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Eating Disorders (eating + disorders)
Terms modified by Eating Disorders Selected AbstractsA case series evaluation of a modified version of interpersonal psychotherapy (IPT) for the treatment of bulimic eating disorders: A pilot studyEUROPEAN EATING DISORDERS REVIEW, Issue 4 2009Jon Arcelus Abstract Objective To determine the therapeutic outcome of a modified form of (IPT-BNm) amongst patients with Bulimia Nervosa (BN) and Eating Disorders Not Otherwise Specified (EDNOS). Method Following initial assessment, 59 patients with diagnoses of BN or EDNOS entered treatment in the form of 16 sessions of IPT-BNm. At initial assessment, patients completed measures of general psychopathology (SCL-90), Self esteem (RSE), eating psychopathology (EDE-Q), interpersonal functioning (Inventory of Interpersonal Functioning; IIP-32) and depression (BDI). At the middle and end of treatment, EDE-Q, IIP-32 and BDI measures were repeated. Results By the middle of therapy, patients had made significant improvements in terms of their eating disordered cognitions and behaviours (including reductions in EDE-Q scores, bingeing and self-induced vomiting), interpersonal functioning and levels of depression. Conclusions IPT-BNm is an effective treatment for patients with Bulimic Eating Disorders and appears to work quickly, as there were significant reductions in eating disorders symptoms within the first eight sessions of treatment. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source] How important are motivation and initial Body Mass Index for outcome in day therapy services for eating disorders?EUROPEAN EATING DISORDERS REVIEW, Issue 4 2007Alysun Jones Abstract This study was designed to investigate the impact of initial Body Mass Index (BMI) and motivation for recovery on a 12-week day therapy programme for Eating Disorders. Outcome was assessed by changes in eating disorder symptomology, mood and self-esteem. A battery of assessment questionnaires was given to 34 eating disorder clients on admission to and completion of the programme. This study found that BMI at admission did not affect treatment outcome directly. Only patient self-rated motivation directly affected treatment outcome with more highly motivated clients making more significant changes to their eating disorder symptomology across the programme. However, motivation, BMI and duration of illness influenced how likely a patient was to complete the 12 weeks and completion of the programme had a direct effect on eating disorder symptomology, mood and self-esteem. BMI and motivation can therefore be seen to indirectly effect the outcome of treatment via the ability to complete the programme. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Counting the COST: a European collaboration on the efficiency of psychotherapeutic treatment of patients with eating disordersEUROPEAN EATING DISORDERS REVIEW, Issue 3 2005Hans Kordy Abstract In 1993, a European collaboration on the efficiency of psychotherapeutic treatment of patients with Eating Disorders was initiated. The European Union supported it under the name COST Action B6 from 1994,2001. This unique opportunity to co-ordinate research and to exchange clinical experience eventually attracted more than 200 researchers and clinicians from 19 European countries. This is the first paper of a series of five through which we report on the general background, the organizational structure, the objectives, the design, the main findings, and specific methodological developments of COST Action B6. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Eating behaviour: social influences in open community nunsEUROPEAN EATING DISORDERS REVIEW, Issue 2 2003Juan A. Guisado Macías Abstract This article analysed the eating behaviour and the psychological discomfort in a sample of 44 religious women living in open communities. The Eating Attitudes Test-40 items, the Interview for the Diagnosis of Eating Disorders, the Bulimic Investigatory Test, and the revised Symptom Checklist-90 were used in order to assess the sample, and a factor analysis was performed. Three basic dimensions in the mental state were obtained: (1) Psychological discomfort, (2) Anorexic behaviour, and (3) Bulimic behaviour. Our results support the idea that people living in open communities share the social values regarding weight and body size, and show elevated levels of psychological discomfort strongly associated with symptoms of eating disturbances. