Brief Psychotherapy in the Treatment of Anorexia Nervosa

1987 ◽  
Vol 151 (2) ◽  
pp. 185-191 ◽  
Author(s):  
A. Hall ◽  
A. H. Crisp
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Social Adjustment ◽  
Statistical Significance ◽  
Dietary Advice ◽  
Brief Psychotherapy ◽  
Significant Weight Gain ◽  
One Year ◽  
Advice Group

Thirty out-patients with severe anorexia nervosa were randomly allocated to either 12 sessions of dietary advice or 12 sessions of combined individual and family psychotherapy. At one-year follow-up both groups showed significant overall improvement, and the dietary advice group showed significant weight gain. A similar mean weight gain for the psychotherapy patients did not reach statistical significance, but this group made significant improvements in sexual and social adjustment.

GAIT SPEED AND HANDGRIP STRENGTH AS PREDICTORS OF INCIDENT DISABILITY IN MEXICAN OLDER ADULTS

2014 ◽  
pp. 1-4
Author(s):  
T. LOPEZ-TEROS ◽  
L.M. GUTIERREZ-ROBLEDO ◽  
M.U. PEREZ-ZEPEDA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Daily Living ◽  
Handgrip Strength ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Performance Tests ◽  
One Year

Physical performance tests are associated with different adverse outcomes in older people. Theobjective of this study was to test the association between handgrip strength and gait speed with incidentdisability in community-dwelling, well-functioning, Mexican older adults (age ≥70 years). Incident disability wasdefined as the onset of any difficulty in basic or instrumental activities of daily living. Of a total of 133participants, 52.6% (n=70) experienced incident disability during one year of follow-up. Significant associationsof handgrip strength (odds ratio [OR] 0.96, 95% confidence interval [95%CI] 0.93-0.99) and gait speed (OR0.27, 95%CI 0.07-0.99) with incident disability were reported. The inclusion of covariates in the models reducedthe statistical significance of the associations without substantially modifying the magnitude of them. Handgripstrength and gait speed are independently associated with incident disability in Mexican older adults.

scholarly journals High Prevalence of Weight Gain in Childhood Brain Tumor Survivors and Its Association With Hypothalamic-Pituitary Dysfunction

2021 ◽  
pp. JCO.20.01765
Author(s):  
Jiska van Schaik ◽  
Ichelle M. A. A. van Roessel ◽  
Netteke A. Y. N. Schouten-van Meeteren ◽  
Laura van Iersel ◽  
Sarah C. Clement ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Tumor ◽  
Weight Gain ◽  
Standard Deviation Score ◽  
Cardiometabolic Health ◽  
Low Grade ◽  
Childhood Brain Tumor ◽  
Significant Weight Gain ◽  
Overweight Or Obesity

PURPOSE Childhood brain tumor survivors (CBTS) are at risk for developing obesity, which negatively influences cardiometabolic health. The prevalence of obesity in CBTS may have been overestimated in previous cohorts because of inclusion of children with craniopharyngioma. On the contrary, the degree of weight gain may have been underestimated because of exclusion of CBTS who experienced weight gain, but were neither overweight nor obese. Weight gain may be an indicator of underlying hypothalamic-pituitary (HP) dysfunction. We aimed to study prevalence of and risk factors for significant weight gain, overweight, or obesity, and its association with HP dysfunction in a national cohort of noncraniopharyngioma and nonpituitary CBTS. METHODS Prevalence of and risk factors for significant weight gain (body mass index [BMI] change ≥ +2.0 standard deviation score [SDS]), overweight, or obesity at follow-up, and its association with HP dysfunction were studied in a nationwide cohort of CBTS, diagnosed in a 10-year period (2002-2012), excluding all craniopharyngioma and pituitary tumors. RESULTS Of 661 CBTS, with a median age at follow-up of 7.3 years, 33.1% had significant weight gain, overweight, or obesity. Of the CBTS between 4 and 20 years of age, 28.7% were overweight or obese, compared with 13.2% of the general population between 4 and 20 years of age. BMI SDS at diagnosis, diagnosis of low-grade glioma, diabetes insipidus, and central precocious puberty were associated with weight gain, overweight, or obesity. The prevalence of HP dysfunction was higher in overweight and obese CTBS compared with normal-weight CBTS. CONCLUSION Overweight, obesity, and significant weight gain are prevalent in CBTS. An increase in BMI during follow-up may be a reflection of HP dysfunction, necessitating more intense endocrine surveillance.

