scholarly journals Advances in Diagnosis and Treatment of Anorexia Nervosa and Bulimia Nervosa*

1992 ◽  
Vol 37 (5) ◽  
pp. 309-315 ◽  
Author(s):  
Sidney H. Kennedy ◽  
Paul E. Garfinkel
Keyword(s):  
Substance Abuse ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Psychiatric Comorbidity ◽  
High Rate ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Compulsive Disorder ◽  
Cognitive Behavioural

This paper reviews four areas of research into anorexia nervosa (AN) and bulimia nervosa (BN). First, in terms of diagnosis, the psychological concerns about weight and shape are now addressed in BN, bringing it more in line with the related disorder, anorexia nervosa. Second, studies of psychiatric comorbidity confirm the overlap between eating disorders and depression, obsessive compulsive disorder, substance abuse, and personality disorder. Nevertheless, there are reasons to accept the distinct qualities of each syndrome, and eating disorders are not merely a variant of these other conditions. Third, treatment advances in BN involve mainly cognitive-behavioural or interpersonal psycho-therapies and pharmacotherapies primarily with antidepressants. The effect of combining more than one approach is beginning to be addressed. Finally, outcome studies involving people with both AN and BN have shown that the disorders “cross over” and that both conditions have a high rate of relapse. A renewed interest in the treatment of AN is needed.

scholarly journals Predicting Eating Disorder and Anxiety Symptoms Using Anorexia Nervosa and Obsessive-Compulsive Disorder Polygenic Scores

2020 ◽  
Author(s):  
Zeynep Yilmaz ◽  
Katherine Schaumberg ◽  
Matt Halvorsen ◽  
Erica L. Goodman ◽  
Leigh C. Brosof ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Sex Differences ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Obsessive Compulsive Disorder ◽  
Genetic Risk ◽  
Anxiety Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Polygenic Scores

Clinical, epidemiological, and genetic findings support an overlap between eating disorders, obsessive-compulsive disorder (OCD), and anxiety symptoms. However, little research has examined the role of genetic factors in the expression of eating disorders and OCD/anxiety phenotypes. We examined whether the anorexia nervosa (AN), OCD, or AN/OCD transdiagnostic polygenic scores (PGS) predict eating disorders, OCD, and anxiety symptoms in a large population-based developmental cohort. Using summary statistics files from the Psychiatric Genomics Consortium Freeze 2 AN and Freeze 1 OCD GWAS, we first conducted an AN/OCD transdiagnostic GWAS meta-analysis and then calculated PGS for AN, OCD, and AN/OCD in participants from the Avon Longitudinal Study of Parents and Children with available genetic and phenotype data on eating disorder, OCD, and anxiety diagnoses and symptoms (sample size 3,212-5,369 per phenotype). We observed sex differences in the PGS prediction of eating disorder, OCD, and anxiety-related phenotypes, with AN genetic risk manifesting at an earlier age and playing a more prominent role in eating disorder phenotypes in boys than in girls. Compulsive exercise was the only phenotype predicted by all three PGS (e.g., PAN(boys)=0.0141 at age 14; POCD(girls)=0.0070 at age 16; PAN/OCD(all)=0.0297 at age 14). Our results suggest that earlier detection of eating disorder, OCD, and anxiety-related symptoms could be made possible by including measurement of genetic risk for these psychiatric conditions while being mindful of sex differences.

Cognitive behaviour therapy for eating disorders

2012 ◽  
pp. 1298-1304
Author(s):  
Zafra Cooper ◽  
Rebecca Murphy ◽  
Christopher G. Fairburn
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
General Management ◽  
Not Otherwise Specified ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour

The eating disorders provide one of the strongest indications for cognitive behaviour therapy. This bold claim arises from the demonstrated effectiveness of cognitive behaviour therapy in the treatment of bulimia nervosa and the widespread acceptance that cognitive behaviour therapy is the treatment of choice. Cognitive behaviour therapy is also widely used to treat anorexia nervosa although this application has not been adequately evaluated. Recently its use has been extended to ‘eating disorder not otherwise specified’ (eating disorder NOS), a diagnosis that applies to over 50 per cent of cases, and emerging evidence suggests that it is just as effective with these cases as it is with cases of bulimia nervosa. In this chapter the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. The data on the efficacy and effectiveness of the treatment are considered in the chapters on anorexia nervosa and bulimia nervosa (see Chapters 4.10.1 and 4.10.2 respectively), as is their general management.

