Distribution by Scientific Domains

Kinds of Nervosa

  • adolescent anorexia nervosa
  • anorexia nervosa
  • bulimia nervosa

  • Terms modified by Nervosa

  • nervosa patient

  • Selected Abstracts

    A case series evaluation of a modified version of interpersonal psychotherapy (IPT) for the treatment of bulimic eating disorders: A pilot study

    Jon 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]

    Eating disorders in females with type 1 diabetes: an update of a meta-analysis

    Søren 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]

    Should bulimia nervosa be subtyped by historyof anorexia nervosa?

    A longitudinal validation
    Abstract Objective: To determine whether a past diagnosis of anorexia nervosa (AN) predicts longitudinal course and outcome among women with bulimia nervosa (BN). Method: A subset (n = 176) of participants in the Longitudinal Study of Anorexia and Bulimia Nervosa who met DSM-IV criteria for BN either at study intake (n = 144) or during follow-up (n = 32; 4 had restricting AN at intake, 28 had binge/purge AN at intake) were included in this report. Over a median of 9 years, weekly eating disorder symptom data were collected from participants using the Longitudinal Interview Follow-up Examination, Eating Disorders Version. Results: While there were no between-group differences in likelihood of partial recovery, women with BN who had a history of AN were more likely to have a protracted illness, relapsing into AN during follow-up, compared to those with no AN history who were more likely to move from partial to full recovery. Conclusion: Lifetime AN is an important prognostic indicator among women with BN and these longitudinal data would support the subtyping of BN on the basis of AN history. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [source]

    Ehlers,Danlos Syndrome and Anorexia Nervosa: A Dangerous Combination?

    Stacia C. Miles M.D.
    Although prior occurrences of pneumomediastinum and visceral perforations have been reported in adolescents with isolated anorexia nervosa or Ehlers,Danlos syndrome, to our knowledge this is the first instance to be noted in a patient with both conditions. We explore several possibilities regarding the etiology of his mediastinal air, but ultimately conclude that it was the existence of Ehlers,Danlos syndrome in the presence of anorexia nervosa that led to the development of this dangerous condition. [source]

    Recent Developments in Anorexia Nervosa

    Rachel Bryant-Waugh
    Background:, This review summarises recent clinical developments, topics of debate, and research findings in relation to anorexia nervosa in children and adolescents. Following an update of diagnostic and prevalence issues, recent developments in treatment approaches are discussed. These cover recommendations for the medical management of anorexia nervosa in young people, as well as psychological interventions for children, adolescents and their families. The question of which type of service setting is most appropriate for the treatment of young people with anorexia nervosa remains a subject of discussion, and recent guidance and work in this area is presented. Finally, the ongoing relatively poor prognosis in terms of general mental health associated with anorexia nervosa is highlighted and the implications for CAMHS practitioners discussed. [source]

    Treatment Manual for Anorexia Nervosa.

    A Family Based Approach
    No abstract is available for this article. [source]

    A Multidimensional Meta-Analysis of Psychotherapy for Bulimia Nervosa

    Heather Thompson-Brenner
    We report a multidimensional meta-analysis of psychotherapy trials for bulimia nervosa published between 1980 and 2000, including multiple variables in addition to effect size such as inclusion and exclusion, recovery, and sustained recovery rates. The data point to four conclusions. First, psychotherapy leads to large improvements from baseline. Approximately 40% of patients who complete treatment recover completely, although 60% maintain clinically significant posttreatment symptoms. Second, individual therapy shows substantially better effects than group therapy for the therapies tested. Third, additional approaches or treatment parameters (e.g., number of sessions) need to be tested for the substantial number of patients who enter treatment and do not recover. Finally, the utility of meta-analyses can be augmented by including a wider range of outcome metrics, such as recovery rates and posttreatment symptom levels. [source]

    Emotional processing in eating disorders: specific impairment or general distress related deficiency?

