1
|
The Effects of Comorbid Disordered Eating Behaviours on Outcomes at Follow-up from Residential Substance Use Disorder Treatment: a Latent Class Approach. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00975-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
2
|
Papacharalampous KE, Dallas C, Dallas G. DETECTION OF EATING DISORDERS IN MALE AND FEMALE ARTISTIC GYMNASTS. SCIENCE OF GYMNASTICS JOURNAL 2022. [DOI: 10.52165/sgj.14.3.421-433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The purpose of this study was to investigate the trend of eating disorders in competitive male and female artistic gymnasts. The study involved 23 male and 42 female gymnasts, aged 7-27, from sports clubs throughout Greece. The EAT-26 Diet Attitudes scale was used to investigate participants' eating habits. The data collection process included communication with sports organizations throughout Greece on the content and purpose of the research. After consultation, the questionnaire was due to the COVID-19 pandemic provided in an electronic form and also included the consent form for participation in the research. The results of the study indicated that eleven of the sixty-five gymnasts had a total score of >20 on the EAT-26, a rate higher among female gymnasts (~ 24%) compared to male gymnasts (~ 4.4%) (p <.05). Although female gymnasts develop more eating disorders and bulimia than male gymnasts, no significant differences were found in the subscales of the questionnaire (p > .05). Therefore, this finding in combination with the fact that most of the gymnasts were teenagers (15.23 ± 6.35 years old) requires particular importance and attention from coaches and the family environment.
Collapse
|
3
|
Robinson LD, Kelly PJ, Larance BK, Griffiths S, Deane FP. Eating Disorder Behaviours and Substance Use in Women Attending Treatment for Substance Use Disorders: a Latent Class Analysis. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00497-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
4
|
Review: questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes. J Eat Disord 2021; 9:41. [PMID: 33789771 PMCID: PMC8011161 DOI: 10.1186/s40337-021-00396-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A sustained mismatch between energy intake and exercise energy expenditure (EEE) can lead to Low Energy Availability (LEA), health and performance impairments characteristic of Relative Energy Deficiency in Sport (RED-S). Questionnaires can conveniently identify symptoms and/or LEA/ RED-S risk factors. This study aimed to systematically identify, and critique questionnaires used or developed to measure LEA/ RED-S risk in athletic populations. METHODS A systematic search was conducted using PubMed database. Full text articles were included if: (i) the questionnaire(s) in the study identified LEA and/or RED-S risk; (ii) studies developed questionnaires to identify LEA and/or RED-S risk; (iii) participants belonged to athletic population(s); and (iv) in English. RESULTS Thirty-three articles met the inclusion criteria and were reviewed, 13 questionnaires were identified. Eight questionnaires had undergone validation procedures, and three questionnaires included questions related to EEE. The most widely used validated questionnaires were Low Energy Availability in Females Questionnaire (LEAF-Q) (48% articles) and Eating Disorder Examination Questionnaire (EDE-Q) (12% articles). The LEAF-Q determines LEA risk from symptoms but cannot be used in males as nearly half of the items (n = 12) relate to menstrual function. The EDE-Q serves as a surrogate marker of LEA risk in both sexes, as it measures a major risk factor of LEA, disordered eating. Better validation is needed for many questionnaires and more are needed to address LEA/RED-S risk in male athletes. CONCLUSION These questionnaires may be effective in identifying intentional energy restriction but less valuable in identifying inadvertently failure to increase energy intake with increased EEE.
