses is discussed.
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Affiliation(s)
- Lindsay Moskowitz
- Department of Psychiatry, Northwell Health, New Hyde Park, NY; Hofstra-Northwell School of Medicine, Hempstead, NY
| | - Eric Weiselberg
- Division of Adolescent Medicine, Cohen Children׳s Medical Center, Northwell Health, New Hyde Park, NY; Hofstra-Northwell School of Medicine, Hempstead, NY
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154
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Kamin HS, Kertes DA. Cortisol and DHEA in development and psychopathology. Horm Behav 2017; 89:69-85. [PMID: 27979632 DOI: 10.1016/j.yhbeh.2016.11.018] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 11/19/2016] [Accepted: 11/30/2016] [Indexed: 01/01/2023]
Abstract
Dehydroepiandrosterone (DHEA) and cortisol are the most abundant hormones of the human fetal and adult adrenals released as end products of a tightly coordinated endocrine response to stress. Together, they mediate short- and long-term stress responses and enable physiological and behavioral adjustments necessary for maintaining homeostasis. Detrimental effects of chronic or repeated elevations in cortisol on behavioral and emotional health are well documented. Evidence for actions of DHEA that offset or oppose those of cortisol has stimulated interest in examining their levels as a ratio, as an alternate index of adrenocortical activity and the net effects of cortisol. Such research necessitates a thorough understanding of the co-actions of these hormones on physiological functioning and in association with developmental outcomes. This review addresses the state of the science in understanding the role of DHEA, cortisol, and their ratio in typical development and developmental psychopathology. A rationale for studying DHEA and cortisol in concert is supported by physiological data on the coordinated synthesis and release of these hormones in the adrenal and by their opposing physiological actions. We then present evidence that researching cortisol and DHEA necessitates a developmental perspective. Age-related changes in DHEA and cortisol are described from the perinatal period through adolescence, along with observed associations of these hormones with developmental psychopathology. Along the way, we identify several major knowledge gaps in the role of DHEA in modulating cortisol in typical development and developmental psychopathology with implications for future research.
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Affiliation(s)
- Hayley S Kamin
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA
| | - Darlene A Kertes
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA; University of Florida Genetics Institute, University of Florida, Gainesville, FL 32611, USA.
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155
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Hirata T, Uemura T, Shinohara M, Hirano M. Association between Dopamine Transporter Gene (<i>DAT1</i>) Polymorphisms and Eating Disorders with Binge Eating Behavior. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojpsych.2017.74028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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156
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Guss CE, Williams DN, Reisner SL, Austin SB, Katz-Wise SL. Disordered Weight Management Behaviors, Nonprescription Steroid Use, and Weight Perception in Transgender Youth. J Adolesc Health 2017; 60:17-22. [PMID: 28029539 PMCID: PMC8091135 DOI: 10.1016/j.jadohealth.2016.08.027] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Disordered weight management behaviors are prevalent among youth; recent case reports suggested that these behaviors might also be common in transgender youth. We studied associations of gender identity with disordered weight management behaviors, nonprescription steroid use, and weight perception among transgender and cisgender (nontransgender) high-school students in Massachusetts. METHODS Data were analyzed from the 2013 Massachusetts Youth Health Survey, an anonymous survey in a random sample of Massachusetts public high schools. Respondents were divided into three groups: transgender (n = 67), cisgender male (n = 1,117), and cisgender female (n = 1,289). Fisher's exact tests and multivariable logistic regression models were used to examine unhealthy weight management behaviors in the past 30 days: fasting >24 hours, vomiting, diet pill use, and laxative use; nonprescription steroid use; and self-perceived weight status. Analyses controlled for age, race/ethnicity, and body mass index. RESULTS Compared with cisgender males, transgender adolescents had higher odds of fasting >24 hours (adjusted odds ratio [AOR] = 2.9, confidence interval [CI] = 1.1-7.8), using diet pills (AOR = 8.9, 95% CI = 2.3-35.2) and taking laxatives (AOR = 7.2, 95% CI = 1.4-38.4). Transgender youth had higher odds of lifetime use of steroids without a prescription than male cisgender respondents (AOR = 26.6, 95% CI = 3.5-200.1). Compared with cisgender females, transgender respondents had higher odds of perceiving themselves as healthy weight/underweight when they were overweight/obese (AOR = 2.4, 95% CI = 1.5-4.1). CONCLUSIONS Transgender youth disproportionately self-reported unsafe weight management behaviors and nonprescription steroid use compared with cisgender youth. Clinicians should be aware of this increased risk among transgender youth. Research is needed to further understand these disparities and to inform future interventions.
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Affiliation(s)
- Carly E. Guss
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - David N. Williams
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Sari L. Reisner
- Division of General Pediatrics, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston Massachusetts,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston Massachusetts,Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston Massachusetts
| | - Sabra L. Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatrics, Harvard Medical School, Boston Massachusetts
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157
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Peebles R, Lesser A, Park CC, Heckert K, Timko CA, Lantzouni E, Liebman R, Weaver L. Outcomes of an inpatient medical nutritional rehabilitation protocol in children and adolescents with eating disorders. J Eat Disord 2017; 5:7. [PMID: 28265411 PMCID: PMC5331684 DOI: 10.1186/s40337-017-0134-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/26/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Medical stabilization through inpatient nutritional rehabilitation is often necessary for patients with eating disorders (EDs) but includes the inherent risk of refeeding syndrome. Here we describe our experience of implementing and sustaining an inpatient nutritional rehabilitation protocol designed to strategically prepare patients with EDs and their families for discharge to a home setting in an efficient and effective manner from a general adolescent medicine unit. We report outcomes at admission, discharge, and 4-weeks follow-up. METHODS Protocol development, implementation, and unique features of the protocol, are described. Data were collected retrospectively as part of a continuous quality improvement (QI) initiative. Safety outcomes were the clinical need for phosphorus, potassium, and magnesium supplementation, other evidence of refeeding syndrome, and unexpected readmissions within one month of discharge. The value outcome was length of stay (LOS). Treatment outcomes were the percentage median BMI (MBMI) change from admission to discharge, and from discharge to 4-weeks follow-up visit. RESULTS A total of 215 patients (88% F, 12% M) were included. Patients averaged 15.3 years old (5.8-23.2y); 64% had AN, 18% had atypical anorexia (AtAN), 6% bulimia nervosa (BN), 5% purging disorder (PD), 4% avoidant-restrictive food intake disorder (ARFID), and 3% had an unspecified food and eating disorder (UFED). Average LOS was 11 days. Initial mean calorie level for patients at admission was 1466 and at discharge 3800 kcals/day. Phosphorus supplementation for refeeding hypophosphatemia (RH) was needed in 14% of inpatients; full-threshold refeeding syndrome did not occur. Only 3.8% were rehospitalized in the thirty days after discharge. Patients averaged 86.1% of a median MBMI for age and gender, 91.4% MBMI at discharge, and 100.9% MBMI at 4-weeks follow-up. Mean percentage MBMI differences between time points were significantly different (admission-discharge: 5.3%, p <0.001; discharge-follow-up: 9.2%, p <0.001). CONCLUSIONS Implementation of the CHOP inpatient nutritional rehabilitation protocol aimed at rapid, efficient, and safe weight gain and integration of caregivers in treatment of patients with diverse ED diagnoses led to excellent QI outcomes in percentage MBMI at discharge and 4-weeks follow-up, while maintaining a short LOS and low rates of RH phosphorus supplementation.