    Eva Gilboa-Schechtman Ph.D.
    Abstract The literature on eating disorders emphasizes the relationship between alexithymia and anorexia nervosa on the one hand, and between bulimia nervosa and affect dysregulation on the other. In our study, two questions are addressed: (1) Are there different patterns of emotional processing deficiencies in anorexia and bulimia? and (2) Is there a unique contribution of eating disorders to emotional processing deficiencies? Participants were women with anorexia nervosa (ANs, n=20), bulimia nervosa (BNs, n=20), and normal controls (NCs, n=20). Three hypotheses were examined: (1) Women with eating disorders will exhibit lower emotional awareness and more deficient emotional regulation than will NCs (emotional deficiency); (2) ANs will be less emotionally aware than BNs, whereas BNs will be less capable of effective emotional regulation than ANs (disorder specificity); and (3) emotional distress will mediate the relationships between emotional processing and eating disorders (emotional distress mediation). Results supported the emotional deficiency and distress mediation hypotheses, and partially supported the disorder specificity hypothesis. The need to move beyond alexithymia in understanding the pattern of emotional processing deficiencies in eating disorders is discussed. Depression and Anxiety 23:331,339, 2006. © 2006 Wiley-Liss, Inc. [source]

    Indicators of pretreatment suicidal ideation in adults with major depressive disorder

    D. W. Morris
    Morris DW, Trivedi MH, Husain MM, Fava M, Budhwar N, Wisniewski SR, Miyahara S, Gollan JK, Davis LL, Daly EJ, Rush AJ. Indicators of pretreatment suicidal ideation in adults with major depressive disorder. Objective:, In order to evaluate the presence of treatment emergent suicidal ideation (SI), it becomes necessary to identify those patients with SI at the onset of treatment. The purpose of this report is to identify sociodemographic and clinical features that are associated with SI in major depressive disorder (MDD) patients prior to treatment with a selective serotonin reuptake inhibitor. Method:, This multisite study enrolled 265 out-patients with non-psychotic MDD. Sociodemographic and clinical features of participants with and without SI were compared post hoc. Results:, Social phobia, bulimia nervosa, number of past depressive episodes, and race were independently associated with SI by one or more SI measure. Conclusion:, Concurrent social phobia and bulimia nervosa may be potential risk factors for SI in patients with non-psychotic MDD. Additionally, patients with more than one past depressive episode may also be at increased risk of SI. [source]

    Self-help treatments for disorders of recurrent binge eating: a systematic review

    S. C. Stefano
    Objective:, To evaluate self-help interventions for patients with binge eating disorder (BED) and bulimia nervosa (BN), tested in randomized controlled trials, and compared with waiting list or any other type of control group. Methods:, A systematic review including quality appraisal was conducted of randomized controlled trials, using self-help techniques in patients with BED and/or BN. Six databases were searched during the period between January 1994 and June 2004. Results:, A total of 2686 articles were identified, 1701 abstracts were evaluated in detail and, nine studies fulfilled the inclusion criteria for this review. All studies indicated that patients treated with active interventions had a reduced number of binge eating episodes at end of treatment. Conclusion:, The results support self-help interventions but shall be interpreted with caution. Because of the small number of studies using self-help techniques for BED and BN, further larger randomized, multi-center controlled studies that apply standardized inclusion criteria, evaluation instruments and self-help materials, are needed. [source]

    Staging anorexia nervosa: conceptualizing illness severity

    Sarah Maguire
    Abstract In recent years, there has been increasing attention to the conceptualization of anorexia nervosa (AN) and its diagnostic criteria. While varying levels of severity within the illness category of AN have long been appreciated, neither a precise definition of severity nor an empirical examination of severity in AN has been undertaken. The aim of this article is to review the current state of knowledge on illness severity and to propose a theoretical model for the definition and conceptualization of severity in AN. AN is associated with significant medical morbidity which is related to the ,severity' of presentation on such markers as body mass index, eating and purging behaviours. The development of a functional staging system, based on symptom severity, is indicated for reasons similar to those cited by the cancer lobby. Improving case management and making appropriate treatment recommendations have been the primary purpose of staging in other fields, and might also apply to AN. Such a standardized staging system could potentially ease communication between treatment settings, and increase the specificity and comparability of research findings in the field of AN. [source]

