Artículos de revistas: "Anorexia nervosa Etiology"

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Mcfarlane, A. C. "Blindness and Anorexia Nervosa". Canadian Journal of Psychiatry 34, n.º 5 (junio de 1989): 431–33. http://dx.doi.org/10.1177/070674378903400512.

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Two cases of anorexia nervosa in blind patients are reported. They demonstrate that blind children experience many developmental problems which are thought to be important in the etiology of anorexia nervosa. Similarly, blind children are unusually susceptible to misperceive their body size and weight. The apparent absence of a strong association between congenital blindness and anorexia nervosa challenges the presumed aetiological link between disturbed body image and identity diffusion, and anorexia nervosa.

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2

Young, John K. "Estrogen and the etiology of anorexia nervosa". Neuroscience & Biobehavioral Reviews 15, n.º 3 (septiembre de 1991): 327–31. http://dx.doi.org/10.1016/s0149-7634(05)80025-9.

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Roberts, Avalon, H. Mandin y P. Roxburgh. "Unexplained Seizure in Anorexia Nervosa". Canadian Journal of Psychiatry 31, n.º 7 (octubre de 1986): 653–55. http://dx.doi.org/10.1177/070674378603100710.

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A grand mal seizure occurred in a young woman in the weight gain phase of treatment of anorexia nervosa. The etiology of this seizure is explored and suggestions are made for the avoidance of this potential hazard in behavioural reward programs based on contingent weight gain.

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4

Ohwada, Rina, Mari Hotta, Shinichi Oikawa y Kazue Takano. "Etiology of hypercholesterolemia in patients with anorexia nervosa". International Journal of Eating Disorders 39, n.º 7 (2006): 598–601. http://dx.doi.org/10.1002/eat.20298.

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5

Staylen, Inge Jari y Jon Chr Laberg. "Anorexia Nervosa and Bulimia Nervosa Perspectives on etiology and cognitive behavior therapy". Acta Psychiatrica Scandinavica 82, s361 (noviembre de 1990): 52–58. http://dx.doi.org/10.1111/j.1600-0447.1990.tb10756.x.

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6

Ross, Colin A. "How the Incorrect Belief That Eating Disorders Are Predominantly Genetic Is Maintained". Ethical Human Psychology and Psychiatry 20, n.º 2 (1 de agosto de 2018): 73–78. http://dx.doi.org/10.1891/1559-4343.20.2.73.

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The incorrect belief that anorexia nervosa is predominantly genetic is maintained in the psychiatric literature by a series of misquotations and misrepresentations of research data. An example of this type of scholarship is as an editorial in The American Journal of Psychiatry. Data from family and twin studies referenced in the editorial provide compelling evidence that the genetic contribution to the etiology of anorexia nervosa is small. The incorrect belief that anorexia nervosa is predominantly genetic is maintained, in addition, by statistical procedures such as heritability estimates. The incorrect belief that anorexia nervosa is predominantly genetic should not be endorsed by the American Psychiatric Association, in either its journals, in its published books, or in DSM–V.

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7

Ramoz, N. "Is there epigenetics in anorexia nervosa?" European Psychiatry 28, S2 (noviembre de 2013): 21. http://dx.doi.org/10.1016/j.eurpsy.2013.09.050.

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Anorexia Nervosa (AN) is a young-onset psychiatric illness, for which the etiology remains unknown and presents a high heritability. Thus, the genetic component is estimated to be 70%. To identify the vulnerability genes to AN, different approaches of molecular genetic are performed, including linkage analysis, the candidate gene association study and, the Genome-Wide Association Study (GWAS). Some polymorphisms of candidate genes, such as the BDNF gene that encodes for the brain-derived neurotrophic factor, were found associated with AN in several studies. In addition to the DNA polymorphisms, there are several other changes around the DNA information, like methylation or the histone modifications, named epigenetic, that modulate the transcription of genes. Thus, first descendents after the Dutch famine in the Second World War have showed a higher risk of impaired glucose tolerance in adulthood. And women exposed to famine in utero presented DNA methylation differences but without link of cause or consequence between famine event and epigenetic changes. To date, only few events of methylation in specific candidate genes have been investigated in AN. Thus, an hypermethylation of the DRD2 gene's promoter was found associated with a downregulation of this gene expression in AN compared to healthy control women (HCW), using leucocytes. While a hypermethylation of the DAT1 promoter was observed correlated with an upregulation of this gene expression. Another study has showed no difference of the methylation level of the Proopiomelanocortin (POMC) promoter between the goups of HCW, underweight AN (acAN) and weight-recovered AN (recAN). But, the expression of POMC was significantly higher in acAN compared to recAN and HCW, and correlated with the leptin levels. These studies suggest that both the etiology and the pathologic consequences of AN could be derived by epigenetic factors, such as the methylation.

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8

Goldbloom, David S. "The Early Canadian History of Anorexia Nervosa". Canadian Journal of Psychiatry 42, n.º 2 (marzo de 1997): 163–67. http://dx.doi.org/10.1177/070674379704200206.

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Objective: To examine several early Canadian descriptions of anorexia nervosa (AN) in light of modern understanding of the disorder. Method: Two clinical reports of AN from the late 19th century and early 20th century in Canada are cited and summarized. These original case descriptions are then compared with late 20th century knowledge of the disorder. Results: Both of these early descriptions contain many astute and prescient observations on the etiology and sequelae of AN and reveal a compassionate approach to patient care. Conclusions: Canadian contributions to the medical literature on AN prior to 1970 merit both careful scrutiny and appreciation in the world literature on this disorder.

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Schumaker, John F., William G. Warren, Stuart C. Carr, Gwenda S. Schreiber y Craig C. Jackson. "DISSOCIATION AND DEPRESSION IN EATING DISORDERS". Social Behavior and Personality: an international journal 23, n.º 1 (1 de enero de 1995): 53–57. http://dx.doi.org/10.2224/sbp.1995.23.1.53.

