Search

Introducción. El incremento de la incidencia de la anorexia nerviosa conduce a unas cifras de prevalencia cada vez mayores, especialmente tras la pandemia COVID-19. El abordaje de esta patología es complejo y requiere de una colaboración y coordinación multidisciplinar, donde la enfermera desempeña un rol esencial, con unas competencias definidas y unas habilidades terapéuticas necesarias. Objetivos. Explorar la vivencia de las enfermeras en la relación terapéutica con personas con anorexia nerviosa y las consecuencias de las mismas. Del mismo modo, relatar las emociones experimentadas por las enfermeras en la atención de este tipo de pacientes, las herramientas percibidas como facilitadoras, las dificultades en la comunicación, así como la percepción en la necesidad del cuidado y el papel que juega la institución. Metodología. Se empleará un diseño cualitativo, concretamente la teoría fundamentada, a través de entrevistas semiestructuradas en profundidad, en el Instituto de Psiquiatría y Salud Mental del Hospital General Universitario Gregorio Marañón. Se procederá a la transcripción, revisión, lectura y relectura de las transcripciones para su posterior codificación. A partir de los códigos y su interpretación, se generarán las grandes áreas temáticas que representarán los fenómenos. Se seguirá un proceso de triangulación de datos por medio de tres investigadores. ABSTRACT Introduction. The increasing incidence of anorexia nervosa leads to increasing prevalence figures, especially after the COVID-19 pandemic. The approach to this pathology is complex and requires multidisciplinary collaboration and coordination, where the nurse plays an essential role, with defined competencies and necessary therapeutic skills. Objetives. To explore nurses’ experiences in the therapeutic relationship with people with anorexia nervosa and its consequences. Likewise, report the emotions experienced by nurses in caring this type of patients, the tools perceived as facilitators, difficulties in communication, as well as the perception of the need for caring and the role played by the institution. Methodology. A qualitative design will be used, specifically grounded theory, through in-depth semi-structured interviews, at the Institute of Psychiatry and Mental Health of the Gregorio Marañón University General Hospital. The interviews will be transcribed, reviewed, read and reread for subsequent coding. From the codes and their interpretation, the large thematic areas that will represent the phenomena will be generated. A data triangulation process will be followed by three researchers.

Introduction: Eating disorders (EDs) develop more frequently in young females. Following the COVID-19 pandemic, there has been evidence of an increase in children and adolescents, with an earlier onset and a worse body weight and nutritional status. The aim of this study was to determine whether this trend has also been observed in our region over the past 6 years. Material and methods: We conducted a retrospective and descriptive cohort study in paediatric patients with a diagnosis of ED, referred during the 3 years preceding and following the declaration of the state of alarm due to the pandemic. We analysed and compared clinical, anthropometric and laboratory variables and bioelectrical impedance and bone density data. Results: Of the 129 patients in the sample, 28 were referred before the lockdown period and 101 after. When we compared these groups, we found a longer time elapsed from onset to the initial assessment (mean delay, 11.87 [SD, 6.75] vs. 6.64 [SD, 4.36] months), a greater hospitalization rate (14.1% vs. 10.1%), and lower vitamin D values (mean level, 28.19 [SD, 9.95] vs. 34.39 [SD, 11.87] ng/mL) in the post-lockdown group. We also found a greater frequency of self-harm suicide attempts in these patients. Conclusions: This study confirms the increasing trend in EDs in children and adolescents in our area. Moreover, we found differences in the clinical characteristics and time elapsed to diagnosis compared to the patients referred to the hospital before the pandemic. Resumen: Introducción: Los trastornos de la conducta alimentaria (TCA) se presentan con mayor frecuencia en personas jóvenes de sexo femenino. Tras la pandemia por COVID-19, se ha descrito su incremento en niños y adolescentes, con presentación a edades más tempranas y peor estado ponderal y nutricional. Este estudio pretende constatar si esa tendencia se cumple también en nuestro medio. Material y métodos: Se realizó un estudio de cohortes descriptivo, retrospectivo en el que se incluye a los pacientes pediátricos con diagnóstico de TCA, remitidos durante los tres años previos y posteriores a la declaración del estado de alerta por la pandemia. Se analizaron y compararon parámetros clínicos, antropométricos, analíticos, bioimpedancia eléctrica y densitometría ósea. Resultados: De los 129 pacientes de la muestra, 28 se derivaron en periodo pre-confinamiento y 101 tras el mismo. En comparación, el segundo grupo presentó mayor tiempo de evolución hasta su primera valoración (11,87 ± 6,75 frente a 6,64 ± 4,36 meses), más hospitalizaciones (14,1% frente a 10,1%), y una reducción de los valores de vitamina D (28,19 ± 9,95 frente a 34,39 ± 11,87 ng/mL). Asimismo, estos pacientes asociaban con más frecuencia autolesiones e intentos de suicidio. Conclusiones: Se comprobó la tendencia creciente de los TCA en niños y adolescentes en nuestro medio. Además, se observaron diferencias en algunas de sus características clínicas, en su gravedad, y en el tiempo de evolución hasta el diagnóstico, en comparación con los pacientes remitidos antes de la pandemia.

