ABSTRACT Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis. The main characteristic of these diseases is changed behavior in the nutrition, either as an intentional restriction of food, i.e. extreme dieting, or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are characteristic forms of compensatory behavior of patients with eating disorder. The most appropriate course of treatment is determined by evaluating the patient's health condition, associated with behavior and eating habits, the experience of one's own body, character traits of personality, and consequently the development and functioning of the individual. The final treatment plan is individual. Eating disorders are a growing medical problem even in this part of the world. Prevention should be planned in cooperation with different sectors so as to stop the epidemic of these diseases.
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ABSTRACT: Anorexia nervosa (AN) is a serious mental illness with marked morbidity and mortality. To explore the prevalence, heritability, and prospectively assessed risk factors for AN in a large population-based cohort of Swedish twins. During a 4-year period ending in 2002, all living, contactable, interviewable, and consenting twins in the Swedish Twin Registry (N = 31 406) born between January 1, 1935, and December 31, 1958, underwent screening for a range of disorders, including AN. Information collected systematically in 1972 to 1973, before the onset of AN, was used to examine prospective risk factors for AN. Population-based sample of twins in Sweden. Cases of AN were identified as those individuals who met full DSM-IV criteria by means of clinical interview of the Swedish Twin Registry, who had a hospital discharge diagnosis of AN, or who had a cause-of-death certificate including an AN diagnosis. The overall prevalence of AN was 1.20% and 0.29% for female and male participants, respectively. The prevalence of AN in both sexes was greater among those born after 1945. Individuals with lifetime AN reported lower body mass index, greater physical activity, and better health satisfaction than those without lifetime AN. Anorexia nervosa was inversely associated with the development of overweight (odds ratio, 0.29; 95% confidence interval [CI], 0.16-0.54 [P<.001]). The heritability of narrowly defined DSM-IV AN (additive genetic effects) was estimated to be a(2) = 0.56 (95% CI, 0.00-0.87), with the remaining variance attributable to shared environment (c(2) = 0.05; 95% CI, 0.00-0.64) and unique environment (e(2) = 0.38; 95% CI, 0.13-0.84). Neuroticism measured about 3 decades before the diagnostic assessment was significantly associated with the development of later AN (odds ratio, 1.62; 95% CI, 1.27-2.05 [P<.001]). The prevalence of AN was higher in both male and female participants born after 1945. Individuals who survive AN and who no longer have body mass indexes in the AN range appear to be at lower risk for the development of overweight. Prospectively assessed neuroticism was associated with the subsequent development of AN, the liability to which is under considerable genetic influence.Archives of General Psychiatry 03/2006; 63(3):305-12. · 13.75 Impact Factor
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ABSTRACT: Eating disorders indicate unhealthy habits in nutrition and/or behaviour in the feeding and maintaining of body weight. The main characteristic of these diseases is changed behaviour in nutrition, either as an intentional restriction of food, namely extreme dieting or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are the forms of compensatory behaviour. The purpose of the present research was to determine the presence of different inappropriate compensatory behaviours among eating disordered patients. The experimental group included 35 female eating disordered patients of 23.02 +/- 3.46 years on average, with anorexia or bulimia nervosa. The control group consisted of 70 girls aged 23.1 +/- 3.0 years on average. Each participant completed a "24-hour Recall Questionnaire" and the "Eating Disorder Diagnostic Scale". A high statistically significant difference existed in the presence of all compensatory behaviours in the experimental and control group, regarding vomiting (chi2 = 40.6; p < 0.001), misuse of laxatives and diuretics (chi2 = 33.7; p < 0.001), extreme dieting (chi2 = 23.4; p < 0.001) and excessive exercising (chi2 = 27.1; p < 0.001). Eating disordered patients showed a significantly higher incidence of all evaluated forms of compensatory behaviour in comparison with the control group. This report confirms the presence of specific symptomatology of anorexia and bulimia patients.Srpski arhiv za celokupno lekarstvo 01/2010; 138(5-6):328-32. · 0.17 Impact Factor
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ABSTRACT: Anorexia nervosa and bulimia nervosa are expressed differently in children and adolescents than in adults. Consequently, diagnostic procedures and multidisciplinary treatments need to be tailored to the unique developmental, medical, nutritional, and psychological needs of children and adolescents with eating disorders. This paper reviews current research outlining the differences between child, adolescent, and adult eating disorders. Research is then reviewed concerning the effectiveness of hospitalization, partial hospitalization, individual dynamic therapy, cognitive-behavioral therapy, interpersonal therapy, family therapy, and medication for treating anorexia nervosa, bulimia nervosa, and related eating disorders in children and adolescents. Specific recommendations are made for practitioners to tailor these treatments to their eating-disordered child and adolescent patients, following a stepped-care, decision-tree model of intervention that takes into account the effectiveness, cost, and intrusiveness of the interventions.Clinical Psychology Review 07/1998; 18(4):421-46. · 7.18 Impact Factor