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Affiliation(s)
- Rebecka Peebles
- The Children's Hospital of Philadelphia, Department of Pediatrics, Division of Adolescent Medicine, Philadelphia, Pennsylvania USA.,The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA
| | - Andrew Lesser
- The Children's Hospital of Philadelphia, Department of Pediatrics, Division of Adolescent Medicine, Philadelphia, Pennsylvania USA
| | - Courtney Cheek Park
- The Children's Hospital of Philadelphia, Department of Pediatrics, Division of Adolescent Medicine, Philadelphia, Pennsylvania USA
| | - Kerri Heckert
- The Children's Hospital of Philadelphia, Department of Clinical Nutrition, Philadelphia, Pennsylvania USA
| | - C Alix Timko
- The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA.,The Children's Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, Pennsylvania USA
| | - Eleni Lantzouni
- The Children's Hospital of Philadelphia, Department of Pediatrics, Division of Adolescent Medicine, Philadelphia, Pennsylvania USA.,The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA
| | - Ronald Liebman
- The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA.,The Children's Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, Pennsylvania USA
| | - Laurel Weaver
- The University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania USA.,The Children's Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, Pennsylvania USA
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158
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Lindstedt K, Kjellin L, Gustafsson SA. Adolescents with full or subthreshold anorexia nervosa in a naturalistic sample - characteristics and treatment outcome. J Eat Disord 2017; 5:4. [PMID: 28265410 PMCID: PMC5333469 DOI: 10.1186/s40337-017-0135-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/26/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anorexia Nervosa (AN) destroys developmentally important early years of many young people and knowledge is insufficient regarding course, treatment outcome and prognosis. Only a few naturalistic studies have been conducted within the field of eating disorder (ED) research. In this naturalistic study we included adolescents with AN or subthreshold AN treated in outpatient care, and the overall aim was to examine sample characteristics and treatment outcome. Additional aims were to examine potential factors associated with remission as an outcome variable, and possible differences between three time periods for treatment onset. METHODS Participants were identified through the Swedish national quality register for eating disorder treatment (SwEat), in which patients are registered at treatment onset and followed up once a year until end of treatment (EOT). Inclusion criteria were: medical or self-referral to one of the participating treatment units between 1999 and 2014, 13-19 years of age at initial entry into SwEat and diagnosed with AN or subthreshold AN. The total sample consisted of 3997 patient from 83 different treatment units. RESULTS The results show that 55% of the participants were in remission and approximately 85% were within a healthy weight range at EOT. Of those who ended treatment according to plan, 70% were in remission and 90% within a healthy weight range. The average treatment duration was approximately 15 months. About one third of the patients terminated treatment prematurely, which was associated with a decreased chance of achieving remission. Remission rates and weight recovery increased over time, while treatment duration decreased. Considering treatment outcome, the results did not show any differences between patients with AN or subthreshold AN. CONCLUSIONS The present study shows a relatively good prognosis for adolescent patients with AN or subthreshold AN in routine care and the results indicate that treatment for adolescents with ED in Sweden has become more effective over the past 15 years. The results of the present study contribute to the scope of treatment research and the large-scale naturalistic setting secures the generalizability to a clinical environment. However, more research is needed into different forms of evidence, new research strategies and diversity of treatment approaches. TRIAL REGISTRATION Registered in FOU in Sweden (Researchweb.org) 2014-04-14, ID nr 147301.
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Affiliation(s)
- Katarina Lindstedt
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
| | - Sanna Aila Gustafsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden
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159
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Smith K, Lesser J, Brandenburg B, Lesser A, Cici J, Juenneman R, Beadle A, Eckhardt S, Lantz E, Lock J, Le Grange D. Outcomes of an inpatient refeeding protocol in youth with Anorexia Nervosa and atypical Anorexia Nervosa at Children's Hospitals and Clinics of Minnesota. J Eat Disord 2016; 4:35. [PMID: 28018595 PMCID: PMC5165845 DOI: 10.1186/s40337-016-0124-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Historically, inpatient protocols have adopted relatively conservative approaches to refeeding in Anorexia Nervosa (AN) in order to reduce the risk of refeeding syndrome, a potentially fatal constellation of symptoms. However, increasing evidence suggests that patients with AN can tolerate higher caloric prescriptions during treatment, which may result in prevention of initial weight loss, shorter hospital stays, and less exposure to the effects of severe malnutrition. Therefore the present study sought to examine the effectiveness of a more accelerated refeeding protocol in an inpatient AN and atypical AN sample. METHODS Participants were youth (ages 10-22) with AN (n = 113) and atypical AN (n = 16) who were hospitalized for medical stabilization. A retrospective chart review was conducted to assess changes in calories, weight status (percentage of median BMI, %mBMI), and indicators of refeeding syndrome, specifically hypophosphatemia, during hospitalization. Weight was assessed again approximately 4 weeks after discharge. RESULTS No cases of refeeding syndrome were observed, though 47.3 % of participants evidenced hypophosphatemia during treatment. Phosphorous levels were monitored in all participants, and 77.5 % were prescribed supplemental phosphorous at the time of discharge. Higher rates of caloric changes were predictive of greater changes in %mBMI during hospitalization. Rates of caloric and weight change were not related to an increased likelihood of re-admission. CONCLUSIONS Results suggest that a more accelerated approach to inpatient refeeding in youth with AN and atypical AN can be safely implemented and is not associated with refeeding syndrome, provided there is close monitoring and correction of electrolytes. These findings suggest that this approach has the potential to decrease length of stay and burden associated with inpatient hospitalization, while supporting continued progress after hospitalization.
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Affiliation(s)
- Kathryn Smith
- Neuropsychiatric Research Institute, Fargo, North Dakota USA
| | - Julie Lesser
- Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota USA
| | - Beth Brandenburg
- Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota USA
| | - Andrew Lesser
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania USA
| | - Jessica Cici
- Fairview Health Services, Minneapolis, Minnesota USA
| | - Robert Juenneman
- Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota USA
| | - Amy Beadle
- Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota USA
| | - Sarah Eckhardt
- Children’s Hospitals and Clinics of Minnesota, Minneapolis, Minnesota USA
| | - Elin Lantz
- Drexel University, Philadelphia, Pennsylvania USA
| | - James Lock
- Department of Psychiatry, Stanford University School of Medicine, Stanford, California USA
| | - Daniel Le Grange
- University of California, San Francisco Department of Psychiatry, San Francisco, California USA
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160
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Rice T. On Targeting Emotion Regulation Deficits in Eating Disorders through Defense Analysis. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/15289168.2016.1231539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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161
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McClain Z, Peebles R. Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth. Pediatr Clin North Am 2016; 63:1079-1090. [PMID: 27865334 PMCID: PMC6402566 DOI: 10.1016/j.pcl.2016.07.008] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care.