Collapse
|
5
|
Robinson LD, Kelly PJ, Deane FP, Reis SL. Exploring the Relationships Between Eating Disorders and Mental Health in Women Attending Residential Substance Use Treatment. J Dual Diagn 2019; 15:270-280. [PMID: 31519142 DOI: 10.1080/15504263.2019.1660019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Comorbid eating disorders (EDs) and ED symptoms are highly prevalent among women with substance use disorders and may be a barrier to recovery. Higher rates of psychiatric illness are common when more than one disorder is present. Yet little is known about the rates and risk factors for EDs/ED symptoms in women attending treatment centers in Australia. The primary aim is to examine the prevalence of ED symptoms among women attending treatment centers. This study also examines past physical and sexual abuse and mental health as specific predictors of EDs/ED symptoms. Methods: Participants were 1,444 women attending residential treatment for substance use issues provided by the Salvation Army in Australia. Measures included the Addiction Severity Index, the Eating Disorder Screen for Primary Care, medication use, hospitalization, mental health, and past abuse. Results: Alcohol was the primary substance of concern for 53.3% of the women, followed by amphetamines (17.5%), and the mean age was 37.83 years (SD = 10.8). Nearly 60% of women screened positive for ED symptoms and 32% reported a previous or current ED. Women with a history of sexual abuse had significantly greater odds (1.96) of positive screening for an ED compared to those without a history of sexual abuse. Similarly, compared to women without a history of physical abuse, those who did have a history had significantly higher odds (1.59) of a positive screen for an ED. These women were also significantly more likely to have had a health care provider recommend they take medications for psychological or emotional problems in the past 30 days, χ2(1) = 8.42, p = .004, and during their lifetime, χ2(1) = 17.89, p < .001. They also had a significantly greater number of overnight hospitalizations for medical problems compared to those who screened negative, t(137) = -2.19, p = .03. Conclusions: Women with comorbid substance use issues and EDs are highly likely to have a history of past abuse. This combination of comorbidities makes treatment and recovery difficult. Increased awareness and research are required to explore integrated approaches to treatment that accommodate these vulnerabilities and improve long-term outcomes.
Collapse
Affiliation(s)
- Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Samantha L Reis
- School of Psychology, University of Wollongong, Wollongong, Australia
| |
Collapse
|
6
|
Lichtenstein MB, Hemmingsen SD, Støving RK. Identification of eating disorder symptoms in Danish adolescents with the SCOFF questionnaire. Nord J Psychiatry 2017; 71:340-347. [PMID: 28290749 DOI: 10.1080/08039488.2017.1300322] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Eating disorders often develop in adolescence and, therefore, instruments are needed that are useful to detect risk behaviour in young people. The SCOFF is a 5-item screening instrument, named SCOFF as an acronym of keywords from the questions. It has been used widely in adult samples, but studies that evaluate the scale in adolescents are missing. AIMS The aim of this study was to test the psychometric properties of the SCOFF in adolescents aged 11-20 years and for the first time validate the questionnaire in Danish. METHODS A total of 184 adolescents completed the Danish version of the SCOFF and sub-scales from the Eating Disorder Inventory (EDI-3). The sample consisted of 87 patients (mean age = 16) from a specialized eating disorder department in the Region of Southern Denmark and 97 healthy adolescents (mean age = 17) from Danish primary and high schools. RESULTS It was found that the reliability of the SCOFF was acceptable, and that cut-off 2 is useful to detect those with potential eating disorder pathology. Item 3 (weight loss) correlated poorly with EDI-3 sub-scales and might be reformulated by addressing the intentionality behind weight loss (due to unhappiness with body) rather than a specific amount of weight loss (1 stone), because this could have somatic reasons. CONCLUSIONS The SCOFF is a very easily applicable questionnaire, which may fulfil the necessary psychometric properties for detection of ED symptoms in Danish adolescents. Before general screening can be recommended, conditions regarding benefits and potential adverse effects still remain to be addressed.