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [source] International Journal of Eating Disorders: Statistical formatting requirements and reporting guidelinesINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2009Cynthia M. Bulik PhD No abstract is available for this article. [source] Long-term stability of eating disorder diagnosesINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue S3 2007Manfred M. Fichter MD Abstract Objective: Data on the stability of eating disorder (ED) diagnoses (DSM-IV) over 12 years are presented for a large sample (N = 311) of female eating disordered patients with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Method: Assessments were made at the beginning of therapy and 2-, 6-, and 12-year follow-ups. Diagnoses were derived from the Structured Inventory for Anorexic and Bulimic Eating Disorders. Possible diagnostic outcome categories were AN, BN, BED, NOS, no ED, and deceased. Results: At all follow-ups, more patients changed from AN or BED to BN than vice versa. No diagnostic crossover from AN to BED or vice versa occurred. BED showed the greatest variability and AN had the greatest stability over time. While the long-term outcome of BN and BED is similar, AN had a considerably worse long-term outcome than either BN or BED. Conclusion: Of the ED diagnoses, AN was most stable and BED most variable. The considerable diagnostic flux between BN and BED and similarities in course and outcome of BN and BED point to common biological and psychological maintaining processes. AN and BED are nosologically quite distant. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [source] Incidence of severe anorexia nervosa in Switzerland: 40 years of developmentINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2004Gabriella Milos Abstract Objective The current study examined the development of the incidence of severe anorexia nervosa with five sampling periods covering the years 1956,1995 in a geographically defined region of Switzerland. Method Applying the same methodology as in the earlier sampling periods, the medical records of all hospitals of the canton of Zurich were screened manually for first-time hospitalizations of female anorexia nervosa patients during the years 1993,1995. Incidence rates were compared with the previous sampling period (1956,1985). Results The incidence rate of severe anorexia nervosa in the total population and the rate in the population at risk (females 12,25 years old) did not differ significantly from the incidence rates of 1983,1985. Discussion The incidence of severe anorexia nervosa in the canton of Zurich rose significantly during the 1960s and 1970s. Since then, the incidence appears to have reached a plateau. © 2004 by Wiley Periodicals, Inc. Int J Eat Disord 35: 250,258, 2004. An erratum to this article is published in International Journal of Eating Disorders (2004) 36(1) 118,119. [source] Eating Disorders in Children: What Parents Need to KnowTHE BROWN UNIVERSITY CHILD AND ADOLESCENT BEHAVIOR LETTER, Issue S7 2005Article first published online: 18 AUG 200 No abstract is available for this article. [source] Food, Functioning and Justice: From Famines to Eating DisordersTHE JOURNAL OF POLITICAL PHILOSOPHY, Issue 2 2001Mika Lavaque-Manty First page of article [source] Cognitive Behavioural Therapy and Eating DisordersCHILD AND ADOLESCENT MENTAL HEALTH, Issue 2 2009Mari Campbell No abstract is available for this article. [source] Evidence Based Research in CBT with Adolescent Eating DisordersCHILD AND ADOLESCENT MENTAL HEALTH, Issue 1 2006Simon G. Gowers Cognitive behaviour therapy (CBT) is increasingly becoming the treatment of choice for a number of adolescent mental health problems, including depression (Harrington et al., 1998) and obsessive compulsive disorder (OCD), (March, 1995). In considering the role of CBT in the treatment of adolescent eating disorders, it is helpful to review the phenomenology of anorexia and bulimia nervosa in this age group and to assess the theoretical relevance of a cognitive behavioural approach to their management. The evidence base has been reviewed in the recently published National Institute of Clinical Excellence (NICE) Guidelines on the treatment of eating disorders (NICE, 2004). To date, CBT approaches have not been widely tested in controlled trials in this age group. However, a randomised controlled treatment trial is under way in the North West of England (The TOuCAN Trial), in which CBT is an important component of one of the interventions being studied and this will be described. [source] Eating Disorders and Cultures in TransitionCHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2004Tony Jaffa No abstract is available for this article. [source] Treatment emergent mania responding to valproate in a Chinese female adolescent population with eating disorders: A case seriesEUROPEAN EATING DISORDERS REVIEW, Issue 6 2008Phern Chern Tor Abstract Eating disorders are commonly associated with depressive symptoms. In an adolescent and binge eating population fluoxetine is commonly used to treat co-morbid depression associated with eating disorders. In some patients this may precipitate treatment emergent mania (TEM). Risk factors in the adolescent population include being older, female, having a longer duration of illness, more previous mood episodes, a higher prevalence of subclinical hypothyroidism, early-onset anxiety and recent exposure to a mood-elevating agent. Diagnosis and management of these co-morbid conditions is challenging due to the overlapping symptomatology and the adverse effects of both conditions complicating pharmacological management. This is illustrated with three cases in a Chinese female adolescent population that experienced TEM while on fluoxetine and responded to valproate. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Eating disorders and attachment: the effects of hidden family processes on eating disorders,EUROPEAN EATING DISORDERS REVIEW, Issue 2 2007Francoise Ringer Abstract Aim This study examined pattern of attachment in cohort of women with an eating disorder to determine what types of self-protective strategies they used, and further whether there was a specific relationship between strategy and diagnosis. Method The participants were 62 young women with an eating disorder (19 with anorexia nervosa, 26 with bulimia nervosa and 17 with bulimic anorexia). Attachment was assessed using the Adult attachment interview (AAI), classified using Crittenden's Dynamic-Maturational Method. Results The results indicated that all women with an eating disorder were anxiously attached. About half used an extreme coercive Type C strategy while most of the others combined coercion with an extreme dismissing Type A strategy. The content of the AAIs suggested lack of resolution of trauma or loss among the mothers and also of hidden family conflict between the parents. This in turn elicited extreme strategies for generating parent,child contingency from the daughters. Conclusions Central in almost all cases was the women's confusion regarding how parental behaviour was tied causally to their own behaviour. Questions are raised regarding the focus of treatment. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Long-term follow-up of adolescent onset anorexia nervosa in northern SwedenEUROPEAN EATING DISORDERS REVIEW, Issue 2 2005Karin Nilsson Abstract Objective This study examines the long-term outcome of adolescent onset anorexia nervosa, 8 and 16 years after first admission to child and adolescent psychiatric (CAP) treatment in northern Sweden. Method Two follow-ups (1991 and 1999) were made of 68 women who were first admitted to CAP between 1980 and 1985. The follow-ups included interviews and self-report inventories. Eating disorders and GAF were evaluated according to DSM-III-R. Results Recovery increased from 46 (68%) to 58 (85%). EDNOS (eating disorder not otherwise specified) decreased from 16 (24%) to seven (10%). The numbers for anorexia nervosa (AN) were the same, two (3%) in both follow-ups. Bulimia nervosa (BN) decreased from four (6%) in the first follow-up to one (1.5%) in the second follow-up. The mortality rate was one (1%). Self-evaluation of mental health indicated that 15% had problems with depression, anxiety or compulsive symptoms. Somatic problems and paediatric inpatient care during the first treatment period could predict long-term outcome. Most former patients had a satisfactory family and work situation. Conclusion Recovery from eating disorders continued during the follow-ups. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Self-injurious behaviour in people with eating disordersEUROPEAN EATING DISORDERS REVIEW, Issue 1 2005Raquel Solano Abstract Objective To determine the importance of self-injurious behaviour in people with eating disorders (ED) and to analyse the possible differences between ED subtypes. Method 109 patients with ED (51 anorexia nervosa (AN) and 58 bulimia nervosa (BN)), according to DSM-IV diagnostic criteria, who were consecutively referred to our unit, participated in this study. All cases were female. Assessment Subjects were assessed by means of a semi-structured clinical interview and self-report questionnaires (Eating Attitudes Test, EAT-40; Eating Disorders Inventory, EDI; Bulimic Investigatory Test Edinburgh, BITE; Body Shape Questionnaire, BSQ; Beck Depression Inventory, BDI; Social Anxiety Scale, SAD). Design Comparison of cases by considering the factors diagnosis and self-injurious behaviour. Results The presence of self-injurious behaviour (SIB) (32% of cases) was not associated with the diagnosis (p,=,0.28). There was no association between SIB, suicide attempts, alcohol abuse and stealing, but a positive correlation between SIB and drug abuse was found (r,=,0.284, p,<,0.003). Likewise, patients with SIB showed higher scores on severity of the disorder (EDI, p,<,0.04), depressive symptoms (BDI, p,<,0.02), social anxiety (SAD, p,<,0.02) and body image dissatisfaction (BSQ, p,<,0.03). Conclusions: Eating disorders are pathologies in which self-injurious behaviour will be commonly present. SIB is associated with greater depression and anxiety and in general terms with greater severity of the disorder. Copyright © 2005 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Eating disorders and general psychopathology: a comparison between young adult patients and normal controls with and without self-reported eating problemsEUROPEAN EATING DISORDERS REVIEW, Issue 4 2004K. Ekeroth Abstract Aim To investigate