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Measures of dissociation and depression were obtained from 26 women with anorexia nervosa, 18 with bulimia nervosa, and 31 non eating disordered controls using the Questionnaire of Experiences of Dissociation (Riley, 1988) and the Beck Depression Inventory (Beck, Ward, Mendelson, Mock & Erbaugh, 1961). Eating disordered subjects scored significantly higher on both dissociation and depression than non eating disordered subjects. A moderate positive correlation was found between dissociation and depression in both the anorexia nervosa and bulimia nervosa groups. The data are discussed in terms of previous research and possible future studies. The necessity for further enquiry of the role of dissociation in the etiology of eating disorders is underscored.

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10

Shekter-Wolfson, Lorie F., D. Blake Woodside y Jan Lackstrom. "Social Work Treatment of Anorexia and Bulimia: Guidelines for Practice". Research on Social Work Practice 7, n.º 1 (enero de 1997): 5–31. http://dx.doi.org/10.1177/104973159700700101.

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The eating disorders anorexia nervosa (AN) and bulimia nervosa (BN) continue to demand significant attention from health care professionals, both due to their high prevalence, mortality, and severe morbidity. Despite nearly 3 decades of investigation, much still remains to be learned about the etiology of the conditions, and there is only a moderate consensus about appropriate treatments. This review article reviews generally accepted models of etiology, modes of assessment, and treatment options for AN and BN, commenting on the empirical basis for the various treatments reviewed The role of social work in these illnesses is reviewed, and some directions for the future are considered.

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Hogan, Ebony M. y Connie J. McReynolds. "An Overview of Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorders: Implications for Rehabilitation Professionals". Journal of Applied Rehabilitation Counseling 35, n.º 4 (1 de diciembre de 2004): 26–34. http://dx.doi.org/10.1891/0047-2220.35.4.26.

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This article addresses anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorders (BED) through the discussion of demographic information, symptomatology, DSM IV criteria for diagnosis, etiology, current treatment modalities, and the potential prognosis of each of these disorders. Additional information about an eating disorder that exclusively affects men is also provided. Intervention strategies for each eating disorder, as well as the relapse phenomenon affecting recovery from eating disorders, are discussed. Specific suggestions are provided for rehabilitation counselors as well as suggestions for future research.

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12

Steiger, Howard. "Anorexia Nervosa and Bulimia in Males: Lessons from a Low-risk Population". Canadian Journal of Psychiatry 34, n.º 5 (junio de 1989): 419–24. http://dx.doi.org/10.1177/070674378903400510.

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The literature on anorexia nervosa and bulimia in male patients was reviewed with the intention of (a) identifying differences that may exist between male and female sufferers, and (b) isolating, through a study of etiological factors in the low-risk (male) group, those factors that may be specific in the etiology of these disorders in both sexes. Current knowledge suggests that fundamental male-female differences do not exist as far as the etiology or symptomatology of these disorders is concerned. Given such similarities, the lower incidence among males suggests biological, social and intrapsychic determinants, that can be conceived to be more active in female versus male populations.

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13

Støving, René Klinkby. "MECHANISMS IN ENDOCRINOLOGY: Anorexia nervosa and endocrinology: a clinical update". European Journal of Endocrinology 180, n.º 1 (enero de 2019): R9—R27. http://dx.doi.org/10.1530/eje-18-0596.

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Anorexia nervosa is a syndrome, that is collections of symptoms, which is not defined by its etiology. The severe cases are intractable. The syndrome is associated with multiple, profound endocrine alterations which may be adaptive, reactive or etiologic. Adaptive changes potentially may be inappropriate in clinical settings such as inpatient intensive re-nutrition or in a setting with somatic comorbidity. Electrolyte levels must be closely monitored during the refeeding process, and the need for weight gain must be balanced against potentially fatal refeeding complications. An important focus of clinical research should be to identify biomarkers associated with different stages of weight loss and re-nutrition combined with psychometric data. Besides well-established peripheral endocrine actions, several hormones also are released directly to different brain areas, where they may exert behavioral and psychogenic actions that could offer therapeutic targets. We need reliable biomarkers for predicting outcome and to ensure safe re-nutrition, however, first of all we need them to explore the metabolism in anorexia nervosa to open new avenues with therapeutic targets. A breakthrough in our understanding and treatment of this whimsical disease remains. Considering this, the aim of the present review is to provide an updated overview of the many endocrine changes in a clinical perspective.

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14

Strober, Michael y Laura L. Humphrey. "Familial contributions to the etiology and course of anorexia nervosa and bulimia." Journal of Consulting and Clinical Psychology 55, n.º 5 (1987): 654–59. http://dx.doi.org/10.1037/0022-006x.55.5.654.

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15

Bienvenu, Thierry, Nicolas Lebrun, Julia Clarke, Philibert Duriez, Philip Gorwood y Nicolas Ramoz. "Exome sequencing in a familial form of anorexia nervosa supports multigenic etiology". Journal of Neural Transmission 126, n.º 11 (6 de agosto de 2019): 1505–11. http://dx.doi.org/10.1007/s00702-019-02056-2.

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16

Le Grange, Daniel. "Elusive Etiology of Anorexia Nervosa: Finding Answers in an Integrative Biopsychosocial Approach". Journal of the American Academy of Child & Adolescent Psychiatry 55, n.º 1 (enero de 2016): 12–13. http://dx.doi.org/10.1016/j.jaac.2015.10.003.

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17

Laban, Myron M., Jeffrey C. Wilkins, Alexander H. Sackeyfio y Ronald S. Taylor. "Osteoporotic stress fractures in anorexia nervosa: Etiology, diagnosis, and review of four cases". Archives of Physical Medicine and Rehabilitation 76, n.º 9 (septiembre de 1995): 884–87. http://dx.doi.org/10.1016/s0003-9993(95)80558-3.

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18

Gaudio, S. y G. Riva. "1966 – A wrong body: a neuroscience perspective on the etiology of anorexia nervosa". European Psychiatry 28 (enero de 2013): 1. http://dx.doi.org/10.1016/s0924-9338(13)76906-2.

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Andrade, Rodrigo, Manuel Gonçalves-Pinho, António Roma-Torres y Isabel Brandão. "Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis". Acta Médica Portuguesa 30, n.º 7-8 (31 de agosto de 2017): 517. http://dx.doi.org/10.20344/amp.8963.