The purpose of the present article is to contribute a theoretical review of anorexia, self-harm cutting, and anxiety in the adolescent population. Adolescence is a time of opportunity and significant challenges for individuals. However, due to physical, emotional, and social changes, they are often exposed to various risks. Adolescents are a vulnerable population to present mental or behavioral problems. Anorexia, anxiety, and self-injury are common during this period, causing difficulties in emotional control and negatively affecting quality of life. A timely approach to these conditions focused on properly managing emotions helps adolescents favorably transit to adulthood as they improve social skills, problem-solving ability, and self-confidence. We conclude by highlighting the importance of multidisciplinary work and family support for treatment efficacy. [ABSTRACT FROM AUTHOR]

Introduction: Nutritional status assessment in anorexia nervosa (AN) includes the evaluation and monitoring of body composition throughout the treatment period. The gold standard for the study of body composition is dual-energy X-ray absorptiometry (DEXA), although electrical bioimpedance (BIA) is a more accessible, cheaper and faster method that does not involve exposure to radiation. Material and methods: We recruited 33 female adolescents with AN (age, 11.7–16.3 years) by consecutive sampling. We collected data on clinical, anthropometric and laboratory variables. Patients were assessed with BIA and DEXA at inclusion in the study and at the end of the study, with a mean duration of follow-up of 1 year, during the nutritional rehabilitation phase. Results: There was significant improvement in nutritional status, reflected by the body composition obtained by anthropometric measurements and BIA. The phase angle increased significantly during the follow-up. Greater weight loss was associated with the presence of secondary amenorrhoea and decreased bone mineral density in the spine. Conclusions: Electrical BIA is a useful tool for assessment and monitoring of nutritional status in paediatric patients with AN. Dual-energy X-ray absorptiometry continues to be essential to assess bone mineral density. The role of hormones such as leptin remains to be elucidated. Resumen: Introducción: La valoración nutricional en anorexia nerviosa (AN) incluye determinar la composición corporal y monitorizar su evolución a lo largo del periodo de tratamiento. La prueba gold standard para el estudio de la composición corporal es la absorciometría de rayos X de energía dual (DEXA), si bien la bioimpedancia eléctrica (BIA) se postula como una alternativa más accesible, barata, rápida y que no irradia. Material y métodos: Se reclutaron secuencialmente a 33 mujeres adolescentes (11,7–16,3 años) diagnosticadas de AN. Se recogieron parámetros clínicos, antropométricos y analíticos, y se realizó BIA y DEXA a la inclusión en el estudio y a la finalización del mismo con separación media de un año, durante la fase de rehabilitación nutricional. Resultados: Se objetivó mejoría significativa a nivel nutricional, reflejada en la composición corporal obtenida mediante antropometría y BIA. El ángulo de fase aumentó significativamente durante el periodo de seguimiento. Una mayor pérdida ponderal se correlacionó con la presencia de amenorrea secundaria y con una menor densidad mineral ósea en columna. Conclusiones: La BIA es una herramienta útil para la valoración y el seguimiento del estado nutricional en pacientes con AN en edad pediátrica. La DEXA sigue siendo imprescindible para conocer la afectación de la densidad mineral ósea. El papel de hormonas como la leptina está aún por determinar.

Anorexia nervosa (AN) is a multifactorial disorder. A possible role of the social network and the gut microbiota in pathogenesis has been added. Exogenous shocks such as the COVID19 pandemic have had a negative impact on patients with AN. The potential medical and nutritional impact of malnutrition and/or compensatory behaviors gives rise to a complex disease with a wide range of severity, the management of which requires a multidisciplinary team with a high level of subject matter expertise. Coordination between levels of care is necessary as well as understanding how to transition the patient from pediatric to adult care is essential. A proper clinical evaluation can detect possible complications, as well as establish the organic risk of the patient. This allows caregivers to tailor the medical-nutritional treatment for each patient. Reestablishing adequate nutritional behaviors is a fundamental pillar of treatment in AN. The design of a personalized nutritional treatment and education program is necessary for this purpose. Depending on the clinical severity, artificial nutrition may be necessary. Although the decision regarding the level of care necessary at diagnosis or during follow-up depends on a number of factors (awareness of the disease, medical stability, complications, suicidal risk, outpatient treatment failure, psychosocial context, etc.), outpatient treatment is the most frequent and most preferred choice. However, more intensive care (total or partial hospitalization) may be necessary in certain cases. In severely malnourished patients, the appearance of refeeding syndrome should be prevented during renourishment. The presence of AN in certain situations (pregnancy, vegetarianism, type 1 diabetes mellitus) requires specific care. Physical activity in these patients must also be addressed correctly. [ABSTRACT FROM AUTHOR]

