Inappropriate use of psychostimulants.
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Biomedical subjects
Publications and source records attributed to S Timimi.
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OBJECTIVE: The etiology of anorexia nervosa is not fully understood, but is probably multifactorial, including a biological substrate. The purpose of this paper is to investigate the possible underlying biological substrate. METHOD: Fifteen children and adolescents aged 8-16 years underwent regional cerebral blood blow radioisotope scans. All fulfilled DSM-IV criteria for anorexia nervosa. Three of the girls had a follow-up scan when they had regained their lost weight. RESULTS: Thirteen of the 15 patients had unilateral temporal lobe hypoperfusion, 8 on the left side and 5 on the right. The abnormality persisted in the 3 girls who had a follow-up scan after weight restoration. DISCUSSION: This is the first report of reduced regional cerebral blood flow in childhood-onset anorexia nervosa, and suggests an underlying primary functional abnormality.
The literature on children who present with selective eating is limited to single case studies. This study aims to provide a descriptive clinical profile for these children. Case notes of 33 patients between 4 and 14 years of age, seen in two clinics over a 4-year-period were studied. Over two-thirds of the cases were boys. A significant minority had poor growth or weight gain. The children suffered from anxiety, obsessive compulsive symptoms, both food and non-food related and often had social and school difficulties. Mealtimes caused immense anxiety for family members and frequent mealtime battles was reported by the parents of the younger selective eaters, whereas parents of older children seemed to have given up trying to change their child's eating habits. A history of depression in at least one parent was found in a third of the parental couples.