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Do the levels of psychopathology displayed by patients with an eating disorder not otherwise specified (EDNOS) more closely resemble those displayed by full-criteria anorexia and bulimia nervosa patients than they do those of non-eating-disorder controls? Three groups of eating disorder patients (anorexia nervosa, n  = 27; bulimia nervosa, n  = 23; EDNOS, n  = 19) and a group of non-eating-disorder controls ( n  = 25) were compared on four subscales of the Eating Disorders Inventory - 2 (EDI-2), and on the Eating Disorders Belief Questionnaire, the Rosenberg Self-Esteem Scale, and the Depression Anxiety Stress Scales. EDNOS patients were indistinguishable from the other two eating disorder groups on all of the measured variables, except for the Perfectionism subscale of the EDI-2. The findings of the present study support the view that EDNOS should not be considered a subclinical eating disorder. However, much remains to be understood about who EDNOS patients are. [ABSTRACT FROM AUTHOR]

Objective To examine relationships between exercise behaviour, eating-disordered behaviour and quality of life in a community sample of women. Method Self-report measures of frequency of exercise, obligatoriness of exercise and motivation for exercise, and of eating disorder psychopathology and quality of life, were completed by 169 women aged 18–45 who engaged in regular exercise. Results Exercising to improve appearance or body tone, and feelings of guilt following the postponement of exercise, were the exercise variables most strongly associated with elevated levels of eating disorder psychopathology and, in turn, reduced quality of life. There was no association between exercise behaviour and quality of life independent of the effects of eating disorder psychopathology. Conclusions Operational definitions of ‘excessive exercise’ might usefully include reference to the use of exercise to improve appearance or body tone and the experience of guilt following postponement of exercise. Inclusion of such information in prevention programmes for eating disorders may also be of benefit. ‘Excessive exercise’ is unlikely to be associated with impairment in psychosocial functioning in the absence of eating disorder psychopathology. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Background:. Few studies have examined attitudes towards eating-disordered behaviour among women in the general population. Methods:. A vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa (BN) was presented to a community sample of women aged 18–45. Respondents (n = 208) were asked a series of questions concerning the severity and prevalence of the problem described. Results:. Most respondents viewed BN as a distressing condition whose sufferers are deserving of sympathy. However, more than one-third of respondents had at some stage believed that it ‘might not be too bad’ to be like the person described in the vignette. Most respondents believed that the prevalence of the problem described among women in the community was likely to be between 10 % and 30 % (48.6%) or between 30% and 50 % (23.1 %). Individuals with a clinically significant eating disorder (n = 13, 6.3%) were more likely to perceive the symptoms of BN as being acceptable, and its prevalence higher, than individuals with no eating disorder diagnosis. Conclusions:. Information concerning the medical and psychological sequelae of BN and other eating disorders might usefully be incorporated in prevention programmes. Prospective community-based research is required to elucidate the nature of the relationship between perceived acceptability of eating disorder symptoms and actual eating disorder psychopathology. Extension of the present research to examine the views of women in other cultures would also be of interest. [ABSTRACT FROM AUTHOR]

Eating behaviour, nutritional intake and psychopathology were examined in 16 weight-recovered anorexia nervosa patients. The Eating Disorders Examination (EDE) and a food diary were the main outcome measures, but body fat content and psychosocial adjustment were also assessed. Although body fat and overall psychosocial adjustment had returned to normal in most patients, 12 still had a restricted eating pattern with nutritional intake below 90% of their energy requirements. These results suggest that weight, menstruation, and psychosocial criteria are not sufficient to determine full recovery from anorexia nervosa, and that attention should be given also to measures of the specific behavioural and attitudinal disturbance. [ABSTRACT FROM AUTHOR]

In a comparison of nutritional management (NM) and stress management (SM) for treatment of bulimia nervosa, 55 female patients were randomly assigned to either treatment. Therapy consisted of 15 sessions in a group over three months, by the end of which, patients under both treatment conditions showed a significant reduction in the frequency of binge eating and vomiting and a significant improvement in various psychopathological features such as body dissatisfaction and depression. All improvements were maintained over 12-month follow-up NM produced a more rapid improvement in general eating behaviour, a faster reduction in binge frequency and a higher abstinence rate from binge eating. SM led to greater positive changes in certain psychopathological features such as feelings of ineffectiveness, interpersonal distrust and anxiety. NM should be regarded as a necessary first intervention in all bulimic patients. Further psychological therapy, such as SM, is indicated as well for some patients, depending on their specific psychological difficulties. [ABSTRACT FROM AUTHOR]

