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PubMed1984

Psychoendocrine interaction in anorexia nervosa, and the retreat from puberty: a study of attitudes to adolescent conflict, and luteinizing hormone response to luteinizing hormone releasing factor, in refed anorexia nervosa subjects.

Seventeen young women suffering from anorexia nervosa underwent LHRF infusion, and repertory grid psychometric measures, soon after they had regained ideal body weight. Those who had regained normal LH responsiveness showed repertory grid evidence of increased adolescent conflict compared to those who failed to respond to LHRF. Certain other clinical variables which might account for this finding were excluded, and the hypothesis that amenorrhoea in anorexia nervosa is partly explicable as a psychobiological defence against adolescent conflict is supported.

Adaptation, Psychological↗
PubMedDate not supplied

Anorexia nervosa and the family: effects on younger sisters to anorexia nervosa patients.

The aim of this study was to describe and analyze the experience of the sister of the anorexia nervosa (AN) patient. This experience was examined in terms of the illness, the sister herself, and relations within the family during the course of coping with AN. A qualitative study method was employed in an attempt to understand the complexity and nature of a younger sister's subjective experience regarding an anorexia patient. Nine sisters of AN patients in the active stage of the illness were interviewed. Data were gathered through in-depth, semi-structured taped interviews and content-analyzed by using the layer system theory. The findings provide the sister's personal perspective in regard to her emotional experience in the shadow of the illness and in regard to the systemic processes that take place in the course of a family's coping with the illness. The findings are divided into six main content categories: (1) structural processes; (2) family dynamic processes; (3) emotional processes; (4) change in life functions; (5) body image; and (6) narrative of the illness. Two theoretical concepts are presented that analyze the reality of the sister as an individual and of the family as a system. The first concept relates to the illness as a new member of the family system. The second concept relates to the sister's emotional experience as one of duality. These two concepts underscore the implications of the illness in terms of placing the sister at risk of developing additional pathological symptoms. The present study provides an in-depth description, explanation, and analysis of the younger sister's experience, thus elucidating risks to her emotional and mental functioning. In addition, it opens a window to the world of a family coping with the illness, and clarifies processes of change taking place within it.

Adolescent↗
PubMed1998

[Anorexia nervosa and "anorexia athletica"].

Available evidence supports the assumption that stressors in vulnerable adolescence potentially lead to restrictive dieting and imbalances of serotonergic metabolic particularly in females. In conjunction with idealized body images and developmentally characteristic bodily perceptions prone to distortion pathogenetic mechanisms of eating disorders are released. The entities of eating disorders are dimensionally viewed as points of continua a functions and categorized according to ICD-10 or DSM-IV, respectively. Data of our studies on grammar school students, ballet dancers and anorexia nervosa patients emphasize the necessity to differentiate different types of body shape by using the metric index. Facing this background a distinction of "anorexia athletica" appears unreasonable.

Adolescent↗
PubMed2003

Candidate genes for anorexia nervosa in the 1p33-36 linkage region: serotonin 1D and delta opioid receptor loci exhibit significant association to anorexia nervosa.

Serotonergic and opioidergic neurotransmitter system alterations have been observed in people with eating disorders; the genes for the serotonin 1D receptor (HTR1D) and the opioid delta receptor (OPRD1) are found on chr1p36.3-34.3, a region identified by our group in a linkage analysis of anorexia nervosa (AN). These candidate genes were evaluated for sequence variation and for linkage and association of this sequence variation to AN in family and case : control data sets. Resequencing of the HTR1D locus and a portion of the OPRD1 locus identified novel SNPs and confirmed existing SNPs. Genotype assay development and genotyping of nine SNPs (four at HTR1D and five at OPRD1) was performed on 191 unrelated individuals fulfilling DSM-IV criteria (w/o amenorrhea criterion) for AN, 442 relatives of AN probands and 98 psychiatrically screened controls. Linkage analysis of these candidate gene SNPs with 33 microsatellite markers in families including relative pairs concordantly affected with restricting AN (N=37) substantially increased the evidence for linkage of this region to restricting AN to an NPL score of 3.91. Statistically significant genotypic, allelic, and haplotypic association to AN in the case : control design was observed at HTR1D and OPRD1 with effect sizes for individual SNPs of 2.63 (95% CI=1.21-5.75) for HTR1D and 1.61 (95% CI=1.11-2.44) for OPRD1. Using genotype data on parents and AN probands, three SNPs at HTR1D were found to exhibit significant transmission disequilibrium (P&<0.05). The combined statistical genetic evidence suggests that HTR1D and OPRD1 or linked genes may be involved in the etiology of AN.

Anorexia Nervosa↗
PubMed1985

Long-term outcome of 151 cases of anorexia nervosa. The Copenhagen Anorexia Nervosa Follow-Up Study.