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Introduction: Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by food restriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image. Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexia nervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration before admission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and poorer outcome.Material and Methods: The sample included data from case records of 169 patients seen consecutively and for the first time at Centro Hospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected at admission and from later follow-up years.Results: From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended up with exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differences on outcome rates between distinct illness duration groups (p = 0.007).Discussion: There are several factors frequently associated with poor outcome for anorexia nervosa. The interpretation of outcome findings was limited by the high rate of dropout and lack of consistent definition criteria.Conclusion: Our results support the idea that illness duration has an important role on the outcome and prognostic features of these patients.

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Djurovic, Dusanka. "Psychological and social-cultural factors of the origination and treatment of anorexia nervosa". Psihologija 36, n.º 1 (2003): 89–99. http://dx.doi.org/10.2298/psi0301089d.

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The paper provides and overview of modern literature on psychological and social-cultural factors of anorexy etiology and psychotherapy. Nutrition problems are pointed out, which are necessary to be solved before any psychotherapeutic intervention, and it also provides the overview of our therapeutic approach efficiency.

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Pinheiro, Andréa Poyastro, Patrick F. Sullivan, Josue Bacaltchuck, Pedro Antonio Schmidt do Prado-Lima y Cynthia M. Bulik. "Genetics in eating disorders: extending the boundaries of research". Revista Brasileira de Psiquiatria 28, n.º 3 (9 de agosto de 2006): 218–25. http://dx.doi.org/10.1590/s1516-44462006005000004.

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OBJECTIVE: To review the recent literature relevant to genetic research in eating disorders and to discuss unique issues which are crucial for the development of a genetic research project in eating disorders in Brazil. METHOD: A computer literature review was conducted in the Medline database between 1984 and may 2005 with the search terms "eating disorders", "anorexia nervosa", "bulimia nervosa", "binge eating disorder", "family", "twin" and "molecular genetic" studies. RESULTS: Current research findings suggest a substantial influence of genetic factors on the liability to anorexia nervosa and bulimia nervosa. Genetic research with admixed populations should take into consideration sample size, density of genotyping and population stratification. Through admixture mapping it is possible to study the genetic structure of admixed human populations to localize genes that underlie ethnic variation in diseases or traits of interest. CONCLUSIONS: The development of a major collaborative genetics initiative of eating disorders in Brazil and South America would represent a realistic possibility of studying the genetics of eating disorders in the context of inter ethnic groups, and also integrate a new perspective on the biological etiology of eating disorders.

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Sarin, Sabina y John R. Z. Abela. "The Relationship Between Core Beliefs and a History of Eating Disorders: An Examination of the Life Stories of University Students". Journal of Cognitive Psychotherapy 17, n.º 4 (octubre de 2003): 359–74. http://dx.doi.org/10.1891/jcop.17.4.359.52540.

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The goal of the current study was to examine the relationship between core beliefs and a history of eating disorders using a retrospective design. Sixty-three university students completed self-report measures assessing current depressive symptoms. They also completed a semistructured interview assessing current and past histories of eating disorders. The presence of core beliefs was identified through an examination of participants’ life stories. Core beliefs were associated with past histories of both anorexia and bulimia nervosa, even after controlling for current depressive symptoms and eating disorders. Further analyses revealed that core beliefs centering around themes of disconnection and rejection, other-directedness, and overvigilance and inhibition were associated with past histories of anorexia nervosa, whereas core beliefs centering around themes of disconnection and rejection, impaired limits, and overvigilance and inhibition were associated with past histories of bulimia nervosa. These findings provide preliminary support for recent theoretical models highlighting the potential importance of core beliefs in the etiology of eating disorders.

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Jagielska, Gabriela. "Bone mineralization disorders as a complication of anorexia nervosa - etiology, prevalence, course and treatment". Psychiatria Polska 50, n.º 3 (2016): 509–20. http://dx.doi.org/10.12740/pp/59289.

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Bienvenu, O. J., D. S. Davydow y K. S. Kendler. "Psychiatric ‘diseases’ versus behavioral disorders and degree of genetic influence". Psychological Medicine 41, n.º 1 (12 de mayo de 2010): 33–40. http://dx.doi.org/10.1017/s003329171000084x.

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BackgroundPsychiatric conditions in which symptoms arise involuntarily (‘diseases’) might be assumed to be more heritable than those in which choices are essential (behavioral disorders). We sought to determine whether psychiatric ‘diseases’ (Alzheimer's disease, schizophrenia, and mood and anxiety disorders) are more heritable than behavioral disorders (substance use disorders and anorexia nervosa).MethodWe reviewed the literature for recent quantitative summaries of heritabilities. When these were unavailable, we calculated weighted mean heritabilities from twin studies meeting modern methological standards.ResultsHeritability summary estimates were as follows: bipolar disorder (85%), schizophrenia (81%), Alzheimer's disease (75%), cocaine use disorder (72%), anorexia nervosa (60%), alcohol dependence (56%), sedative use disorder (51%), cannabis use disorder (48%), panic disorder (43%), stimulant use disorder (40%), major depressive disorder (37%), and generalized anxiety disorder (28%).ConclusionsNo systematic relationship exists between the disease-like character of a psychiatric disorder and its heritability; many behavioral disorders seem to be more heritable than conditions commonly construed as diseases. These results suggest an error in ‘common-sense’ assumptions about the etiology of psychiatric disorders. That is, among psychiatric disorders, there is no close relationship between the strength of genetic influences and the etiologic importance of volitional processes.

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Carvalho, Anny Priscylla Silva de, Larissa Silva de Assis, Dayane Lorraine Vale Simões, Wollner Materko y Maysa de Vasconcelos Brito. "Inflammatory mediators and their clinical repercussions on anorexia nervosa". Research, Society and Development 10, n.º 1 (2 de enero de 2021): e4510111474. http://dx.doi.org/10.33448/rsd-v10i1.11474.

