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Objective: We determined the standardized mortality ratio (SMR) in our anorexia nervosa (AN) patient population., Method: We used a cross-sectional design to study an inception cohort (1981-2000) drawn from the provincial tertiary care eating disorders program at St. Paul's Hospital (British Columbia, Canada). All patients who completed their initial assessment for an eating disorder were included in the study. Vital status, date and cause of death from British Columbia Vital Statistics Agency, date of assessment, date of birth, and diagnosis at the time of assessment were collected for each patient., Results: Of 954 patients, 326 diagnosed with AN completed an assessment over the 20 years. The SMR was 10.5 (95% confidence interval [CI] = 5.5-15.5) for AN., Discussion: Some studies in the literature report that AN has the highest mortality rate of any psychiatric disorder in young females. However, others dispute this fact and report an SMR lower than the normal population mortality (SMR = 0.71). Contrary to some reports in the literature, our study confirms a high mortality rate within the AN population., (2005 by Wiley Periodicals, Inc.)

Recent research has suggested that a large proportion of patients with bulimia nervosa have seasonal (winter) worsening of mood symptoms similar to seasonal affective disorder (SAD). The objectives of this study were to determine the specificity of this finding in anorexia and bulimia nervosa, and to further delinaeate the seasonal mood and eating patterns in bulimia nervosa. The BN group had higher global seasonality scores and more presumptive diagnoses of SAD than the other two groups; the An patients, whether they had the restricting or binge eating/purging subtype, did not differ from the NC subjects. Thirty-two percent of the identifies seasonal BN patients did not have parallel worsening of mood and eating symptoms in the same season. These results suggested that seasonality of symptoms is specific to BN and that there may be separate mechanisms for the seasonality of mood and eating symptoms in some BN patients. [ABSTRACT FROM AUTHOR]

Zinc supplementation of anorexia nervosa (AN) patients has been reported to increase the weight gain of AN patients in open trials. In this randomized, double-blind, placebo-controlled trial 100 mg of zinc gluconate, or placebo, was given daily to 35 female AN inpatients until they achieved a 10% increase in body mass index (BMI). The rate of increase in BMI of the zinc supplemented group (n = 16) was twice that of the placebo group (n = 19), and this difference was statistically significant (p = .03). The use of zinc supplementation should be considered in the treatment of AN patients. [ABSTRACT FROM AUTHOR]

To determine whether bioelectrical impedance analysis (BIA) is a valid measure of change in body fat in anorexia nervosa (AN) patients during refeeding, as compared to skinfold calipers (SF). Twenty patients completed the study. Comparison of the two methods by the Pearson correlation coefficient showed a weak negative correlation of r = -.305. Analysis by a graphical method confirmed the poor agreement that exists between the two methods. The inability of BIA to detect changes in body composition due to altered hydratrion, and to accurately assess the distribution of water between intracellular and extracellular compartments, limits its clinical usefulness in AN. It appears that SF measurements are preferable to BIA as a measure of body fat change in patients with AN. [ABSTRACT FROM AUTHOR]

The chronic form of anorexia nervosa (AN) affects about one-quarter of patients and has serious somatic and psychological consequences. This paper presents evidence in support of the hypothesis that pregnancy and birth complications (PBCs) associated with neuropathology may be risk factors for chronic anorexia nervosa. There is increasing evidence that PBCs are risk factors for other psychiatric and somatic disorders. Recent findings of possible premorbid neuropathology in patients with anorexia nervosa suggest that PBCs may be risk factors for chronicity in anorexia nervosa. Topics discussed include the origins of constitutional vulnerability to anorexia nervosa, correlates of PBCs and of chronic anorexia nervosa, the relationship of PBCs to neurological and neurochemical abnormalities, chronicity of anorexia nervosa in relation to PBCs and to neurological and neurochemical abnormalities, and the research implications of the hypothesis that PBCs and associated neuropathology are risk factors for chronicity in anorexia nervosa. [ABSTRACT FROM AUTHOR]

A case of anorexia nervosa (AN) is reported where heart failure occurred secondary to severe hypophosphatemia despite oral phosphate supplementation. We recommend starting patients with AN on oral phosphate when refeeding is begun, monitoring serum phosphate every 1 to 2 days for at least the first week refeeding, and discontinuation of refeeding during phosphate supplementation should severe hypophosphatemia develop. [ABSTRACT FROM AUTHOR]

The first case of polyglandular autoimmune syndrome (PAS) in a patient with anorexia nervosa is reported. The association of pernicious anemia with vitiligo and endocrine hypofunction (PAS) is reviewed. Eating disorder patients with B12 deficiency who have vitiligo or a history of endocrine hypofunction should have a Schilling test to exclude pernicious anemia. [ABSTRACT FROM AUTHOR]