In the present study, two raters, a psychologist and a nurse, each made five independent ratings of 30 different video-recorded patient-examinations. Having thus excluded patient fluctuation, individual-rater consistency and between-rater agreement over the 6 weeks of the study are examined. While between-rater agreement was apparently being maintained, mean AIMS scores steadily increased. In the hands of these raters, AIMS items 2 and 4 emerged as very reliable, while items 1, 6, and 7 showed high variability. Some patients appeared to be hard to rate. Differences between the study raters and the author JB highlight the issue: how reproducible is an AIMS rating? [ABSTRACT FROM AUTHOR]

The present paper compares a lenient and a strict operant conditioning programme in refeeding patients with anorexia nervosa. Sixty-five consecutive in-patients participated in the study. We found no significant difference in the rate of weight-gain between the two treatments. There were, however, a number of practical advantages in using the more lenient programme: it was more economical of nursing time, and patients were more accessible to psychotherapy. The programme was also more acceptable to the patients. [ABSTRACT FROM AUTHOR]

Tardive dyskinesia (TD) is usually described as fluctuating in its clinical manifestations. We attempted to quantify fluctuations in TD using the Abnormal Involuntary Movement Scale (AIMS). Three psychiatrists rated multiple video-recorded examinations of four outpatients with mild TD. The unexpected finding was that within-rater variability dominated within-patient variability. [ABSTRACT FROM AUTHOR]

The perception of body shape was studied in 15 female patients with anorexia nervosa and 15 age matched controls. A lens was used which could be manipulated to cause a horizontal distortion of an image projected onto a video monitor. The patients showed a greater tendency to over- and under-estimate their present body shape than did the controls. Further, the patients' desired body shape was significantly thinner than that of controls, as was their estimation of what constitutes a normal body shape. These findings are discussed in relation to the literature and it is suggested that they may have important implications for treatment. [ABSTRACT FROM AUTHOR]

Urinary MHPG (3-methoxy-4-hydroxyphenyl-ethylene glycol) was measured in seven anorexia nervosa patients during a bed rest and refeeding programme. MHPG levels were positively related to increase in body weight. [ABSTRACT FROM AUTHOR]

Twenty-two female patients with anorexia nervosa were assessed by means of objective personality testing. The EPI, Leyton Obsessional Inventory, Cattell's 16 PF and Raven's Matrices were used for this purpose. The personality profile that emerged was of a highly neurotic and introverted person with moderately severe obsessional features and average intelligence. [ABSTRACT FROM AUTHOR]

The article presents a study that examines the minor psychiatric and physical symptoms during the menstrual cycle. Scores on the mood scale and mental symptoms check-list were highly correlated with each other and both correlated with the physical symptoms scores. Twenty five women with normal menstruation showed fluctuations in psychological and physical symptomatology during the menstrual cycle, symptoms being more intense during the premenstrual and menstrual weeks. The 7 women who had undergone simple hysterectomy with conservation of the ovaries and who were shown to have an apparently normal cyclical hormonal pattern, did not demonstrate similar significant changes in symptoms during the various phases of their cycles.

The article presents a study which examines the effects of long-term neuroleptic treatment on plasma levels of luteinizing hormone (LH), estrogens, testosterone and prolactin in human subjects. Subjects of the study were a group of twelve chronic schizophrenic patients consisting of eight men and four post-menopausal women who had been receiving neuroleptic treatment for at least ten years. During treatment, testosterone level in male subjects was low or normal, without attendant changes in LH levels. However, testosterone rose upon withdrawal of the drugs. On the other hand, plasma prolactin during treatment was elevated in female patients, within the normal level for male patients. Prolactin levels decreased in both men and women following drug withdrawal.

The article presents a study which examines the effect of phenothiazines on the circulating levels of prolactin and luteinizing hormone (LH). Subjects of the study were sixteen female psychiatric patients that developed inappropriate lactation and amenorrhea while receiving phenothiazines. Data concerning the patient's mental state, presence of extrapyramidal signs, occurrence of menstruation and severity of inappropriate lactation were recorded. The results showed that plasma prolactin was elevated in majority of the patients during phenothiazines treatment. In patients with amenorrhea, basal LH levels were variable, while estrogen and progesterone followed the normal pattern of menstrual cycle.

Investigates attentional biases among persons with eating disorders. Visual probe detection task; Assessment of attention toward stimulus words; Detection of target probes among subjects with eating disorders; Observation of effects among restrained eaters.

Studies the food and body weight and shape-related stimuli in women with eating disorders. Presentation of stimuli under both masked and unmasked conditions; Effects of high calorie food words and body shape words; Delayed color-naming latencies for both thin and fat word categories of patients with anorexia nervosa; Lack of effects for emotion words.