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Anorexia Nervosa (AN) is an eating disorder that affects adults, young people and children, has a multifactorial etiology, characterized by a distortion of body image associated with fear of gaining weight, leading the individual to commit severe food restriction, causing extreme weight loss and malnutrition. This, clinical and metabolic manifestations associated with inflammatory biomarkers are triggered, based on evidence on the dysregulation of the immune system and an inflammatory immunomodudulation during AN. The present study aims to present evidence that demonstrates how inflammatory mediators are systematically related to the most common clinical manifestations more in AN. This is an integrative review, based on consultation of the databases: MEDLINE and LILACS. Sixteen studies were selected from 2014 to 2020 with 56, 25% NE3, followed by 31, 25% NE 5 and 12, 5% NE 2. Studies have shown that inflammatory biomarkers such as interleukins, and chemokines, leptin, ghrelin, omentine-1, adinonectin, BDNF, VEGF, VCAM, PCR, OC, CTX, OPG, RANK, RANKL, IFN -γ, NO, IGF and some classes of TNF are related to clinical manifestations in AN contributing to prolonged and difficult to reverse symptoms, such as depression, sleep disorders, memory and learning, altered behavior , tissue damage, decreased appetite, risk for cardiovascular disease, changes in the intestinal microbiome, osteoporosis, amenorrhea, inflammation of the hypothalamus, impaired energy metabolism and unregulated inflammatory state. However, further clarification is needed on this topic, as there are still few studies in this line of research.

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Mohee, Kevin, Amalan Karthigeyan, Stephen B. Wheatcroft y Katarzyna Kucharska. "Cardiac abnormalities in anorexia nervosa inpatients – a retrospective study". Polish Journal of Public Health 125, n.º 3 (1 de septiembre de 2015): 125–28. http://dx.doi.org/10.1515/pjph-2015-0038.

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Abstract Introduction. Anorexia nervosa (AN) is a life-threatening condition, with significant risk of death due to cardiac abnormalities. Aim. The aim of this study was to investigate for QTc interval or heart rate (HR) abnormalities in AN patients and any correlation between BMI, HR and QTc interval at baseline and at completion of treatment. Material and methods. 30 patients (29 females, 1 male) aged 16 to 45 years with a diagnosis of AN were retrospectively analyzed from January 2012 to September 2014. An ECG, biochemical tests, BMI and clinical assessment were performed on admission. ECG and BMI were also repeated at discharge. Results. A paired t-test was used to compare two sets of scores that come from the same participants on both admission and discharge. The mean baseline BMI was 14.8 +/− 4 kg/m2, baseline HR was 53.4 +/− 16 bpm and QTc interval 416 +/− 40 ms. At discharge, mean BMI was 18.7 +/− 2 kg/m2, HR was 73 +/− 11 bpm and QTc interval 402 +/− 34. The mean QTc interval was decreased by 14 ms and the HR increased by 19 beats/min. A Wilcoxon test showed that the treatment course did not elicit a statistically significant change in HR score in individuals with AN (Z=−4, p=0.000). Pearson correlations showed that patients with a higher magnesium had lower heart rate on admission (r=−0.61; p=0.002). Conclusion. Further exploration is needed in a larger population to investigate for etiology and medical management of cardiac abnormalities in AN.

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Aydin, Ibrahim, Ahmet Pergel, Ahmet Fikret Yucel, Dursun Ali Sahin y Ender Ozer. "Gastric Necrosis due to Acute Massive Gastric Dilatation". Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/847238.

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Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

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Chazova, T. Ye y S. Yu Kalinchenko. "Somatoendocrine disorders in nervous anorexia". Problems of Endocrinology 40, n.º 5 (15 de diciembre de 1994): 59–62. http://dx.doi.org/10.14341/probl12176.

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Anorexia nervosa (AN) is expressed in the extremely stubborn desire to lose weight through targeted, long-term self-restraint in food, sometimes accompanied by intense physical exercise or taking large doses of a laxative. If it is impossible to withstand prolonged starvation, patients resort to a method such as inducing artificial vomiting. AN is a pathology characteristic of adolescent girls and young girls, although it can sometimes occur in males of puberty or adolescence. AN is more common at the age of 15-25 years. The incidence among women is on average 10 times higher than among men. There is no information on the prevalence of AN in our country. According to foreign authors, the frequency of AN is 112 per 100,000 of the population. However, these data are underestimated, since only patients with severe, protracted forms of the course of AN go to the hospital and are subject to accounting. Patients with "mild" forms of AN remain outside the field of vision of doctors. The beginning of a scientific study of AN was laid by W. Gull (1868) and E.-Ch. Laseque (1873). However, despite the increasing number of studies devoted to this interesting problem, AN still causes numerous discussions regarding its etiology, pathogenesis, and neuroendocrine disorders, and methods for their correction. In this review, we tried to summarize the available data of recent years. One of the first reviews on the nature of neuroendocrine shifts in AN was made in 1984.

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BLANK, SHULAMIT y YAEL LATZER. "The Boundary-Control Model of Adolescent Anorexia Nervosa: An Integrative Approach to Etiology and Treatment?" American Journal of Family Therapy 32, n.º 1 (enero de 2004): 43–54. http://dx.doi.org/10.1080/01926180490255756.

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Boehm, I., J. A. King, F. Bernardoni, D. Geisler, M. Seidel, F. Ritschel, T. Goschke, J. D. Haynes, V. Roessner y S. Ehrlich. "Subliminal and supraliminal processing of reward-related stimuli in anorexia nervosa". Psychological Medicine 48, n.º 5 (23 de agosto de 2017): 790–800. http://dx.doi.org/10.1017/s0033291717002161.

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BackgroundPrevious studies have highlighted the role of the brain reward and cognitive control systems in the etiology of anorexia nervosa (AN). In an attempt to disentangle the relative contribution of these systems to the disorder, we used functional magnetic resonance imaging (fMRI) to investigate hemodynamic responses to reward-related stimuli presented both subliminally and supraliminally in acutely underweight AN patients and age-matched healthy controls (HC).MethodsfMRI data were collected from a total of 35 AN patients and 35 HC, while they passively viewed subliminally and supraliminally presented streams of food, positive social, and neutral stimuli. Activation patterns of the group×stimulation condition×stimulus type interaction were interrogated to investigate potential group differences in processing different stimulus types under the two stimulation conditions. Moreover, changes in functional connectivity were investigated using generalized psychophysiological interaction analysis.ResultsAN patients showed a generally increased response to supraliminally presented stimuli in the inferior frontal junction (IFJ), but no alterations within the reward system. Increased activation during supraliminal stimulation with food stimuli was observed in the AN group in visual regions including superior occipital gyrus and the fusiform gyrus/parahippocampal gyrus. No group difference was found with respect to the subliminal stimulation condition and functional connectivity.ConclusionIncreased IFJ activation in AN during supraliminal stimulation may indicate hyperactive cognitive control, which resonates with clinical presentation of excessive self-control in AN patients. Increased activation to food stimuli in visual regions may be interpreted in light of an attentional food bias in AN.