    Change processes in residential cognitive therapy for bulimia nervosa

    Asle Hoffart
    Abstract The purpose of the study was to examine the relationships of process variables derived from the cognitive model of bulimia nervosa (BN) and weekly outcome. The participants were 39 patients with BN or subthreshold bulimia consecutively admitted to an inpatient treatment program for bulimia. Theory-derived process and outcome variables were measured repeatedly during the course of therapy with a gap of a week between each measurement. The data were analysed with time series methods (ARIMA). Weekly variations in the process variables: self-efficacy about resisting binge eating, dysfunctional beliefs, negative affect and positive affect influenced variations in subsequent outcome, whereas weekly outcome did not influence subsequent process. These results are consistent with the cognitive model of BN and suggest that self-efficacy, dysfunctional beliefs, negative affect and positive affect are potential targets for treatment that need further investigation. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Anorexia nervosa: Towards an integrative neuroscience model

    A. Hatch
    Abstract We reviewed the evidence for emotion-related disturbances in anorexia nervosa (AN) from behavioural, cognitive, biological and genetic domains of study. These domains were brought together within the framework of an integrative neuroscience model that emphasizes the role of emotion and feeling and their regulation, in brain organization. PsychInfo and Medline searches were performed to identify published peer-reviewed papers on AN within each domain. This review revealed evidence for ,Emotion', ,Thinking and Feeling' and ,Self-regulation' disturbances in AN that span non-conscious to conscious processes. An integrative neuroscience framework was then applied to develop a model of AN, from which hypotheses for empirical investigation are generated. We propose that AN reflects a core disturbance in emotion at the earliest time stage of information processing with subsequent effects on the later stages of thinking, feeling and self-regulation. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Atypical antipsychotics and anorexia nervosa: A review

    Rebecca F. McKnight
    Abstract Background There is currently mixed opinion regarding the value of using atypical antipsychotics to treat anorexia nervosa (AN). Aims To evaluate the literature on the use of atypical antipsychotics in AN. Method A review of all studies and clinical guidelines published before September 2009 involving use of an atypical antipsychotic in patients with AN. Analysis is by narrative synthesis. Results Forty-three publications or study protocols were found, including four randomized-controlled trials, five open-label trials and 26 case reports. The most studied drugs were olanzapine, quetiapine and risperidone. Atypical antipsychotics appear safe and there is some evidence of positive effects on depression, anxiety and core eating disordered psychopathology in patients with anorexia nervosa. Currently there is insufficient evidence to confirm atypical antipsychotics enhance weight gain in this setting. Conclusions Further high quality evidence is needed in this area in order to provide practical guidance to clinicians. However, the main challenge is to persuade adequate numbers of AN patients to participate in research trials. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    A case series investigating acceptance and commitment therapy as a treatment for previously treated, unremitted patients with anorexia nervosa

    M. I. Berman
    Abstract The aim of the present study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) for treatment of anorexia nervosa (AN) using a case series methodology among participants with a history of prior treatment for AN. Three participants enrolled; all completed the study. All participants had a history of 1,20 years of intensive eating disorder treatment prior to enrollment. Participants were seen for 17,19 twice-weekly sessions of manualized ACT. Symptoms were assessed at baseline, post-treatment and 1-year follow-up. All participants experienced clinically significant improvement on at least some measures; no participants worsened or lost weight even at 1-year follow-up. Simulation modelling analysis (SMA) revealed for some participants an increase in weight gain and a decrease in eating disorder symptoms during the treatment phase as compared to a baseline assessment phase. These data, although preliminary, suggest that ACT could be a promising treatment for subthreshold or clinical cases of AN, even with chronic participants or those with medical complications. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    User satisfaction with services in a randomised controlled trial of adolescent anorexia nervosa

