Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

Andrade, Rodrigo; Gonçalves‐Pinho, Manuel; Roma-Torres, António; Brandão, Isabel

doi:10.20344/amp.8963

Cited by 5 publications

(24 citation statements)

References 24 publications

(35 reference statements)

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“…Among eating disorders, AN is well known to have relatively poor prognosis 31,32. As for quality of life in AN patients, previous researchers reported their lowered quality of life 16–18.…”

Section: Discussionmentioning

confidence: 99%

<p>Clinical factors influencing resilience in patients with anorexia nervosa</p>

Kane

Tomotake

Hamatani

et al. 2019

NDT

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PurposeThis study was to elucidate clinical factors influencing resilience in anorexia nervosa (AN) patients.Patients and methodsTwenty female patients with AN (median age =30.0 years, quartile deviation =6.8) and 40 female healthy controls (HCs) (median age =30.0 years, quartile deviation =8.6) participated in the present study. Resilience was assessed with the Connor– Davidson resilience scale (CD-RISC). Clinical symptoms were evaluated with the structured interview guide for the Hamilton depression rating scale (SIGH-D) and the eating disorder inventory-2 (EDI-2).ResultsScores of the CD-RISC in the AN group were lower than those in the HC group, and the SIGH-D score in the AN group was higher than that in the HC group. Scores of interoceptive confusion, interpersonal difficulty and negative self-image subscales of the EDI-2 negatively correlated with the CD-RISC score. Moreover, stepwise regression analysis showed that negative self-image score was an independent predictor of the CD-RISC score.ConclusionThese results suggest that among these clinical factors including psychopathologies, self-dissatisfaction and feeling of being rejected by others are the most important influencing factors on an AN patients’ resilience.

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Section: Discussionmentioning

confidence: 99%

<p>Clinical factors influencing resilience in patients with anorexia nervosa</p>

Kane

Tomotake

Hamatani

et al. 2019

NDT

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“…Significant dental caries, erosive tooth wear, and loss of periodontal health were observed in other studies considering adult AN subjects ( 8 , 9 ). However, in the available literature, few scientific reports focused on the oral status among AN individuals under the age of 18 and affected by disease < 5 years, i.e., during the first acute stage of ED ( 10 , 11 ). It is proven that AN patients should be encouraged to undertake psychiatric/psychotherapy ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population—A Case-Control Study

et al. 2022

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IntroductionRestrictive type of anorexia nervosa (AN) is still one of the most severe eating disorders worldwide with an uncertain prognosis. Patients affected by AN should be encouraged to undertake psychiatric care and psychotherapy, but whether they should necessarily be included in careful dental care or not may still be questionable. Even though there is a constantly increasing number of AN studies, there are just a few data about the youngest group of AN children and adolescents aged < 18.MethodologyThis case-control study aimed to compare the dental health and gingival inflammation level in female adolescent inpatients affected by severe AN restrictive subtype vs. controls. Based on clinically confirmed 117 AN cases (hospitalized in years 2016–2020 in public Psychiatric Unit, BMI < 15 kg/m2, mean age 14.9 ± 1.8), the dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 103 female dental patients (BMI 19.8 ± 2.3 kg/m2, age 15.0 ± 1.8, p = 0.746) treated in a public University dental clinic.ResultsAN patients were found to present a higher incidence of oral-related complications according to dental status (DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1, p = 0.005), erosive tooth wear (BEWE 18.9 vs. 2.9%, p < 0.001), less efficient in controlling plaque (PCR 43.8 vs. 13.7%, p < 0.001) and gingival inflammation (BOP 20.0 vs. 3.9%, p < 0.001) compared with female adolescents. In the AN group, a significant correlation between BOP, BEWE, and duration of AN disease (p < 0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p < 0.05).ConclusionsAlthough the obtained results did not reveal any severe oral status, our findings indicated impaired dental and gingival conditions in young anorexics. Considering AN's potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future.

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“…Além disso, pacientes com AN tendem a ser mais novos, em comparação com pacientes com outros TAs, evidenciado do mesmo modo na amostra do presente estudo 36 . Relativamente a estado civil e filhos, analisando a idade jovem dos pacientes e a ocupação, parece coerente que a grande maioria não tivesse companheiro nem filhos, o que é corroborado pela literatura 37 . Porém, há de se considerar a dificuldade no estabelecimento e manutenção de relacionamentos interpessoais e afetivos comuns nesses quadros, consequência do provável espelhamento das suas relações familiares conflituosas, do fato de sua dinâmica psíquica englobar emoções e pensamentos disfuncionais, além da baixa autoestima 38,39 .…”

Section: Discussionunclassified

Tratamento dos transtornos alimentares: perfil sociodemográfico, desfechos e fatores associados

Stefani,

Azevedo,

Souza

et al. 2023

J. bras. psiquiatr.

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RESUMO Objetivo: Avaliar o perfil dos pacientes com transtornos alimentares (TAs) atendidos por um serviço especializado e investigar os fatores associados ao desfecho do tratamento. Métodos: Estudo retrospectivo, realizado com dados de pacientes com TAs que fizeram seguimento em um serviço especializado, desde a sua criação, em 1982, até 2019. Foram coletadas informações, nos prontuários médicos, referentes ao primeiro atendimento, de natureza sociodemográfica, clínica e antropométrica, e ao desfecho do tratamento. Resultados: Foram incluídos 271 pacientes. A amostra foi predominantemente do sexo feminino (89,7%), com idade média de 21,5 ± 9 anos, sem companheiro (86,9%) e diagnóstico de anorexia nervosa (AN) (65,7%), e o índice de massa corporal mais frequente foi de magreza (53,9%). A metade dos indivíduos tinha comorbidades psiquiátricas (50,6%), e 88,5% dos pacientes (n = 100) dos 113 prontuários com essa informação realizaram tratamento anterior. O tempo médio de tratamento foi de 2,16 ± 3,25 anos (1 mês a 40 anos). O abandono foi o desfecho terapêutico mais prevalente na amostra (68,3%). O maior tempo de tratamento e a realização de tratamento anterior reduziram a taxa de abandono, de forma significativa (p = 0,0001 e p = 0,0101, respectivamente). Para os pacientes com diagnóstico de transtorno de personalidade, a média de encaminhamento/inassistência foi 4,47 vezes maior (p = 0,0003). Conclusões: O perfil dos pacientes foi composto por mulheres adultas jovens, estudantes, sem companheiro, com AN, magreza e comorbidades psiquiátricas. A taxa de abandono foi elevada, e os fatores associados foram o tempo de tratamento e a realização de tratamento anterior. Além disso, transtornos de personalidade foram associados a encaminhamento para outro serviço e alta por inassistência.

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Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

Cited by 5 publications

References 24 publications

<p>Clinical factors influencing resilience in patients with anorexia nervosa</p>

<p>Clinical factors influencing resilience in patients with anorexia nervosa</p>

Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population—A Case-Control Study

Tratamento dos transtornos alimentares: perfil sociodemográfico, desfechos e fatores associados

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