Cognitive Behaviour Therapy for People with Asperger Syndrome

2005 ◽  
Vol 34 (3) ◽  
pp. 293-303 ◽  
Author(s):  
Stephen Anderson ◽  
Jane Morris
Keyword(s):  
Substance Abuse ◽  
Eating Disorders ◽  
Asperger Syndrome ◽  
Cognitive Behaviour Therapy ◽  
Bipolar Affective Disorder ◽  
Relevant Literature ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Behaviour

People with Asperger syndrome (AS) appear to have higher than expected rates of co-morbid psychiatric disorder. The main co-morbid diagnoses are anxiety disorders and depression, but eating disorders, obsessive compulsive disorder, substance abuse and bipolar affective disorder have all been reported. Cognitive Behaviour Therapy (CBT) is used effectively to treat these conditions, so could it be used in people who also have Asperger syndrome? This paper reviews important components and characteristics of cognitive behaviour therapy in relation to its use with people who have Asperger syndrome with reference to the relevant literature and to feedback from people with AS. The use of CBT in people with Asperger syndrome appears promising, but further work is needed to evaluate its effectiveness and to examine which particular aspects of therapy are helpful.

Sexual Abuse in Patients with Eating Disorder, Patients with Depression, and Normal Controls

1995 ◽  
Vol 167 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Christine M. Vize ◽  
Peter J. Cooper
Keyword(s):  
Eating Disorders ◽  
Sexual Abuse ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Psychiatric Patients ◽  
Self Report ◽  
High Rate ◽  
Clinical Samples ◽  
Control Group ◽  
History Of

BackgroundA history of sexual abuse has been widely reported in patients with eating disorders. However, the association does not appear to be specific, because a high rate of such abuse has also been found in other psychiatric patients.MethodA standardised interview method was used to elicit details of sexual abuse in a psychiatrically normal control group and samples of patients with anorexia nervosa, bulimia nervosa, or depression.ResultsAn equally high rate of abuse was found in all three clinical samples. Among the patients with anorexia nervosa the presence of bulimic episodes was not found to be associated with reports of abuse; and among the patients with bulimia nervosa there was no relationship between abuse and a history of anorexia nervosa. Among the patients with eating disorders, borderline personality disorder, assessed by means of self-report questionnaire, was not found to be related to reports of abuse, although there was an association between abuse and both indices of impulsive behaviour and the overall level of personality disturbance.ConclusionsChildhood sexual abuse appears to be a vulnerability factor for psychiatric disorder in general and not eating disorders in particular. The way in which abuse interacts with other aetiological factors to produce different psychopathological trajectories remains to be elucidated.

scholarly journals Description of characteristics and outcomes of a cohort of patients with severe and enduring eating disorders (SE-ED)

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ana Piñar-Gutiérrez ◽  
Elena Dios-Fuentes ◽  
Pablo Remón-Ruiz ◽  
Diego Del Can-Sánchez ◽  
Antonio Vázquez-Morejón ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Conventional Treatment ◽  
Hypogonadotropic Hypogonadism ◽  
High Rate ◽  
The People ◽  
Mental Comorbidity ◽  
Current Sample

Abstract Objective To describe the characteristics of the patients, as well as the treatment outcomes for the people treated in an Endocrinology and Nutrition unit with a diagnosis of SE-ED (> 7 years evolution despite evidence-based conventional treatment). Methods A descriptive observational study was conducted. Patients with a diagnosis of SE-ED (anorexia nervosa and bulimia nervosa) treated in the Endocrinology and Nutrition service of the Virgen del Rocío University Hospital between 2014 and 2019 were included. Results 67 patients were contacted and accepted to participate in the study. 95.5% were women. 67.2% were diagnosed with AN (anorexia nervosa) and 32.8% with BN (bulimia nervosa). Their median ages (years) at the onset of symptoms, beginning of follow-up and at present were 17, 32 and 42.5 respectively. Their median time of follow-up was 9 years. 73.1% had mental comorbitidy and AN patients had more osteoporosis (48.9% vs 22.7%, p = 0.04) and hypogonadotropic hypogonadism (31.1% vs. 4.5%, p = 0.014). Discussion The SE-ED patients in our sample began treatment years after the onset of symptoms, which may have led to their chronification. This emphasizes the importance of an early diagnosis in eating disorders. They presented with a high rate of physical complications and mental comorbidity. In the current sample, it was determined that patients with AN presented with higher rates of osteoporosis and hypogonadotropic hypogonadism than patients with BN. Level of evidence Level III: Evidence obtained from well-designed cohort or case–control analytic studies. Plain English summary At present, the criteria for severe and enduring eating disorders (SE-ED) are not sufficiently clearly defined. It has been calculated that approximately 20% of patients with anorexia nervosa (AN) and 10% of patients with bulimia nervosa (BN) suffer a chronification. We evaluated the characteristics of the patients, as well as the treatment outcomes for the people treated in an Endocrinology and Nutrition unit with a diagnosis of SE-ED (which was made based on an evolution greater than 7 years despite conventional treatment). The SE-ED patients in our sample began treatment years after the onset of symptoms, which may have led to their chronification. They presented with a high rate of physical complications and mental comorbidity. In the current sample, it was determined that patients with AN presented with higher rates of osteoporosis (health condition that weakens bones, making them fragile and more likely to break) and hypogonadotropic hypogonadism (illness in which testes or ovaries produce little or no sex hormones due to a problem in the pituitary gland) than patients with BN.