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Herpertz-Dahlmann y Dahmen. "Children in Need—Diagnostics, Epidemiology, Treatment and Outcome of Early Onset Anorexia Nervosa". Nutrients 11, n.º 8 (16 de agosto de 2019): 1932. http://dx.doi.org/10.3390/nu11081932.

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Knowledge of anorexia nervosa (AN) in childhood is scarce. This review gives a state-of-the-art overview on the definition, classification, epidemiology and etiology of this serious disorder. The typical features of childhood AN in comparison to adolescent AN and avoidant restrictive eating disorder (ARFID) are described. Other important issues discussed in this article are somatic and psychiatric comorbidity, differential diagnoses and medical and psychological assessment of young patients with AN. Special problems in the medical and psychological treatment of AN in children are listed, although very few studies have investigated age-specific treatment strategies. The physical and mental outcomes of childhood AN appear to be worse than those of adolescent AN, although the causes for these outcomes are unclear. There is an urgent need for ongoing intensive research to reduce the consequences of this debilitating disorder of childhood and to help patients recover.

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Groth-Marnat, Gary y Jack F. Scumaker. "LOCUS OF CONTROL AND ATTITUDE TOWARD EATING IN A FEMALE COLLEGE POPULATION". Social Behavior and Personality: an international journal 16, n.º 1 (1 de enero de 1988): 19–23. http://dx.doi.org/10.2224/sbp.1988.16.1.19.

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This study investigated the relationship between locus of control and attitude to food intake. One hundred and one females (mean age = 21.3) were administered the I-E Scale, and Eating Attitudes Test, and Goldfarb Fear of Fat Scale. Results indicated that locus of control was unable to predict attitudes towards eating and fear of becoming overweight. The thesis that locus of control would be related to attitude towards food intake was not supported. Possible explanations, areas of future research, and implications in the etiology of anorexia nervosa are discussed.

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Thompson, Ron A. "Management of the Athlete with an Eating Disorder: Implications for the Sport Management Team". Sport Psychologist 1, n.º 2 (junio de 1987): 114–26. http://dx.doi.org/10.1123/tsp.1.2.114.

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While college women in general are at risk for anorexia nervosa and bulimia, these disorders may present more of a problem for the student-athlete due to her weight/body consciousness and the pressure associated with athletic competition at the college or university level. This paper discusses the physical and psychological characteristics of each disorder, their etiology, and how each affects the life and performance of the athlete. Recommendations are offered regarding the role of the sport management team (i.e., sport psychologist, team physician, coach, athletic trainer, exercise physiologist) in assisting the eating-disordered athlete.

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Hariz, Anis, Mohamed Salah Hamdi, Imen Boukhris, Nadia Boujelbène, Samira Azzabi y Narjess Khalfallah. "Gelatinous Transformation of Bone Marrow in a Patient with Anorexia Nervosa: An Uncommon but Reversible Etiology". American Journal of Case Reports 19 (7 de diciembre de 2018): 1449–52. http://dx.doi.org/10.12659/ajcr.911287.

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Jimerson, Shane R. y Renee Pavelski. "The School Psychologist’s Primer on Anorexia Nervosa: A Review of Research Regarding Epidemiology, Etiology, Assessment, and Treatment". California School Psychologist 5, n.º 1 (enero de 2000): 65–77. http://dx.doi.org/10.1007/bf03340877.

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Sundgot-Borgen, Jorunn. "Eating Disorders, Energy Intake, Training Volume, and Menstrual Function in High-level Modern Rhythmic Gymnasts". International Journal of Sport Nutrition 6, n.º 2 (junio de 1996): 100–109. http://dx.doi.org/10.1123/ijsn.6.2.100.

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This study examined clinical and subclinical eating disorders (EDs) in young Norwegian modern rhythmic gymnasts. Subjects were 12 members of the national team, age 13-20 years, and individually matched nonathletic controls. All subjects participated in a structured clinical interview for EDs, medical examination, and dietary analysis. Two of the gymnasts met the DSM-III-R criteria for anorexia nervosa, and 2 met the criteria for anorexia athletica (a subclinical ED). AH the gymnasts were dieting in spite of the fact that they were all extremely lean. The avoidance of maturity, menstrual irregularities, energy deficit, high training volume, and high frequency of injuries were common features among the gymnasts. There is a need to learn more about risk factors and the etiology of EDs in different sports. Coaches, parents, and athletes need more information about principles of proper nutrition and methods to achieve ideal body composition for optimal health and athletic performance.

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Elliott, Haley, Payton J. Jones y Ulrike Schmidt. "Central Symptoms Predict Posttreatment Outcomes and Clinical Impairment in Anorexia Nervosa: A Network Analysis". Clinical Psychological Science 8, n.º 1 (11 de octubre de 2019): 139–54. http://dx.doi.org/10.1177/2167702619865958.

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Network analysis can be used to identify central symptoms of eating disorders such as anorexia nervosa (AN), but the validity of this approach has been questioned. Using network analysis, in the present study we identify central symptoms of adult AN, identify key bridge symptoms between AN and anxiety/depression, and examine whether central symptoms at baseline are important predictors of treatment outcomes. We conducted network analyses for AN and comorbid depression and anxiety using longitudinal data (N = 142) with measurements at baseline, and at 6-month, 12-month, and 24-month postrandomization follow-ups. We identified central symptoms and bridge symptoms and tested whether centrality values calculated at baseline were related to the prognostic utility of symptoms longitudinally. Feeling fat and fear of weight gain were among the most central symptoms of AN. Feelings of worthlessness had the highest bridge centrality connecting depression to AN. Symptom centrality at baseline was strongly related to prognostic utility ( r2 = .52, .55). The finding that symptom centrality was strongly related to prognostic utility supports the validity of network theory in that central symptoms may have a particularly strong influence on clinical impairment and recovery. These analyses generate useful hypotheses about the etiology and maintenance of AN and related comorbidities and may inform future treatment development.