Since the time of Freud, anorexia nervosa has puzzled the psychoanalytic clinic. This article aims to show the link between anorexia and addiction, highlighting the style of addictive pleasure as typical of consumer society. The anorexic symptom therefore presents itself as a subjective solution to the malaise of contemporary civilization. Two clinical cases are used to illustrate the diagnostic implications, focusing on the singular position of the Subject in relation to the Other and to pleasure. [ABSTRACT FROM AUTHOR]

Eating disorders are severe psychiatric illnesses associated with physical and psychological morbidity and mortality. Their incidence has increased, highlighting the emerging public health importance of these conditions and their comorbidities. Oral healthcare professionals may be among the first to observe the signs and symptoms of an eating disorder due to the recognizable links with oral pathology. It is crucial that they are sufficiently informed and confident in diagnosing and treating oral comorbidities. This review describes the oral impacts of Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in the oral cavity, and presents a related case study. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The treatment of anorexia nervosa has been marked by challenges, prompting scholars to establish therapeutic guidelines aimed at overcoming barriers, and enhancing the efficacy of treatment. Although previous studies have documented the difficulties that usually arise in anorexia treatment, the challenges and the vulnerabilities therapists face have not been fully illuminated. The objective of this study is to delve into therapists' experiences and explore the sense of vulnerability they encounter during the treatment of anorexia nervosa, thereby fostering a more profound comprehension of their perspectives. One-to-one interviews were carried out with a cohort of 7 Greek therapists, all of whom had a minimum of 5 years of professional experience. Data were analyzed using interpretative phenomenological analysis and two main themes were constructed: therapist-related factors and building communication. Therapists experienced moments of self-doubt wherein they questioned their capacity to provide an efficacious treatment plan. Aside from this sense of vulnerability, treatment was also thought to be hindered by personal biases while issues of mistrust and parental involvement were considered to be additional challenges. Lastly, the study raises doubts about the therapist's role as the confident and unbiased expert, emphasizing the criticality of addressing these challenges to enhance the overall treatment outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The NICE guidelines (2017) for the psychological treatment of anorexia nervosa in young people recommend family-based therapy, cognitive behaviour therapy or psychodynamic therapy focused on the eating disorder, of all which externalisation is an integral technique. In contrast to this, we are challenging the premise of this method by using Sartre's phenomenological ontology that does not presuppose the separation of the person from the illness, which is the basic premise of the externalisation. We present the key-concepts of Sartre as described in 'Being and Nothingness'. We describe the ontological categories of the in itself and for itself, and their development into human reality in the form of facticity and transcendence. In addition, we explore the concept of the look, the psychic body and the notion of objectification through three clinical cases. We conclude by reflecting on the value of Sartre's existential ontology to the promotion of the importance of collaboration in co-constructing treatment with patients and their families. [ABSTRACT FROM AUTHOR]

Objetivo: Brindar cronológicamente intervenciones de enfermería en el resultado de los objetivos del paciente, interrelacionando NNN durante la estancia hospitalaria a través de la tabla cronológica de interrelaciones NNN individualizado. Caso clínico: Estudiante de secundaria de 14 años de edad, de sexo femenino, con 15 días de hospitalización, con diagnóstico de trastorno de anorexia nerviosa (AN) y desnutrición; ideación lítica, corte en muñeca derecha, adelgazada, caquéxica, antecedentes de bullying, llora por muerte de padre por COVID-19, expresa miedo, no quiere vivir, deja de comer e intentó suicidarse. Métodos: De enfoque cualitativo y de método caso único, se utilizó el marco de valoración de los 11 PFS, con la identificación de problema-objetivo-actividad, articulando la interrelación NNN y está basada en el PAE. Resultados: Trabajamos riesgo de conducta suicida, desequilibrio nutricional, deterioro de la integridad cutánea, ansiedad y baja autoestima situacional. En el cual se logró un 90 % y 100 % (resultado positivo = 4 y 5) del NOC durante los 15 días de hospitalización. Conclusiones: De los cinco diagnósticos enfermeros priorizados y realizados en el paciente, tres de ellos: desequilibrio nutricional, ansiedad y baja autoestima situacional, se logró un 80 % (resultado positivo = 4), no se logró un 100 %; por lo que el paciente sale de alta (15 días de hospitalización) y el proceso de recuperación de este trastorno es largo. Por ello, se acordó con el paciente que se continuará el control post hospitalario especializado después del alta y en el resto de diagnósticos se logró un 100 % (resultado positivo = 5).