Impulsivity and Eating Disorders

1993 ◽  
Vol 162 (2) ◽  
pp. 193-197 ◽  
Author(s):  
Thomas Fahy ◽  
Ivan Eisler
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Treatment Trial ◽  
Eating Disturbance ◽  
Distinct Subgroup ◽  
Impulsive Behaviour ◽  
Poor Treatment ◽  
One Year ◽  
Poor Treatment Response

Sixty-seven patients with bulimia nervosa and 29 patients with anorexia nervosa completed the Impulsiveness Questionnaire and questionnaires detailing severity of eating disorder. Bulimic patients had higher impulsivity scores than anorexic patients. Bulimics with high impulsivity scores did not have more severe eating disorders than low scorers. When 39 bulimics and 25 anorexics were interviewed about other impulsive behaviour, 51 % of bulimics and 28% of anorexics reported at least one other impulsive behaviour. Patients with so-called ‘multiimpulsive’ bulimia reported more severe eating disturbance, but this was not reflected on more reliable measures of symptoms. Thirty-nine bulimics entered an eight-week treatment trial and their progress was assessed at eight weeks, 16 weeks and one year. ‘Non-impulsive’ bulimics had a more rapid response than ‘impulsives' during treatment, but there was no difference at follow-up. There was no evidence of an association between high impulsivity trait scores and poor treatment response. It is concluded that impulsivity may shape the expression of eating disorders, but that ‘multi-impulsives' do not constitute a categorically distinct subgroup of bulimics.

Rate of Weight Gain of Inpatients with Anorexia Nervosa Under Two Behavioral Contracts

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 989-991
Author(s):  
Mary V. Solanto ◽  
Stanley Hertz ◽  
Marc S. Jacobson ◽  
Neville H. Golden ◽  
Lenore Heller
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Female Gender ◽  
Analysis Of Covariance ◽  
Adolescent Medicine ◽  
Medical Illness ◽  
Chronic Medical Illness ◽  
Criterion Weight ◽  
Behavioral Contracts

Objective. To ascertain the rate of weight gain of inpatients with anorexia nervosa under two behavioral contracts, differing in criterion weight gain required to earn increasing privileges. Design. Follow-up comparison of cohorts receiving different interventions. Setting. Eating disorders service, operating on a general adolescent medicine unit. Patients. Patients admitted consecutively who met the following criteria: (1) weight at least 15% less than that expected for age, sex, and height; (2) female gender; (3) absence of chronic medical illness; (4) hospital stay of at least 28 days. Twenty-two patients meeting these criteria were treated between July 1987 and October 1988, when contract 1 was in effect. This cohort of patients was compared with a group of 31 patients, also meeting the these criteria, who were treated between November 1988 and December 1991, when contract 2 was in effect. Interventions. The behavioral contract, signed by the patient on admission, specifies the minimum 4-day weight gain necessary to earn increasing ward privileges, such as use of phone, frequency of visits, etc. Contracts 1 and 2 differed only in the 4-day weight gain criterion: 0.8 lb (0.36 kg) and 1.2 lb (0.55 kg), respectively. Results. The results of analysis of covariance, with admission weight as the covariate, revealed a significant interaction between contract and day, such that patients receiving contract 2 gained weight more rapidly (0.36 lb/d) than those receiving contract 1 (0.20 lb/d). There was no confounding difference between groups in the use of psychotropic medication, and no complications of refeeding in either group. Conclusion. Increasing the 4-day criterion weight gain from 0.8 to 12 lb in a behavioral contracting intervention was associated with a significant increase in the rate of weight gain, without an accompanying increase in complications of refeeding. This result simultaneously: (a) provides support for the efficacy of behavioral contracting and (b) reveals malleability in the rate of gain based on the targeted gain specified in the contract.