Collapse
Affiliation(s)
- Mia Beck Lichtenstein
- a Centre for Telepsychiatry, Odense, Region of Southern Denmark, Department of Psychology , University of Southern Denmark , Denmark
| | - Simone Daugaard Hemmingsen
- b Nutrition Clinic, Centre for Eating Disorders, Odense University Hospital, Psychiatric Services in the Region of Southern Denmark, Research Unit of Medical Endocrinology, Department of Clinical Research , University of Southern Denmark , Denmark
| | - René Klinkby Støving
- c Nutrition Clinic, Centre for Eating Disorders, Odense University Hospital, Psychiatric Services in the Region of Southern Denmark, Research Unit of Medical Endocrinology, Department of Clinical Research , University of Southern Denmark , Denmark
| |
Collapse
|
7
|
Schirk DK, Lehman EB, Perry AN, Ornstein RM, McCall-Hosenfeld JS. The impact of social support on the risk of eating disorders in women exposed to intimate partner violence. Int J Womens Health 2015; 7:919-31. [PMID: 26648759 PMCID: PMC4664489 DOI: 10.2147/ijwh.s85359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are often found among women exposed to intimate partner violence (IPV). The role of social support (SS) as a protective factor against ED among IPV-exposed women is not firmly established. OBJECTIVE The objective of this study is to determine the distribution of risk of EDs among women exposed to IPV and to examine the impact of SS on risk of ED among IPV-exposed women. METHODS Women (aged 18-64 years) exposed to IPV during their lifetimes (defined by the Humiliation-Afraid-Rape-Kick instrument) were recruited from primary care and domestic violence service agencies and surveyed on demographics, mood/anxiety disorders, psychosocial/community factors, and strategies used in response to IPV. The Eating Disorder Screen for Primary Care assessed the risk of ED. A modified Medical Outcomes Study Social Support Survey assessed overall functional support (scale range: 0-32; categorized into quartiles). Ordinal logistic regression examined the risk of ED based on SS, controlling for prespecified demographics (age, race/ethnicity, marital status, near-poverty level), and health-related factors significant in bivariate analyses (risky alcohol use). RESULTS Among 302 women with lifetime IPV, 41 (14%) were at high risk, 127 (42%) were at moderate risk, and 134 (44%) were at low risk of an ED. In bivariate analyses, high risk of an ED was significantly more frequent among women with a low SS score (<19, 24%) versus a high SS score (≥30, 12%) (P=0.03). High risk of an ED was significantly associated with risky alcohol use (18%) versus non-risky alcohol use (13%; P=0.008). In multivariable analysis, a 5-unit increase in overall SS was significantly associated with decreased odds of ED risk (P=0.007). CONCLUSION Among IPV-exposed women, low SS is associated with an increased risk of ED. SS may protect against ED by reducing anxiety and promoting positive actions, but further study is needed to confirm this.
Collapse
Affiliation(s)
- Dana K Schirk
- The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Erik B Lehman
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Amanda N Perry
- Department of Agricultural Economics, Sociology, and Education, Division of Rural Sociology, College of Agriculture, Pennsylvania State University, University Park, Hershey, PA, USA
| | - Rollyn M Ornstein
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Jennifer S McCall-Hosenfeld
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA ; Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| |
Collapse
|
8
|
Munn-Chernoff MA, McQueen MB, Stetler GL, Haberstick BC, Rhee SH, Sobik LE, Corley RP, Smolen A, Hewitt JK, Stallings MC. Examining associations between disordered eating and serotonin transporter gene polymorphisms. Int J Eat Disord 2012; 45:556-61. [PMID: 22271047 PMCID: PMC3323686 DOI: 10.1002/eat.22001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2011] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The serotonin system has been implicated in mood and appetite regulation, and the serotonin transporter gene (SLC6A4) is a commonly studied candidate gene for eating pathology. However, most studies have focused on a single polymorphism (5-HTTLPR) in SLC6A4; little research has utilized multiple single nucleotide polymorphisms (SNPs) to investigate associations between SLC6A4 and eating pathology more comprehensively. METHOD Family-based association tests were conducted for seven polymorphisms in or near SLC6A4, using families from the Colorado Center for Antisocial Drug Dependence. Data were available for 135 families, with phenotypic data available for female twins and female nontwin siblings. Seven items assessed two disordered eating characteristics: weight and shape concerns and behaviors (WSCB) and binge eating (BE). RESULTS No significant associations were found between any genetic variant and the two disordered eating characteristics. DISCUSSION This study suggests that utilizing polymorphisms in and near SLC6A4, including 5-HTTLPR, may not be useful in identifying genetic risk factors for disordered eating.
