Personality characteristics and medical impact of stimulant laxative abuse in eating disorder patients—a pilot study

Background Stimulant laxative abuse as a purging behavior can be profound in those with eating disorders. However, the psychopathology leading to stimulant laxative abuse is poorly understood. Furthermore, the medical impact of stimulant laxative abuse has not been studied in this population. Methods Six individuals abusing stimulant laxatives underwent a barium enema to assess for evidence of the cathartic colon syndrome and 29 individuals engaging in any purging behaviors completed the Tri-dimensional Personality Questionnaire-Short Form, Sensitivity to Punishment/Sensitivity to Reward Questionnaire-Short Form, Beck Depression Inventory, and the State Trait Anxiety Inventory questionnaires. Results Three of the six patients completing the barium enema had the radiographic findings consistent with cathartic colon. Individuals engaging in laxative abuse showed higher Novelty Seeking compared to those engaging in other forms of purging, and those engaging in any form of purging behavior showed greater Sensitivity to Punishment compared to Sensitivity to Reward. There was also the presence of greater Harm Avoidance than Reward Dependence in this population. Conclusion There may be different psychopathology that contributes to the abuse of stimulant laxatives than that associated with other forms of purging. Regardless of the driving factor, further research is warranted to discover best therapeutic interventions given the potential to develop the cathartic colon syndrome with ongoing use of stimulant laxatives. Plain English Summary Cathartic colon is a condition whereby the colon, or lower intestine, is converted into an inert tube incapable of propagating fecal matter. It is thought to develop due to over-use of stimulant laxatives. However, it is unclear if this condition truly exists and whether it contributes to the constipation experienced by individuals with eating disorders who have extensive past histories of abusing laxatives. It is also unclear if laxative abuse presents with different medical complications than other forms of purging. The purpose of this study is to determine whether radiographic evidence of cathartic colon can be found in eating disorder patients abusing stimulant laxatives, whether there are different medical complications with laxative abuse versus other forms of purging, and to examine the psychological composition of individuals who engage in severe laxative abuse. Specifically, the authors investigated the interrelationship between Harm Avoidance and Reward Dependence, with emphasis on gaining a better understanding of Reward Dependence by examining both Sensitivity to Reward and Sensitivity to Punishment in patients who engage in severe laxative abuse. Our findings suggest that stimulant laxative abuse may cause the development of cathartic colon changes and that there may be unique psychopathology that contributes to the abuse of stimulant laxatives. Given the higher Novelty Seeking personality-dimension in those abusing laxatives, it is possible that this purging behavior may be considered addiction-like in nature, which would have distinct treatment implications.

ACCOMPANYING SYMPTOMS OF THE DISORDERED EATING IN THE PATIENTS WITH SCHIZOPHRENIA AS THE REASON FOR THE SUSPENSION OF MAKING A DIAGNOSIS (THE RESULTS OF THE CLINICAL NEUROPSYCHOLOGICAL ANALYSIS)

The article focuses on the study of the neuropsychological features of the patients with schizophrenia, who have the signs of the disordered eating at the preclinical stage. The paper contains the data of the study of 60 female patients (aged 28 (25-33) years, median Me (25%-75%)) who have suffered from paranoid schizophrenia for up to 5 years. 23 of the female patients have had the disordered eating in the past medical history, i.e. during the examination the female patients reported that they had tried to loose weight, had taken laxatives and had trained intensively 5 years before they were diagnosed with schizophrenia. At the moment of examination the female patients have also had the signs of the disordered eating, moreover, the signs included only overeating and purging behavior. Besides, we have used the Kaplan-Meier method to determine the difference in the time of making clinical diagnoses (schizophrenia) depending on the absence and presence of the relevant signs of the disordered eating.

Health Outcomes, Personality Traits, And Eating Disorders

Bulimia Nervosa (BN) is a detrimental persistent eating disorder that impacts millions of women, and imposes serious costs on the economy in terms of physical health, treatment costs, absence from work, and reduced human capital accumulation. One important issue in treating BN is that it is often undiagnosed, especially among disadvantaged girls. The failures to diagnose BN occur, in part, because many cases of BN are unobservable to others, and asking girls about their bingeing and purging behavior can be considered invasive. Using data on eating disorder behaviors from the National Heart, Lung, and Blood Institute Growth and Health Study, we show that information on a girl’s personality traits, along with information on her family’s socioeconomic status, can be used to impute the unobservable BN behavior. In particular, we find that personality traits are significant determinants of bulimic behavior, even after controlling for socioeconomic status. These results suggest a way to target those who are likely to suffer from BN based on identifiable personality traits. Given the costs involved in BN, and the number of individuals affected, our research suggests a practical direction for public health policy to reduce the number of undiagnosed cases.