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Coman, Alina, Finn Skårderud y Bjørn M. Hofmann. "A Disorder of a Vulnerable Self: Anorexia Nervosa Patients’ Understanding of Disorder and Self in the Context of fMRI Brain Scanning". Ethical Human Psychology and Psychiatry 15, n.º 2 (2013): 120–34. http://dx.doi.org/10.1891/1559-4343.15.2.120.

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In this article, we aim to explore patient perspectives regarding the etiology of anorexia nervosa (AN) in the context of participating in brain research for AN. This is a qualitative study using semistructured interviews with 12 young AN patients. Data were analyzed according to thematic analysis method. This study shows that patients’ language used to express their understanding of the etiology of AN was characterized by psychological terms such as personality, self-esteem, control, and coping rather than neuroscientific terms.Participants held a complex understanding of the causes of AN, acknowledging a brain–mind relationship. However, participants expressed the hope that brain sciences could contribute to identify an objective, physical proof for AN, that would validate their illness, increase understanding, and reduce blame. The study suggests that prevailing biological explanations promoted by brain research did not encourage simplistic perspectives on causation among patients. Instead, patients viewed biological-based theories and brain science as a means of validating their illness.

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Oriani, M. G., M. Barchiesi, L. Sabbatini y B. Nardi. "Association between eating disorders and 5-HTTLPR polymorphism: The experience of an Italian eating disorders unit". European Psychiatry 41, S1 (abril de 2017): S558. http://dx.doi.org/10.1016/j.eurpsy.2017.01.804.

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IntroductionEating Disorders (ED) as Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) are severe and debilitating psychiatric diseases whose etiology is complex and still largely unknown. Several studies seem to suggest that serotonin could be involved and notably there are several associations with 5-HTTLPR polymorphism, especially with the S allele and the S/S genotype.ObjectivesThe purpose of this study is to evaluate if an association between ED and 5-HTTLPR (especially the S allele frequency) can be shown.Material and methodsA group of about 100 subjects attending the eating disorders unit of Ancona will be tested. Their DNA will be taken and the frequency of the S allele will be compared with a control subjects group negative for ED. Then, the ED group will be divided, according to the DSM-5 criteria, in 3 subgroups (AN, BN, BED) and potential differences will be evaluated.ResultsAt the moment, we are still collecting patients. According to other studies involving 5-HTTLPR, the S allele frequency in Italy is comparable with the European one, so there is reason to believe that an association could be found.ConclusionsSerotonin involvement in ED in literature is shown, but it still has to be completely expounded. Studies as this one could help in describing the etiology and the development of this disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Thornton, Laura M., Sara E. Trace, Kimberly A. Brownley, Monica Ålgars, Suzanne E. Mazzeo, Jocilyn E. Bergin, Millie Maxwell, Paul Lichtenstein, Nancy L. Pedersen y Cynthia M. Bulik. "A Comparison of Personality, Life Events, Comorbidity, and Health in Monozygotic Twins Discordant for Anorexia Nervosa". Twin Research and Human Genetics 20, n.º 4 (24 de mayo de 2017): 310–18. http://dx.doi.org/10.1017/thg.2017.27.

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Genetic and environmental factors contribute to the etiology of anorexia nervosa (AN). The co-twin control design is one of the most powerful methods available to evaluate environmental factors that could contribute to differences between monozygotic (MZ) twins who are discordant for AN. Using available data from a unique and rare sample of 22 Swedish female MZ pairs discordant for AN, we compared personality, life events, comorbidity, and health factors. Twins with AN had significantly higher perfectionism scores than unaffected co-twins and reported younger ages at first diet than unaffected co-twins who had dieted. Consistent with previous literature, more twins with AN reported gastrointestinal problems than unaffected co-twins. Although not significant due to low statistical power, more unaffected co-twins reported experiencing emotional neglect than twins with AN. Early dieting may be a harbinger of the development of AN or an early symptom. Higher perfectionism may represent a risk factor, sequela, or both. Sibling perception of neglect is noteworthy given the impact of an ill child with AN on family function and wellbeing. The health and wellbeing of siblings should be addressed clinically when one child in the family suffers from AN.

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Monteleone, Palmiero, Antonio DiLieto, Eloisa Castaldo y Mario Maj. "Leptin Functioning in Eating Disorders". CNS Spectrums 9, n.º 7 (julio de 2004): 523–29. http://dx.doi.org/10.1017/s1092852900009615.

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AbstractLeptin is an adipocyte-derived hormone, which is involved predominantly in the long-term regulation of body weight and energy balance by acting as a hunger suppressant signal to the brain. Leptin is also involved in the modulation of reproduction, immune function, physical activity, and some endogenous endocrine axes. Since anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by abnormal eating behaviors, dysregulation of endogenous endocrine axes, alterations of reproductive and immune functions, and increased physical activity, extensive research has been carried out in the last decade in order to ascertain a role of this hormone in the pathophysiology of these syndromes. In this article, we review the available data on leptin physiology in patients with eating disorders. These data support the idea that leptin is not directly involved in the etiology of AN or BN. However, malnutrition-induced alterations in its physiology may contribute to the genesis and/or the maintenance of some clinical manifestations of AN and BN and may have an impact on the prognosis of AN.

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Simon, Joe J., Marion A. Stopyra y Hans-Christoph Friederich. "Neural Processing of Disorder-Related Stimuli in Patients with Anorexia Nervosa: A Narrative Review of Brain Imaging Studies". Journal of Clinical Medicine 8, n.º 7 (18 de julio de 2019): 1047. http://dx.doi.org/10.3390/jcm8071047.