general psychopathology among women with DSM-IV confirmed eating disorders (ED) and women from the general population with and without self-reported eating disorder problems. Method Ninety-six ED patients between 18 and 26 years (M,=,21.59, SD,=,2.01) were compared with 265 randomly chosen age-matched controls (M,=,20.99, SD,=,2.01) with the Symptom Check List-90 (SCL-90). Result ED patients scored significantly higher on all subscales compared with women without self-reported eating problems, and higher on several scales compared to women reporting previous eating problems. There were no differences between ED patients and controls with current eating problems. Women with self-reported eating disorder problems scored significantly higher than women without such problems on all scales except for ,phobic anxiety'. Discussion Increased psychopathology in both ED patients and women with self-reported eating problems suggests that general psychopathology is related to eating disturbances per se, and not only to being a psychiatric patient. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Eating disorders in females with type 1 diabetes: an update of a meta-analysisEUROPEAN EATING DISORDERS REVIEW, Issue 4 2002Søren Nielsen Abstract Objective: Firstly to provide a quantitative summary of existing studies on the occurrence of eating disorders (ED) in females with type 1 diabetes (IDDM), with the focus on retinopathy and insulin misuse for the different eating disorders. Secondly to disseminate knowledge about useful statistical tools. Research Design and Methods: Data were extracted from the relevant case,control and follow-up studies. Odds ratios (OR) and risk differences (RD) were the main effect sizes analysed. Analyses were based on ,exact' methods as many studies are sparse. Data and findings are presented in sufficient detail for re-analysis. Results: An hypothesis of an increase in Anorexia Nervosa (AN) in IDDM is not supported by existing evidence. Bulimia Nervosa is increased (OR,=,2.9 (95%CI: 1.03 to 8.4); pOR,=,0.04) in IDDM. Both ED-NOS and subthreshold ED is increased (OR ,2; pOR,<,0.001) in females with IDDM. Co-existing ED in IDDM increases the overall common OR for retinopathy to 4.8 (95%CI: 3.0 to 7.8); pOR,<,0.00001, and the overall mean RD is 33% (95%CI: 25% to 42%); pRD,<,0.001. Insulin misuse (IM) is increased when ED co-exists with IDDM: OR 12.6 (95%CI: 7.8 to 21.1); pOR,<,0.00001, and mean RD is 40% (95%CI: 29% to 50%); pRD,<,0.001. Conclusions: ED-NOS and subthreshold ED seem to be the quantitatively most important EDs in type 1 diabetic females. Mismanagement of diabetes in the form of IM is frequent in eating disordered IDDM probands. Early occurrence of retinopathy and other complications is an increased risk in concurrent cases, as is premature death. The implications of Binge Eating Disorder (BED) and overweight needs to be elucidated for both type 1 and type 2 diabetes. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Eating disorders in Italy: a historical reviewEUROPEAN EATING DISORDERS REVIEW, Issue 5 2001Giovanni Maria Ruggiero This paper reviews the history of medical knowledge of eating disorders in Italy. It starts with the first examples of the medical interpretation of starvation during the Middle and Renaissance Ages, continues with the seminal figure of Brugnoli in the late XIX century, describes the neurological interpretations of the 1930s, the return to psychiatry in the 1940s and 1950s, the rise to international prominence of Mara Selvini Palazzoli in the 1960s and 1970s and ends with a description of the present state of the art. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Eating disorders in older women: Does late onset anorexia nervosa exist?INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 5 2010Samantha Scholtz MRCPsych Abstract Objective: The objective of this study is to determine whether eating disorders can present for the first time in older people. Method: This is a descriptive study of patients above the age of 50 years who have presented to a national eating disorder center within the last 10 years. Results: Thirty-two patients were identified; data were available for 26 of these patients and 11 agreed for further interview and questionnaire completion. There were no cases where the eating disorder had its onset late in life. Of the 11 interviewed, six participants retained a diagnosis of anorexia nervosa, four had Eating Disorder Not Otherwise Specified and only one was recovered. Comorbid depression was universal in those still suffering with an eating disorder diagnosis, and their level of social functioning was impaired. Discussion: Anorexia nervosa is a chronic and enduring mental illness that, although rare, can be found in older people. In our sample, we found no evidence of late-onset disorders; all described cases were lifelong. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010 [source] Eating disorders in DSM-V: Review of existing literature (Part 2)INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 8 2009B. Timothy Walsh MD No abstract is available for this article. [source] Eating disorders in DSM-V: Review of existing literature (Part 1)INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 7 2009B. Timothy Walsh MD No abstract is available for this article. [source] Slow-growing craniopharyngioma masquarading as early-onset eating disorder: Two cases,INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 5 2009Laura Vad Winkler MD Abstract Background: Craniopharyngiomas are slow-growing tumors, which can either be asymptomatic or present themselves with visual, neuropsychiatric or endocrine disturbances. Eating disorders (EDs) are syndromes with unknown etiology, associated with multiple endocrine abnormalities. In pediatric cases the presentation of EDs may differ markedly from those of adults. Objective: We report on two pediatric patients with craniopharyngioma misinterpreted as ED. Method: Available patient records, psychiatric examinations, neuro-radiographic imaging, and biochemical data were evaluated. Discussion: The reported cases illustrate the importance to consider slow-growing craniopharyngioma in ED. Especially in atypical ED, neuro-radiographic, ophthalmologic and endocrine examination should be carried out. Furthermore, structural hypothalamic lesions in these cases mimicking features of ED, suggesting the possibility of an as yet unidentified structural hypothalamic disorder to be implicated in the etiopathogeny of ED. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord, 2009 [source] Males assessed by a specialized adult eating disorders service: Patterns over time and comparisons with femalesINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 8 2008Eric Button PhD Abstract Objective: In view of previous inconsistencies and the limited literature on males with eating disorders, we aimed to examine changes in presentation rates over time and any differences between males and females. Method: In a cohort of 2,554 new patients assessed by a specialized service for adults over a 21-year period, we examined rates by gender over time. We also carried out a detailed comparison of selected clinical and demographic variables on a series of 65 males and females matched by diagnosis and date of assessment. Results: Approximately 5% of patients were male and there was no evidence of a change in presentation rate by gender over time. Males were more likely to be diagnosed as not having a clinical eating disorder and less likely to abuse laxatives, but otherwise there was little difference in clinical presentation. Conclusion: Eating disorders continue to present predominantly in females and the proportion of males remains broadly stable. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Severe eating disorder initially diagnosed in a 72-year-old manINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2008Susan G. Manejías Parke MD Abstract Objective: Eating disorders in our society mainly affect young women. Cases in males are far less common, and reported cases in elderly males are rare. Method: We report the case of 72-year- old male admitted to a geriatric psychiatry service for grave passive neglect with mild dementia thought to be due to nutritional deficiency. Results: The patient was found to have an eating disorder not otherwise specified, most closely resembling anorexia nervosa, which was believed to be the cause of the nutritional problem. Conclusion: This case highlights the need for diagnostic awareness regarding eating disorders in patients of all ages and of both genders. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Managing infant feeding practices: the competing needs of bulimic mothers and their childrenJOURNAL OF CLINICAL NURSING, Issue 6 2009Helen Stapleton Aim., This paper seeks to explain how bulimic mothers accommodated infant feeding demands in conjunction with managing their disordered eating practices. Background., Eating disorders are chronic and disabling illnesses primarily affecting women. There are few qualitative studies describing bulimia in the context of motherhood. Design., The study employed an inductive qualitative approach. Methods., A purposive sample of childbearing women (n = 16), who self-defined as living with an eating disorder, were recruited. Data were generated from one-to-one interviews; a thematic analysis identified key issues. Results., Participants were primarily responsible for ensuring child/ren's socialisation processes, including modelling appropriate dietary behaviours and these demands often conflicted with their personal needs for food restraint. Pressures to participate in social activities with children were widely experienced as stressful especially when these events focused on food. Participants viewed early and repeated exposure to ,healthy' eating as protective against their children acquiring an eating disorder and in this respect commercial child-care facilities provided alternative environments for children to