    Peter Roots
    Abstract Background User satisfaction is a neglected outcome in adolescent anorexia nervosa especially since the relative effectiveness of different treatments is unclear. It may also affect clinical outcome. Aims To assess young person's and parents' satisfaction with CAMHS outpatient, specialist outpatient and inpatient treatment received in a large randomised controlled trial. Method Quantitative and qualitative analysis of questionnaire data from 215 young people and their parents followed by focus groups to further explore emerging themes. Results High levels of satisfaction were reported, more amongst parents than young people and with specialist services. Both young people and carers strongly valued clinical relationships that involved being listened to and understood. They valued the expertise of specialist rather than generic CAMHS services. There were polarised views on the influence of other young people in inpatient units. Parents in particular valued support for themselves, both from professionals and other parents and felt this, and sibling support was lacking. Conclusions All comprehensive CAMH services are able to provide the good generic psychotherapeutic skills that parents and young people value so highly. However, generic CAMHS struggle to provide the demanded level of expertise and more specialised individual and family therapeutic interventions. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Meta-analysis on drugs in people with eating disorders

    Ana Calero-Elvira
    Abstract Objective The aim of this study was to examine whether drug use (DU) is higher in people with eating disorders (EDs) compared to a healthy control group and to perform a meta-analysis on the literature related to DU in people with EDs. Method We searched electronic databases (Medline, PsycINFO, Web of Science and CINAHL) and reviewed studies published from 1994 to August, 2007, in English, German or Spanish. A total of 16 papers fulfilled the inclusion criteria and were included. Results The general meta-analysis revealed a negligible albeit significant effect size (0.119, p,<,.05). Risk was found to be higher in bulimia nervosa (BN, ,,=,0.462, p,=,,<,.001), smaller in binge eating disorder (,,=,0.14, p,<,.05) and non-significant in anorexia nervosa (AN, ,,=,,.167, p,=,.070). Conclusions The differential risk observed in patients with BN might be related to differences in temperament or might be the result of reward sensitization. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Cognitive-behavioural therapy for individuals with bulimia nervosa and a co-occurring substance use disorder

    Robyn Sysko
    Abstract A significant percentage of individuals with bulimia nervosa (BN) also can be diagnosed with a co-occurring substance use disorder (SUD). Although studies have addressed the frequency of overlap between the disorders, etiology and shared personality traits, limited research is available about the treatment of these comorbid patients. Adapting cognitive-behaviour therapy (CBT) to serve as an integrated treatment for patients with both BN and a SUD is a viable option, as studies of CBT suggest that this form of treatment is efficacious for both disorders independently. The shared strategies in CBT for BN and SUDs facilitate the development of a combined treatment for individuals with both disorders with the addition of modules designed to address some common features of these disorders, such as motivation, difficulty with interpersonal relationships, reward sensitivity and impulsivity. Future research should begin to evaluate the efficacy of an integrated CBT in treating individuals with BN and a SUD. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Are Anorexia nervosa and bulimia nervosa separate disorders?

    Challenging the, transdiagnostic' theory of eating disorders
    Abstract Background Anorexia nervosa (AN) and bulimia nervosa (BN) are classified as separate and distinct clinical disorders. Recently, there has been support for a transdiagnostic theory of eating disorders, which would reclassify them as one disorder. Objective To determine whether AN and BN are a single disorder with one cause or separate disorders with different causes. Method Hill's Criteria of Causation were used to test the hypothesis that AN and BN are one disorder with a single cause. Hill's Criteria of Causation demand that the minimal conditions are needed to establish a causal relationship between two items which include all of the following: strength of association, consistency, temporality, biological gradient, plausibility, coherence, experimental evidence and analogy. Results The hypothesis that AN and BN have a single cause did not meet all of Hill's Criteria of Causation. Strength of association, plausibility, analogy and some experimental evidence were met, but not consistency, specificity, temporality, biological gradient, coherence and most experimental evidence. Conclusions The hypothesis that AN and BN are a single disorder with a common cause is not supported by Hill's Criteria of Causation. This argues against the notion of a transdiagnostic theory of eating disorders. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Cross-cultural differences in the macronutrient intakes of women with anorexia nervosa in Australia and Singapore

