PubMed · 3769711
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R W McCallum, R Lange. 1986. Gastric emptying abnormalities.. https://doi.org/10.1007/bf01296533
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Anorexia nervosa is a psychiatric disorder with a very high mortality rate. If the eating disorder reaches life-threatening severity, for example through a body mass index lower than 13 kg/m (2), the possibility of compulsory treatment has to be considered. However, civil commitment of patients and forced feeding against their will may reduce self confidence and self esteem. This impedes the important goal of motivating patients to undergo psychotherapy. Furthermore, compulsory treatment is regarded as a contravention of the patient's physical inviolability as enshrined in the German Constitution. Up to now only a few studies about the use of guardianship legislation for anorexia nervosa have been published. The present paper reviews psychiatric literature and significant judgements of German courts on this topic. It finishes by examining clinical issues on forced feeding and possible consequences for psychotherapy.
The literature suggests that aspects of hypnotizability may be involved in the etiology and maintenance of self-defeating eating. However, interpretation of the published research findings has been complicated by the use of instruments that appear to have measured different or, at best, only related facets of the underlying constructs. This article reports relationships between weight, shape, dietary concerns, hypnotizability, dissociative capacity, and fantasy proneness. Implications for a key role for hypnosis in the treatment of eating behaviors, attitudes, and concerns are discussed.
OBJECTIVE: To evaluate the role of olanzapine in the treatment of anorexia nervosa. DATA SOURCES: Literature was obtained through searches of MEDLINE (1966-December 2006), EMBASE (1980-4th Quarter 2006), and PsycINFO (1985-December 2006) and a bibliographic review of published articles. Key terms used in the searches included anorexia nervosa, antipsychotics, eating disorders, olanzapine, and Zyprexa. STUDY SELECTION AND DATA EXTRACTION: All English language articles that were identified from the search were evaluated. All primary literature was included in the review. DATA SYNTHESIS: In several case reports and most clinical trials, patients with anorexia nervosa successfully gained weight while being treated with olanzapine. Moreover, many patients treated with olanzapine achieved a healthy body weight. Case reports and trials identified additional benefits of olanzapine, including reduction in delusional thinking; improvement in body image, sleep, depressive symptoms, adherence to treatment, and eating-disorder symptoms; and decreased agitation and premeal anxiety. CONCLUSIONS: Preliminary evidence supports the use of olanzapine for treatment of anorexia nervosa by demonstrating that olanzapine 2.5-15 mg daily promotes weight gain and has positive effects on associated psychological symptoms. Limitations of the reported data include small sample size, low completion rate in clinical trials, and open-label trial design. Although olanzapine appears to have a potential role in the treatment of anorexia nervosa that has been unresponsive to other therapy, randomized, placebo-controlled studies with larger sample sizes are necessary to establish its role in therapy.