Emotional Aspects of Anorexia Nervosa: Results of Prospective Naturalistic Cognitive Behavioral Group Therapy.

Emotional aspects of anorexia nervosa: results of prospective naturalistic cognitive behavioral group therapy.

Neuropsychiatr. 2013 Jun 18;
Ohmann S, Popow C, Wurzer M, Karwautz A, Sackl-Pammer P, Schuch B

BACKGROUND: Anorexic girls have difficulties in handling their emotions. We examined emotional problems of adolescent girls with anorexia nervosa (AN) during the course of cognitive behavioral group therapy (G-CBT). METHODS: Overall, 29 girls with AN (age 13-17 years) participated in four groups of manual based G-CBT. We assessed the body mass index (BMI), eating behavior psychopathology, emotions, depression, hedonistic activities, self-care and-efficacy, social phobia, sense of coherence (SOC), and alexithymia before, during and up to 1 year after therapy. RESULTS: Out of 29, 16 (55 %, intent to treat, or 76 %, per protocol) girls were successfully treated, 5 (17 or 24 %) had a “poor outcome”, and 8 (28 %) dropped out. BMI, eating behavior, mood, social anxiety, self-care, and self-efficacy persistently improved. Anorexic girls had multiple emotional deficits, low self-confidence, and exaggerated needs of control and of being accepted. Emotional deficits were resistant to change. Hedonistic activities, social skills, and recovery from depression were positive, comorbid disorders and parental psychopathology negative prognostic factors. HubMed – eating

Patient-Perceived Long-Term Communication and Swallow Function Following Cerebellopontine Angle Surgery.

Laryngoscope. 2013 Jun 18;
Starmer HM, Ward BK, Best SR, Gourin CG, Akst LM, Hillel A, Brem H, Francis HW

OBJECTIVES/HYPOTHESIS: Evaluation of long-term patient-perceived functional outcomes and quality of life (QOL) related to communication and eating with an emphasis on voice, speech production, and swallowing after cerebello-pontine angle (CPA) surgery. STUDY DESIGN: Prospective cross-sectional study. METHODS: The MD Anderson Dysphagia Inventory (MDADI), Voice Handicap Index (VHI), and Facial Clinimetric Evaluation (FaCE) surveys were distributed to patients who underwent CPA surgery between January 2008 and December 2010. Immediate postoperative cranial nerve function extracted from medical records was compared to long-term patient-perceived function and associated QOL. RESULTS: There was a 61% response rate with a mean postoperative period of 31.6 months (range 15-49). The presence of facial palsy in the postoperative period and the corresponding House-Brackmann (H-B) score were the strongest predictors of patient-perceived long-term function and QOL in all three domains (P <.005). Postoperative vagal palsy by comparison was not associated with long-term disturbance of voice or speech function. Postoperative dysphagia had a particularly large association with perceived long-term facial function and related QOL (P <.0005), with a smaller but significant impact on perceived swallow outcome (P <.05). After adjusting for other variables, the postoperative H-B score remained a significant predictor of perceived long-term facial and voice function and related QOL. CONCLUSIONS: Patients with severe facial dysfunction following surgery to the CPA are at increased risk for long-term self-reported difficulties with communication and eating, even with improvement of vagal function. Speech and swallow therapy should therefore be provided to these patients whether or not they also have pharyngeal dysphagia or voice disturbance. LEVEL OF EVIDENCE: 2b. Laryngoscope, 2013. HubMed – eating

Influence of Dopamine Polymorphisms on the Risk for Anorexia Nervosa and Associated Psychopathological Features.

J Clin Psychopharmacol. 2013 Jun 14;
Gervasini G, Gordillo I, García-Herráiz A, Flores I, Jiménez M, Monge M, Carrillo JA

Dopamine neuronal functions make polymorphisms in dopaminergic pathways good candidates for playing a relevant role in anorexia nervosa (AN) and related psychopathological features. We have analyzed the effect of 8 polymorphisms in genes coding for dopamine receptors (DRD2, DRD3, and DRD4), transporters (DAT1) and metabolizing enzymes (COMT) in 78 women with AN and 186 control subjects. Associated psychopathological characteristics in patients with AN were assessed by the Eating Disorders Inventory Test-2 and SCL-90R self-reported questionnaires. The DRD4 variable number of tandem repeats (VNTR) 7R/7R and DRD4 -616CC genotypes were significantly associated with a greater risk for AN (odds ratio, 3.83; confidence interval, 1.05-13.98; P = 0.04; and odds ratio, 1.74; confidence interval, 1.01-2.97; P = 0.03, respectively). The analysis of physiological parameters in the patients with AN revealed that the short allele of a 120-base pair tandem repeat in the promoter region of the DRD4 gene was associated with higher weight (48.35 ± 6.79 vs 43.95 ± 5.78 kg; Bonferroni, P < 0.05), whereas the DRD4 -521TT genotype was associated with significantly higher body mass index (17.29 ± 2.25 vs 18.13 ± 2.41 kg/m; Bonferroni, P < 0.05). The DRD4 C-616G and DAT1 VNTR polymorphisms correlated with several psychopathological features in patients with AN. Carriers of the mutant homozygous genotypes scored higher in all but one of the Eating Disorders Inventory Test-2 subscales. After correction for multiple testing, differences in Asceticism scores between DAT1 VNTR genotypes, as well as differences in Drive for Thinness and Body Dissatisfaction between C-616G genotypes remained significant (P < 0.05). The results show that certain genetic alterations in the dopamine pathways are able to modify the risk for AN as well as modulate psychopathological features that are often coupled to this disorder. HubMed – eating

[Cluster analysis of smoking, alcohol drinking and other health risk behaviors in undergraduate students].

Beijing Da Xue Xue Bao. 2013 Jun 18; 45(3): 382-6
Guo SJ, Yu XM, Zhang X, An WW, Guo LN, Wang J

To investigate the status of smoking and alcohol drinking behaviors in undergraduate students, and explore the relationship between smoking and alcohol drinking and other health risk behaviors.A total of 7 979 students from 44 universities or colleges across China were sampled with multiple-stage stratified sampling method. A cross-sectional investigation on smoking, alcohol drinking and other health risk behaviors was conducted, and SPSS 13.0 was used to statistically analyze the data.The prevalence of current smoking and alcohol drinking behaviors was 19.6% and 42.2%, respectively. There was significant difference in different genders (male 34.1% vs. female 6.1%), geographical regions (East China 15.7% vs. Mid-China 19.0% vs. West China 29.8%), types of university (key university 17.9% vs. vocational college 21.2%) and majors (arts 15.4% vs. science and engineering 21.5%) in undergraduate students who currently smoked (P<0.01). And there was significant difference in different genders (male 58.6% vs. female 26.9%), geographical regions (East China 37.9% vs. Mid-China 42.8% vs. West China 50.8%) and majors (arts 36.4% vs. science and engineering 46.1%) in undergraduate students who currently drank (P<0.01). The incidence of health risk behaviors, such as unhealthy eating behaviors, substance abuse, bad personal health habits, intentional and unintentional injuries, in the smoking and alcohol drinking students was higher than that of the control group.The smoking and alcohol drinking status was not optimistic in undergraduate students in China, which is highly related to other health risk behaviors. Comprehensive prevention and intervention programs should be developed according to different demographic distributions. HubMed – eating

What is cognitive behavior therapy and how can it help people with eating disorders? – Jennifer Thomas, PhD, Assistant Professor of Psychology at Harvard Medical School, and staff psychologist at Massachusetts General Hospital in Boston For mor…