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Affiliation(s)
- Zachary McClain
- Craig Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, 11 Northwest Tower, Room 10, Philadelphia, PA 19104, USA.
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162
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Lindvall Dahlgren C, Wisting L. Transitioning from DSM-IV to DSM-5: A systematic review of eating disorder prevalence assessment. Int J Eat Disord 2016; 49:975-997. [PMID: 27528542 DOI: 10.1002/eat.22596] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to systematically review the literature on assessment of eating disorder prevalence during the DSM-IV era (1994-2015). METHOD A PubMed search was conducted targeting articles on prevalence, incidence and epidemiology of eating disorders. The review was performed in accordance with PRISMA guidelines, and was limited to DSM-IV based eating disorder diagnoses published between 1994 and 2015. RESULTS A total of 74 studies fulfilled inclusion criteria and were included in the study. Results yielded evidence of over 40 different assessment instruments used to assess eating disorder prevalence, with the EAT-40 being the most commonly used screening instrument, and the SCID being the most frequently used interview. The vast majority of studies employed two-stage designs, closely followed by clinical interviews. Observations of higher prevalence rates were found in studies employing self-reports compared to two-stage designs and interviews. DISCUSSION Eating disorder prevalence rates have varied significantly during the DSM-IV era, and are dependent on assessment methods used and samples investigated. Following the transition to the DSM-5, eating disorder prevalence will change, warranting novel approaches to assessment and treatment planning. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Camilla Lindvall Dahlgren
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål HF, Oslo, 0424, Norway
| | - Line Wisting
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål HF, Oslo, 0424, Norway
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163
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Kells M, Kelly-Weeder S. Nasogastric Tube Feeding for Individuals With Anorexia Nervosa: An Integrative Review. J Am Psychiatr Nurses Assoc 2016; 22:449-468. [PMID: 27519612 DOI: 10.1177/1078390316657872] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The use of nasogastric (NG) feeding in individuals with anorexia nervosa (AN) is endorsed by national professional organizations; however, no guidelines currently exist. OBJECTIVES The objectives of this review were to identify and evaluate outcomes of NG feedings for individuals with AN and to develop recommendations for future research, policy, and practice. DESIGN An integrative review of the research literature was conducted. RESULTS Of the 19 studies reviewed, all indicated short-term weight gain following NG feeding. Four studies examined adherence; nearly 30% of subjects were nonadherent as evidenced by tube manipulation. Seven studies reported psychiatric outcomes, suggesting NG feeding reduces eating disorder behaviors but not overall symptomology. CONCLUSIONS NG feeding promotes short-term weight gain; however, long-term outcomes are poorly understood. Future research, using rigorous methods, is still needed to inform practice.
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Affiliation(s)
- Meredith Kells
- Meredith Kells, MSN, RN, CPNP, Boston College, Chestnut Hill, MA, USA; Boston Children's Hospital, Boston MA, USA
| | - Susan Kelly-Weeder
- Susan Kelly-Weeder, PhD, FNP-BC, FAANP, Boston College, Chestnut Hill, MA, USA
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164
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Tan JOA, Calitri R, Bloodworth A, McNamee MJ. Understanding Eating Disorders in Elite Gymnastics: Ethical and Conceptual Challenges. Clin Sports Med 2016; 35:275-92. [PMID: 26832977 DOI: 10.1016/j.csm.2015.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Eating disorders and disordered eating are more common in high performance sports than the general population, and particularly so in high performance aesthetic sports. This paper presents some of the conceptual difficulties in understanding and diagnosing eating disorders in high performance gymnasts. It presents qualitative and quantitative data from a study designed to ascertain the pattern of eating disorder symptoms, depressive symptoms and levels of self-esteem among national and international level gymnasts from the UK in the gymnastic disciplines of sport acrobatics, tumbling, and rhythmic gymnastics.
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Affiliation(s)
- Jacinta Oon Ai Tan
- Institute of Life Sciences 2, College of Medicine, Swansea University, Room 306, Floor 3, Singleton Campus, Swansea SA2 8PP, UK.
| | - Raff Calitri
- Psychology Applied to Health, College House, University of Exeter Medical School, St. Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK
| | - Andrew Bloodworth
- Interprofessional Studies, College of Human and Health Sciences, Floor 7, Vivian Tower, Swansea University Singleton Campus, Swansea SA2 8PP, UK
| | - Michael J McNamee
- College of Engineering, Swansea University Bay Campus, Fabian Way, Swansea SA1 8EN, UK
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165
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Chen J, Toyomasu Y, Hayashi Y, Linden DR, Szurszewski JH, Nelson H, Farrugia G, Kashyap PC, Chia N, Ordog T. Altered gut microbiota in female mice with persistent low body weights following removal of post-weaning chronic dietary restriction. Genome Med 2016; 8:103. [PMID: 27716401 PMCID: PMC5048651 DOI: 10.1186/s13073-016-0357-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/15/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nutritional interventions often fail to prevent growth failure in childhood and adolescent malnutrition and the mechanisms remain unclear. Recent studies revealed altered microbiota in malnourished children and anorexia nervosa. To facilitate mechanistic studies under physiologically relevant conditions, we established a mouse model of growth failure following chronic dietary restriction and examined microbiota in relation to age, diet, body weight, and anabolic treatment. METHODS Four-week-old female BALB/c mice (n = 12/group) were fed ad libitum (AL) or offered limited food to abolish weight gain (LF). A subset of restricted mice was treated with an insulin-like growth factor 1 (IGF1) analog. Food access was restored in a subset of untreated LF (LF-RF) and IGF1-treated LF mice (TLF-RF) on day 97. Gut microbiota were determined on days 69, 96-99 and 120 by next generation sequencing of the V3-5 region of the 16S rRNA gene. Microbiota-host factor associations were analyzed by distance-based PERMANOVA and quantified by the coefficient of determination R2 for age, diet, and normalized body weight change (Δbwt). Microbial taxa on day 120 were compared following fitting with an overdispersed Poisson regression model. The machine learning algorithm Random Forests was used to predict age based on the microbiota. RESULTS On day 120, Δbwt in AL, LF, LF-RF, and TLF-RF mice was 52 ± 3, -6 ± 1*, 40 ± 3*, and 46 ± 2 % (*, P < 0.05 versus AL). Age and diet, but not Δbwt, were associated with gut microbiota composition. Age explained a larger proportion of the microbiota variability than diet or Δbwt. Random Forests predicted chronological age based on the microbiota and indicated microbiota immaturity in the LF mice before, but not after, refeeding. However, on day 120, the microbiota community structure of LF-RF mice was significantly different from that of both AL and LF mice. IGF1 mitigated the difference from the AL group. Refed groups had a higher abundance of Bacteroidetes and Proteobacteria and a lower abundance of Firmicutes than AL mice. CONCLUSIONS Persistent growth failure can be induced by 97-day dietary restriction in young female mice and is associated with microbiota changes seen in lean mice and individuals and anorexia nervosa. IGF1 facilitates recovery of body weights and microbiota.