Genome-wide association studies (GWAS) of psychiatric disorders have focused primarily on individuals of European ancestry, excluding other ancestries, including Latin American populations. We explore representation of Latin American populations in psychiatric genetics, with a focus on eating disorders. Latin America is "admixed," representing the rich migration history from Africa, Europe, and Asia. Early GWAS technology and analytic strategies performed best in European-ancestry populations. New technology and statistical methods are designed to be inclusive of the genetic richness of admixed populations. Failure to include Latin American and other underrepresented ancestries in genetic studies could lead to incomplete or faulty conclusions about genetic and environmental contributions to psychiatric disease. This raises ethical questions and has critical scientific repercussions, as GWAS findings may not fully replicate across ancestries, ultimately exacerbating health disparities. We review efforts to accelerate genetic research by the Latin American Genetics Consortium (LAGC); highlight strategies to increase transparency and willingness of Latin American individuals to participate in research; and efforts to build capacity throughout Latin America. Achieving these goals advance etiological understanding of psychiatric disorders and assure that future treatments will serve people across all ancestries. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the relationship between personality traits of parents and their daughters with anorexia nervosa (AN) by a case-control study. Fifty adolescent girls with AN (G-AN) and 50 control girls without pathology (GC) were measured with the "Junior Temperament and Character Inventory" and the "Eating Disorder Inventory-2", and both parents. The G-AN and the CG did not differ in personality traits. Both parents of G-AN showed significant differences in temperamental and character traits compared to both parents in CG. In the G-AN, complementary relationships were found in mothers' harm avoidance daughters cooperativeness and fantasy, while in fathers and daughters associations between reward dependence, persistence and self-directedness were found. The only scale that discriminated between the two groups was drive for thinness for G-AN and CG (classification: 74.7%). Identifying personality traits of parents and their daughters at the onset of AN will allow improvements in the intervention. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antecedentes: se ha observado baja calidad de vida relacionada con la salud en pacientes con trastornos de la conducta alimentaria, pero poco se sabe acerca de cómo inciden los tratamientos, tal como la terapia cognitivo conductual, desde las percepciones y experiencias de los pacientes. Objetivo: explorar la calidad de vida relacionada con la salud en jóvenes diagnosticados con trastornos de la conducta alimentaria que reciben terapia cognitivo conductual. Materiales y métodos: estudio cualitativo con metodología de casos múltiples y muestreo intencional de cinco jóvenes que recibían terapia cognitivo conductual para trastornos de la conducta alimentaria en dos programas de tratamiento de la ciudad de Medellín, a los cuales se les realizó una entrevista a profundidad relacionada con la calidad de vida respecto a la salud. Resultados: aunque la terapia cognitivo conductual generó restricciones en la vida de los participantes al inicio del tratamiento, se observaron mejoras en diferentes ámbitos de la calidad de vida relacionada con la salud a medida que este avanzaba: capacidad para hacer cosas, moverse o cuidarse a sí mismo; habilidades cognitivas y académicas; estado emocional; relaciones sociales; percepción de sí mismo y percepción del estado de salud, incluyendo la salud mental. Conclusión: los participantes mejoraron su calidad de vida relacionada con la salud progresivamente, como resultado de la terapia cognitivo conductual, tanto por la reducción de las problemáticas asociadas a trastornos de la conducta alimentaria como por el incremento de habilidades para la vida.

Background: anorexia nervosa (AN) is a severe psychiatric pathology that has one of the highest mortality rates among mental illnesses, estimated at 5.1 deaths per 1,000 people/year, and is associated with high comorbidity, both psychiatric and somatic. Aim: to characterize hospitalized adolescents and their nutritional rehabilitation using a standardized protocol. Methods: a descriptive-retrospective study of adolescent patients hospitalized at the San Carlos of Apoquindo Clinic with a diagnosis of AN, hemodynamically stable and without refeeding syndrome criteria, between 2015 and 2021. Epidemiological, clinical, and nutritional data of the patients were analyzed. Results: of 46 patients studied, 37 were female; the average length of stay was 45.4 (SD ± 36.1) days; 53.8 % of the patients had mood disorder as psychiatric comorbidity, and the most common personality trait was obsessive-compulsive (36.9 %); the most frequent somatic comorbidity was thyroid pathology (19.2 %). The initial oral caloric intake was 1467 (SD ± 479) kcal, with an average weekly increase of 400 kcal, reaching 2430 (SD ± 457) kcal at discharge. An average percentage median body mass index (BMI%) of 7.8 % (SD ± 6.1) was obtained. Conclusions: this is the first study done in Chilean adolescents hospitalized with AN that describes nutritional rehabilitation and length of stay. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Negative & No Positive Results is the property of Research & Science S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La anorexia nerviosa es un trastorno con altos niveles de cronicidad. Sin embargo, los datos epidemiológicos referidos al pronóstico suelen obviar la probabilidad de recuperación a lo largo del tiempo, refiriéndose de manera exclusiva al inicio del curso del trastorno. El objetivo de este artículo es mostrar cómo varía la probabilidad de recuperación de los pacientes con anorexia nerviosa a lo largo del tiempo a partir de la información obtenida de un estudio publicado por Theander en 1985 con datos que abarcan un período medio de observación de 33 años. La pertinencia del presente estudio radica en que el cuidado de los pacientes que la padecen requiere un conocimiento adecuado de las posibilidades de éxito terapéutico en cada momento de la evolución del trastorno y no solo en su inicio. Es conveniente ofrecer datos sobre la evolución temporal de las probabilidades de recuperación y cronicidad, que brindan una visión más ajustada de las perspectivas terapéuticas.