Collapse
Affiliation(s)
- Melissa A. Munn-Chernoff
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO,Institute for Behavioral Genetics, University of Colorado, Boulder, CO,To whom correspondence should be addressed: Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO 80503; Phone: 303-492-2817; Fax: 303-492-8063;
| | - Matthew B. McQueen
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO,Department of Integrative Physiology, University of Colorado, Boulder, CO
| | - Gary L. Stetler
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | | | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO,Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | | | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | - Andrew Smolen
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | - John K. Hewitt
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO,Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | - Michael C. Stallings
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO,Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| |
Collapse
|
9
|
Munn MA, Stallings MC, Rhee SH, Sobik LE, Corley RP, Rhea SA, Hewitt JK. Bivariate analysis of disordered eating characteristics in adolescence and young adulthood. Int J Eat Disord 2010; 43:751-61. [PMID: 20957703 PMCID: PMC2980580 DOI: 10.1002/eat.20854] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We examined the etiology of two disordered eating characteristics. METHOD Participants included 1,470 female adolescent and young adult twins and their female nontwin siblings. Phenotypic factor analyses of a seven-item eating pathology screening tool yielded two factors: weight and shape concerns and behaviors (WSCB) and binge eating (BE). Univariate and bivariate extended twin analyses (including cotwins and nontwin siblings) were used to estimate the magnitude of genetic and environmental influences on these characteristics. RESULTS Analyses indicated that individual differences in WSCB and BE could be explained by additive genetic influences (a² = 0.43 (95% CI: 0.33-0.52) and 0.49 (95% CI: 0.36-0.58), respectively), with the remaining variance due to nonshared environmental influences. The genetic correlation between WSCB and BE was estimated at 0.64; the nonshared environmental correlation was estimated at 0.27. DISCUSSION These results corroborate previous findings on genetic and environmental influences on disordered eating characteristics and suggest that findings can be extended to nontwin populations.
Collapse
Affiliation(s)
- Melissa A. Munn
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, Institute for Behavioral Genetics, University of Colorado, Boulder, CO,To whom correspondence should be addressed: Institute for Behavioral Genetics, University of Colorado, 447 UCB, Boulder, CO 80503; Phone: 303-735-2428; Fax: 303-492-8063;
| | - Michael C. Stallings
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | - Soo Hyun Rhee
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | | | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | - Sally Ann Rhea
- Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| | - John K. Hewitt
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, Institute for Behavioral Genetics, University of Colorado, Boulder, CO
| |
Collapse
|
10
|
Abstract
The practical guidance to insulin management is a simple tool for health care providers, particularly primary care physicians (PCPs). Developed by experts in diabetes care at an international meeting, it aims to help physicians make key decisions to optimize insulin management and decrease long-term morbidity risk. With a growing role for PCPs in type 2 diabetes, the practical guidance focuses on confident, appropriate and timely insulin initiation. Using the acronym 'TIME' (Targets, Insulin, Managing weight, Encouragement and support) the practical guidance aims, in a visually appealing format, to help physicians address the challenges of insulin management with their patients, from diagnosis through insulin initiation to follow-up.
Collapse
|
11
|
González-Juárez C, Pérez-Pérez E, Martín Cabrera B, Mitja Pau I, Roy de Pablo R, Vázquez de la Torre Escalera P. [Detection of adolescents at risk of suffering eating disorders]. Aten Primaria 2007; 39:189-94. [PMID: 17428423 PMCID: PMC7664523 DOI: 10.1157/13100842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To analyse which risk factors are related to eating disorders and to identify useful questions for their early detection in primary care. DESIGN Observational, cross-sectional study. SETTING Six secondary schools in Leganés, Madrid, Spain. PARTICIPANTS Adolescents aged between 12 and 18 years old attending secondary school. MAIN MEASUREMENTS Risk of suffering an eating disorder (Eating Attitudes Test-26) and questions about weight, height, family, attitudes towards body image, use of health services for eating disorders, and mental illness history. RESULTS An 8.8% of the adolescents were at risk of developing an eating disorder (4.6% male; 11.8% female). Age in males (OR=0.76) and 24-hour fasting to lose weight (OR for males =7.44; OR for females =3.09) were associated with the risk of eating disorders. Early menarche (OR=1.69), having dieted for social or environmental reasons, and self-induced vomiting (OR=5.71) were associated with eating disorders in women. The specificity and negative predictive value of asking about self-induced vomiting and 24-hour fasting in order to detect an eating disorder were around 95%. CONCLUSIONS Age is a protective factor for eating disorders, especially in males. In women, early menarche is a risk factor. Asking about self-induced vomiting and 24-hour fasting enables eating disorders in women to be ruled out.