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Affiliation(s)
- Jun Chen
- Division of Biomedical Statistics and Bioinformatics, Department of Health Sciences Research, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Yoshitaka Toyomasu
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Yujiro Hayashi
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - David R Linden
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Joseph H Szurszewski
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Heidi Nelson
- Department of Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Center for Individualized Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Gianrico Farrugia
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Center for Individualized Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Purna C Kashyap
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Center for Individualized Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Nicholas Chia
- Division of Biomedical Statistics and Bioinformatics, Department of Health Sciences Research, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Center for Individualized Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Tamas Ordog
- Enteric NeuroScience Program, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA. .,Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA. .,Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA. .,Center for Individualized Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
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Abstract
Abstract:On seeing promising results in a small number of patients, some researchers are conducting trials to determine whether deep brain stimulation (DBS) is an effective treatment for anorexia nervosa (AN). This article asks whether we should open enrollment in trials of DBS for AN to adolescents. Despite concerns about informed consent, parental consent, and unforeseeable psychological sequelae, the article concludes that the risks to anorexic adolescents associated with participation in trials of DBS are reasonable considering the substantial risks of not enrolling teens with AN in research on DBS. The seriousness of AN, its high incidence in teens, and serious shortfalls in the AN treatment literature point to the need for improved, evidence-based treatments for teens with AN. This unmet need generates an obligation on the part of researchers and physicians to promote and conduct research on AN in adolescents.
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168
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Pinch, cinch or step: Evaluating the effectiveness and acceptability of mid upper arm circumference measurements in adolescents with eating disorders. Eat Behav 2016; 22:72-75. [PMID: 27089385 DOI: 10.1016/j.eatbeh.2016.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 03/18/2016] [Accepted: 03/30/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE Mid Upper Arm Circumference (MUAC) measurement is proposed as an adjunctive measure of re-nutrition progress in youth with eating disorders. We propose that MUAC is a clinically-useful measurement that can be used to inform clinicians about treatment progress. The aims of this study were twofold: 1) to test whether assessments of MUAC can track weight restoration in a similar pattern to direct measures of weight and 2) to examine adolescents' self-reported feelings in response to assessments of MUAC, weighing, and skinfolds (SF). METHODS The study involved two phases of data collection. Participants in both phases of the study were female patients who fulfilled DSM IV-TR diagnostic criteria for an eating disorder. In Phase 1, MUAC measurements and weight assessments were collected weekly to examine changes in these values during the first 8weeks of treatment. In Phase 2, participants reported their feelings towards three different anthropometric measures - weight, SF and MUAC. RESULTS Simple contrasts between the weekly weight and MUAC assessments prospectively collected in Phase 1 (N=40) reveal that MUAC and weight follow similar patterns over time. Phase 2 (N=30) data indicate that participants felt more relaxed, and less angry, scared or embarrassed during MUAC measurements than weighing and SF. MUAC also emerged as the measurement that was most preferred by participants. CONCLUSIONS MUAC measurements are a useful adjunct to measurements of weight, and are perceived to be less distressing than routinely used measurement techniques of weight and SF.
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169
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Affiliation(s)
- Ellen S Rome
- Department of General Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, OH
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170
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Ford CA, Cheek C, Culhane J, Fishman J, Mathew L, Salek EC, Webb D, Jaccard J. Parent and Adolescent Interest in Receiving Adolescent Health Communication Information From Primary Care Clinicians. J Adolesc Health 2016; 59:154-61. [PMID: 27151760 DOI: 10.1016/j.jadohealth.2016.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Patient-centered health care recognizes that adolescents and parents are stakeholders in adolescent health. We investigate adolescent and parent interest in receiving information about health topics and parent-teen communication from clinicians. METHODS Ninety-one parent-adolescent dyads in one practice completed individual interviews. Items assessed levels of interest in receiving health and health communication information from the adolescent's doctor about 18 topics, including routine, mental health, sexual health, substance use, and injury prevention issues. Analyses tested differences between parents and adolescents, within-dyad correlations, and associations with adolescent gender and age. RESULTS Most parents were female (84%). Adolescents were evenly divided by gender; 36 were aged 12-13 years, 35 were aged 14-15 years, and 20 were aged 16-17 years. Adolescent race reflected the practice population (60% black; 35% white). The vast majority of parents and adolescents reported moderate or high levels of interest in receiving information about all 18 health issues and information to increase parent-teen communication about these topics. Parents' interest in receiving information varied by adolescent age when the expected salience of topics varied by age (e.g., acne, driving safety), whereas adolescents reported similar interest regardless of age. Adolescent gender influenced parent and adolescent interest. Level of interest in receiving information from doctors within adolescent-parent pairs was not significantly correlated for one-half of topics. CONCLUSIONS Parents and adolescents want health care professionals to help them learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication, and specific adolescent health outcomes are needed.
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Affiliation(s)
- Carol A Ford
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
| | - Courtney Cheek
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jennifer Culhane
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jessica Fishman
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Leny Mathew
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Elyse C Salek
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - David Webb
- Division of Adolescent Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - James Jaccard
- Center for Latino Adolescent and Family Health, School of Social Work, New York University, New York City, New York
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171
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Latzer IT, Agmon-Levin N, Somech R, Stein D. Eruption of urticaria and angioedema induced by binging and purging in an anorexia nervosa patient. Int J Eat Disord 2016; 49:822-5. [PMID: 27038089 DOI: 10.1002/eat.22514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/20/2015] [Accepted: 01/06/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Anorexia nervosa is a perplexing psycho-biological disorder with a systemic nature, which can present in almost every organ and system of the body. Among the different presentations of starvation, several immunological and dermatological manifestations have been documented. To the best of our knowledge the occurrence of urticaria and angioedema in patients with binge or purge behaviors has yet to be documented. CASE PRESENTATION We present a 16-year-old female patient diagnosed with anorexia nervosa binge/purge type, who presented with urticaria and angioedema shortly after binge/purge episodes that subsided when these behaviors ceased. Other possible causes for the urticaria were ruled out. DISCUSSION This finding may represent a form of inducible urticaria, exacerbated in low-weight patients by the occurrence of binge/purge behaviors. We wish to report this observation in an attempt to widen the scope of the physical signs that may accompany eating disorders and bring this specific phenomenon into awareness. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:822-825).