The most up-to-date information on the secondary prevention of eating disorders (EDs) is systematically and thoughtfully reviewed. Recommendations are given on screening and detection methods in the school population and at-risk populations; successful programs, training of professionals; referral to care and therapeutic resources; and early intervention. Also future lines are pointed out. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The cognitive profile of patients with anorexia nervosa is characterized by difficulties in central coherence and mental flexibility. Central coherence is defined by the ability to integrate incoming information in its own context, and weakness in central coherence is characterized by poor overall processing and superior detail processing. Mental flexibility is defined by the ability to change the course of a thought or action according to the demands of the environment. Alterations in this cognitive domain generate rigid and inflexible behavior. An open question in the literature is whether these cognitive characteristics are a transient state derived from the disease or whether they are stable traits associated with anorexia nervosa and endophenotypical features of this disease. The concept of endophenotype refers to the internal phenotype that is not clinically appreciable but can be observed indirectly through deficits that arise in the performance of certain neuropsychological tests. In recent years the search for endophenotypes has been renewed in the field of psychiatry as they would constitute an important route for the understanding of the biological and genetic bases of mental illnesses, constituting markers that allow a diagnosis before the onset of clinical symptomatology. For a cognitive marker to be considered an endophenotype it must meet a series of characteristics such as being measurable, inherited, found in patients with and without active disease and in first-degree relatives not affected by the disease. The aim of the present study was to assess whether difficulties in central coherence and mental flexibility are shared by unaffected first-degree relatives of patients with anorexia nervosa and thus constitute an endophenotypical feature of this disease. This is a cross-sectional, descriptive-comparative study in which 34 women participated: 17 unaffected first-degree relatives of patients with anorexia nervosa (mothers and sisters) and 17 healthy controls matched by age and education. For the study of central coherence the copy of Rey's Complex Figure was used and to assess set-shifting the Stroop test, the Trail Making Test B and the Phonological Fluency test were used. Demographic and clinical aspects such as age, educational level, body mass index, anxiety, depression, obsessive-compulsive and eating disorder related symptoms were also evaluated. First-degree relatives of patients with anorexia nervosa showed lower performance on measures of central coherence (p < .05) and phonological fluency (p < .05) than healthy controls. A correlation was observed between the Stroop test and depression and eating disorders symptoms (p < .05). The results of this study show that unaffected first-degree relatives of patients with anorexia nervosa presented alterations in central coherence and, to a lesser degree, in mental flexibility. These results, in addition to previous research in which difficulties persisted even after recovery, indicate that these alterations could be genetically mediated, constituting a characteristic trait of anorexia nervosa and therefore a possible candidate for neuropsychological endophenotype of this disease. Regarding practical implications of the study, the findings reinforce the importance of cognitive remediation treatments not only for patients with anorexia nervosa but also emphasize that they could be useful for unaffected family members. Taking into account that family intervention is a widely used tool in the psychological treatment of anorexia, improving the perception of the patient and his relatives about cognitive biases, could contribute to raising awareness of the disease, something that patients with anorexia nervosa do not usually have, and generate a positive impact on the response to treatment as a whole. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Perspectivas en Nutrición Humana is the property of Universidad de Antioquia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Our objective was to clarify the relationship between adverse life events and the altered body image in eating disorders. We reviewed English and Spanish papers indexed in MEDLINE, PsycINFO and ScienceDirect from the last 10 years. We included 16 studies of which 37.5% focus on eating disorders. Sexual abuse, physical abuse, domestic violence, bullying and having experienced multiples adverse life events have been associated with overweight patients and high body dissatisfaction. Emotional abuse has been associated with underweight and body shape concerns. Posttraumatic symptoms and emotion dysregulation have been identified as mediating factors. Eating disorder psychopathology could be the response to a bad regulation of negative emotion coming from different adverse life events and this mechanism could underlie patiens' body dissatisfaction. [ABSTRACT FROM AUTHOR]

Los pacientes con delgadez constitucional suelen presentar un peso habitual reducido pero estacionario en el tiempo, con dificultad para aumentarlo incluso luego de someterse a dietas hipercalóricas. A diferencia de otras entidades, no se suelen encontrar trastornos de la alimentación, enfermedades sistémicas, desnutrición o sobre ejercitación. Sin embargo, su presencia suele despertar preocupación y motivar la búsqueda de causas patológicas asociadas, tanto por parte de los pacientes como de los profesionales de la salud. Partiendo de la viñeta clínica de una paciente que presenta estas características, el autor realiza una búsqueda bibliográfica para intentar esclarecer cuán diferentes resultan los pacientes con delgadez constitucional de aquellos que presentan el principal diagnóstico diferencial a tener en cuenta, la anorexia nerviosa.