    Nerissa Li-Wey Soh
    Abstract Aim To compare the macronutrient intakes of women with and without anorexia nervosa (AN) across cultures. Method Participants were women with AN (n,=,39) and without AN (n,=,89) of North European and East Asian backgrounds recruited in Australia and Singapore. Energy and the percentage energy contributed by protein (%protein), fat (%fat) and carbohydrate (%CHO) were assessed from participant's diet histories and analysed in terms of cultural group, acculturation, socio-economic status (SES) and education level. Results AN status was associated with lower energy and higher %CHO. Greater %protein was associated with greater acculturation to Western culture and lower SES, but not AN. Greater %fat was associated with lower SES and lower acculturation in women with AN, but with higher acculturation in controls. Greater %CHO was also associated with higher SES. Conclusion The findings may represent Western diets' higher protein and fat contents, ,Western' knowledge of weight-loss diets, and affordability of low fat foods. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    The inpatient management of physical activity in young people with anorexia nervosa

    Sarah Davies
    Abstract This study investigates the management of physical activity in young inpatients with anorexia nervosa. Through telephone interviews and postal surveys inpatient units across the UK were asked about written documents regarding physical activity management, how they viewed healthy exercise, how they assessed physical fitness to engage in activity, the management approaches taken, provision of education and support around this issue and range of activities provided. Results indicated that a variety of approaches were taken, with little consensus between units, although the majority of approaches did involve some form of restriction, frequently determined by weight criteria. There were few substantial written documents to guide practice and a range of interpretations of healthy exercise. The findings are discussed and suggestions made for research to explore this area further and to inform the development of effective interventions. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Personality traits and self-injurious behaviour in patients with eating disorders

    Jennie Ahrén-Moonga
    Abstract The interest in different aspects of personality and the neuropsychological basis for behaviour in eating disorder patients has increased over the last decade. The present study aims at exploring personality traits, self-injurious behaviour (SIB) and suicide attempts in a group of severely ill eating disorder patients. Patients with eating disorders (N,=,38) and age-matched controls (N,=,67) were examined concerning self-reported personality traits by means of the Karolinska scales of personality (KSP). Psychosocial history and SIB was collected from medical records. Depression was rated by means of the Beck Depression Inventory (BDI). Results indicated significantly higher anxiety-related and detachment traits in both anorexia nervosa (AN) and bulimia nervosa (BN) patients and higher hostility in BN patients than controls. No specific personality traits could be defined as typical for self-injurious or suicidal behaviour. The AN group was lower than the BN group on scales measuring impulsivity, guilt and anxiety. Furthermore, presence of SIB and suicide attempts was more frequent among the BN patients. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Primary prevention of eating disorders: characteristics of effective programmes and how to bring them to broader dissemination

    Uwe Berger
    Abstract Objective Based upon the observation of advances in the primary prevention of eating disorders (ED), it is summarized that school-based programmes, focusing on risk factors for females with interactive elements, dissonance induction and booster sessions yield significant effects even under strong methodological conditions. However, beyond the presented research findings it remains often unclear, if and how programmes can be brought to a broader dissemination within a community, region or country. Method Introducing the programme PriMa (German school-based programme for the primary prevention of anorexia nervosa (AN) for girls up to the age of 12), we describe the process of programme evaluation (including 1.006 girls from 42 schools in Thuringia, Germany, who participated in a controlled study using a pre-post-design and a 3 months follow-up), programme implementation and development of follow-up programmes, including an intervention for boys and flanking secondary preventive actions (such as a telephone hotline). Results Using standardized measures, the girls in the intervention group of PriMa reported significant improvements in body self esteem, figure dissatisfaction, knowledge and eating attitudes. The teachers, who conducted the programme, felt well qualified and were evaluated significantly positive by their students. Based upon the PriMa evaluation, we established a comprehensive health promotion programme at 60 Thuringian schools within the last 3 years, which could function as a model of a fruitful cooperation between a governmental institution (Thuringian Ministry of Culture) and a research institution (University Hospital Jena). Conclusions Existing programmes have the potential for effective prevention of ED. To confirm these effects under ,real world conditions' within a given community will still be a great challenge that often requires methodological and organizational concessions and compromises. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Getting better byte by byte: a pilot randomised controlled trial of email therapy for bulimia nervosa and binge eating disorder,