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Affiliation(s)
- Itay Tokatly Latzer
- Department of Pediatrics A, Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nancy Agmon-Levin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Raz Somech
- Department of Pediatrics A, Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Stein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Psychosomatic Department, Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel Hashomer, Israel
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172
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Chen EY, Weissman JA, Zeffiro TA, Yiu A, Eneva KT, Arlt JM, Swantek MJ. Family-Based Therapy for Young Adults with Anorexia Nervosa Restores Weight. Int J Eat Disord 2016; 49:701-7. [PMID: 27037965 PMCID: PMC7350506 DOI: 10.1002/eat.22513] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/29/2015] [Accepted: 12/31/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We examined the preliminary acceptability and efficacy of family-based therapy (FBT) for weight restoration in young adults (FBTY) with Anorexia Nervosa (AN). METHOD Twenty-two primarily female participants ranging from age 18 to 26, with AN or atypical AN (ICD-10) and their support adults were enrolled in a 6-month open trial of FBTY. Participants were assessed at baseline, after treatment, and at six and 12 month follow-up visits. The primary outcome was BMI and secondary outcomes included eating disorder psychopathology, current eating disorder obsessions, and compulsions, number of other Axis I disorders and global assessment of functioning. RESULTS Although FBTY was rated as suitable by participants and their support adults, during FBTY, 9/22 participants dropped out and 3/22 dropped out at follow-up assessments. Despite being offered 18-20 sessions over six months, a mean of 12 FBTY sessions (SD = 6) were attended. After FBTY, 15 of the intent-to-treat sample of 22 were no longer underweight (BMIs ≥ 19 kg/m(2) ) and 12 months after treatment, 13/22 were no longer underweight. The magnitude of the BMI increase during FBTY (Hedges g = 1.20, 95th percentile CI = 0.55-1.85) was comparable to findings for adolescent FBT for AN. Secondary outcomes also improved. DISCUSSION FBTY for young adults with AN and atypical AN, which involves support adults participants have chosen, results in weight restoration that is sustained up to a year after treatment. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:701-707).
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Affiliation(s)
- Eunice Y. Chen
- Temple Eating Disorders Program, Department of Psychology, Temple University, Philadelphia, Pennsylvania,Correspondence to: E. Chen,
| | | | | | - Angelina Yiu
- Temple Eating Disorders Program, Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Kalina T. Eneva
- Temple Eating Disorders Program, Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Jean M. Arlt
- Temple Eating Disorders Program, Department of Psychology, Temple University, Philadelphia, Pennsylvania
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173
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Arseniev-Koehler A, Lee H, McCormick T, Moreno MA. #Proana: Pro-Eating Disorder Socialization on Twitter. J Adolesc Health 2016; 58:659-64. [PMID: 27080731 DOI: 10.1016/j.jadohealth.2016.02.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Pro-eating disorder (ED) online movements support engagement with ED lifestyles and are associated with negative health consequences for adolescents with EDs. Twitter is a popular social media site among adolescents that provides a unique setting for Pro-ED content to be publicly exchanged. The purpose of this study was to investigate Pro-ED Twitter profiles' references to EDs and how their social connections (followers) reference EDs. METHODS A purposeful sample of 45 Pro-ED profiles was selected from Twitter. Profile information, all tweets, and a random sample of 100 of their followers' profile information were collected for content analysis using the Twitter Application Programming Interface. A codebook based on ED screening guidelines was applied to evaluate ED references. For each Pro-ED profile, proportion of tweets with ED references and proportion of followers with ED references in their own profile were evaluated. RESULTS In total, our 45 Pro-ED profiles generated 4,245 tweets for analysis. A median of 36.4% of profiles' tweets contained ED references. Pro-ED profiles had a median of 173 followers, and a median of 44.5% of followers had ED references. Pro-ED profiles with more tweets with ED references also tended to have more followers with ED references (β = .37, p < .01). CONCLUSIONS Findings suggest that profiles which self-identify as Pro-ED express disordered eating patterns through tweets and have an audience of followers, many of whom also reference ED in their own profiles. ED socialization on Twitter might provide social support, but in the Pro-ED context this activity might also reinforce an ED identity.
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Affiliation(s)
- Alina Arseniev-Koehler
- Department of Sociology, University of Washington, Seattle, Washington; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.
| | - Hedwig Lee
- Department of Sociology, University of Washington, Seattle, Washington
| | - Tyler McCormick
- Department of Sociology, University of Washington, Seattle, Washington; Department of Statistics, University of Washington, Seattle, Washington
| | - Megan A Moreno
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington
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174
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Higher Caloric Refeeding Is Safe in Hospitalised Adolescent Patients with Restrictive Eating Disorders. J Nutr Metab 2016; 2016:5168978. [PMID: 27293884 PMCID: PMC4880718 DOI: 10.1155/2016/5168978] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 03/16/2016] [Indexed: 12/02/2022] Open
Abstract
Introduction. This study examines weight gain and assesses complications associated with refeeding hospitalised adolescents with restrictive eating disorders (EDs) prescribed initial calories above current recommendations. Methods. Patients admitted to an adolescent ED structured “rapid refeeding” program for >48 hours and receiving ≥2400 kcal/day were included in a 3-year retrospective chart review. Results. The mean (SD) age of the 162 adolescents was 16.7 years (0.9), admission % median BMI was 80.1% (10.2), and discharge % median BMI was 93.1% (7.0). The mean (SD) starting caloric intake was 2611.7 kcal/day (261.5) equating to 58.4 kcal/kg (10.2). Most patients (92.6%) were treated with nasogastric tube feeding. The mean (SD) length of stay was 3.6 weeks (1.9), and average weekly weight gain was 2.1 kg (0.8). No patients developed cardiac signs of RFS or delirium; complications included 4% peripheral oedema, 1% hypophosphatemia (<0.75 mmol/L), 7% hypomagnesaemia (<0.70 mmol/L), and 2% hypokalaemia (<3.2 mmol/L). Caloric prescription on admission was associated with developing oedema (95% CI 1.001 to 1.047; p = 0.039). No statistical significance was found between electrolytes and calories provided during refeeding. Conclusion. A rapid refeeding protocol with the inclusion of phosphate supplementation can safely achieve rapid weight restoration without increased complications associated with refeeding syndrome.
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175
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Hart LM, Damiano SR, Paxton SJ. Confident body, confident child: A randomized controlled trial evaluation of a parenting resource for promoting healthy body image and eating patterns in 2- to 6-year old children. Int J Eat Disord 2016; 49:458-72. [PMID: 26749163 DOI: 10.1002/eat.22494] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Body image and eating patterns develop in early childhood and are influenced by the family environment. This research evaluated Confident Body, Confident Child (CBCC), an intervention for parents of 2- to 6-year-old children, designed to promote body satisfaction, healthy eating, and weight management in early childhood. METHOD A randomized controlled trial compared four groups: (A) received the CBCC resource pack and a workshop, (B) received the CBCC resource pack only, (C) received a nutrition-only resource and (D) received no interventions until all questionnaires were completed (i.e., functioned as waitlist control). Measures of parenting variables relevant to child body image and eating patterns, parent-report of child weight, and evaluation questions about the resource, were implemented pre- and post-intervention. RESULTS At 6-weeks post-intervention, the CBCC resource was associated with significant reductions in parents' intentions to use behaviors that increase the risk of negative body attitudes or unhealthy eating in their children, in parents' use of feeding practices associated with childhood overweight, and in television watching during family meals. Significant increases in parents' intentions to use positive behaviors and knowledge of child body image and healthy eating patterns were also found. Superior results were found for the CBCC resource + workshop condition, suggesting it is the preferred delivery method. DISCUSSION CBCC positively impacts parenting variables associated with childhood risk for body dissatisfaction, unhealthy eating and weight. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:458-472).
