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Antecedentes de obesidad y/o sobrepeso en anorexia nerviosa: un estudio piloto

Cuadernos de medicina psicosomática y psiquiatria de enlace, ISSN 1695-4238, Nº. 64, 2002, pags. 19-25
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    ABSTRACT: The nosology for eating disorders, despite having been extensively revised over time, may not capture the natural clustering of eating-related pathology as it occurs in general population samples. Detailed information about anorectic and bulimic behaviors was assessed through personal interviews of 2,163 Caucasian female twins from a population-based registry. Latent class analysis was applied to nine eating disorder symptoms to develop an empirically based typology. Demographic, comorbidity, personality, and co-twin diagnosis data were used to validate the resultant classes. A six-class solution provided the best fit. One class displayed distorted eating attitudes without low body weight. Two classes demonstrated low weight without the psychological features of eating disorders. Three classes broadly resembled the DSM-IV classifications of anorexia nervosa, bulimia nervosa, and binge-eating disorder. For all classes, and especially for the three that reflected current diagnoses of eating disorders, monozygotic twins resembled one another much more in terms of class membership than did dizygotic twins. The authors found within a community sample, and through an empirical method, classes of eating-related pathology that broadly resembled the current classifications of anorexia nervosa, bulimia nervosa, and binge-eating disorder. Additional classes were marked by either the psychological features of eating disorders or low body weight. Individuals in the three eating-disorder classes had similar personality profiles but displayed differences in symptom expression and co-twin risk for anorexia nervosa, bulimia nervosa, and obesity.
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    ABSTRACT: Tested the validity of a Spanish version of the Eating Attitudes Test (EAT) among 78 female patients (mean age 16.8 yrs) with anorexia nervosa and a comparison group of 78 normal Ss paired according to age and social class. The difference between the mean scores of these groups was highly significant. The global validity coefficient was .61. The study of discriminant validity indicated the need to establish a cutoff point of 20, which permits a sensitivity of 91% and a specificity of 69.2%. The alpha reliability coefficient was 0.93. The factor analysis allowed the extraction of 3 factors that explain 41% of the variance. A significant correlation with the Beck Depression Inventory was established. At the reevaluation of 27 patients after their clinical remission, the scores on the EAT were within the normal range. (Spanish abstract) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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    ABSTRACT: Since there are discrepant findings in the literature, we studied the longer-term course in a large sample of 103 DSM-IV anorexia nervosa (AN) patients. Assessments were made at four points of time: beginning of therapy, end of therapy, 2-year follow-up, and 6-year follow-up. Self-rating scales as well as expert-rating interview data were used. Eating disorder-specific and general psychopathology were assessed. These data were also compared with data on the 6-year course of patients with bulimia nervosa and binge eating disorder, respectively, who were treated at the same institution at about the same time. The participation rate at the two follow-ups was high (97.9% of those alive). The general pattern of results over time of those alive at 6-year follow-up was as follows: substantial improvement during therapy, moderate (in many instances nonsignificant) decline during the first 2 years posttreatment, and further improvement from 3 to 6 years posttreatment. At the time of the 6-year follow-up, 26.8% had AN, 9. 9% had bulimia nervosa-purging type (BN-P), 2.0% were classified as eating disorder not otherwise specified (ED-NOS), all diagnosed according to DSM-IV criteria; more than one half (55.4%) showed no major DSM-IV eating disorder. Based on an operationalized global outcome score at 6-year follow-up, 34.7% had a good outcome, 38.6% an intermediate outcome, 20.8% a poor outcome, and 6 of 101 persons (5.9%) were deceased. Body mass index was 17.9 +/- 2.8 at the 6-year follow-up; amenorrhea was still found in 23.9%. In comparison to samples with bulimia nervosa or binge eating disorder, the 6-year course of anorexia nervosa was less favorable. Mortality was rather high and symptomatic recovery protracted; predictors of unfavorable 6-year course were the presence of binges during 4 weeks before index treatment, psychiatric comorbidity, and low body weight at discharge from index treatment.
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