    Paul Robinson
    Abstract One hundred and ten people in an university population responded to emailed eating disorder questionnaires. Ninty-seven fulfilling criteria for eating disorders (bulimia nervosa (BN), binge eating disorder (BED), EDNOS) were randomised to therapist administered email bulimia therapy (eBT), unsupported Self directed writing (SDW) or Waiting list control (WLC). Measures were repeated at 3 months. Diagnosis, Beck depression inventory (BDI) and Bulimia investigatory test (BITE) scores were recorded. Follow-up rate was 63% and results must be interpreted cautiously. However significantly fewer participants who had received eBT or SDW fulfilled criteria for eating disorders at follow up compared to WLC. There was no significant difference between eBT and SDW in the analysis of variance (ANOVA), although in separate analyses, eBT was significantly superior to WLC (p,<,0.02) and the difference for SDW approached significance (p,=,0.06). BDI and BITE scores showed no significant change. For eBT participants there was a significant positive correlation between words written and improvement in BITE severity score. BN, BED and EDNOS can be treated via email. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Personality disorders in 545 patients with eating disorders

    *Article first published online: 5 DEC 200, Kristine Godt
    Abstract Objective Previous research on the prevalence of personality disorders in patients with eating disorders varies greatly in findings, but a general understanding seem to exist that personality disorders are rather common among eating-disordered patients. The present investigation is aimed at establishing the prevalence of DSM III-R or DSM IV personality disorders in a large population seeking treatment for eating disorders. Method Five hundred and forty-five patients with DSM IV- eating disorders have been evaluated using the structured clinical interview for DSM III-R or IV-Axis II and the eating disorder examination. Results The 29.5% of the population have one or more personality disorders according to DSM III-R or DSM IV criteria. Personality disorders, and specifically borderline personality disorder, are significantly more common in patients with bulimia nervosa. Discussion The proportion of eating-disordered patients with co-morbid personality disorder may not be as large as often found in studies. This challenges the understanding of a strong overall connection between the two groups of disorder; however, the connection seems to exist in subsets of eating disorder samples. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Metacognition in patients with anorexia nervosa, dieting and non-dieting women: a preliminary study

    Rachel A. Woolrich
    Abstract Objective To explore metacognition in women with anorexia nervosa (AN), dieting and non-dieting women. Method A cross-sectional study between groups design compared women with AN (n,=,15), normal dieters (n,=,17) and non-dieters (n,=,18). A semi-structured interview was used to explore presence and content of explicit metacognitions and use of metacognitive control strategies. Results Explicit metacognitions and metacognitive control strategies were present in all three groups of women. There were group differences in amount and function of metacognitive activity and trends in the qualitative data suggested participants with AN believed that their thoughts were abnormal and uncontrollable. They used six metacognitive strategies more than control groups and were less successful at using thought re-appraisal and attending to body and others. Half of participants with AN reported using these strategies to deliberately make themselves feel worse. Discussion It is suggested that metacognitive activity may play a role in the maintenance of AN, particularly in reinforcing negative self-evaluations. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    The needs of carers of patients with anorexia and bulimia nervosa

