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Anorexia Nervosa: The Diagnosis

Tomoko Udo, Carlos M Grilo
OBJECTIVE: To examine psychiatric and somatic correlates of DSM-5 eating disorders (EDs)-anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED)-in a nationally representative sample of adults in the United States. METHOD: A national sample of 36,309 adult participants in the national epidemiologic survey on alcohol and related conditions III (NESARC-III) completed structured diagnostic interviews (AUDADIS-5) to determine psychiatric disorders, including EDs, and reported 12-month diagnosis of chronic somatic conditions...
January 2019: International Journal of Eating Disorders
Kendra J Homan, Leslie A Sim, Susan L Crowley, Jocelyn R Lebow, Lisa N Kransdorf
OBJECTIVE: To examine the medical assessment and triage of pediatric patients with anorexia nervosa (AN) initially seen in primary care. METHODS: A retrospective cohort study was conducted for all pediatric patients with AN who had eating/weight concerns and initially identified symptoms in primary care in a single health care system between January 1, 2010, and December 31, 2016. Information on presenting concern, medical assessment/laboratory tests, clinical diagnoses, treatment recommendations, and referrals were abstracted from the medical record...
February 2019: Journal of Developmental and Behavioral Pediatrics: JDBP
C R André Lange, Hanna Ekedahl Fjertorp, Riitta Holmer, Elin Wijk, Ulf Wallin
OBJECTIVE: To compare long term outcome between childhood-onset Anorexia Nervosa (AN) and low-weight Avoidant/Restrictive Food Intake Disorder (ARFID) in regard to psychiatric diagnoses, social and occupational functioning. METHOD: A consecutive series of 56 children originally treated for low-weight restrictive eating disorder (ED) were followed up after a mean of 15.9 years. ARFID-diagnoses were assigned retrospectively. RESULTS: Thirty-seven patients originally had AN and 19 patients were diagnosed retrospectively with ARFID...
February 11, 2019: International Journal of Eating Disorders
Melissa Lieberman, Melissa E Houser, Anne-Pier Voyer, Shelley Grady, Debra K Katzman
OBJECTIVE: The purpose of this study was to examine the medical and psychological characteristics of children under the age of 13 years with avoidant restrictive food intake disorder (ARFID) and anorexia nervosa (AN) from a Canadian tertiary care pediatric eating disorders program. METHOD: Participants included 106 children assessed between 2013 and 2017 using the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5). Data were collected through clinical interviews, psychometric questionnaires, and chart review...
February 1, 2019: International Journal of Eating Disorders
Gaby Resmark, Stephan Herpertz, Beate Herpertz-Dahlmann, Almut Zeeck
Anorexia nervosa is the most severe eating disorder; it has a protracted course of illness and the highest mortality rate among all psychiatric illnesses. It is characterised by a restriction of energy intake followed by substantial weight loss, which can culminate in cachexia and related medical consequences. Anorexia nervosa is associated with high personal and economic costs for sufferers, their relatives and society. Evidence-based practice guidelines aim to support all groups involved in the care of patients with anorexia nervosa by providing them with scientifically sound recommendations regarding diagnosis and treatment...
January 29, 2019: Journal of Clinical Medicine
Sonja Lackner, Sabrina Mörkl, Wolfram Müller, Alfred Fürhapter-Rieger, Andreas Oberascher, Michael Lehofer, Claudia Bieberger, Willibald Wonisch, Omid Amouzadeh-Ghadikolai, Maximilian Moser, Harald Mangge, Sieglinde Zelzer, Sandra Johanna Holasek
BACKGROUND & AIMS: Anorexia nervosa (AN) is a severe psychosomatic disease that seriously affects nutritional status. Therapeutic approaches primarily aim for rapid weight restoration by high caloric diets and activity restriction. This often promotes abdominal body fat gain, which potentially negatively influences the patient's compliance and increases the risk of relapse. This study focused on the evaluation of body weight and subcutaneous adipose tissue (SAT) in AN patients by novel approaches...
January 10, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
José H Marco, Montserrat Cañabate, Sandra Pérez
Previous studies indicated that meaning in life was inversely associated with eating behaviors and a negative attitude toward food, body satisfaction, and borderline symptoms. However, research on the association between meaning in life and eating disorder psychopathology is scarce, and there are no studies on the association between meaning in life and the eating disorder psychopathology depending on the diagnosis. The aim of the present study is to verify whether meaning in life is differentially associated with a broad range of psychopathology symptoms commonly observed in people with ED, depending on the diagnosis, in a sample of 240 ED patients...