RESUMEN Los trastornos de la conducta alimentaria (TCA) se definen como alteraciones específicas y severas en la ingesta de los alimentos, observadas en personas que presentan patrones distorsionados en el acto de comer y que se caracterizan, bien sea por comer en exceso o por dejar de hacerlo. Las terapias contextuales o de tercera generación se están utilizando para tratar los trastornos de conducta alimentaria, tienen como objetivo modificar la manera como las personas se relacionan con sus pensamientos sobre el peso, su aspecto físico y la alimentación, para favorecer los procesos de aceptación y flexibilidad cognitiva. El objetivo del presente estudio es realizar una revisión del panorama actual de las terapias contextuales o de tercera generación como intervención terapéutica en los TCA, seleccionando por su desarrollo de adaptaciones y procesos específicos en TCA, a la Terapia Conductual Dialéctica (DBT) y la Terapia de Aceptación y Compromiso (ACT) y también incluyendo en la revisión, el Programa de Alimentación Consciente basado en Mindfulness (MB EAT). Consideramos que DBT ha demostrado mayor estabilización afectiva, mejoría en los niveles de depresión y ansiedad, reducción de atracones y mayor adherencia al tratamiento. ACT ha demostrado ser efectivo en la conducta por atracones y la insatisfacción corporal producida por la inflexibilidad cognitiva. MB EAT ha logrado utilidad mediante la creación de mayor aceptación y flexibilidad en el acto de comer, reconociendo señales de hambre y saciedad, además demostrar reducción de la ingesta compulsiva y atención plena en la alimentación. Son necesarios más estudios, sobre todo con ACT y MB-EAT, para lograr mayor nivel de evidencia.

Introduction: The incidence and manifestations of Eating Disorders (ED) are influenced by the sociocultural context. This study analyzes the changes observed in an Adolescent Psychiatric Short Stay Unit in patients with ED after the COVID-19 pandemic outbreak. Materials and methods: Medical records of patients admitted with a diagnosis of ED in an Adolescent Psychiatric Short Stay Unit were studied, comparing sociodemographic and clinical variables in the pre-COVID-19 pandemic year (March 14, 2019 to March 13, 2020) and the COVID-19 pandemic year (March 14, 2020 to March 13, 2021). Results: 32 patients were included in the study We observed an increase in the percentage of hospital admissions and a change in the clinical profile of patients with ED, with a decrease in BMI at admission (17.53 in pre-COVID-19 pandemic year vs. 16.32 in the year of the COVID-19 pandemic, p=0.950) and BMI at discharge (18.27 in pre-COVID-19 year vs. 17.24 in COVID-19 year, p=0.615), and a statistically significant increase in the duration of admissions in the year of COVID-19 pandemic (10.89 days in pre-COVID-19 year vs. 22.67 days in COVID-19 year, p=0.006). Moreover, a significant increase in food restraint was observed (close to statistical significance; p=0.057), as well as non significant increase in patients' perception of weight gain prior to the onset of eating behaviors. Finally, significant changes were detected in the relational patterns of the patients admitted during the COVID-19 year, in relation to exposure to social networks (p=0.015). Conclusions: The trends found in this study reinforce the need to further explore the possible influence of the COVID pandemic on adolescent ED, pointing to a possible change in clinical characteristics. Implementation of protocols at a social level, that include the specific needs of children and adolescents, should be considered in order to prevent ED. [ABSTRACT FROM AUTHOR]

Objective: Eating disorder (ED) and trauma have often been associated, and there is evidence that early experiences of traumatic events are associated with subsequent ED. Research results point toward an increased prevalence of sexual trauma in individuals with ED, and it has been suggested that sexual trauma precedes and contributes to the development of ED. The aim of this study was to assess the prevalence of sexual trauma as well as other types of traumatic life events in a clinical sample of children, adolescents, and adults with ED.Method: Patients (N = 329), median age 16.9 [Interquartile Range (IQR):4.5], diagnosed with various EDs in a specialized ED unit were included.Results: The majority (67%) of patients with ED reported at least one traumatic life event at time of assessment such as bullying (32%), loss (24%), or accidents (11%). Nineteen per cent of the patients reported having been the victim of a sexual trauma or another sexual traumatic event distributed as follows in terms of severity: 13% had been the victim of a negative experience associated with sex; 57% reported having experienced sexual assault other than rape; and 30% had been the victim of severe forms of sexual assault. The median time between the sexual trauma and the ED diagnosis was 3.4 years (IQR: 6.6). The median time between the sexual trauma and the onset of ED symptoms was 0 years (IQR: 5). The study results imply that the sexual trauma could be experienced either prior to or after onset of ED symptoms.Conclusions: Sixty-seven per cent of the patients with an ED reported traumatic life events at time of assessment, whereby 19% reporting negative sexual experiences or sexual abuse. However, sexual trauma does not necessarily play a causal role in the development of EDs.

La Parálisis Cerebral (PC) es un trastorno persistente del movimiento y de la postura que causa limitación de la actividad, y que tiene como principal causa la lesión encefálica precoz, no evolutiva, de origen fetal o infantil. Se presenta el caso clínico de una paciente de 22 años con PC, sin retraso mental y con anorexia nerviosa(AN), sin alteración de la conducta alimentaria previa (criterios diagnósticos según la CIE-10, 1992). Existen similitudes importantes entre el comportamiento alimentario de los niños con PC y el comportamiento adoptado por los pacientes con AN, en particular. Además de estas comorbilidades, está presente inclusivamente abuso sexual repetido y un episodio depresivo mayor (CIE-10). El abuso sexual además de ser más frecuente en pacientes con discapacidad (incluyendo PC) también parece estar, según la literatura, relacionado con el trastorno del comportamiento alimentario. El trastorno depresivo mayor aparece aquí favorecido por un terreno fértil en factores de riesgo. Se trata de un caso clínico atípico y desafiante en términos de diagnóstico, pero sobre todo terapéutico, necesitando una intervención multidisciplinaria que involucre a profesionales de varias áreas, en particular psiquiatría, psicología, terapía del habla, nutrición, psicomotricidad y terapía ocupacional.