Symptomatic Treatment of Agoraphobia and Social Phobias: A Follow-up Study

1975 ◽  
Vol 127 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Peter Tyrer ◽  
Derek Steinberg
Keyword(s):  
Personality Disorder ◽  
Social Adjustment ◽  
Prolonged Treatment ◽  
Comparable Efficacy ◽  
List Type ◽  
Behaviour Therapy ◽  
Double Blind ◽  
Social Phobias ◽  
One Year

Summary1.Twenty-six out of 28 out-patients with agoraphobia and social phobias who had originally been treated with phenelzine or placebo in a double-blind clinical trial were followed up for a mean period of one year. During the follow-up period patients received further pharmacotherapy or behaviour therapy, except that those patients originally receiving placebo were not allowed therapy with monoamine oxidase inhibitors.2.Ratings of phobic and additional symptoms, social adjustment and degree of personality disorder were made after one year by one of the authors (D.S.) who had no prior knowledge of the treatment each patient had received.3.There were no significant differences in any of the ratings between the patients of the two groups, but those originally receiving placebo had more additional treatment in the follow-up period. Patients continuing to receive phenelzine frequently experienced a return of symptoms if the drug was withdrawn before six months treatment had elapsed.4.Degree of personality disorder showed a significant negative correlation (p = –0.6) with improvement in the phenelzine group but not in those receiving placebo originally.5.Improvement in social adjustment items was less than improvement in symptoms at follow-up. The implications of this are discussed.6.The results suggest that phenelzine is of comparable efficacy to other symptomatic treatments for agoraphobia and social phobias, but that it acts mainly by symptom suppression. Prolonged treatment in patients with personality disorders is not indicated, for improvement is less likely and the dangers of dependence are greater.

scholarly journals Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up

2020 ◽  
Vol 8 (2) ◽  
pp. 35 ◽  
Author(s):  
Roberto Lo Giudice ◽  
Frank Lipari ◽  
Francesco Puleio ◽  
Angela Alibrandi ◽  
Fabrizio Lo Giudice ◽  
...  
Keyword(s):  
Color Change ◽  
Statistical Significance ◽  
Color Variation ◽  
White Spot ◽  
White Spot Lesions ◽  
Color Changes ◽  
The Difference ◽  
One Year ◽  
The Stability

The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.

Epigenetics in the Remission of Anorexia Nervosa: A Follow-up Study of Whole-genome Methylation Profiles

2017 ◽  
Vol 41 (S1) ◽  
pp. S102-S102 ◽  
Author(s):  
N. Ramoz ◽  
S. Guillaume ◽  
P. Courtet ◽  
P. Gorwood
Keyword(s):  
Anorexia Nervosa ◽  
Whole Genome ◽  
Biological Processes ◽  
Methylation Of Dna ◽  
Genome Methylation ◽  
The Difference ◽  
Competing Interest ◽  
One Year ◽  
Epigenetic Signatures

IntroductionAnorexia nervosa (AN) is a severe psychiatric disorder. The epigenetic regulations are strongly suggested in AN. We and other groups have performed a whole-genome methylation study (methylome) in AN. We found that the differentially methylated CpG sites are located around genes involved in biological processes in link with embryonic morphogenesis, brain development and its plasticity, in particular adhesion and axon guidance. Here, we study an independent group of 40 AN patients. Furthermore, we have done a follow-up during more than one year, to compare the methylation profiles in subjects that evolve to the remission.ObjectivesOur work is to replicate the methylome study in an independent AN cohort and to characterize profiles of methylation at two times for the same subjects to compare the AN patients that convert to remitters.AimsOur goal is to identify diagnostic and prognostic epigenetic signatures for AN.MethodsOf the 40 AN patients, 18 evolved to remission. Furthermore, the blood samples of the subjects from the 2 times will be investigated, like this, each subject is its own control. Methylation of DNA is measured by using the Infinium HumanMethylation450 BeadChip technology.ResultsComparisons of AN to controls showed similar profiles of methylation involving the same biological processes as previously identified. We are comparing now the difference of methylation between the 18 remitters and the 18 actual AN, taking into account of the two times of samples.ConclusionsWe expect to characterize specific methylation signature of the prognostic of the AN remission.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Behavioural Programme for the Management of Anorexia Nervosa