explore food-related activities. Conclusions., Participants employed a variety of strategies to ensure children's exposure to normalising influences and socialising processes. Concerns about personal competencies with respect to food preparation and storage were articulated by all participants. Relevance to clinical practice., Professionals involved with providing care to mothers and their infants are well placed to support bulimic clients and to foster confidence in their mothering skills. Early and appropriate intervention is key to effecting positive changes in bulimic patterns, with potential benefits to women's future health and well-being and that of their children. [source] Altering women's relationships with food: A relational, developmental approachJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2001Margo Maine Eating disorders, ranging from body-image distortions to full-blown anorexia nervosa and bulimia nervosa, reflect developmental issues and significant deficits in feelings of self-efficacy. The relational model, an outgrowth of theoretical work specific to the psychology of women, is an appropriate treatment approach. This model appreciates the social context and pressures that foster disconnection from the self and helps the woman to reconnect with self and others, decreasing the need for obsessive control over food and weight. Treatment emphasizes empathy, connection, mutuality, and authenticity and views disconnections and disruptions as the predisposing, precipitating, and perpetuating factors related to eating disorders. The client,therapist relationship is central to this model as demonstrated by a case illustration. © 2001 John Wiley & Sons, Inc. J Clin Psychol/In Session 57: 1301,1310, 2001. [source] Eating disorders: a patient-centered approachJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2003Gillie Bonner No abstract is available for this article. [source] Eating disorders in adults with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2000S. Gravestock Abstract There is an increasing focus on the nutrition of people with intellectual disability (ID), but less interest in the range of eating disorders (EDs) that they may exhibit and the bio-psycho-social impact of these conditions. Despite diagnostic and methodological difficulties, psychopathology and ED research studies suggest that 3,42% of institutionalized adults with ID and 1,19% of adults with ID in the community have diagnosable EDs. Weight surveys indicate that 2,35% of adults with ID are obese and 5,43% are significantly underweight, but the contribution of diagnosable EDs is unknown. Such data and case reports suggest that EDs are associated with considerable physical, behavioural, psychiatric and social comorbidity. Review papers have focused on the aetiology and treatment of pica, rumination, regurgitation, psychogenic vomiting and food faddiness/refusal. Emerging clinical issues are the development of appropriate diagnostic criteria, multimodal assessment and clinically effective treatment approaches. Key service issues include staff training to improve awareness, addressing comorbidity and access issues, and maintaining support for adults with ID and EDs, and their carers. Research should confirm the multifaceted aetiology and comorbidity of EDs. Then multicomponent assessment and treatment models for EDs can be developed and evaluated. [source] Review article: recognition and treatment of eating disorders in primary and secondary careALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2000Robinson Eating disorders are serious illnesses affecting 1,2% of young women. Patients may present to any doctor, sometimes atypically (e.g. unexplained weight loss, food allergy, infertility, diarrhoea), delaying diagnosis and leading to needless investigation. The cardinal signs are weight loss, amenorrhoea, bingeing with vomiting and other compensatory behaviours, and disturbances in body image with an exaggeration of the importance of slimness. When other causes have been excluded, useful investigations are serum potassium, bone mineral density scanning and pelvic ultrasound. In emaciated patients multiple systems may fail with pancytopaenia, neuromyopathy and heart failure. Clinical assessment of muscle power is used to monitor physical risk. Treatment may involve individual, group or family sessions, using cognitive-behavioural, psychodynamic and family approaches. More severe or intractable illness is treated with day care, with in-patient care in a medical or specialist psychiatric unit reserved for the most severely ill patients. Antidepressants have a place in the treatment of bulimia nervosa unresponsive to psychological approaches, and when severe depressive symptoms develop. The children of people with eating disorders may have an increased risk of difficulties. Support for the patient and family, and effective liaison between professionals, are essential in the treatment of severe eating disorders. [source] | ||||||||||||||||||||||||||||||||||