Objective: Eating disorder (ED) and trauma have often been associated, and there is evidence that early experiences of traumatic events are associated with subsequent ED. Research results point toward an increased prevalence of sexual trauma in individuals with ED, and it has been suggested that sexual trauma precedes and contributes to the development of ED. The aim of this study was to assess the prevalence of sexual trauma as well as other types of traumatic life events in a clinical sample of children, adolescents, and adults with ED. Method: Patients (N = 329), median age 16.9 [Interquartile Range (IQR):4.5], diagnosed with various EDs in a specialized ED unit were included. Results: The majority (67%) of patients with ED reported at least one traumatic life event at time of assessment such as bullying (32%), loss (24%), or accidents (11%). Nineteen per cent of the patients reported having been the victim of a sexual trauma or another sexual traumatic event distributed as follows in terms of severity: 13% had been the victim of a negative experience associated with sex; 57% reported having experienced sexual assault other than rape; and 30% had been the victim of severe forms of sexual assault. The median time between the sexual trauma and the ED diagnosis was 3.4 years (IQR: 6.6). The median time between the sexual trauma and the onset of ED symptoms was 0 years (IQR: 5). The study results imply that the sexual trauma could be experienced either prior to or after onset of ED symptoms. Conclusions: Sixty-seven per cent of the patients with an ED reported traumatic life events at time of assessment, whereby 19% reporting negative sexual experiences or sexual abuse. However, sexual trauma does not necessarily play a causal role in the development of EDs. [ABSTRACT FROM AUTHOR]

Introduction: Nutrition education (NE), as part of the treatment of eating disorders (EDs), plays a crucial role in helping patients to change their food attitudes and routines, lose fears, and recover a healthy eating pattern. All these changes may contribute to improving their nutritional status. However, there is a lack of consensus and standardization concerning the procedures to teach it. This work's objective was to elaborate a consensual protocol for NE implementation in the treatment of EDs to help in decision-making regarding which patients are appropriate candidates to receive NE, the agents (family, school community) and professionals involved, and the areas in the healthcare system that are best suited for implementation. Moreover, it would help in selecting the the topics to be imparted, and in following up treatment progression. [ABSTRACT FROM AUTHOR]

Refeeding syndrome is a clinical manifestation that occurs in patients with severe malnutrition as a consequence of eating disorders such as anorexia nervosa, nutritional treatment, whether oral, enteral or parenteral. Occurs mainly in adolescent women between 15 and 19 years of age, this being the group that best responds to treatment and has the highest recovery rate and reincorporation to a normal diet. This syndrome occurs when, starting from a fasting state, food is reintroduced abruptly or with an inadequate distribution and brings clinical and biochemical consequences such as hypophosphatemia, hypokalemia, hypomagnesemia, rhabdomyolysis, respiratory failure and heart failure. The prevention of RS lies in the identification of risk factors and an adequate medical-nutritional approach to prevention based on the patient's physical and nutritional status. The treatment aims to avoid more severe complications and restore the state of homeostasis. This syndrome is the consequence of affected nutritional support in a patient at risk of presenting it and there is no consensus on the most effective and safe treatment for weight restoration in hospitalized children and adolescents with anorexia nervosa. [ABSTRACT FROM AUTHOR]

Different investigations on the onset and maintenance of eating disorders have suggested a significant relationship between cognitive schemas and eating behavior pathologies. The aim of this research was to carry out a documentary review on the relationship between eating disorders and early maladaptive schemas; using the thematic review as methodology. The results show that anorexia nervosa can be associated with the schemas of defectiveness-shame and insufficient self-control, while obesity and binge eating are associated with the domains of disconnection-rejection and autonomy and poor performance. [ABSTRACT FROM AUTHOR]