Collapse
|
12
|
Coleman VH, Morgan MA, Zinberg S, Schulkin J. Clinical Approach to Mental Health Issues Among Obstetrician???Gynecologists: A Review. Obstet Gynecol Surv 2006; 61:51-8. [PMID: 16359569 DOI: 10.1097/01.ogx.0000193877.72966.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED In recent years, obstetrician-gynecologists have taken on a greater role in the provision of primary care. Mental health has been a topic worthy of further exploration as a result of the high prevalence rates of women presenting in gynecologic settings with depressive, anxiety, or eating-disordered symptoms. The detrimental effects of psychopathology have been well documented in the literature, especially if present during pregnancy. This article provides a review of the literature in the area of clinical practice related to mental health among obstetrician-gynecologists based on searches of the Psyc Info and MEDLINE databases. Lack of recognition and underdiagnosis are common problems that need to be addressed by focused educational initiatives. TARGET AUDIENCE Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES After completion of this article, the reader should be able to recall the importance of screening for various types of mental disease during an ob/gyn visit; describe the detrimental effects of psychopathology, especially during pregnancy; and explain the importance of educational initiatives in detecting and treating mental disorders.
Collapse
Affiliation(s)
- Victoria H Coleman
- Doctoral Candidate, Department of Psychology, American University, Washington DC 20024, USA.
| | | | | | | |
Collapse
|
13
|
Becker AE, Thomas JJ, Franko DL, Herzog DB. Disclosure patterns of eating and weight concerns to clinicians, educational professionals, family, and peers. Int J Eat Disord 2005; 38:18-23. [PMID: 15971235 DOI: 10.1002/eat.20141] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The current study investigated disclosure of eating and weight concerns to professionals, peers, and family. METHOD Responses to a telephone questionnaire probing disclosure patterns were analyzed in a sample of 216 adult subjects with eating or weight symptoms, concerns, or problems. RESULTS Nearly all of the sample (97.7%) had disclosed information about eating or weight symptoms or concerns to someone. Only 57% of the sample had disclosed this information to a health care professional. However, among subjects who had not otherwise volunteered information about their concerns, those who were queried were more likely than not to disclose them to health care professionals, counselors, and coaches. Disclosure to a health care professional or school counselor was associated with a higher likelihood of subsequent treatment seeking. DISCUSSION These data suggest that individuals with disordered eating may be quite amenable to disclosing symptoms in clinical settings. Asking about an eating disorder may enhance detection and facilitate treatment in clinical settings.
Collapse
Affiliation(s)
- Anne E Becker
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | | | | | | |
Collapse
|
14
|
Olson AF. Outpatient Management of Electrolyte Imbalances Associated With Anorexia Nervosa and Bulimia Nervosa. JOURNAL OF INFUSION NURSING 2005; 28:118-22. [PMID: 15785332 DOI: 10.1097/00129804-200503000-00005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Bulimia nervosa and anorexia nervosa are eating disorders with significant morbidity that often go undetected. Nurses and primary care providers are encouraged to recognize the early signs and symptoms of these disorders and to intervene appropriately. Several case reports in this article describe patients with these disorders and various related electrolyte abnormalities. Understanding electrolyte imbalances associated with both disorders may lead to earlier effective intervention and overall improved health outcomes.
Collapse
|
15
|
Abstract
OBJECTIVE The current study reviews the state of eating disorder screens. METHODS Screens were classified by their purported screening function: identification of cases with (a) anorexia nervosa only; (b) bulimia nervosa only; (c) eating disorders in general; (d) partial syndrome, eating disorder not otherwise specified (EDNOS), or subclinical; (e) not a-d but at high risk. Information is presented on development, psychometric properties, and external validation (e.g., sensitivity, specificity, positive predictive values, and negative predictive values). RESULTS Screens differ widely with regard to objective, psychometric properties and the validation methodology used. Most screens that identify cases are not appropriate for the identification of at-risk behaviors. Little data on the external validity of screens are available. DISCUSSION Screens should be used with caution. A sequential procedure, in which subjects identified as being at risk during the first stage is followed by more specific diagnostic tests during the second stage, might overcome some of the limitations of the one-stage screening approach.
