We conducted a study of the clinical presentation and outcome in patients with avoidant/restrictive food intake disorder (ARFID), aged 15–40years, and compared this group to an anorexia nervosa (AN) ...group in a Japanese sample. A retrospective chart review was completed on 245 patients with feeding and eating disorders (FEDs), analyzing prevalence, clinical presentation, psychopathological properties, and outcomes. Using the DSM-5 criteria, 27 (11.0%) out of the 245 patients with a FED met the criteria for ARFID at entry. All patients with ARFID were women. In terms of eating disorder symptoms, all patients with ARFID had restrictive eating related to emotional problems and/or gastrointestinal symptoms. However, none of the ARFID patients reported food avoidance related to sensory characteristics or functional dysphagia. Additionally, none of them exhibited binge eating or purging behaviors, and none of them reported excessive exercise. The ARFID group had a significantly shorter duration of illness, lower rates of admission history, and less severe psychopathology than the AN group. The ARFID group reported significantly better outcome results than the AN group. These results suggest that patients with ARFID in this study were clinically distinct from those with AN and somewhat different from pediatric patients with ARFID in previous studies.
•Clinical presentation and outcome in avoidant/restrictive food intake disorder•ARFID patients were clinically distinct from anorexia nervosa patients.•ARFID patients in this study were somewhat different from pediatric ARFID patients.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The works of Miyazawa Kenji are full of fantastic descriptions and it may be the essential characteristic of his literature. The author discusses the origins of these fantastic characteristics from ...Miyazawa’s original literary method called ‘mental sketch’ and his innate sensitive trait. In the former aspects, Miyazawa had a view of the world which regarded all things were perceptive phenomena in the mind, and he wrote poems called ‘mental sketches’ from this viewpoint. Furthermore, he frequently recorded his ‘mental sketches’ during all-night ramble in the mountains and wilds or on the night train and ships. These situations probably made him experience supernatural phenomena which are the characteristics of his poems.In the latter aspect, Miyazawa was highly sympathetic to others from childhood and showed high hypnotizability in puberty. These episodes suggest the thinness of his ego-boundary. The author also discusses that the dissociative experiences which Shibayama pointed out in the Miyazawa’s works can be interpreted as the alteration in the ego-boundary. These sensory traits may also contributed to the fantasies of his works.
Tumor necrosis factor-alpha (TNF-alpha) is a cytokine with numerous immunological and metabolic activities. To study the role of TNF-alpha on the pathophysiology of anorexia nervosa and its ...complications, plasma concentrations of TNF-alpha, 2 soluble TNF receptors (sTNF-RI and sTNF-RII), and leptin were measured in 20 female patients with anorexia nervosa (AN) and 20 age-matched normal women (N). Plasma TNF-alpha concentrations in AN were significantly higher than those in N (4.1 +/- 0.6 pg/mL vs. 1.6 +/- 0.1 pg/mL; P < 0.01). Although no significant difference was observed in plasma sTNF-RI concentrations between the two groups, plasma sTNF-RII concentrations in AN were significantly higher than those in N (2094.0 +/- 138.5 pg/mL vs. 1569.5 +/- 84.0 pg/mL; P < 0.01). Plasma concentrations of TNF-alpha and sTNF-RII after treatment of 8 anorectic patients were not different from those before treatment, although body fat mass and plasma leptin concentrations significantly increased after treatment. Plasma TNF-alpha concentrations were not related to body fat mass in anorectic patients. These results suggest that the adipose tissue may not be the immediate source of TNF-alpha in anorectic patients and that TNF-alpha may contribute to the pathophysiology of immunological and metabolic abnormalities in anorexia nervosa.
Objective: The SCOFF was developed as a simple, five-question screening tool for eating disorders to be used in primary care. The aim of this study was to examine the appropriateness of each question ...in comparison with the Eating Attitudes Test-26. Methods: The SCOFF and the EAT-26 were administered to 80 patients with eating disorders who had received treatment from May through October 2003 in Japan. Results: The scores of the SCOFF and those of the EAT-26 were positively correlated (P<0.001), and each question of the SCOFF was strongly associated with different items of the EAT-26. The detection rates with the SCOFF of the patients with anorexia nervosa or bulimia nervosa and that of the patients with eating disorders not otherwise specified (EDNOS) were 96.2 and 48.1%, respectively. The scores of the SCOFF and the values of body mass index were significantly correlated (P=0.041), and the detection rate with the SCOFF of patients with low body weight and EDNOS was low (10%). Conclusion: Each question of the SCOFF has been selected appropriately for reflecting characteristics of eating disorders, although one question about body weight loss should be modified to detect patients with anorexia nervosa more accurately.
Full text
Available for:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
BACKGROUND
Tumor necrosis factor‐α (TNF‐α) is a cytokine with numerous immunological and metabolic activities. In addition, TNF‐α can stimulate a variety of physiological, neuroendocrine and ...behavioural responses of the central nervous system. In experimental animals, TNF‐α induces changes in physiological and behavioural parameters which have also been observed in eating disorders. The biological activities of TNF‐α are mediated by two structurally related, but functionally distinct receptors, TNF‐RI and TNF‐RII. Since injection of TNF‐α results in increased shedding of TNF‐α receptors, it is likely that TNF‐α release is reflected by soluble TNF‐receptors (sTNF‐Rs) levels.