Introduction: Atypical anorexia nervosa (AN) and anorexia nervosa (ANA) are psychiatric disorders characterized by an overestimation of the volume and weight of the patient towards himself. This condition can be aggravated to the point of becoming life-threatening, a situation that warrants emergency hospitalization. Objective: To characterize the frequency of hospitalizations for AN and ANA during the years 2017-2020 in Chile Materials and methods: Cross-sectional observational study, from a secondary data source, which analyzes the database of the Department of Health Statistics and Information (DEIS) of hospitalization for AN and ANA between the years 2017-2020 (n = 578 ) in Chile. Due to the nature of this work, it did not require an ethics committee since there was no intervention with people. We declare that there is no conflict of interest. Results: The highest and lowest frequency found were the years 2019 and 2017 respectively. Where there is a greater number in the age range between 15 and 19 years. Of these two pathologies, a frequency of hospitalization for AN of 530 (91.7%) and for ANA of 48 (8.3%) patients was observed. The female sex is the one who has 92.39% (534) of hospitalizations and also, an average of days of hospitalization of 28.8 days, being much higher than in the male sex who has an average of 16.9 days of hospitalization. Conclusion: Although there are not a large number of national studies regarding these pathologies, we can observe that there is a significant number of affected patients, who have no lesser hospital stay. There is a decrease in cases during 2020, which could be observed due to the impact of the current SARS-CoV-2 pandemic. The results observed are consistent with the literature. It is important to continue studying these pathologies, and thus anticipate, prevent and / or avoid complications associated with hospitalizations. [ABSTRACT FROM AUTHOR]

Lisa herself expressed that the therapy had been helpful, she reported that a close observer of her life (her mother) had noticed significant gains, there were clear links between key elements of therapy process (e.g. therapist interpretation of transference and use of metaphor) and eventual outcomes, and there were no extra-therapy factors that could account for these results. While these treatments had helped her to increase her body weight and to maintain the weight after treatment, at the beginning of the therapy described in the present study, Lisa remained preoccupied with food planning, which dominated her social life and waking thoughts. Prior to the treatment described here, Lisa had received several symptom-focused treatments, over a span of seven years. [Extracted from the article]

Case description: The objective of this study is to present a clinical case of a 17-year-old patient who is currently under follow-up at the hospital's eating disorder unit, diagnosed with Anorexia Nervosa. Her background is an admission to the Child and Adolescent Psychiatry Hospitalization Unit of Clinical University Hospital in Zaragoza, after presenting a severe clinical picture of "complete paralysis of the lower extremities" and "refusal to eat solids and liquids" of probable conversion origin, which severely limited her daily life, and that was a challenge for medical care due to the high complexity and comorbidity of the diagnosis and treatment of conversion disorder in adolescents. The patient was finally able to walk and to do sports activities following psychopharmacological treatment, rehabilitation and cognitive-behavioral psychotherapy. Conclusions: Conversion disorder in adolescents is a severe pathology that poses a challenge for medical care due to the high complexity and comorbidity of diagnosis and treatment. It is essential for a favorable evolution, early diagnosis and psychotherapeutic work with the patient and the family. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: los trastornos de comportamiento alimentario (TCA) son un grupo de síndromes que tienen en común rasgos psicopatológicos fuertemente determinados por la apariencia física. Son mucho más frecuentes en mujeres que en varones, predominando en jóvenes. Hay aumento en la incidencia de los TCA, como producto del mejoramiento en el conocimiento y en la implementación cada vez más temprana de mejores instrumentos de búsqueda de síntomas, factores de riesgo y la disponibilidad de criterios diagnósticos bien definidos. Objetivo: identificar las principales escalas validadas que permiten detectar síntomas y conductas de riesgo para trastornos del comportamiento alimentario en adolescentes y adultos. Metodología: revisión temática de publicaciones en las que se presentan, validan y analizan diversas escalas para evaluar síntomas y conductas de riesgo para TCA. Se realizó búsqueda electrónica desde 1984 al 2011, en inglés y español. Se incluyeron todas las modalidades de publicaciones. Se revisaron los resúmenes y se escogieron los documentos completos que trataban sobre escalas para valorar síntomas y factores de riesgo para trastornos del comportamiento alimentario. Resultados: se obtuvieron 539 resúmenes sobre TCA. Se revisaron 75 artículos completos y se identificaron seis escalas validadas para identificar síntomas y conductas de riesgo: SCOFF (Sick, Control, Outweight, Fat, Food), EDE-Q (Eating Disorder Examination-self-report Questionnaire), EAT (Eating Attitudes Test), en versiones de 40 y 26 preguntas, además de una escala específica para niños (ChEAT-26). EDI (Eating Disorder Inventory), BULIT (Bulimia Test) y su versión revisada (BULIT-R), BITE (Bulimia Test of Edimburg). Conclusión: la escala SCOFF se destaca por ser sencilla y fácil de aplicar ya sea de forma oral o escrita. La escala EAT, en ambas versiones, es considerada como el estándar de oro para identificar síntomas y conductas de riesgo para TCA. BULIT o BULIT-R y BITE son específicas para bilimia.Rev.cienc.biomed. 2012;3(1):99-111

La anorexia nerviosa se considera una patología típica de clase social media y alta y se caracteriza por el miedo excesivo a aumentar de peso y/o una alteración en la imagen corporal, que motiva a la persona a implementar una severa restricción dietética u otros comportamientos de pérdida de peso como actividad física excesiva. Esta patología se clasifica en dos tipos: la restrictiva y la de tipo compulsivo purgativo. El tratamiento de esta enfermedad siempre requiere manejo por parte de un equipo multidisciplinario conformado principalmente por médicos, nutricionistas y psicólogos entrenados en el manejo de trastornos de la conducta alimentaria.