One hundred and fifty-one patients (140 females - 11 males) with anorexia nervosa (AN) from three departments (child psychiatry, psychiatry, and internal medicine) were re-examined 4-22 years (average 12.5 years) after their first contact with the Rigshospital in Copenhagen. During the years 1960-76 the number of referrals was on the increase, and relatively more patients were treated in the psychiatric departments at the end than at the beginning of the period. Mean age was 16.6 years at onset, 19.0 years at primary contact. Mean weight loss was 32%. Mean duration of treatment was 12 months. Differences between the three departments concern especially age, sex, and duration of treatment. Mean age at follow-up was 31.0 years (range 16-63 years) for surviving probands. Follow-up information originated from semi-structured personal interviews (in 80% of surviving probands) together with register data on all probands, supplemented by extensive hospital data. Nine patients (6%), including six who committed suicide, died on the average 7.3 years after primary contact (average age 27.1 years). The mortality rate was 0.5% per year. At follow-up one fourth of the surviving probands had AN and one fourth suffered from other psychiatric disorders, while one half were free from mental illness. There were no significant differences in outcome between the three departments. As a whole, the group experienced a social decline. It is concluded that a substantial part of this group of AN patients had a poor prognosis with a tendency towards chronicity, despite relatively long and intensive treatment, but, on the other hand, about one half of the probands seemed to be healthy and well functioning.

Adolescent↗
PubMed1985

Anorexia and bulimia in anorexia nervosa: a study of psychosocial functioning and associated psychiatric symptomatology.

Seventeen fasting patients with anorexia nervosa and 15 who also binged were compared in terms of their psychosocial functioning and associated psychiatric symptomatology, using the Delusions Symptoms and States Inventory (Foulds & Bedford, 1975). Both groups scored very highly on the state of anxiety, depression, and elation sets of the DSSI, but less highly on the compulsive and ruminative symptoms sets and on the phobic dissociative and conversion symptom sets. The bingeing anorexic group was significantly older and heavier than the fasting group and experienced more feelings of self-harm and guilt. The bingeing group reported sexual interference during childhood, and currently experienced a desire to vomit during sexual activity to a significantly greater degree than the fasting group.

Adolescent↗
PubMedDate not supplied

[Epidemiology of anorexia nervosa. Prevalence of anorexia nervosa in female adolescents from the districts of Lisboa and Setubal].

UNLABELLED: Prevalence studies of anorexia nervosa (AN) have shown differences depending of the country and method applied. The partial syndrome is being emphasized. There has been no epidemiological study done on AN in the Portuguese population of continental Portugal. Our objectives were: 1) to study the prevalence of AN in Portuguese populations; 2) to study the presence of partial syndrome and of body image disturbance; 3) to calculate the number of girls dieting; 4) to correlate with other variables. A population of 2,398 girls ranging 10 to 21 years old, from 30 State secondary schools in the Lisbon and Setubal districts were studied. A questionnaire was answered with questions allowing assessment of all DSM IIIR criteria for AN. RESULTS: Prevalence of AN--0.37%, partial syndrome--12.6%, body image disturbance without weight loss--7%, wish to decrease weight in normal or low weight girls--38%, overweight--15.3%, the peak of age for AN was 15 years, the most prevalent socio-economic class for AN was 2 (scale 1 (higher) to 5). School performance was worse with AN and the age menarche was sooner.

Adolescent↗
PubMed1978

[Dysperception of body image and dysmorphophobias in mental anorexia. Apropos of 115 cases involving both sexes. I. Altered mechanisms of perception in mental anorexia].

We noted frequency of body-image disturbance (BID) and dismorphophobias (DPP) in 97 girls and 8 boys among 107 girls and 8 boys with Anorexia Nervosa (AN), seen since 1973 and coming up semiologic criterions of Laboucarie and Dally & Sargant. 91,5% of the girls and 7 out of 8 boys presented a BID at one time of their evolution. The other ones did not form a characteristic group. BID prevailed in no-perception of emaciation. No-perception of overweight was exceptional. That of variations of weight was frequent, explaining to need objective elements to measure real volume. BID seems to result from an incapacity to integrate well individually perceived details into a coherent image. Its apparition signals starting of AN, and it is a fundamental criterion of evolutivity. It's not frequent it's extended to body-image disperception of the close people, but it is often associated to an increase of mental representation of ingested feed volume.

Adolescent↗
PubMed2002

Do people with anorexia nervosa use sauna baths? A reconsideration of heat-treatment in anorexia nervosa.

The paper addresses the absence of reports about the sauna use among the weight loss strategies of patients with anorexia nervosa (AN). Because AN entails a relentless pursuit of thinness, it might be expected that these patients would frequently resort to saunas. The paper sustains that the absence of reports should not be taken to mean that sauna use is irrelevant to AN. Support for this possibility is founded in the apparent progress shown by AN patients whose treatment consisted of different strategies of heat supply, which included a protocol of sauna sessions. First recommended by W. Gull, heat-treatment may be relevant to hyperactivity, a significant clinical characteristic in AN. This treatment was developed as an extrapolation from animal research model, where a simple manipulation of ambient temperature (AT) was found to impede and reverse excessive running in food-restricted rats. Sauna use may have been unreported either because it impedes the development of the syndrome, or its benefits have been attributed to conventional treatments. The elucidation of sauna experience among AN patients may have potential implications for the role of heat in the treatment of AN.

Journal Article↗
PubMed1995

Complications of bereavement as seen in infant anorexia and adolescent anorexia nervosa.

In a certain number of cases, parents of infant and adolescent anorexics may exhibit complications of bereavement. Both infant and adolescent forms of anorexic symptoms constitute indeed two distinct pathologies. Sometimes, however, these two forms of anorexic symptoms share points in common, namely a psychopathological aspect. Making references to two clinical cases, the authors show that difficulties in the mourning process may in fact play a key role in the constitution of anorexic symptoms.

Adolescent↗