January 20, 2019: Eating Disorders
Sophie C Norris, David H Gleaves, Amanda D Hutchinson
OBJECTIVE: Despite the multitude of research surrounding anorexia nervosa (AN) and perfectionism, there is yet to be a thorough investigation comparing perfectionism in those diagnosed with AN and other eating disorders, and other psychiatric diagnoses. The current meta-analysis aimed to explore these comparisons. METHOD: Following the Preferred Reporting Items or Systematic Reviews Meta Analyses (PRISMA) guidelines, we identified empirical studies that compared maladaptive and/or adaptive perfectionism scores in those diagnosed with AN and either a non-clinical comparison group, people diagnosed with a non-AN ED, or people diagnosed with another psychological disorder (i...
January 11, 2019: International Journal of Eating Disorders
Andrea S Hartmann, Martin Cordes, Gerrit Hirschfeld, Silja Vocks
Checking behavior (CB) occurs in a variety of disorders such as obsessive-compulsive (OCD), body dysmorphic (BDD), illness anxiety (IA), and panic disorder (PD), as well as anorexia (AN) and bulimia nervosa (BN). Etiological models of these disorders - with the exception of those for PD - postulate that CB mainly occurs in situations characterized by negative affect and serves to regulate it. We aimed to test these assumptions: N = 386 individuals with a self-reported diagnosis of one of the disorders rated their affect at baseline, directly before a remembered CB episode, during, immediately afterwards, and 15 and 60 minutes afterwards, and rated their endorsement of different functions of CB...
December 25, 2018: Psychiatry Research
Alyssa Izquierdo, Franziska Plessow, Kendra R Becker, Christopher J Mancuso, Meghan Slattery, Helen B Murray, Andrea S Hartmann, Madhusmita Misra, Elizabeth A Lawson, Kamryn T Eddy, Jennifer J Thomas
OBJECTIVE: The majority of individuals with anorexia nervosa (AN) have a fat-phobic (FP-AN) presentation in which they explicitly endorse fear of weight gain, but a minority present as non-fat-phobic (NFP-AN). Diagnostic criteria for avoidant/restrictive food intake disorder (ARFID) specifically exclude fear of weight gain. Differential diagnosis between NFP-AN and ARFID can be challenging and explicit endorsements do not necessarily match internal beliefs. METHOD: Ninety-four adolescent females (39 FP-AN, 13 NFP-AN, 10 low-weight ARFID, 32 healthy controls [HC]) completed implicit association tests (IATs) categorizing statements as pro-dieting or non-dieting and true or false (questionnaire-based IAT), and images of female models as underweight or normal-weight and words as positive or negative (picture-based IAT)...
December 31, 2018: International Journal of Eating Disorders
Jocelyn Lebow, Leslie Sim, Ross D Crosby, Andrea B Goldschmidt, Daniel Le Grange, Erin C Accurso
OBJECTIVE: Given that weight gain patterns in adolescents receiving outpatient Family-Based Treatment (FBT) have not been characterized, the purpose of this study was to examine trajectories of weight gain in a group of adolescent patients with a restrictive eating disorder [e.g., anorexia nervosa (AN) and atypical AN] receiving FBT. This study also examined the association of patient characteristics with weight gain trajectories, including age, diagnosis, weight suppression, presenting BMI-for-age percentile, and eating pathology...
December 22, 2018: International Journal of Eating Disorders
Kendra R Becker, Ani C Keshishian, Rachel E Liebman, Kathryn A Coniglio, Shirley B Wang, Debra L Franko, Kamryn T Eddy, Jennifer J Thomas
OBJECTIVE: Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are restrictive eating disorders. There is a proposal before the American Psychiatric Association to broaden the current DSM-5 criteria for ARFID, which currently require dietary intake that is inadequate to support energy or nutritional needs. We compared the clinical presentations of ARFID and AN in an outpatient sample to determine how a more inclusive definition of ARFID, heterogeneous for age and weight status, is distinct from AN...
December 22, 2018: International Journal of Eating Disorders
Mariusz Jaworski, Mariusz Panczyk, Andrzej M Śliwczyński, Melania Brzozowska, Katarzyna Janaszek, Piotr Małkowski, Joanna Gotlib
BACKGROUND Little has been reported regarding the epidemiology of eating disorders (EDs) in type 2 diabetes (T2DM). We examined the Polish National Health Fund-NFZ database estimates of all medical visits from 2008 to 2017 to determine the trend and the epidemiology of EDs in T2DM patients. MATERIAL AND METHODS The NFZ database were used. We defined the T2DM group diagnosed with both T2DM and EDs according to the ICD-10 codes. Demographic data were collected from the webpage of Statistics Poland (GUS). The annual prevalence of EDs was estimated according to the T2DM diagnosis status, and the age groups were stratified into 8 groups...
