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Psychosomatics 2020The purpose of this study was to describe the medical complications of anorexia nervosa (AN) to enable a consult-liaison psychiatrist to be familiar with these... (Review)
Review
OBJECTIVE
The purpose of this study was to describe the medical complications of anorexia nervosa (AN) to enable a consult-liaison psychiatrist to be familiar with these complications when involved with the care of a hospitalized patient with AN.
METHODS
Comprehensive PubMed search of English language publications of adult patients with AN was carried out using keywords, phrases, and medical subject headings of anorexia nervosa-medical complications, cardiac, osteoporosis, gastrointestinal, hematological, and endocrine. The database search was restricted by time of publication of studies from 2005 to 2020.
RESULTS
Every organ system can be adversely affected by AN. Most are fully reversible with time and informed medical care. A multidisciplinary team is needed to optimally care for patients who are hospitalized as a result of the medical complications of their AN.
CONCLUSIONS
Consult-liaison psychiatrists are asked to help in the care of patients with AN who are admitted to a hospital because of a medical complication of their illness. Being familiar with these complications and their treatments will optimize their hospital stays and the care provided. In addition, involving other relevant ancillary services is an important care consideration.
Topics: Adult; Anorexia Nervosa; Hospitalization; Humans; Osteoporosis; Referral and Consultation
PubMed: 32778424
DOI: 10.1016/j.psym.2020.06.020 -
Soins; La Revue de Reference Infirmiere Dec 2023Supporting people suffering from anorexia nervosa remains a challenge. While traditional treatment focuses more on speech and its emergence for the patient and family,...
Supporting people suffering from anorexia nervosa remains a challenge. While traditional treatment focuses more on speech and its emergence for the patient and family, non-medicinal and non-verbal therapies are used more systematically, sometimes as a last resort. Yet, as a non-verbal mediated therapy, music therapy can find a legitimate place and complement all the psychiatric, psychotherapeutic, somatic, dietetic and nursing areas where speech already circulates.
Topics: Humans; Anorexia Nervosa; Music Therapy
PubMed: 38070983
DOI: 10.1016/j.soin.2023.10.012 -
The Primary Care Companion For CNS... Nov 2022
Topics: Humans; Anorexia Nervosa; Muscular Diseases; Polyneuropathies
PubMed: 36343356
DOI: 10.4088/PCC.21cr03169 -
Cambridge Quarterly of Healthcare... Oct 2016On seeing promising results in a small number of patients, some researchers are conducting trials to determine whether deep brain stimulation (DBS) is an effective...
On seeing promising results in a small number of patients, some researchers are conducting trials to determine whether deep brain stimulation (DBS) is an effective treatment for anorexia nervosa (AN). This article asks whether we should open enrollment in trials of DBS for AN to adolescents. Despite concerns about informed consent, parental consent, and unforeseeable psychological sequelae, the article concludes that the risks to anorexic adolescents associated with participation in trials of DBS are reasonable considering the substantial risks of not enrolling teens with AN in research on DBS. The seriousness of AN, its high incidence in teens, and serious shortfalls in the AN treatment literature point to the need for improved, evidence-based treatments for teens with AN. This unmet need generates an obligation on the part of researchers and physicians to promote and conduct research on AN in adolescents.
Topics: Adolescent; Anorexia Nervosa; Deep Brain Stimulation; Ethics, Research; Humans; Informed Consent By Minors; Parental Consent; Patient Selection
PubMed: 27634717
DOI: 10.1017/S0963180116000384 -
Neuroscience and Biobehavioral Reviews Jan 2016We have suggested that reduced food intake increases the risk for anorexia nervosa by engaging mesolimbic dopamine neurons, thereby initially rewarding dieting. Recent...
We have suggested that reduced food intake increases the risk for anorexia nervosa by engaging mesolimbic dopamine neurons, thereby initially rewarding dieting. Recent fMRI studies have confirmed that dopamine neurons are activated in anorexia nervosa, but it is not clear whether this response is due to the disorder or to its resulting nutritional deficit. When the body senses the shortage of nutrients, it rapidly shifts behavior toward foraging for food as a normal physiological response and the mesolimbic dopamine neurons may be involved in that process. On the other hand, the altered dopamine status of anorexics has been suggested to result from a brain abnormality that underlies their complex emotional disorder. We suggest that the outcomes of the treatments that emerge from that perspective remain poor because they target the mental symptoms that are actually the consequences of the food deprivation that accompanies anorexia. On the other hand, a method that normalizes the disordered eating behavior of anorexics results in much better physiological, behavioral, and emotional outcomes.