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Abnormalities and alterations in brain function are commonly associated with the etiology and maintenance of anorexia nervosa (AN). Different symptom categories of AN have been correlated with distinct neurobiological patterns in previous studies. The aim of this literature review is to provide a narrative overview of the investigations into neural correlates of disorder-specific stimuli in patients with AN. Although findings vary across studies, a summary of neuroimaging results according to stimulus category allows us to account for methodological differences in experimental paradigms. Based on the available evidence, the following conclusions can be made: (a) the neural processing of visual food cues is characterized by increased top-down control, which enables restrictive eating, (b) increased emotional and reward processing during gustatory stimulation triggers disorder-specific thought patterns, (c) hunger ceases to motivate food foraging but instead reinforces disorder-related behaviors, (d) body image processing is related to increased emotional and hedonic reactions, (e) emotional stimuli provoke increased saliency associated with decreased top-down control and (f) neural hypersensitivity during interoceptive processing reinforces avoidance behavior. Taken together, studies that investigated symptom-specific neural processing have contributed to a better understanding of the underlying mechanisms of AN.

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Romero-Martínez, Ángel y Luis Moya-Albiol. "Prenatal testosterone of progenitors could be involved in the etiology of both anorexia nervosa and autism spectrum disorders of their offspring". American Journal of Human Biology 26, n.º 6 (31 de julio de 2014): 863–66. http://dx.doi.org/10.1002/ajhb.22597.

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Davis, Caroline. "Eating Disorders and Hyperactivity: A Psychobiological Perspective". Canadian Journal of Psychiatry 42, n.º 2 (marzo de 1997): 168–75. http://dx.doi.org/10.1177/070674379704200207.

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Objective: To review the eating disorder research investigating the psychobiological connections between self-starvation and high-level exercising, including both animal experimentation and clinical field studies. In recent years it has been proposed that physical activity plays a central role in the pathogenesis and progression of the eating disorders—in particular, anorexia nervosa. Method: A review of research from animal experimentation and from clinical field studies investigating the biological and psychological implications of physical activity and starvation in the pathogenesis of eating disorders. Results: Animal research indicates that physical activity and starvation seem to potentiate one another and that alterations in the serotonergic system may underlie this process. Similar behavioural results have been found in recent clinical studies with eating-disordered patients, which suggests that physical activity plays a more central role in the development and maintenance of the eating disorders than had previously been thought. Conclusions: The emerging picture is that psychosocial factors seem to provide the most compelling factors in the etiology and onset of the disorder, while biological factors—in most cases induced by severe malnutrition and strenuous overexercising—predominate in the maintenance of the disorder.

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Root, T. L., E. M. Pisetsky, L. Thornton, P. Lichtenstein, N. L. Pedersen y C. M. Bulik. "Patterns of co-morbidity of eating disorders and substance use in Swedish females". Psychological Medicine 40, n.º 1 (20 de abril de 2009): 105–15. http://dx.doi.org/10.1017/s0033291709005662.

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BackgroundLittle is known about the association of eating disorder subtypes across multiple categories of substance use in population-based samples. We examined the association between eating disorders and substance use in a large population-based sample.MethodFemale participants (n=13 297) were from the Swedish Twin Registry [Lichtenstein et al., Twin Research and Human Genetics (2006) 9, 875–882]. Substance use was examined in four defined groups – (1) anorexia nervosa (AN); (2) bulimia nervosa (BN); (3) AN and BN (ANBN); and (4) binge eating disorder (BED) as well as a referent group without eating disorder (no ED). Secondary analyses examined differences between restricting AN (RAN) and binge and/or purge AN (ANBP).ResultsIn general, eating disorders were associated with greater substance use relative to the referent. The AN group had significantly increased odds for all illicit drugs. Significant differences emerged across the RAN and ANBP groups for alcohol abuse/dependence, diet pills, stimulants, and polysubstance use with greater use in the ANBP group. Across eating disorder groups, (1) the BN and ANBN groups were more likely to report alcohol abuse/dependence relative to the AN group, (2) the ANBN group was more likely to report diet pill use relative to the AN, BN and BED groups, and (3) the BN group was more likely to report diet pill use relative to the no ED, AN and BED groups.ConclusionsEating disorders are associated with a range of substance use behaviors. Improved understanding of how they mutually influence risk could enhance understanding of etiology and prevention.

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Bergin, Jocilyn E. y Kenneth S. Kendler. "Common Psychiatric Disorders and Caffeine Use, Tolerance, and Withdrawal: An Examination of Shared Genetic and Environmental Effects". Twin Research and Human Genetics 15, n.º 4 (5 de julio de 2012): 473–82. http://dx.doi.org/10.1017/thg.2012.25.

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Background: Previous studies examined caffeine use and caffeine dependence and risk for the symptoms, or diagnosis, of psychiatric disorders. The current study aimed to determine if generalized anxiety disorder (GAD), panic disorder, phobias, major depressive disorder (MDD), anorexia nervosa (AN), or bulimia nervosa (BN) shared common genetic or environmental factors with caffeine use, caffeine tolerance, or caffeine withdrawal. Method: Using 2,270 women from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders, bivariate Cholesky decomposition models were used to determine if any of the psychiatric disorders shared genetic or environmental factors with caffeine use phenotypes. Results: GAD, phobias, and MDD shared genetic factors with caffeine use, with genetic correlations estimated to be 0.48, 0.25, and 0.38, respectively. Removal of the shared genetic and environmental parameter for phobias and caffeine use resulted in a significantly worse fitting model. MDD shared unique environmental factors (environmental correlation = 0.23) with caffeine tolerance; the genetic correlation between AN and caffeine tolerance and BN and caffeine tolerance were 0.64 and 0.49, respectively. Removal of the genetic and environmental correlation parameters resulted in significantly worse fitting models for GAD, phobias, MDD, AN, and BN, which suggested that there was significant shared liability between each of these phenotypes and caffeine tolerance. GAD had modest genetic correlations with caffeine tolerance, 0.24, and caffeine withdrawal, 0.35. Conclusions: There was suggestive evidence of shared genetic and environmental liability between psychiatric disorders and caffeine phenotypes. This might inform us about the etiology of the comorbidity between these phenotypes.

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Chao, Ariana M., Abhrarup Roy, Alexis T. Franks y Paule V. Joseph. "A Systematic Review of Taste Differences Among People With Eating Disorders". Biological Research For Nursing 22, n.º 1 (4 de septiembre de 2019): 82–91. http://dx.doi.org/10.1177/1099800419872824.

