Outpatient Management of Electrolyte Imbalances Associated With Anorexia Nervosa and Bulimia Nervosa

Olson, Ann F.

doi:10.1097/00129804-200503000-00005

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…[9] • Constipation, [10] electrolyte imbalance. [11] • Lanugo. [12] The causes for Anorexia nervosa have been attributed to risk factors such as, family history, obesity, weight…”

mentioning

confidence: 99%

Case Report on Anorexia Nervosa

Srinivasa¹,

Chandrashekar²,

Harish³

et al. 2015

Indian Journal of Psychological Medicine

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Anorexia nervosa is an eating disorder characterized by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception. It is clinically diagnosed more frequently in females, with type and severity varying with each case. The current report is a case of a 25-year-old female, married for 5 years, educated up to 10th standard, a homemaker, hailing from an upper social class Hindu (Marvadi) family, living with husband's family in Urban Bangalore; presented to our tertiary care centre with complaints of gradual loss of weight, recurrent episodes of vomiting, from a period of two years, menstrual irregularities from 1 year and amenorrhea since 6 months, with a probable precipitating factor being husband's critical comment on her weight. Diagnosis of atypical anorexia nervosa was made, with the body mass index (BMI) being 15.6. A multidisciplinary therapeutic approach was employed to facilitate remission. Through this case report the authors call for the attention of general practitioners and other medical practitioners to be aware of the symptomatology of eating disorders as most patients would overtly express somatic conditions similar to the reported case so as to facilitate early psychiatric intervention.

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“…[9] • Constipation, [10] electrolyte imbalance. [11] • Lanugo. [12] The causes for Anorexia nervosa have been attributed to risk factors such as, family history, obesity, weight…”

mentioning

confidence: 99%

Case Report on Anorexia Nervosa

Srinivasa¹,

Chandrashekar²,

Harish³

et al. 2015

Indian Journal of Psychological Medicine

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“…See Table 1 for further details about the vignettes. AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 3 [46] See above GAF score, amenorrhea AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 4 [46] See above GAF score AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 5 [46] See above GAF score "School" changed to "university" AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 6 [46] See above GAF score "School" changed to "university" AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 7 [46] See above GAF score AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 8 [46] See above GAF score "School" changed to "university" AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 9 [46] See above GAF score "Living with parents" changed to "living with boyfriend/girlfriend " AN patient (implied in title of paper), sex, sexual orientation 10 [46] See above GAF score, amenorrhea AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 11 [46] See above GAF score, amenorrhea AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 12 [46] See above GAF score, amenorrhea, suicide attempts AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 13 [46] See above GAF score, amenorrhea, suicide attempts AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 14 [46] See above GAF score, amenorrhea, suicide ideation, self-mutilation AN patient (implied in title of paper), sex, sexual orientation, living with boyfriend/girlfriend 15 [47] Pubmed, August [52] See above city, education, menstrual irregularities, weight (unrealistic if changed to male sex) living with boyfriend/girlfriend 24 [53] See above PTSD c , sexual abuse, mens, study living with boyfriend/girlfriend 25 [53] See above sexual abuse, PTSD, mens/menopause living with husband/wife (> 30 years) 26 [53] See above Enrollment in study living with boyfriend/girlfriend 27 [54] See above living with husband/wife (> 30 years) 28 [55] See above living with boyfriend/girlfriend 29 [56] See above living with husband/wife (> 30 years) 30…”

Section: Vignette Selection and Modificationmentioning

confidence: 99%

Exploring Bias(es) of Large Language Models in the Field of Mental Health – A Comparative Study Investigating the Effect of Gender and Sexual Orientation in Anorexia Nervosa and Bulimia Nervosa Case Vignettes (Preprint)

Schnepper,

Roemmel,

Schaefert

et al. 2024

Preprint

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BACKGROUND Large language models (LLMs) are increasingly used in the mental health field, with promising results in assessing mental disorders. However, correctness, dependability, and equity of LLM-generated information have been questioned. Amongst other, societal biases and research underrepresentation of certain population strata may affect LLMs. Because LLMs are already used for clinical practice, including decision support, it is important to investigate potential biases to ensure a responsible use of LLMs. OBJECTIVE We aimed to estimate the presence and size of bias related to gender and sexual orientation produced by a common LLM, exemplified in the context of ED symptomatology and health-related quality of life (HRQoL) of patients with AN or BN. METHODS We extracted 30 case vignettes (22 AN, 8 BN) from scientific articles. We adapted each vignette to create 4 versions, describing a female vs. male patient living with their female vs. male partner (2x2 design), yielding n=120 vignettes. We then fed each vignette into Chat Generative Pre-trained Transformer-4 (ChatGPT-4) thrice with the instruction to evaluate them by providing responses to two psychometric instruments, the RAND-36 questionnaire assessing HRQoL and the eating disorder examination questionnaire (EDE-Q). With the resulting LLM-generated scores, we calculated multilevel models (MLMs) with a random intercept for gender and sexual orientation (accounting for within-vignette variance), nested in vignettes (accounting for between-vignette variance). RESULTS The MLM with N=360 observations indicated for the RAND-36 mental composite summary, a significant association with gender (conditional means: 12.8 for male and 15.1 for female cases; 95% CI of the effect=[-6.15, -0.35]; p=.037) but neither with sexual orientation nor an interaction effect (ps>.370). We found no indications for main or interaction effects of gender or sexual orientation for the EDE-Q overall score (conditional means: 5.59-5.65; ps>.611). CONCLUSIONS LLM-generated estimates of mental HRQoL in AN or BN case vignettes are at risk of being affected by cases’ gender, with male cases scoring lower. Given the lack of real-world epidemiological evidence for such a pattern, our study highlights relevant risk of bias when applying generative AI in the context of mental health. Better understanding and mitigation of risk of bias related to gender and other factors, such as ethnicity or socioeconomic status, are highly warranted to ensure responsible use of LLMs when conducting diagnostic assessments or providing treatment recommendations.

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“…Meanwhile, improved knowledge led to improved confidence in NS infusion management. 42 Therefore, it is necessary to use the present evidence to manage NS infusion, and we summarized some principles as follows. Assess the fluid and electrolyte status of critically ill patients.…”

Section: Ns Vs Buffered Crystalloid Solutionmentioning

confidence: 99%

Normal saline for intravenous fluid therapy in critically ill patients

Zhou

Liu

Mao

et al. 2018

Chinese Journal of Traumatology

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The efficacy and safety of normal saline (NS) for fluid therapy in critically ill patients remain controversy. In this review, we summarized the evidence of randomized controlled trials (RCTs) which compared NS with other solutions in critically ill patients. The results showed that when compared with 6% hydroxyethyl starch (HES), NS may reduce the onset of acute kidney injury (AKI). However, there is no significant different in mortality and incidence of AKI when compared with 10% HES, albumin and buffered crystalloid solution. Therefore, it is important to prescribe intravenous fluid for patients according to their individual condition.

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Outpatient Management of Electrolyte Imbalances Associated With Anorexia Nervosa and Bulimia Nervosa

Cited by 7 publications

References 7 publications

Case Report on Anorexia Nervosa

Case Report on Anorexia Nervosa

Exploring Bias(es) of Large Language Models in the Field of Mental Health – A Comparative Study Investigating the Effect of Gender and Sexual Orientation in Anorexia Nervosa and Bulimia Nervosa Case Vignettes (Preprint)

Normal saline for intravenous fluid therapy in critically ill patients

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