1978 ◽  
Vol 12 (1) ◽  
pp. 49-53 ◽  
Author(s):  
A. Desmond Poole ◽  
R. W. Sanson-Fisher ◽  
Pauline Young
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Family Therapy ◽  
Treatment Planning ◽  
Eating Behaviour ◽  
Active Participation ◽  
Treatment Programme ◽  
Contingent Reinforcement ◽  
Response Cost

A treatment programme, based on the use of behavioural principles, is described. Important components of the programme include the active participation of the patient in all phases of treatment planning, the use of contingent reinforcement for weight gain rather than eating behaviour, the provision of frequent feedback regarding progress and the lowering of the ‘response cost’ for eating. In addition contracting, and the use of random scheduling of follow-up contacts, along with family therapy, are employed to maintain weight gain following discharge. The results achieved with an initial group of 5 female patients are briefly discussed.

scholarly journals Comprehensive strain analysis in oncological patients undergoing thoracic radiotherapy: 1-year follow-up of a prospective study comparing proton vs. photon beam therapy

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S N Cordova-Madera ◽  
L Garcia-Bello ◽  
G Bruno ◽  
C Di Stefano ◽  
J A Quintero-Martinez ◽  
...  
Keyword(s):  
Strain Rate ◽  
Heart Function ◽  
Statistical Significance ◽  
Radial Strain ◽  
Strain Analysis ◽  
Photon Beam ◽  
Wilcoxon Test ◽  
Thoracic Radiotherapy ◽  
One Year

Abstract Background Proton beam therapy (PBT) is a promising radiotherapeutic method by which the proton Bragg peak may be exploited to reduce the dose to non-target normal tissues, when compared with the conventional photon treatment (PhT). Purpose To evaluate the mechanical function of the left ventricle by endocardial longitudinal (GLS-basic strain), circumferential (GCS) and radial strain (GRS) and systolic (SRs) and early diastolic (SRe) strain rate following thoracic radiotherapy. Methods Between March 2016 and March 2017, 58 patients with breast or thoracic cancer scheduled to receive radiotherapy were enrolled prospectively and, underwent 2D-STE echocardiography with basic (GLS) and comprehensive (GCS, GRS,GLSRs, GCSRs, GRSRs, GLSRe, GCSRe, GRSRe parameters) analysis at pre-treatment, mid-treatment, end of treatment, 3 month and 1 year follow-up. LVEF was calculated by the biplane Simpson technique. Shapiro-Wilk's test was performed to evaluate the normal distribution of the data. Comparison between groups was performed with Student's t-test or Wilcoxon test for quantitative variables and with Chi-Square test or Fisher's exact test for qualitative variables. Tukey-Kramer method was used to compare means during follow up. A p-value &lt;0.05 was assumed as the level of statistical significance. Results Mean age was 53.3±10.9 years and 91.3% were women. PBT was used to treat 38 patients; PhT in 20. The median of the mean heart dose was lower with PBT than PhT (79±92 vs 829±1121 cGy, respectively [P&lt;.001]). No significant changes in LVEF or GLS for PBT or PhT were seen. Comprehensive strain analysis showed changes in endocardial longitudinal, radial, and circumferential early diastolic strain rate (SRe) in patients undergoing photon beam (PhT) up to one year of follow up (Table 1). No changes were detected in the PBT group. All other variables were non-significant (Not shown). Conclusion This is the first longitudinal study, with a one-year follow-up, that shows the relaxation properties of LV are compromised during PhT but not PBT. These findings should be followed in time to evaluate their influence on overall heart function. FUNDunding Acknowledgement Type of funding sources: None. Table 1

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