Topics: Animals; Anorexia Nervosa; Comorbidity; Diet, Reducing; Dopamine; Humans; Starvation
PubMed: 26608248
DOI: 10.1016/j.neubiorev.2015.11.003 -
Clinical Nutrition (Edinburgh, Scotland) Mar 2020Anorexia nervosa is a psychiatric disorder defined by an extremely low body weight, a devastating fear of weight gain, and body image disturbance, however the... (Review)
Review
Anorexia nervosa is a psychiatric disorder defined by an extremely low body weight, a devastating fear of weight gain, and body image disturbance, however the etiopathogenesis remains unclear. The objective of the article is to provide a comprehensive review on the potential role of gut microbiota in pathogenesis of anorexia nervosa. Recent advances in sequencing techniques used for microbial detection revealed that this disease is associated with disruption of the composition of normal gut microbiota (dysbiosis), manifested by low microbial diversity and taxonomic differences as compared to healthy individuals. Microorganisms present in the gut represent a part of the so called "microbiota-gut-brain" axis that affect the central nervous system and thus human behavior via the production of various neuroactive compounds. In addition, cells of the immune system are equipped with receptors for these neuroactive substances. Microbiota of the intestinal system also represent a very important antigenic source. These antigens can mimic some host neuropeptides and neurohormones and thus trigger the production of autoantibodies which cross-react with these compounds. The levels and affinities of these antibodies are thought to be associated with neuropsychiatric conditions including anxiety, depression, and eating and sleep disorders. The study of microbiota function in diseases could bring new insights to the pathogenetic mechanisms.
Topics: Anorexia Nervosa; Brain; Humans
PubMed: 30952533
DOI: 10.1016/j.clnu.2019.03.023 -
Expert Opinion on Therapeutic Targets 2023Anorexia nervosa is a frequent eating disorder that affects predominantly young women and may take a severe and chronically worsening course of disease contributing to... (Review)
Review
INTRODUCTION
Anorexia nervosa is a frequent eating disorder that affects predominantly young women and may take a severe and chronically worsening course of disease contributing to its high mortality rate. Although a multitude of treatment options exist, this disease still bears a high relapse rate. In light of these facts, an improvement of existing and development of new treatment targets and options is warranted.
AREAS COVERED
The present review article covers recent developments in psychotherapy associated with the respective neuropsychological and brain alterations as well as highlights current and future pharmacotherapeutic options.
EXPERT OPINION
Several encouraging developments in the field of psychotherapy such as interventions targeting neurocognitive profiles or addressing reward processing, brain stimulation as well as pharmacological modulation of hormones, namely leptin, oxytocin, ghrelin and nesfatin-1 signaling might be - most likely as part of a multimodal treatment approach - efficacious in order to improve treatment of patients with anorexia nervosa, especially those with a severe course of disease as well as comorbidities. As anorexia nervosa represents a complex and severe mental disorder, it seems most likely that a combination and integration of different evidence-based treatment approaches and settings will contribute to an improved prognosis of this eating disorder. This should be further explored in future studies.
Topics: Humans; Female; Anorexia Nervosa; Brain; Combined Modality Therapy; Signal Transduction
PubMed: 37093017
DOI: 10.1080/14728222.2023.2206954 -
Soins. Psychiatrie 2016
Topics: Anorexia Nervosa; Bulimia Nervosa; Combined Modality Therapy; France; Humans
PubMed: 27890278
DOI: 10.1016/j.spsy.2016.09.001 -
Psychiatria Polska Aug 2020Anorexia nervosa constitutes amajor challenge to medical practitioners, especially clinicians, due to a high rate of chronicity and a very serious risk of relapse. One... (Review)
Review
Anorexia nervosa constitutes amajor challenge to medical practitioners, especially clinicians, due to a high rate of chronicity and a very serious risk of relapse. One of the underlying causes of this state of affairs is the ego-syntonicity of the disorder, which differentiates it from similar conditions, and which is responsible for the patient's denial and lack of motivation for treatment (resulting in frequent instances of therapy refusal or drop-out). The paper outlines different approaches to defining chronic anorexia nervosa. Thisform of anorexia and its therapeutic implications are discussed through the lens of clinicians and other medical professionals. Furthermore, the patients'experiences of chronic anorexia nervosa are described. The dilemmas concerning palliative care for this group of patients are addressed and treatment options and relapse prevention strategies are recommended, with a focus on the latest developments in this respect. The paper is concluded with an optimistic report of complete recovery from this diagnosis, including an analysis of the factors underlying the positive therapeutic outcome.
Topics: Anorexia Nervosa; Cognitive Behavioral Therapy; Disease Progression; Humans; Patient Education as Topic; Patient Selection; Psychotherapy
PubMed: 33386730
DOI: 10.12740/PP/OnlineFirst/118601 -
International Review of Psychiatry... Jun 2019For many sufferers of anorexia nervosa, the time course is long, and the prospect of disability and family burden great. This is all too often the case, even with early... (Review)
Review
For many sufferers of anorexia nervosa, the time course is long, and the prospect of disability and family burden great. This is all too often the case, even with early diagnosis and treatment. The term severe and enduring anorexia nervosa has been applied to these survivors. Yet, a majority of patients do eventually recover and, even where this is not the case, adaptive medical stability and function can be maintained despite alarming dilapidation. Managing the years of illness so as to have the best outcome physically and psychologically, even where full weight recovery does not occur, or has not yet occurred, is the topic of this article. Literature pertaining to harm minimization in chronic, severe, enduring, and long-standing anorexia nervosa was selectively reviewed using an Ovid data base and Google Scholar. The authors' own clinical experience over almost four decades in public and private hospital and community settings has also informed much of what has been written. The authors would like to think that it is possible to do better than the familiar injunction (variously attributed to Hippocrates, Galen, and others) of ''-although this is a good place to start.
Topics: Anorexia Nervosa; Harm Reduction; Humans; Patient Education as Topic; Psychotherapy; Social Support
PubMed: 31074662
DOI: 10.1080/09540261.2019.1601073