Somatic comorbidity in anorexia nervosa: First results of a 21-year follow-up study on female inpatients

Erdur, Laurence; Kallenbach-Dermutz, Bettina; Lehmann, Vicky; Zimmermann-Viehoff, Frank; Köpp, Werner; Weber, Cora; Deter, Hans‐Christian

doi:10.1186/1751-0759-6-4

Cited by 35 publications

(25 citation statements)

References 13 publications

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“…This is consistent with the literature, given the severity of anorexia nervosa and the medical sequelae that accompany it [33,58]. The elevation for the patients with depression is also consistent with the physiological symptoms of major depression [59][60][61][62].…”

Section: Additional Findingssupporting

confidence: 89%

Personality assessment inventory profiles of university students with eating disorders

MacGregor

Lamborn

2014

J Eat Disord

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Background: Eating disorders are complex disorders that involve medical and psychological symptoms. Understanding the psychological factors associated with different eating disorders is important for assessment, diagnosis, and treatment. Methods: This study sought to determine on which of the 22 Personality Assessment Inventory (PAI) scales patients with anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (EDNOS) differed, and whether the PAI can be used to classify eating disorder subtypes. Because we were interested in both whether the PAI could be used to differentiate eating disorder subtypes from each other, as well as from other disorders, we also included a group of patients with major depression. Results: The three eating disorder groups did differ significantly from each other, and from the patients with depression, on a number of the PAI scales. Only two PAI scales (Anxiety and Depression), however, exceeded a T-score of 70 for the patients with anorexia nervosa, no scales exceeded a T-score of 70 for the patients with bulimia nervosa or EDNOS, and only two exceeded a T-score of 70 for the patients with depression (Depression and Suicide). A discriminant function analysis revealed an overall correct classification between the groups of 81.6%. Conclusions: The PAI helps to understand the psychological factors associated with eating disorders and can be used to assist with assessment. Continued investigation using the PAI in an eating disordered population is supported.

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Section: Additional Findingssupporting

confidence: 89%

Personality assessment inventory profiles of university students with eating disorders

MacGregor

Lamborn

2014

J Eat Disord

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“…In a 21-year follow-up study, Löwe et al (2001) showed that 16% of AN patients deceased due to consequences of their illness: about 50% died because of somatic complications leading to heart attack and the remainder committed suicide. Moreover, mortality is significantly more common among inpatients with somatic comorbidity (like renal, cardiac, bone, and digestive pathologies) than among inpatients without a somatic disease (Erdur et al, 2012). Finally, among the psychiatric comorbidities, AN is often associated with depression, anxiety, obsessive compulsive or personality disorders, and drug abuse (Erdur et al, 2012).…”

Section: Physiological Alterations In Anorexia Nervosamentioning

confidence: 99%

Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

Méquinion¹,

Langlet²,

Zgheib³

et al. 2013

Front. Endocrinol.

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Increasing clinical and therapeutic interest in the neurobiology of eating disorders reflects their dramatic impact on health. Chronic food restriction resulting in severe weight loss is a major symptom described in restrictive anorexia nervosa (AN) patients, and they also suffer from metabolic disturbances, infertility, osteopenia, and osteoporosis. Restrictive AN, mostly observed in young women, is the third largest cause of chronic illness in teenagers of industrialized countries. From a neurobiological perspective, AN-linked behaviors can be considered an adaptation that permits the endurance of reduced energy supply, involving central and/or peripheral reprograming. The severe weight loss observed in AN patients is accompanied by significant changes in hormones involved in energy balance, feeding behavior, and bone formation, all of which can be replicated in animals models. Increasing evidence suggests that AN could be an addictive behavior disorder, potentially linking defects in the reward mechanism with suppressed food intake, heightened physical activity, and mood disorder. Surprisingly, the plasma levels of ghrelin, an orexigenic hormone that drives food-motivated behavior, are increased. This increase in plasma ghrelin levels seems paradoxical in light of the restrained eating adopted by AN patients, and may rather result from an adaptation to the disease. The aim of this review is to describe the role played by ghrelin in AN focusing on its central vs. peripheral actions. In AN patients and in rodent AN models, chronic food restriction induces profound alterations in the « ghrelin » signaling that leads to the development of inappropriate behaviors like hyperactivity or addiction to food starvation and therefore a greater depletion in energy reserves. The question of a transient insensitivity to ghrelin and/or a potential metabolic reprograming is discussed in regard of new clinical treatments currently investigated.

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“…Among AN patients, 24.3% have a severe comorbid somatic disease [9], including electrolyte disorders, osteoporosis, renal insufficiency and cardiac dysfunction [10,11]. Most of them are reversible with improved nutritional status, but some of them can be life-threatening [12,13,14].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Intractable Anorexia Nervosa with Inactivation of the Nucleus Accumbens Using Stereotactic Surgery

Wang

Chang

Geng

et al. 2013

Stereotact Funct Neurosurg

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Background: For 30% of anorexia nervosa (AN) patients, conventional treatments are unsuccessful; this is termed intractable AN. Objectives: This study investigates whether ablation of the nucleus accumbens (NAc) using stereotactic surgery can arouse the physiological drive to eat in intractable AN patients. Methods: Eight patients with intractable AN were included: 6 patients underwent bilateral stereotactic radio frequency ablation in the NAc and 2 patients received bilateral NAc deep brain stimulation (DBS). Observations were made for basic vital signs, body mass index (BMI), menstruation, depression, anxiety, obsessive-compulsive disorder, personality, intelligence, memory, quality of life, social functioning, as well as complications and adverse events associated with the treatment. Results: Basic vital signs, BMI and menstruation had recovered 1 year after the operation. Depression, anxiety and obsessive-compulsive disorder were improved 1 year postoperatively. There were changes in personality scores for psychoticism, neuroticism and lie tendencies that seemed to be helpful to the recovery from AN. Intelligence and memory improved after 6 months postoperatively. Quality of life and social functioning were dramatically improved at 1 year postoperatively. Conclusions: The results of this study reveal that ablation of the NAc can increase the AN patients' physiological drive to eat. Furthermore, there were no severe and/or life-influencing complications associated with the treatment.

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Somatic comorbidity in anorexia nervosa: First results of a 21-year follow-up study on female inpatients

Cited by 35 publications

References 13 publications

Personality assessment inventory profiles of university students with eating disorders

Personality assessment inventory profiles of university students with eating disorders

Ghrelin: Central and Peripheral Implications in Anorexia Nervosa

Treatment of Intractable Anorexia Nervosa with Inactivation of the Nucleus Accumbens Using Stereotactic Surgery

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