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Affiliation(s)
- Laura M Hart
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia, 3086
| | - Stephanie R Damiano
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia, 3086
| | - Susan J Paxton
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia, 3086
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176
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Dimitropoulos G, Herschman J, Toulany A, Steinegger C. A qualitative study on the challenges associated with accepting familial support from the perspective of transition-age youth with eating disorders. Eat Disord 2016. [PMID: 26212112 DOI: 10.1080/10640266.2015.1064276] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to identify types of family support desired by young adults with eating disorders during the transfer of care from paediatric to adult eating disorders programs. Using constant comparative analysis, two salient themes from qualitative interviews with 15 young adults were identified: (a) uncertainty about the role of parents in maintaining recovery during the transfer; and (b) the need for parental support, defined as assistance with eating and maintenance of recovery. Young adults voiced that parental emotional involvement and assistance with navigating adult care services is critical to their successful transfer between the two systems of care.
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Affiliation(s)
- Gina Dimitropoulos
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada.,b Eating Disorders Program , University Health Network , Toronto , Ontario , Canada.,c Faculty of Social Work , Department of Psychiatry, University of Calgary , Calgary , Alberta , Canada
| | - Jessica Herschman
- d Department of Paediatrics , University of Toronto , Toronto , Ontario , Canada
| | - Alene Toulany
- d Department of Paediatrics , University of Toronto , Toronto , Ontario , Canada.,e Division of Adolescent Medicine , Department of Paediatrics, The Hospital for Sick Children , Toronto , Ontario , Canada
| | - Cathleen Steinegger
- d Department of Paediatrics , University of Toronto , Toronto , Ontario , Canada.,e Division of Adolescent Medicine , Department of Paediatrics, The Hospital for Sick Children , Toronto , Ontario , Canada
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177
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Musaiger AO, Al-Kandari FI, Al-Mannai M, Al-Faraj AM, Bouriki FA, Shehab FS, Al-Dabous LA, Al-Qalaf WB. Disordered Eating Attitudes Among University Students in Kuwait: The Role of Gender and Obesity. Int J Prev Med 2016; 7:67. [PMID: 27141286 PMCID: PMC4837792 DOI: 10.4103/2008-7802.180413] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 10/29/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND This study aimed to highlight the proportion of disordered eating attitudes among university students in Kuwait by gender and obesity. METHODS A sample of 530 Kuwaiti university students was selected from four universities in Kuwait (203 men and 327 women). The eating attitudes test-26 was used to determine disordered eating attitudes. RESULTS The prevalence of disordered eating attitudes was 31.8% and 33.6% among men and women respectively. Obese students of both genders had doubled the risk of disordered eating attitudes compared to nonobese students (odds ratio 1.99 and 1.98, respectively). CONCLUSIONS About one third of university students in Kuwait had disordered eating attitudes. There is an urgent need to prevent and treat disordered eating attitudes in university students in Kuwait.
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Affiliation(s)
| | - Fawzia I. Al-Kandari
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Mariam Al-Mannai
- Department of Mathematics, College of Science, University of Bahrain, Sakheer, Bahrain
| | - Alaa M. Al-Faraj
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Fajer A. Bouriki
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Fatima S. Shehab
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Lulwa A. Al-Dabous
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Wassin B. Al-Qalaf
- Department of Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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178
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Does Sex Matter in the Clinical Presentation of Eating Disorders in Youth? J Adolesc Health 2016; 58:410-416. [PMID: 26830976 PMCID: PMC4808325 DOI: 10.1016/j.jadohealth.2015.11.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 11/15/2015] [Accepted: 11/19/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE Eating disorders (EDs) impact both males and females, but little is known about sex differences in ED psychopathology and overall clinical presentation. This study compared demographic and clinical characteristics of child and adolescent males and females who presented for ED treatment. METHODS Participants included 619 youth (59 males and 560 females) ages 6-18 years who presented for treatment between 1999 and 2011. RESULTS Males presented for ED treatment at a significantly younger age (p < .001), earlier age of onset (p = .004), and were more likely to be nonwhite (p = .023). Females showed more severe ED pathology across the Eating Disorder Examination subscales (weight concern: p < .001; eating concern: p < .001; restraint: p = .001; and shape concern: p = .019) and global score (p < .001). Males were more likely to present with an ED other than anorexia nervosa or bulimia nervosa (p = .002). Females presented with significantly higher rates of mood disorders (p = .027) and had a lower average percent of expected body weight (p = .020). Males and females did not differ in duration of illness, prior hospitalization or treatment, binging and purging episodes, anxiety disorders, behavioral disorders, or self-esteem. All analyses were controlled for age. CONCLUSIONS Results indicate that further exploration into why the sexes present differently may be warranted. Developing ED psychopathology assessments that better capture nuances particular to males and reevaluating criteria to better categorize male ED diagnoses may allow for more targeted treatment.
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Abstract
Functional hypothalamic amenorrhea is a diagnosis of exclusion that is common in female athletes, particularly those participating in aesthetic sports (ballet, other dance genres, figure skating, and gymnastics) and endurance sports (cross-country running). Although common, it should be considered abnormal even in the high-level elite athlete. Amenorrhea in combination with low energy availability and low bone density is labeled "the Female Athlete Triad." Studies have demonstrated numerous long-term consequences of athletes suffering from all or a portion of this triad, including increased rate of musculoskeletal injuries, stress fractures, abnormal lipid profiles, endothelial dysfunction, potential irreversible bone loss, depression, anxiety, low self- esteem, and increased mortality. This article provides the clinician with the tools to evaluate an athlete with secondary amenorrhea, reviews the recommended treatment options for affected athletes, and discusses when to return to the activity in an effort to facilitate "healthy" participation.
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180
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Sondike SB, Pisetsky EM, Luzier JL. Development of significant disordered eating in an adolescent following gastric bypass surgery. Eat Weight Disord 2016; 21:133-6. [PMID: 26449853 PMCID: PMC5013654 DOI: 10.1007/s40519-015-0230-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/21/2015] [Indexed: 11/30/2022] Open
Abstract
The development of eating pathology is a concern following bariatric surgery, even in the absence of any pre-surgical psychopathology. No consistent risk factors have emerged in the literature to identify those at greatest risk. However, post-surgical guidelines encourage eating behaviors that would be considered disordered in other contexts. We present a case of an adolescent developing bulimia nervosa following gastric bypass surgery and the escalation of her symptoms from diligently following recommended food behaviors to a full-syndrome clinical eating disorder. We discuss the differences between appropriate post-surgical eating behaviors and disordered eating behaviors. We provide recommendations for clinicians to screen for eating pathology and referrals to an interprofessional treatment team to address eating disordered behaviors and cognitions.