Early Onset Eating Disorders in Male Adolescents: A Series of 10 Inpatients

2011 ◽  
Vol 19 (6) ◽  
pp. 526-530 ◽  
Author(s):  
Adam Bayes ◽  
Sloane Madden
Keyword(s):  
Eating Disorders ◽  
Clinical Features ◽  
Early Onset ◽  
Psychiatric Comorbidity ◽  
Case Series ◽  
Obsessive Compulsive ◽  
Male Adolescents ◽  
Compulsive Disorder ◽  
Male Patients ◽  
Gender Specific

Objective: This case series aims to describe the demographic and clinical features of male inpatients with early onset eating disorders. Method: Retrospective review was made of medical files of male patients treated for eating disorders at two children's hospitals over a 2 year period, with an onset of eating disorder before age 14 years, presenting for index admission. Demographic characteristics, DSM-IV diagnosis, clinical characteristics and treatment received were reviewed. Results: Ten male patients with a median age of 12.8 years (range 10.2 to 13.5) were identified; three met the full criteria for anorexia nervosa (AN) and four met all except the weight criterion. There was high psychiatric comorbidity: four with a major depressive episode, seven an anxiety disorder, three with obsessive-compulsive disorder (OCD) symptoms. Seven engaged in over-exercise. Seven were treated with an antidepressant, and five with an atypical antipsychotic; six required nasogastric tube (NGT) feeding. Conclusion: A minority of patients met full diagnostic criteria for AN, with many not meeting weight criteria despite medical instability. The main clinical features were food restriction, over-exercise and psychiatric comorbidity. Treatment with antidepressants, antipsychotics and NGT feeding was frequent. Future prospective studies could help identify gender-specific features as well as benefits and potential side effects of pharmacotherapy in this age group.

Eating disorders

1989 ◽  
pp. 277-314 ◽  
Author(s):  
Christopher G. Fairburn ◽  
Peter J. Cooper
Keyword(s):  
Eating Disorders ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Cognitive Distortions ◽  
Cognitive Restructuring ◽  
Patient Treatment ◽  
Behavioural Treatment ◽  
Cognitive Behavioural Treatment ◽  
Cognitive Behavioural

Chapter 8 discusses eating disorders, and focuses on anorexia nervosa and bulimia nervosa. It outlines their clinical features, stages of cognitive–behavioural treatment methods (including the elimination of dieting, cognitive restructuring, addressing cognitive distortions, problem-solving training, and addressing body image misperception), subgroups of patients with bulimia nervosa that may require special consideration, group therapy, in-patient treatment, and the use of drugs in treatment.

Anorexia Nervosa And Dissociative Disorders In Males: a Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S430-S430
Author(s):  
M.D.M. Lázaro Redondo ◽  
F. De la Torre Brasas ◽  
A. Duque Domínguez ◽  
N. Echeverría Hernández ◽  
L. Martín Díaz ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Psychiatric Symptoms ◽  
Specific Treatment ◽  
Cultural Construction ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Competing Interest ◽  
Delay Of Diagnosis ◽  
Low Prevalence

IntroductionThere is a low prevalence of eating disorders among men. In many cases, the disorder arises as a means of avoiding psychosocial maturation. Various psychiatric comorbidities such as depression or obsessive-compulsive disorder are frequently found in these patients.ObjectivesTo analyze psychiatric symptoms in relation to a case of anorexia nervosa.MethodsPubmed revision on clinical presentation of anorexia nervosa in male. Review of patient medical records.ResultsA 23-years-old male with diagnosis of restricting anorexia nervosa was treated and followed since 2012. In July 2015, the patient, who was clinically stabilized for a year, had decreased gradually intake. Suddenly he showed a decreased consciousness, followed by an absence of response and mutism that motivated hospital admission. The diagnosis was dissociative stupor. A research in women with eating disorders shows a prevalence of pathological dissociation between 4.8 and 48.6%. After recovering a normal consciousness, he presented clinical features of anorexia nervosa according DSM 5 criteria. The patient remained two months until he reached his previous BMI (17) to continue an outcome treatment. Despite of several years of specific treatment for anorexia nervosa, both parents and patient still did not accept the diagnosis. Cultural constructions of eating disorders as a “women's illness” mean that men may fail to recognise their disorder.ConclusionsThere is a delay of diagnosis of anorexia nervosa in men. The lack of research on men's experiences and the cultural construction of anorexia nervosa as a female problem may contribute to underdiagnose eating disorders in men.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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