December 18, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Silvia Serino, Nicoletta Polli, Giuseppe Riva
In the last 30 years, virtual reality (VR) has offered innovative solutions for assessing and treating body representation disturbances in anorexia nervosa (AN). The most recent and innovative trend is the exploitation of the so-called VR-based body swapping illusion. The aim of this case study was to report the use of this VR protocol within a multidisciplinary treatment of AN. A patient with a Diagnostic and Statistical Manual-5 diagnosis of AN underwent an intensive multidisciplinary outpatient treatment...
December 15, 2018: Journal of Clinical Psychology
Jennifer S Coelho, Tiffany Lee, Priscilla Karnabi, Alex Burns, Sheila Marshall, Josie Geller, Pei-Yoong Lam
Background: The growing body of research on eating disorders among male adolescents reveals some sex differences in clinical presentation. The current study set out to replicate and extend recent research on the clinical and medical characteristics of male youth with eating disorders, and examine sex differences between biological males and females in a tertiary pediatric eating disorder treatment setting. Methods: A retrospective chart review was conducted with all biological males who were admitted to the Eating Disorders Programs at British Columbia Children's Hospital (2003-2015) or the Looking Glass Residence (2011-2015)...
2018: Journal of Eating Disorders
Anis Hariz, Mohamed Salah Hamdi, Imen Boukhris, Nadia Boujelbène, Samira Azzabi, Narjess Khalfallah
BACKGROUND Anorexia nervosa is a relatively frequently encountered eating disorder. Beyond its psychiatric significance, it is associated with multiple hematological features such as cytopenia. It can be related to gelatinous transformation of the bone marrow. CASE REPORT We describe the case of a 20-year-old male admitted for rapid involuntarily weight loss. He presented with extreme bradycardia with a heart rate of 30 beats per minute with recent psychomotor impairment. Routine laboratory tests showed pancytopenia, and cytolysis on liver function tests...
December 7, 2018: American Journal of Case Reports
Meng-Che Tsai, Shu-Ting Gan, Chih-Ting Lee, Yi-Lin Liang, Lan-Ting Lee, Sheng-Hsiang Lin
OBJECTIVE: Nationwide data on eating disorders (EDs) among East Asian populations are scarce. This study aimed to estimate the prevalence, incidence, and psychiatric comorbidities of EDs in Taiwan. METHOD: Drawing from the National Health Research Institute database, we identified the study subjects aged 11-34 years who received an ED diagnosis during ambulatory visits or hospitalization from 2001 to 2012. We analyzed the subjects by age and gender. Diagnoses for comorbid psychiatric disorders were entered in the analysis only if they occurred within 1 year before or after the ED diagnosis date...
November 28, 2018: International Journal of Eating Disorders
Margarita Sala, Irina A Vanzhula, Cheri A Levinson
Mindfulness-based treatments for eating disorders could be improved by understanding how facets of mindfulness predict eating disorder symptoms over time. We examined whether facets of mindfulness predict eating disorder symptoms over time and vice versa. Individuals with an eating disorder diagnosis (N = 124; 87.9% diagnosed with anorexia nervosa) and an undergraduate sample (N = 290) completed measures of mindfulness at baseline. The clinical sample also completed these measures 1 month later. Individuals in the clinical sample had lower acting with awareness and higher observing than individuals in the undergraduate sample (ps < 0...
November 22, 2018: European Eating Disorders Review: the Journal of the Eating Disorders Association
Karel Kostev, Franka Teichgräber, Marcel Konrad, Louis Jacob
AIMS: The goal of this study was to analyze the association between chronic somatic conditions and depression diagnosis in children and adolescents. METHODS: The present case-control study included 13,326 children and adolescents with depression as well as controls without depression followed in 243 pediatric practices between 2010 and 2015. Cases and controls were matched by age, gender, index year, and physician. The effect of several chronic disorders in terms of the risk of developing depression was estimated using logistic regression models...
November 5, 2018: Journal of Affective Disorders
Klara Meierer, Alexandre Hudon, Marc Sznajder, Marie-France Leduc, Danielle Taddeo, Olivier Jamoulle, Jean-Yves Frappier, Chantal Stheneur
The purpose of our study is to establish if the proportion of patients diagnosed with anorexia nervosa that have a history of excess weight has increased over a 10-year period and to study how different premorbid weight groups vary in terms of clinical characteristics. We performed a single-center, retrospective cohort study of all new patients presenting with anorexia nervosa, restrictive and binge/purge subtypes, in 2004 and 2014 at the Adolescent Medicine Clinic of Sainte-Justine University Health Centre (n = 172)...
November 5, 2018: European Journal of Pediatrics
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