This paper reports a case of anorexia nervosa in a 15-year-old schoolgirl who had been profoundly deaf since birth. She was admitted to a specialized eating disorders unit following a dramatic reduction in her weight. Her deafness and limited communication skills posed significant problems with regard to her overall management on the unit. Her clinical presentation and difficulties in management are presented. [ABSTRACT FROM AUTHOR]

This study investigated the oral status and dental complications in patients with both anorexia and bulimia nervosa. Results revealed that prolonged periods of dietary restraint in anorexic patients did not result in changes to bacteria associated in dental caries. Furthermore, patients did not have lower decay rates or salivary flow but did have more acidic saliva. Moreover, both groups of patients revealed changes indicative of gingivitis and gingival recession but not necessarily of periodontitis when compared to control subjects. [ABSTRACT FROM AUTHOR]

A disturbance of eating may be symptomatic of other physical or psychiatric illness, for example the hypophagias associated with neoplastic disease or severe depression. In most instances of these secondary eating disorders there appears to be a true alteration in appetite, that is in the desire and relish for food. Primary eating disorders on the other hand are complex behavioral disturbances which do not result directly from changes in appetite. In this category are obesity, anorexia nervosa, and bulimia. The conditions of obesity and anorexia nervosa have been accepted for may years as clinical problems, and their history can be traced far back in the annals of medicine. The situation in regard to bulimia is rather different, since it has been recognized only recently as a subject of medical concern. The purpose of the present paper is to review the emergence of bulimia in the medical literature, discuss its status as a disorder, and advise caution before it is uncritically accepted as an illness entity. [ABSTRACT FROM AUTHOR]

Various studies have suggested that patients with anorexia nervosa may have cognitive deficits on neuropsychological examination. A battery of tests was administered to 35 patients (34 female, 1 male), diagnosed as suffering from anorexia nervosa (n = 20) or bulimia nervosa (n = 15) during the early stages of admission to a specialized eating disorders unit. Results revealed no significant differences between the anorexia nervosa and bulimia nervosa patients on any of the intellectual, neuropsychological, or academic-related tasks that were administered. There was no evidence of cognitive deficits in certain patient groups when compared with theoretical norms. [ABSTRACT FROM AUTHOR]

Background: It is important to determine the optimal manner of categorising eating disorder patients so as to aid in the understanding of their specific psychopathological state.Method: We compared subgroups of eating disorder patients divided according to different sets of factors, using a structured interview which elicits the specific psychopathological features of these illnesses. The patients, comprising 116 consecutive women admitted to two university-affiliated eating disorder clinics, were grouped according to DSM-III-R criteria, clinical presentation (purging, binge eating), nutritional status, and age.Result: The clearest separation of groups was afforded by the clinical dimension of purging as opposed to not purging. This was superior to DSM-III-R criteria. Other systems, such as presence of binge eating, and various levels of nutritional status and of age, were clearly inferior.Conclusion: The presence or absence of purging behaviour appears to offer the most heuristic means of categorising eating disorder patients with respect to their specific psychopathological state. [ABSTRACT FROM AUTHOR]

The present study compares the rate of weight gain during refeeding in 1 5 anorectic patients who were weighed daily with that of 1 5 who were weighed three times per week. There was no significant difference between the two groups. [ABSTRACT FROM AUTHOR]

A 19-year-old woman, blind since birth, lost 26 kg over a 7-month period. This was achieved by restriction of food intake, excessive exercise, laxative abuse, and self-induced vomiting. Although the visual experience is often believed to be an integral component of body-shape perception and the overvaluation of thinness in contemporary society, it does not preclude the development of anorexia nervosa. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the paper "Compulsory treatment in anorexia nervosa. Short-term benefits and long-term mortality," by R. Ramsay, A. Ward, J. Treasure and colleagues in the 1999 issue.

The article discusses the study which describes a patient with a schizophrenic illness, who was shown to have the clinical pattern of Turner's syndrome and an XO/XX/XXX mosaic chromosome pattern. Researchers have noted that patients who have shown a schizophrenic illness in the presence of Turner's syndrome have a chromosomal picture of a mosaicism. When XO/XX mosaic has emerged as the result somatic non-disjunction, it is also logical than in some cases both cells could have survived which can give rise to an XO/XX/XXX mosaic. In addition, the increasing use of the sophisticated cytology could clarify the possible relation between clinical Turner's syndrome, karyotype and schizophrenia.

An abstract of the article "A Study of Minor Psychiatric and Physical Symptoms During the Menstrual Cycle" is presented. It determines the relation of psychological and physical symptoms with the phases of the menstrual cycle. Women who menstruated normally and those who have undergone simple hysterectomy with conservation of the ovaries are the subjects of the study. Those subjects who menstruate normally have more symptoms during the premenstrual and menstrual weeks.