Diminution de la mortalité et stabilité du taux de guérison dans le suivi de l’anorexie mentale

Viricel, Josselin; Bossu, C.; Galusca, B.; Kadem, M.; Germain, N.; Nicolau, A.; Millot, L.; Vergély, N.; Lassandre, S.; Carrot, Guy; Lang, François; Estour, B.

doi:10.1016/s0755-4982(05)84213-7

Cited by 18 publications

(4 citation statements)

References 16 publications

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“… 24 , 25 Viricel et al reported that early-onset anorexia (during adolescence) was associated with a good prognosis with 55.8% and 25.7% attaining full and partial recovery respectively. 26 The overall functional improvement of our sample as assessed by the return to school was positive in 57.1% (n = 8) of our sample.…”

Section: Discussionmentioning

confidence: 66%

“…A comparison of the baseline clinical parameters of our sample with established prognostic factors, 5 , 25 , 26 suggests that the patients admitted had a severe form of illness with poor prognostic factors such as long duration of illness, poor response to initial treatment, high level of psychiatric comorbidities, high level of adverse psychosocial factors, and high level of baseline CGI-S. But, the duration of inpatient care positively correlated with weight gain and overall weight gain trajectory, the rate of weight gain during inpatient care and overall functional improvement noted during follow-up were positive.…”

Section: Discussionmentioning

confidence: 99%

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Course and Outcome of Anorexia Nervosa in Adolescents from a Tertiary-level Mental Health Setting in India: A Retrospective Chart Review

Sravanti,

Velusamy,

Karki

et al. 2024

Indian Journal of Psychological Medicine

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Background: Anorexia nervosa is one of the least studied mental health conditions in the Indian setting. The objective of this study was to assess the course and outcome of anorexia nervosa in adolescents who had presented to a tertiary care child and adolescent psychiatry center over a period of 10 years. Methods: The present study is a retrospective chart review of adolescents (up to the age of 18 years) with a diagnosis of anorexia nervosa, coded as F50.0 or F50.1 according to ICD 10, from 1st April 2009 to 31st March 2019. Data were extracted from the case records using standardized abstraction forms and evaluated using descriptive and nonparametric statistics. Results: The average age at presentation and the average age at onset were 14.1 years and 13.1 years, respectively. The male-to-female ratio of the sample who got admitted was 1:9. The average duration of hospital stay was about 30 days. The duration of in-patient care and weight gain were positively correlated, with severe to extremely ill adolescents improving even in less than one month of in-patient care. Seventy per cent of the admitted adolescents followed up. The functional outcome as measured by a ‘return to school’ improved in 57.1% of the sample. Conclusions: The present study highlights the collaborative multidisciplinary and individualized treatment approach employed for adolescents diagnosed with anorexia nervosa within an inpatient mental health facility in India. Adolescents who presented with more severe illness at the initial assessment, such as an early onset of symptoms and a low BMI, experienced substantial weight gain that exhibited a positive correlation with the length of their stay in the inpatient facility.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Course and Outcome of Anorexia Nervosa in Adolescents from a Tertiary-level Mental Health Setting in India: A Retrospective Chart Review

Sravanti,

Velusamy,

Karki

et al. 2024

Indian Journal of Psychological Medicine

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“…Anorexia Nervosa (AN) is an eating disorder characterized by self-starvation leading to weight loss, undernutrition, and subsequent adaptive typical hormonal changes [ 1 , 2 ]. Some of these changes are responsible for a functional gonadal axis blockade [ 3 ]. Specifically, the combination of weight loss, blunted leptin [ 4 ], high cortisol [ 5 ] and high ghrelin plasma levels [ 6 , 7 ] results in a functional hypothalamic amenorrhea through the inhibition of GnRH pulses [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, resumption of menstrual cycles during weight gain remains highly relevant for nutritional recovery [ 10 ]. While achieving weight gain beyond the lower limits of the World Health Organization's body mass index (BMI) normal range (18.5 kg/m 2 ) and normalizing disrupted nutritional markers is generally considered essential, it does not always guarantee the return of menstruation in patients with AN [ 3 ]. It has been observed that menses typically resume within six months after reaching 90% of standard body weight for high and age [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Mechanisms and predictors of menses resumption once normal weight is reached in anorexia nervosa

Galusca,

Gay,

Belleton

et al. 2023

J Eat Disord

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Background In cases of Anorexia Nervosa (AN), achieving weight gain recovery beyond the lower limits set by the World Health Organization and normalizing classical nutritional markers appears to be essential for most patients. However, this is not always adequate to restore menstrual cycles. This discrepancy can cause concern for both patients and healthcare providers, and can impact the medical management of these individuals. Thus, the purpose of this study was to assess the ability of anthropometric and hormonal factors to predict the resumption of menstrual cycles in individuals with anorexia nervosa upon reaching a normal body weight. Method Patients with AN who had achieved a normal Body Mass Index but had not yet resumed their menstrual cycles (referred to as ANRec) were evaluated on two occasions: first at visit 1 and then again 6 months later, provided their body weight remained stable over this period (visit 2). Among the 46 ANRec patients who reached visit 2, they were categorized into two groups: 20 with persistent amenorrhea (PA-ANRec) and 26 who had regained their menstrual cycles (RM-ANRec). Anthropometric measurements, several hormone levels, Luteinizing Hormone (LH) pulsatility over a 4-h period, and LH response to gonadotropin-releasing hormone injection (LH/GnRH) were then compared between the two groups at visit 1. Results Patients in the RM-ANRec group exhibited higher levels of follicular stimulating hormone, estradiol, inhibin B, LH/GnRH, and lower levels of ghrelin compared to those in the PA-ANRec group. Analysis of Receiver Operating Characteristic curves indicated that having ≥ 2 LH pulses over a 4-h period, LH/GnRH levels ≥ 33 IU/l, and inhibin B levels > 63 pg/ml predicted the resumption of menstrual cycles with a high degree of specificity (87%, 100%, and 100%, respectively) and sensitivity (82%, 80%, and 79%, respectively). Conclusions These three hormonal tests, of which two are straightforward to perform, demonstrated a high predictive accuracy for the resumption of menstrual cycles. They could offer valuable support for the management of individuals with AN upon achieving normalized weight. Negative results from these tests could assist clinicians and patients in maintaining their efforts to attain individualized metabolic targets. Trial registration IORG0004981.

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Childbearing and mortality among women with anorexia nervosa

Papadopoulos

Karamanis

Brandt

et al. 2012

Intl J Eating Disorders

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Diminution de la mortalité et stabilité du taux de guérison dans le suivi de l’anorexie mentale

Cited by 18 publications

References 16 publications

Course and Outcome of Anorexia Nervosa in Adolescents from a Tertiary-level Mental Health Setting in India: A Retrospective Chart Review

Course and Outcome of Anorexia Nervosa in Adolescents from a Tertiary-level Mental Health Setting in India: A Retrospective Chart Review

Mechanisms and predictors of menses resumption once normal weight is reached in anorexia nervosa

Childbearing and mortality among women with anorexia nervosa

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