Collapse
Affiliation(s)
- Corinna Jacobi
- Department of Psychology, University of Trier, Trier, Germany
| | | | | |
Collapse
|
16
|
Abstract
There is a high prevalence of mental and physical comorbidity. Increasingly, persons with mental disorders are seen in nonpsychiatric settings where recognition of comorbidity is more complex. This article notes the interactions between mental and physical disorders and provides an assessment approach to improve health outcomes for persons with mental illness who are seen in primary care.
Collapse
Affiliation(s)
- Bonnie Davis
- University of Mississippi School of Nursing, Jackson, Miss, USA
| |
Collapse
|
17
|
Rushing JM, Jones LE, Carney CP. Bulimia Nervosa: A Primary Care Review. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2003; 5:217-224. [PMID: 15213788 PMCID: PMC419300 DOI: 10.4088/pcc.v05n0505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2003] [Accepted: 10/28/2003] [Indexed: 10/20/2022]
Abstract
Bulimia nervosa is a psychiatric condition that affects many adolescent and young adult women. The disorder is characterized by bingeing and purging behavior and can lead to medical complications. Thus, patients with bulimia nervosa commonly present in the primary care setting. Physical and laboratory examinations reveal markers of bulimia nervosa that are useful in making the diagnosis. Treatment is beneficial, and outcomes of early intervention are good. This article discusses the history, presentation, and tools needed for recognizing and treating bulimia nervosa in primary care.
Collapse
Affiliation(s)
- Jona M. Rushing
- Department of Psychiatry, and the Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City; and the Department of Epidemiology, University of Iowa College of Public Health, Iowa City
| | | | | |
Collapse
|
18
|
Abstract
Extensive damage to the teeth may result from self-induced vomiting. Recognition of the oral signs of eating disorders is a responsibility of dental care providers. Young women with BN and AN may seek dental care before seeking medical treatment because they are concerned about their appearance. Early identification of oral changes by the dental practitioner and referral to medical and psychiatric therapists can reduce the risk of further physical damage to the body or greater loss of tooth surface enamel. Home care instructions will be followed when the reasons for timing of toothbrushing, rinsing after vomiting, and use of fluoride are explained. Careful selection of beverages and snacks will help reduce the risk of further erosion and dental caries. Comprehensive dental procedures should not be undertaken until significant improvement in vomiting behavior or complete recovery has occurred.
Collapse
Affiliation(s)
- Mary P Faine
- Department of Prosthodontics, School of Dentistry, University of Washington, 7015 Southeast 32nd Street, Mercer Island, WA 98040, USA.
| |
Collapse
|
19
|
Abstract
Current screening instruments for eating disorders are cumbersome to administer and have not been validated in primary care populations. We compared the performance characteristics of 2 screening tools, the SCOFF clinical prediction guide, and a new set of questions, the Eating disorder Screen for Primary care (ESP), using the Questionnaire for Eating Disorders Diagnosis as the independent standard, in 104 consecutive patients from a primary care practice and 129 university students. Twelve percent of the combined population had an eating disorder. One or no abnormal responses to the ESP ruled out an eating disorder (likelihood ratio [LR] 0.0), whereas 3 or more abnormal responses ruled one in (LR 11). The SCOFF questions were less sensitive than predicted (1 or no abnormal responses, LR 0.25), but were as effective at ruling in an eating disorder (3 or more abnormal responses, LR 11).
Collapse
|
20
|
Dichter JR, Cohen J, Connolly PM. Bulimia nervosa: knowledge, awareness, and skill levels among advanced practice nurses. JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS 2002; 14:269-75. [PMID: 12087787 DOI: 10.1111/j.1745-7599.2002.tb00124.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To examine the knowledge, awareness, and self-perceived skill levels regarding bulimia nervosa (BN) among advance practice nurses (APNs) caring for young female patients. DATA SOURCES Two hundred APNs of various nurse practitioner (NP) specialties were surveyed with a mailed questionnaire. One hundred and twenty-one (61%) surveys were returned and analyzed. CONCLUSIONS Results demonstrated that APNs are knowledgeable and aware about BN. There were several statistically significant relationships among awareness and self-perceived skill levels. Pediatric NPs were found to be the most aware of BN in their young female patients. IMPLICATIONS FOR PRACTICE The incidence of eating disorders is on the rise. Bulimia nervosa, a common secretive illness, poses a significant challenge for APNs potentially leading to missed diagnosis. There is a paucity of research exploring this issue. Study findings provide evidence to enhance curricula on eating disorders in academic and continuing education programs and guidance for future research.