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Background: Eating disorders are a significant cause of morbidity and mortality. The etiology and maintenance of eating-disorder symptoms are not well understood. Evidence suggests that there may be gustatory alterations in patients with eating disorders. Objective: This article systematically reviews research assessing gustatory differences in patients with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Method: A systematic review was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining taste and eating disorders. We reviewed electronic databases and identified 1,490 peer-reviewed English-language studies. Of these, 49 met inclusion criteria. Results: Studies employed psychophysical measures ( n = 27), self-reported questionnaires ( n = 5), and neuroimaging techniques (i.e., electroencephalography, functional magnetic resonance imaging; n = 17). Psychophysical studies showed that individuals with BN, in general, had greater preference for sweetness than healthy controls, and those with AN had a greater aversion for fat than controls. In neuroimaging studies, findings suggested that predictable administration of sweet-taste stimuli was associated with reduced activation in taste-reward regions of the brain among individuals with AN (e.g., insula, ventral, and dorsal striatum) but increased activation in BN and BED. Discussion: To our knowledge, this systematic review is the first to synthesize literature on taste differences in AN, BN, and BED. The inconsistency and variability in methods used across studies increased difficulties in comparing studies and disease processes. Further studies with well-defined population parameters are warranted to better understand how taste varies in patients with eating disorders.

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Frank, Guido K., Ursula F. Bailer, Shannan Henry, Angela Wagner y Walter H. Kaye. "Neuroimaging Studies in Eating Disorders". CNS Spectrums 9, n.º 7 (julio de 2004): 539–49. http://dx.doi.org/10.1017/s1092852900009639.

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AbstractThe understanding of the eating disorders (EDs) anorexia (AN) and bulimia nervosa (BN) has undergone remarkable advancements in the past decade. Most studies that have been done in AN show brain gray and white matter volume loss during the ill state that, at least in part, remit with recovery. Similar patterns occur for brain phopsholipids assessed using magnet resonance spectroscopy (MRS). Imaging studies have been used to provide functional information regarding serotonin neuroreceptor dynamics, regional cerebral blood flow, or cerebral glucose metabolism. Such studies have implicated cingulate, frontal, temporal, and parietal regions in AN. Investigators have found that challenges such as food and body image distortions may activate some of these regions, raising the possibility that such studies may shed light on puzzling AN symptoms, such as body image distortions or extremes of appetitive behaviors. Emerging data suggest these disturbances persist after recovery from AN, suggesting the possibility that these are traits that may create a vulnerability to develop an ED. While fewer studies have been done in BN or binge eating disorder, there may be disturbances of serotonin metabolism in similar brain regions. Taken together, these findings give promise for future investigations with the hope of delineating brain pathways that contribute to the etiology of EDs.

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Konopka, Anna, Katarzyna Rek-Owodziń, Justyna Pełka-Wysiecka y Jerzy Samochowiec. "Parenting style in family and the risk of psychopathology". Postępy Higieny i Medycyny Doświadczalnej 72 (26 de octubre de 2018): 924–31. http://dx.doi.org/10.5604/01.3001.0012.7026.

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Parenting style is one of the exogenous factors, participating both in the etiology of psychopathology and in the healthy development of a child. Four main parenting styles, investigated so far, which evoke researchers interest most frequently, are: authoritative, authoritarian, permissive (liberal) loving and permissive uninvolved style. Research conducted in different countries has allowed us to describe connections between applying particular upbringing models and the occurrence of depression, eating disorders, addictions or violence. It has been evidenced that liberal- unloving parenting style, based on little control, and lack of emotional support, is positively associated with aggressive behavior. Parenting models based on excessive control and emotional coldness increase the risk of depression and substance abuse in children and adolescent, whereas authoritative parenting style applied by both parents minimalizes the risk of depression, suicidal tendencies and is also negatively correlated with substance abuse, bulimia and anorexia nervosa. Scientific reports indicate cross-cultural differences in young people’s perception of their parent’s style. For example, uninvolved parenting style was associated with higher depressiveness in Asian females than in African-American. Our paper presents a review of investigations on parenting styles and their results, conducted in different times and often in different cultures. The presented data allows us to formulate general conclusions and recommendations concerning parenting methods which may minimize the risk of psychopathology in youth. Authoritative style, consisting in high control combined with expression of emotional warmth, seems to be the most advantageous for the child’s development.

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Vilar, Lucio, Maria da Conceição Freitas, Manuel Faria, Renan Montenegro, Luiz Augusto Casulari, Luciana Naves y Oscar D. Bruno. "Pitfalls in the diagnosis of Cushing's syndrome". Arquivos Brasileiros de Endocrinologia & Metabologia 51, n.º 8 (noviembre de 2007): 1207–16. http://dx.doi.org/10.1590/s0004-27302007000800006.

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Among endocrine disorders, Cushing's syndrome (CS) is certainly one of the most challenging to endocrinologists due to the difficulties that often appear during investigation. The diagnosis of CS involves two steps: confirmation of hypercortisolism and determination of its etiology. Biochemical confirmation of the hypercortisolaemic state must be established before any attempt at differential diagnosis. Failure to do so will result in misdiagnosis, inappropriate treatment, and poor management. It should also be kept in mind that hypercortisolism may occur in some patients with depression, alcoholism, anorexia nervosa, generalized resistance to glucocorticoids, and in late pregnancy. Moreover, exogenous or iatrogenic hypercortisolism should always be excluded. The three most useful tests to confirm hypercortisolism are the measurement of 24-h urinary free cortisol levels, low-dose dexamethasone-suppression tests, and determination of midnight serum cortisol or late-night salivary cortisol. However, none of these tests is perfect, each one has different sensitivities and specificities, and several are usually needed to provide a better diagnostic accuracy. The greatest challenge in the investigation of CS involves the differentiation between Cushing's disease and ectopic ACTH syndrome. This task requires the measurement of plasma ACTH levels, non-invasive dynamic tests (high-dose dexamethasone suppression test and stimulation tests with CRH or desmopressin), and imaging studies. None of these tests had 100% specificity and their use in combination is usually necessary. Bilateral inferior petrosal sinus sampling is mainly indicated when non-invasive tests do not allow a diagnostic definition. In the present paper, the most important pitfalls in the investigation of CS are reviewed.

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