Getting Help

The first step in getting a treatment that works is getting treatment, yet there is a vast chasm between the number of people suffering from purging disorder and the number receiving care. This chapter covers barriers to treatment that may uniquely impact those with purging disorder, making it invisible in clinical settings. To help those seeking treatment as well as those providing treatment, this chapter presents what should happen during assessment and how findings should inform level of care. This information is intended to help clinicians recognize purging disorder when they see it. Clinicians should always ask about purging behavior even in those who are not underweight and who do not binge. In addition, assessments should evaluate medical stability, suicide risk, and related problems with mood, anxiety, and substance use to inform a treatment plan.

Association of etiological factors across the extreme end and continuous variation in disordered eating in female Swedish twins

Background Accumulating evidence suggests that many psychiatric disorders etiologically represent the extreme end of dimensionally distributed features rather than distinct entities. The extent to which this applies to eating disorders (EDs) is unknown. Methods We investigated if there is similar etiology in (a) the continuous distribution of the Eating Disorder Inventory-2 (EDI-2), (b) the extremes of EDI-2 score, and (c) registered ED diagnoses, in 1481 female twin pairs at age 18 years (born 1992–1999). EDI-2 scores were self-reported at age 18. ED diagnoses were identified through the Swedish National Patient Register, parent-reported treatment and/or self-reported purging behavior of a frequency and duration consistent with DSM-IV criteria. We differentiated between anorexia nervosa (AN) and other EDs. Results The heritability of the EDI-2 score was 0.65 (95% CI 0.61–0.68). The group heritabilities in DeFries–Fulker extremes analyses were consistent over different percentile-based extreme groups [0.59 (95% CI 0.37–0.81) to 0.65 (95% CI 0.55–0.75)]. Similarly, the heritabilities in liability threshold models were consistent over different levels of severity. In joint categorical-continuous models, the twin-based genetic correlation was 0.52 (95% CI 0.39–0.65) between EDI-2 score and diagnoses of other EDs, and 0.26 (95% CI 0.08–0.42) between EDI-2 score and diagnoses of AN. The non-shared environmental correlations were 0.52 (95% CI 0.32–0.70) and 0.60 (95% CI 0.38–0.79), respectively. Conclusions Our findings suggest that some EDs can partly be conceptualized as the extreme manifestation of continuously distributed ED features. AN, however, might be more distinctly genetically demarcated from ED features in the general population than other EDs.

I was not so

IntroductionThe frontal lobes are the brain structures of latest development and evolution in the human brain. It is considered that the frontal lobes represent the “executive center of the brain”. The frontal tumors represent 16% of all supratentorial tumors. Symptoms are easily confused as psychiatric rather than neurological.ObjectivesCan see the alterations of the executive functions in a case of frontal affectation, for future cases know where to focus our attention and develop concepts associated with frontal lobe.MethodThirty-year-old patient without relevant medical history. Go to the emergency department with major episode of agitation. After performing cranial CT abnormality, it is detected in the front area. Sign up study. It presents amnesia episode before admission, whereupon shown stunned and worried. The patient describes a change in your life 12 months ago, when it begins to be more nervous, increasing their impulsiveness, she has episodes of binge eating, purging behavior with subsequent occasional alcohol abuse. Jealousy. The patient is informed as much as your family of the possible impact of the injury on the behavioral sphere and impulse control when it is still unknown origin.ConclusionsFrom a neuropsychological point of view the frontal lobes represent a system of planning, regulation and control of psychological processes; coordination and allow selection of multiple processes and various behavioral options and strategies available to the human being. Tumour research is important as it provides enough information we cognitive impairment. These patients exhibit symptoms that are easily confused as psychiatric rather than neurological.Disclosure of interestThe authors have not supplied their declaration of competing interest.