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Affiliation(s)
- Stephen B Sondike
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Charleston, WV, USA. .,Charleston Area Medical Center, Charleston, WV, USA. .,Department of Pediatrics, West Virginia University School of Medicine, 830 Pennsylvania Avenue, Suite 103, Charleston, WV, 25302, USA.
| | - Emily M Pisetsky
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Charleston, WV, USA.,Charleston Area Medical Center, Charleston, WV, USA.,Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Jessica L Luzier
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Charleston, WV, USA.,Charleston Area Medical Center, Charleston, WV, USA
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181
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Gonidakis F, Kravvariti V, Fabello M, Varsou E. Anorexia Nervosa and Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2016. [DOI: 10.1007/s11930-016-0064-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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182
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Strandjord SE, Sieke EH, Richmond M, Rome ES. Avoidant/Restrictive Food Intake Disorder: Illness and Hospital Course in Patients Hospitalized for Nutritional Insufficiency. J Adolesc Health 2015; 57:673-8. [PMID: 26422290 DOI: 10.1016/j.jadohealth.2015.08.003] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/04/2015] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Avoidant/restrictive food intake disorder (ARFID), a recently defined Diagnostic and Statistical Manual of Mental Disorders-5 eating disorder diagnosis, has not been extensively studied in the inpatient population. This study compares hospitalized ARFID and anorexia nervosa (AN) patients, including differences in presentation, treatment response, and 1-year outcomes. METHODS We conducted a retrospective chart review of ARFID and AN patients hospitalized between 2008 and 2014 for acute medical stabilization at an academic medical center. Data, including characteristics on admission, during hospitalization, and 1 year after discharge, were recorded for each patient and compared between ARFID and AN patients. RESULTS On presentation, ARFID patients (n = 41) were younger with fewer traditional eating disorder behaviors and less weight loss, comorbidity, and bradycardia than AN patients (n = 203). During hospitalization, although ARFID and AN patients had similar caloric intake, ARFID patients relied on more enteral nutrition and required longer hospitalizations than AN patients (8 vs. 5 days; p = .0006). One year after discharge, around half of ARFID and AN patients met criteria for remission (62% vs. 46%; p = .18), and less than one-quarter required readmission (21% vs. 24%; p = .65). CONCLUSIONS The findings from this study reveal several differences in hospitalized eating disorder patients and emphasize the need for further research on ARFID patients, including research on markers of illness severity and optimal approaches to refeeding. Similar remission and readmission rates among ARFID and AN patients highlight both the success and the continued need for improvement in eating disorder treatment regardless of diagnosis.
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Affiliation(s)
| | - Erin H Sieke
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Miranda Richmond
- Cleveland Clinic Office of Civic Education Initiatives, Beachwood, Ohio
| | - Ellen S Rome
- Department of General Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, Ohio.
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183
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Strandjord SE, Ng H, Rome ES. Effects of treating gender dysphoria and anorexia nervosa in a transgender adolescent: Lessons learned. Int J Eat Disord 2015; 48:942-5. [PMID: 26337148 DOI: 10.1002/eat.22438] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 11/08/2022]
Abstract
Patients with gender dysphoria and patients with eating disorders often experience discontent with their bodies. Several reports have recognized the co-occurrence of these two conditions, typically in adults who identify as transgender females and desire a more feminine physique. This case report, in contrast, describes a 16-year-old patient with a female sex assigned at birth who first presented with features consistent with anorexia nervosa and later revealed underlying gender dysphoria with a drive for a less feminine body shape. We discuss both the path to recognizing gender dysphoria in this patient as well as the impact of treatment on his eating disorder and overall well-being. This case is one of only a few reports describing a female-to-male transgender patient with an eating disorder and is the first to explore the effects of hormone and surgical intervention in an adolescent patient.
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Affiliation(s)
- Sarah E Strandjord
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH
| | - Henry Ng
- Center for Internal Medicine and Pediatrics, MetroHealth Medical Center, Cleveland, OH
| | - Ellen S Rome
- Department of General Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, Ohio
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184
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Tamura A, Minami K, Tsuda Y, Yoshikawa N. Total parenteral nutrition treatment efficacy in adolescent eating disorders. Pediatr Int 2015; 57:947-53. [PMID: 26016952 DOI: 10.1111/ped.12717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 02/16/2015] [Accepted: 03/06/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Management of adolescent patients with severe eating disorders who refuse treatment for weight loss is complicated. Nutritional rehabilitation is most important during the growth period; thus, strong support in the form of total parenteral nutrition (TPN) as soon as possible is necessary in severe cases. No studies involving detailed, long-term follow up have evaluated biochemical markers and gonadotropin in patients undergoing TPN treatment. METHODS Twenty-five adolescent female patients admitted to hospital received TPN immediately, and biochemical marker and gonadotropin levels were measured and analyzed. If subsequent weight gain was observed, TPN treatment was gradually reduced and stopped. RESULTS No patients dropped out of the study. A significant increase in weight was observed during hospitalization (average, 8.0 kg). Under this treatment, serum total bilirubin was significantly decreased at 3 months, total cholesterol was significantly decreased at 2 months, and alkaline phosphatase (ALP) was significantly increased at 3 and 6 months. Follicle-stimulating hormone response significantly preceded both luteinizing hormone response and appetite recovery. After this treatment, nine of the 25 patients were readmitted for recurrence of appetite loss. Two patients required additional TPN treatment, but seven immediately recovered their appetite after hospitalization without TPN treatment. Bodyweight gain per day was significantly lower and ALP on admission was significantly higher in patients with than without recurrence. CONCLUSIONS Most patients had a remarkable recovery of appetite without refusal behaviors and without evidence of malnutrition after admission. Nutrition maintenance with TPN support is particularly important during the growth period.
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Affiliation(s)
- Akira Tamura
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Koichi Minami
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Yuuko Tsuda
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
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185
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Mignot-Bedetti M, Blanchet-Collet C, Moro MR. [Bulimia nervosa, a pathology with multiple complications]. SOINS. PEDIATRIE, PUERICULTURE 2015; 36:22-25. [PMID: 26381068 DOI: 10.1016/j.spp.2015.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Bulimia nervosa is an eating disorder associating binge eating with inappropriate compensatory methods. Patients suffer from multiple organic, psychological and social complications. Of these, the somatic consequences are numerous and of varying degrees of seriousness. Regular monitoring is therefore essential in order to identify them and treat them.