    Holmer Graap
    Abstract Objective This study aims to assess the degree of distress and the need for support of carers of patients with anorexia and bulimia nervosa (BN). Methods Thirty-two carers filled out the General Health Questionnaire (GHQ-12) and the Burden Inventory (BI). In addition, they were interviewed with a semi-structured research interview, the Carers' Needs Assessment (CNA), to assess relevant problem areas as well as the needs for helpful interventions. Patients were interviewed with the Eating Disorder Examination (EDE) to assess the severity of the eating disorder. All patients met criteria for anorexia (n,=,16) or BN (n,=,16) according to DSM-IV criteria. Results The mean duration of illness was 5.6 years. The mean age of the carers was 41 years. Most of the carers were mothers or partners. In the CNA we found high numbers of problems as well as high numbers of needed interventions. The most frequently mentioned problem area was ,disappointment caused by the chronic course of the illness, concerns about the patient's future' and the most frequently reported need for support was ,counselling and support by a professional'. In three problem areas carers of persons suffering from anorexia nervosa (AN) reported significantly higher scores than carers of persons suffering from BN. Conclusions Our results suggest that carers themselves have high levels of needs which are usually not addressed in clinical practice. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Eating disorder not otherwise specified in an inpatient unit: the impact of altering the DSM-IV criteria for anorexia and bulimia nervosa

    Riccardo Dalle Grave
    Abstract Objective To evaluate (1) the Eating Disorder Not Otherwise Specified (EDNOS) prevalence in an eating disorder inpatient unit; (2) the impact of altering the diagnostic criteria for anorexia nervosa and bulimia nervosa on the prevalence of EDNOS. Method One hundred and eighty six eating disorder patients consecutively hospitalised were included in the study. The prevalence of anorexia nervosa, bulimia nervosa and EDNOS was evaluated with the Eating Disorder Examination (EDE). The EDNOS prevalence was recalculated after the alteration of three diagnostic criteria for anorexia nervosa and one for bulimia nervosa. Results Seventy eight patients (41.9%) met the diagnostic criteria for anorexia nervosa, 33 (17.8%) for bulimia nervosa and 75 (40.3%) for EDNOS. The alteration of the DSM-IV diagnostic criteria reduced the prevalence of EDNOS to 28 cases (15%). Conclusion EDNOS is a very frequent diagnostic category in an inpatient setting. Altering the diagnostic criteria for anorexia nervosa and bulimia nervosa reduced significantly the prevalence of EDNOS. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    The co-morbidity of eating disorders and anxiety disorders: a review

    Jessica M. Swinbourne
    Abstract Objective To critically review the literature examining the co-morbidity between eating disorders and anxiety disorders. Method A review of the literature on the co-morbidity between anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and the anxiety disorders of OCD, PTSD, social anxiety, GAD, panic and agoraphobia. Results Of the empirical studies undertaken, it is clear that anxiety disorders are significantly more frequent in subjects with eating disorders than the general community. Researchers have shown that often anxiety disorders pre-date eating disorders, leading to a suggestion that early onset anxiety may predispose individuals to developing an eating disorder. To date however, the research presents strikingly inconsistent findings, thus complicating our understanding of eating disorder and anxiety co-morbidity. Furthermore, despite indications that eating disorder prevalence amongst individuals presenting for anxiety treatment may be high, there is a distinct lack of research in this area. Discussion This review critically examines the available research to date on the co-morbidity of eating disorders and anxiety disorders. Some of the methodological limitations of previous research are presented, in order to highlight the issues which warrant further scientific investigation in this area. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Premature termination of treatment in an inpatient eating disorder programme

    Philip C. Masson
    Abstract This retrospective study was conducted to explore rates, timing and predictors of two forms of premature termination of treatment (PTT) in an inpatient eating disorders programme: patient dropout (DO) and administrative discharge (AD). A chart review was conducted to obtain demographic, Eating Disorder Inventory-2 (EDI-2), and Resident Assessment Instrument-Mental Health (RAI-MH) data for 186 patients being treated for bulimia nervosa (BN), anorexia nervosa (AN), or eating disorder not otherwise specified (EDNOS). Overall, of the 37.6% of patients who terminated treatment prematurely, 22.1% of patients dropped out, and 15.5% of patients were administratively discharged. Time at which discharge occurred was found to be associated with the type of premature termination. The presence of DSM-IV Axis-I comorbidity was found to be the only factor associated with an increased risk of being administratively discharged. No factors were predictive of patients dropping out of treatment. The findings support the notion that AD and patient DO are different events that may have different factors influencing their rates and timing. Implications for future research and programme planning are discussed. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [source]