Collapse
|
21
|
Roerig JL, Mitchell JE, Myers TC, Glass JB. Pharmacotherapy and medical complications of eating disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am 2002; 11:365-85, xi. [PMID: 12109326 DOI: 10.1016/s1056-4993(01)00012-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In this article, the authors cover two areas of interest regarding eating disorders in childhood and adolescence: (1) the detection of eating disorders in medical practice and their medical complications and (2) the psychopharmacologic treatment of patients with eating disorders.
Collapse
Affiliation(s)
- James L Roerig
- Neuropsychiatric Research Institute, 700 First Avenue South, PO Box 1415, Fargo, ND 58103, USA
| | | | | | | |
Collapse
|
22
|
Walsh JM, Wheat ME, Freund K. Detection, evaluation, and treatment of eating disorders the role of the primary care physician. J Gen Intern Med 2000; 15:577-90. [PMID: 10940151 PMCID: PMC1495575 DOI: 10.1046/j.1525-1497.2000.02439.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications. DESIGN A review of literature from 1994 to 1999 identified by a MEDLINE search on epidemiology, diagnosis, and therapy of eating disorders, including anorexia nervosa and bulimia nervosa. MEASUREMENTS AND MAIN RESULTS Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (e.g., unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, partoid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (e.g., arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia). CONCLUSION Primary care providers have an important role in detecting and managing eating disorders.
Collapse
Affiliation(s)
- J M Walsh
- Division of General Internal Medicine, Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
| | | | | |
Collapse
|
23
|
DETECTION AND MANAGEMENT OF EATING DISORDERS DURING PREGNANCY. Obstet Gynecol 2000. [DOI: 10.1097/00006250-200006000-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Freund KM, Boss RD, Handleman EK, Smith AD. Secret patterns: validation of a screening tool to detect bulimia. JOURNAL OF WOMEN'S HEALTH & GENDER-BASED MEDICINE 1999; 8:1281-4. [PMID: 10643836 DOI: 10.1089/jwh.1.1999.8.1281] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We prospectively validated a two-item screening tool for bulimia. Subjects recruited from a women's health practice completed the previously developed two-item screening tool ("Do you ever eat in secret?" and "Are you satisfied with your eating patterns?") at their initial office visit. This was validated against a telephone interview with a licensed psychologist. The prevalence of current bulimia was 16% in 75 subjects, determined by psychologists' assessment (sensitivity 75%, specificity 49%) and 4% by DSM-III-R criteria. The positive and negative predictive values of one screening question positive were 22% and 91%, respectively, when compared with the psychologists' assessments as the gold standard. This screening tool allows physicians to identify patients who warrant further valuation for bulimia.
Collapse
Affiliation(s)
- K M Freund
- Department of Medicine, Boston Medical Center, Massachusetts 02118-2334, USA
| | | | | | | |
Collapse
|
25
|
Abstract
This study was designed to evaluate the differences in nutritional assessments when performed by nurse practitioners, physicians, and physician assistants. Complete patient histories and physical records were assessed with the focus on the detection and prevention of eating disorders in female adolescents. Data included medical records of 111 female adolescents from a family practice with three separate sites. Primary care providers included two nurse practitioners, two physician assistants, and nine physicians. The null hypothesis that there is no difference in assessments of nurse practitioners, physician assistants, and physicians was rejected. A significant difference was found in the assessments of nurse practitioners and physicians (t = 2.62; p = .01). Nurse practitioners were found to be significantly more likely than physicians to perform assessment for eating disorders.
Collapse
|
26
|
Hamm RM. Two-question screen for bulimia. J Gen Intern Med 1993; 8:715-6. [PMID: 8120695 DOI: 10.1007/bf02598301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|