AIMS
We studied plasma concentrations of TNF‐α and two sTNF‐Rs (sTNF‐RI and sTNF‐RII) in female patients with bulimia nervosa.
DESIGN AND PATIENTS
Twenty female patients with bulimia nervosa (BN) and 20 age‐matched normal women (N) were studied.
MEASUREMENTS
Plasma TNF‐α concentrations were measured by enzyme immunoassay kit and plasma concentrations of sTNF‐RI and sTNF‐RII were measured by enzyme‐linked immunosorbent assay.
RESULTS
Plasma TNF‐α concentrations in BN were significantly higher than those in N (4.7 ± 0.5 ng/l vs. 1.6 ± 0.1 ng/l; P < 0.01). Although no significant difference was observed in plasma sTNF‐RI concentrations between the two groups, plasma sTNF‐RII concentrations in BN were significantly higher than those in N (2080.0 ± 107.5 ng/l vs. 1569.5 ± 84.0 ng/l; P < 0.01). Plasma TNF‐α concentrations were significantly related to plasma sTNF‐RI concentrations (r = 0.511, P < 0.05) and to plasma sTNF‐RII concentrations (r = 0.532, P < 0.05) in bulimic patients. However, plasma TNF‐α concentrations were not related to body fat mass or to bulimic behaviours in these patients.
CONCLUSIONS
Our present findings suggest that the adipose tissue may not be the immediate source of TNF‐α in bulimic patients but the increase in plasma TNF‐α in these patients may be derived from the central nervous system sources. The elevated sTNF‐RII may reflect different shedding kinetics compared with sTNF‐RI in bulimic patients.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
8.
Leptin in women with eating disorders Nakai, Yoshikatsu; Hamagaki, Seiji; Kato, Seika ...
Metabolism, clinical and experimental,
02/1999, Volume:
48, Issue:
2
Journal Article
Peer reviewed
The aim of the present study was to determine the factors controlling leptin secretion and to clarify the role of leptin in eating disorders. The subjects were 152 eating-disordered women with ...different fat mass, eating behavior, and endocrine abnormalities and 24 age-matched control subjects. The body fat mass, eating behavior score, and plasma leptin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), triiodothyronine (T3), free thyroxine (T4), insulin, and cortisol levels were evaluated for each subject. In patients with eating disorder, logarithmic values for leptin were significantly correlated with the body fat mass (r = .828, P < .001), eating behavior score (r = .777, P < .001), and LH (r = .465, P < .001), FSH (r = .440, P < .001), T3 (r = .572, P < .001), insulin (r = .410, P < .001), and cortisol (r = −.389, P < .001) levels. After adjusting for fat mass, the partial correlations of log leptin with LH, FSH, insulin, and cortisol were not statistically significant, but log leptin remained correlated with T3 (r = .390, P < .01). Stepwise regression analysis showed that the body fat mass and eating behavior score were significant determinants of leptin levels. These results suggest that eating behavior, as well as the body fat mass, is the control factor for leptin secretion in eating disorders.
Full text
Available for:
IJS, IMTLJ, KILJ, KISLJ, NUK, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Objective: This study investigated the role of leptin on eating behavior and reproductive function in eating disorders. Method: The subjects included 80 eating-disordered women, having different fat ...mass, eating behavior, and endocrine abnormalities, and 26 control women. Plasma leptin, insulin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), cortisol, insulin growth factor-1 (IGF-1), free T(4) levels, percent body fat, eating behavior score, and menstrual status score were evaluated for each subject. Results: In eating-disordered patients, log of leptin levels were significantly correlated with body fat mass, eating behavior score, menstrual status score, and insulin, LH, and FSH levels. Stepwise regression analysis showed that fat mass and eating behavior score were significant determinants of leptin levels. Furthermore, in patients undergoing recovery, leptin levels were determined by fat mass and/or eating behavior. Discussion: These results suggest that leptin may play some role in counteracting the abnormal eating behavior, reproductive function, and fat mass in these disorders.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
Tumor necrosis factor-α (TNF-α) is a cytokine with numerous
immunological and metabolic activities. To study the role of TNF-α on
the pathophysiology of anorexia nervosa and its complications, plasma
...concentrations of TNF-α, 2 soluble TNF receptors (sTNF-RI and
sTNF-RII), and leptin were measured in 20 female patients with anorexia
nervosa (AN) and 20 age-matched normal women (N). Plasma TNF-α
concentrations in AN were significantly higher than those in N
(4.1 ± 0.6 pg/mL vs. 1.6 ± 0.1 pg/mL;
P < 0.01). Although no significant difference was
observed in plasma sTNF-RI concentrations between the two groups,
plasma sTNF-RII concentrations in AN were significantly higher than
those in N (2094.0 ± 138.5 pg/mL vs. 1569.5 ±
84.0 pg/mL; P < 0.01). Plasma concentrations of
TNF-α and sTNF-RII after treatment of 8 anorectic patients were not
different from those before treatment, although body fat mass and
plasma leptin concentrations significantly increased after treatment.
Plasma TNF-α concentrations were not related to body fat mass in
anorectic patients. These results suggest that the adipose tissue may
not be the immediate source of TNF-α in anorectic patients and that
TNF-α may contribute to the pathophysiology of immunological and
metabolic abnormalities in anorexia nervosa. .
PDF