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Affiliation(s)
- Mathilde Mignot-Bedetti
- Maison de Solenn-Maison des adolescents de Cochin (AP-HP), 97 boulevard de Port-Royal, 75014 Paris, France
| | - Corinne Blanchet-Collet
- Unité Inserm 1178, Maison de Solenn-Maison des adolescents de Cochin (AP-HP), 97 boulevard de Port-Royal, 75014 Paris, France.
| | - Marie Rose Moro
- Maison de Solenn-Maison des adolescents de Cochin (AP-HP), 97 boulevard de Port-Royal, 75014 Paris, France; Unité Inserm 1178, Maison de Solenn-Maison des adolescents de Cochin (AP-HP), 97 boulevard de Port-Royal, 75014 Paris, France; Université Sorbonne Paris Cité, 190 avenue de France, 75013 Paris, France
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186
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Blanchet-Collet C, Moro MR. [Anorexia, treating and caring for the mistreated body]. SOINS. PEDIATRIE, PUERICULTURE 2015; 36:17-21. [PMID: 26381067 DOI: 10.1016/j.spp.2015.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Anorexia is a complex, multifactorial disease, emerging during puberty and requiring cross-disciplinary care. The body, taken hostage, expresses psychological suffering and the patient's developmental impasse. Compassionate treatment and the care given to this mistreated and undernourished body facilitate the access to the psychological care and are an essential step towards recovery.
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Affiliation(s)
- Corinne Blanchet-Collet
- Unité Inserm 1178, Maison de Solenn-Maison des adolescents de Cochin (AP-HP), 97 boulevard de Port-Royal, 75014 Paris, France.
| | - Marie Rose Moro
- Unité Inserm 1178, Maison de Solenn-Maison des adolescents de Cochin (AP-HP), 97 boulevard de Port-Royal, 75014 Paris, France; Université Sorbonne Paris Cité, 190 avenue de France, 75013 Paris, France
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187
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Bergeron MF, Mountjoy M, Armstrong N, Chia M, Côté J, Emery CA, Faigenbaum A, Hall G, Kriemler S, Léglise M, Malina RM, Pensgaard AM, Sanchez A, Soligard T, Sundgot-Borgen J, van Mechelen W, Weissensteiner JR, Engebretsen L. International Olympic Committee consensus statement on youth athletic development. Br J Sports Med 2015; 49:843-51. [PMID: 26084524 DOI: 10.1136/bjsports-2015-094962] [Citation(s) in RCA: 408] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Michael F Bergeron
- Youth Sports of the Americas, Birmingham, Alabama, USA Lemak Sports Medicine, Birmingham, Alabama, USA
| | - Margo Mountjoy
- Department of Family Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada IOC Medical Commission-Games Group
| | - Neil Armstrong
- Children's Health and Exercise Research Centre, St Luke's Campus, University of Exeter, Exeter, UK
| | - Michael Chia
- Physical Education & Sports Science, National Institute of Education, Nanyang Technological University, Singapore
| | - Jean Côté
- Queen's University, School of Kinesiology and Health Studies, Kingston, Ontario, Canada
| | - Carolyn A Emery
- Alberta Children's Hospital Research Institute for Child and Maternal Health Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Avery Faigenbaum
- Department of Health & Exercise Science, The College of New Jersey, Ewing, New Jersey, USA
| | - Gary Hall
- Hallway Consulting, Los Olivos, California, USA
| | - Susi Kriemler
- Institut für Epidemiologie, Biostatistik und Prävention, Gruppe Children, Physical Activity and Health (CHIPAH), Universität Zürich, Switzerland
| | - Michel Léglise
- International Gymnastics Federation (FIG), Paris, France
| | - Robert M Malina
- University of Texas at Austin, Austin, Texas, USA Tarleton State University, Stephenville, Texas, USA
| | - Anne Marte Pensgaard
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Alex Sanchez
- International Basketball Federation (FIBA), Switzerland
| | - Torbjørn Soligard
- Medical & Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | | | - Willem van Mechelen
- Department of Public & Occupational Health and EMGO+ Institute, VU University Medical Center Amsterdam, Amsterdam, The Netherlands School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | | | - Lars Engebretsen
- Medical & Scientific Department, International Olympic Committee, Lausanne, Switzerland Orthopaedic Center, Ullevaal University Hospital, Oslo, Norway
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188
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Fujisawa TX, Yatsuga C, Mabe H, Yamada E, Masuda M, Tomoda A. Anorexia Nervosa during Adolescence Is Associated with Decreased Gray Matter Volume in the Inferior Frontal Gyrus. PLoS One 2015; 10:e0128548. [PMID: 26067825 PMCID: PMC4465897 DOI: 10.1371/journal.pone.0128548] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/28/2015] [Indexed: 11/18/2022] Open
Abstract
Anorexia nervosa (AN) is an eating disorder characterized by the relentless pursuit to lose weight, mostly through self-starvation, and a distorted body image. AN tends to begin during adolescence among women. However, the underlying neural mechanisms related to AN remain unclear. Using voxel-based morphometry based on magnetic resonance imaging scans, we investigated whether the presence of AN was associated with discernible changes in brain morphology. Participants were 20 un-medicated, right-handed patients with early-onset AN and 14 healthy control subjects. Group differences in gray matter volume (GMV) were assessed using high-resolution, T1-weighted, volumetric magnetic resonance imaging datasets (3T Trio scanner; Siemens AG) and analyzed after controlling for age and total GMV, which was decreased in the bilateral inferior frontal gyrus (IFG) (left IFG: FWE corrected, p < 0.05; right IFG: uncorrected, p < 0.05) of patients with AN. The GMV in the bilateral IFG correlated significantly with current age (left IFG: r = -.481, p < .05; right IFG: r = -.601, p < .01) and was limited to the AN group. We speculate that decreased IFG volume might lead to deficits in executive functioning or inhibitory control within neural reward systems. Precocious or unbalanced neurological trimming within this particular region might be an important factor for the pathogenesis of AN onset.
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Affiliation(s)
- Takashi X. Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, Japan
| | - Chiho Yatsuga
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, Japan
| | - Hiroyo Mabe
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiji Yamada
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masato Masuda
- Department of Child Development, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Fukui, Japan
- * E-mail:
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189
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Suetani S, Yiu SM, Batterham M. Defragmenting paediatric anorexia nervosa: the Flinders Medical Centre Paediatric Eating Disorder Program. Australas Psychiatry 2015; 23:245-8. [PMID: 25838555 DOI: 10.1177/1039856215579543] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the establishment and the main characteristics of the Flinders Medical Centre Paediatric Eating Disorder Program. CONCLUSION While the programme is still in its infancy, it is hoped that our model of care can provide a sustainable, long term contribution to the management of paediatric eating disorders.
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Affiliation(s)
- Shuichi Suetani
- Psychiatry Registrar, Queensland Centre for Mental Health Research, Wacol, QLD, and; Adjunct Research Registrar, Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
| | - Sau Man Yiu
- Consultant paediatrician, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Michael Batterham
- Consultant psychiatrist, Flinders Medical Centre, Bedford Park, SA, Australia
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190
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López CC, Raimann TX, Gaete P. MV. Prevención de los trastornos de conducta alimentaria en la era de la obesidad: rol del clínico. REVISTA MÉDICA CLÍNICA LAS CONDES 2015. [DOI: 10.1016/j.rmclc.2014.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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