Standardized body mass index (BMI), prevalence of overweight, and obesity was higher in patients with ADHD compared with the population. Higher incidence of obesity was shown in patients with analyzed comorbidities.
Self-injury is a common phenomenon among adolescents and young adults, however its prevalence in clinical population is estimated at 40-80%, especially in regard to patients during puberty. Symptoms usually appear between 12th and 14th year of age, and their average duration is approx. 2 years. According to accepted sociocultural norms self-injury can be regarded as a normal behavior. Nevertheless, the prevalence of body art phenomenon in Western culture including professional tattooing, piercing, scarification, burning tattoos and other body modification typical for tribal cultures, has forced the need to redefine the boundaries for normative behavior. Introduction of a separate nosological unit of Non-Suicidal Self Injury in the fifth edition of DSM classification proves the validity of discussion, being hold for many years, regarding classification and understanding of the underlying mechanisms of self-harm. The aim of our study was to present the current state of knowledge regarding self-harm, with an emphasis on issues devoted to their placement in newest mental disorders classifications and mechanisms responsible for their development and maintenance. Databases such as: PubMed, EBSCO (medical and psychological resources) and WEB OF SCIENCE (years 1990-2016) have been screened for the following key words: self-injury, self-harm, self-mutilation, suicide, deliberate self-harm, affect regulation, NSSI, DSH, personality disorders, suicide attempt, neurobiology self-harm, DSM-5, adolescent, adults, stress coping styles, self-mutilation - children, adolescents and adults-prevalence. The analysis indicated 110 articles and 3 textbooks. We have used the following criteria: (1) for the articles presenting the latest research on risk factors for self-harm we have used the criterion of the study group number (>30 people) and meta-analyses have been included, (2) for theories explaining the mechanisms of self-harm criterion of empirical review of the assumptions and the number of the published studies that verify the theory has been applied.
Diabetes is associated with increased risk for eating disorders, various dependent on type of diabetes. Binge eating disorder is more common in patient with type 2 diabetes (T2DM). Whereas, intentional omission of insulin doses for the purpose of weight loss occurs mainly in patient with type 1 diabetes (T1DM), however, in some patients with type 2 diabetes omission of oral hypoglycemic drugs can be present. Risk factors for the development of eating disorders in patients with diabetes include: age, female gender, greater body weight, body image dissatisfaction, history of dieting and history of depression. Poor glycemic control, recurrent episodes of ketoacidosis or recurrent episodes of hypoglycemia, secondary to intentional insulin overdose, missed clinical appointments, dietary manipulation and low self-esteem should raise concern. The consequence of eating disorders or disordered eating patterns in patients with diabetes is poor glycemic control and hence higher possibility of complications such as nephropathy, retinopathy and premature death.
W niniejszej pracy przedstawiono przegląd literatury dotyczącej zespołu katatonicznego ze szczególnym uwzględnieniem specyfiki wieku rozwojowego. Najnowsze klasyfikacje wprowadziły zmiany w dotychczasowym rozumieniu katatonii. Katatonia może być rozpoznana jako odrębny zespół lub jako zespół towarzyszący innym zaburzeniom psychicznym. Kryteria diagnostyczne dla katatonii u dzieci i młodzieży są tożsame z kryteriami dla dorosłych, jednakże badacze zwracają uwagę na pewne odmienności obrazu klinicznego i względnie wysoki procent pacjentów ze schorzeniami somatycznymi, których manifestacją kliniczną jest zespół katatoniczny. Rośnie także liczba badań dotycząca współwystępowania katatonii i całościowych zaburzeń rozwoju. Z kolei schorzeniami opisywanymi w literaturze, lecz nieujętymi w sposób ścisły w klasyfikacjach jest przewlekły zespół odmowy i ostra śmiertelna katatonia. W niniejszej pracy omówiono także podstawowe zasady leczenia. Podstawowym leczeniem w katatonii jest stosowanie benzodiazepin i elektrowstrząsów. Zagadnienie diagnozy i leczenia katatonii ma duże znaczenie praktyczne. Jest to schorzenie, które nieprawidłowo rozpoznane i leczone może prowadzić do śmierci – a równocześnie jest to także choroba, w której dysponujemy skutecznym leczeniem.
Anorexia nervosa (AN) most often has its onset in adolescence, which is a crucial period to achieve peak bone mass. The hormonal abnormalities (hypoestrogenism, hypercortisolism, decreased secretion of dehydroepiandrosterone, testosterone, insulin-like growth factor) and malnutrition are associated with profound bone mineralization disorders. Densitomertic bone mineral density (BMD) values for osteopenia and osteoporosis were found respectively in 35-98% and 13-50% of women with AN. Prospective studies indicate a further decline in BMD at the beginning of treatment and a crucial importance of weight gain and return of spontaneous menses for its growth. Due to frequent chronic and relapsing course of AN densitometric assessment of BMD is recommended in all patients with AN and amenorrhea lasting around twelve months. In order to establish standards for the treatment of osteoporosis in AN, studies on pharmacological treatment are conducted. There are promising results indicating the improvement in BMD after treatment with physiologic oestrogen replacement treatment and sequential administration of medroxyprogesterone in teenage girls and bisphosphonates in adult women. Supplementation of vitamin D and adequate consumption of calcium from diet are recommended. Further studies on the effectiveness of long-term treatment of osteoporosis with regard to the possibility of increase in BMD and reducing the risk of osteoporotic fractures are needed.
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