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Összefoglaló. A táplálkozás iránti figyelmet igénylő krónikus betegségek (így a coeliakia, az 1-es típusú diabetes és a gyulladásos bélbetegségek), valamint az evészavartünetek kapcsolata egyelőre kevéssé széleskörűen tanulmányozott terület serdülők körében. Az eddigi kutatási eredmények kiemelik a testkép- és evészavartünetek iránti magasabb kockázatot ezekben a betegségekben. Rizikótényező lehet az evési szokások megváltozása, a táplálkozásra irányuló fokozott figyelem és az ételekkel, valamint az elfogyasztásuk következményeivel kapcsolatos aggodalom. A korai felismerést nehezíti, hogy az evészavartünetek sokáig rejtve maradhatnak, és átfedést mutathatnak a krónikus betegség egyes tüneteivel (például testsúlyváltozás, hasmenés, hányás, hasfájás). A fennálló evészavar-érintettség gyengítheti a krónikus betegség hatékony terápiáját, súlyosbíthatja a szövődményeket, és növelheti a mortalitási rizikót. A tünetek korai felismerése és az adekvát terápia csak multidiszciplináris szemléletben és teammunkával, a szomatikus gondozás és a pszichoterápia összehangolásával lehet eredményes. Orv Hetil. 2020; 161(44): 1872-1876. Summary. Disordered eating is not a well-understood phenomenon in diet-related chronic illnesses (e.g., celiac disease, type 1 diabetes, inflammatory bowel diseases) among adolescents. Previous research found a higher risk for eating disorders and negative body image among these patients. Following the prescribed or suggested dietary regime may lead to increased food awareness and become an eating disorder risk factor. Further risks may be the altered eating patterns, the fear from unknown food sources and its consequences. In many cases, eating disorder characteristics may be hidden and the symptoms of chronic illness (e.g., changes in weight, diarrhoea, vomiting, abdominal pain) and disordered eating can mimic each other. Disordered eating can worsen the effective therapy of physical illnesses and increase complications and mortality. Early diagnosis and adequate treatment can only be provided through multidisciplinary approach and teamwork. Orv Hetil. 2020; 161(44): 1872-1876.

Introduction and Objectives: Orthorexia nervosa is a new type of disordered eating, characterized by an unhealthy fixation on healthy food. Those who suffer from it are showing compulsive behaviors and increasing dietary restrictions, that can lead to anxiety and physical health problems. Measuring tools for estimating the seve rity of its symptoms are available in Hungary only to a limited extent. The aim of this study was to adapt the Eating Habits Questionnaire's revised version (EHQ-R) to Hungarian, and to perform a psychometric analysis, moreover, to explore the demographic features of orthorexic tendencies., Methods: The cross-sectional online questionnaire included adults who perform physical exercize regularly (n = 175, 29% male; mean age 35.4 [SD = 7.59] years)., Measurements: sociodemographic data, anthropometric data (body - weight, height), EHQ-R, ORTO-11-Hu questionnaires., Results: Confirmatory factor analysis supported the EHQ-R's five-factor theoretical structure (c2 (395) = 856.2; p < 0.001; CFI = 0.914; TLI = 0.906; RMSEA = 0.082 [CI 90: 0.074-0.089]). Both the internal reliability of the scales (Cronbach-a = 0.75-0.87) and its consistency over time (r / r = 0.67-0.86) were adequate. The construct validity of the questionnaire is supported by the close correlation of the scales with the ORTO-11-Hu questionnaire (r / r = | 0.63-0.68 |). Regarding gender differences, women scored higher than men on the EHQ-R's Rigidity subscale (t [173] = -1.807; p = 0.073). Age showed a significant, weak, negative relationship with the Negative Emotionality (r = -0.18; p = 0.017) and Time Impairment (r = -0.21; p = 0.005) subscales., Conclusion: The EHQ-R has proven to be a reliable and valid measurement tool, thus, we recommend utilizing it as it can provide a quick and valid assessment about the severity of orthorexia symptoms, enabling appropriate interventions.

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Symptomes and complications of PCOS have adverse effect on quality of life among concerned women. Most research findings suggest that PCOS is associated with eating disorders, but there are inconsistent results in connection with their relationship in the published literature., Objective: The aim of this study was to determine the prevalence of eating disorders among women with PCOS., Method: Body mass index (BMI), Eating Attitudes Test (EAT) and Eating Behaviour Severity Scale (EBSS) were used to measure eating attitudes and behaviors. Furthermore PCOS symptomes were measured by Ferriman-Gallwey Score, Global Acne Grading Score, Savin Scale and other pcos symptoms were also accessed. A total of 318 women were included in this analysis. The sample consists of a PCOS group (N=95), a control group (N=100) and a hyperandrogen group (N=123). The Prevalence of clinical bulimia nervosa was 5.3%, subclinical anorexia nervosa 1.1% and subclinical bulimia nervosa was 10.5% among PCOS women. 1.6% subclinical bulimia nervosa was detected in the hyperandrogen group., Conclusions: The results of the study indicate that the prevalence of clinical and subclinical bulimia nervosa is increased among women with PCOS compared to healthy women. Eating disorders can have significant negative influence on the outcome of the treatment of PCOS. To sum up, these findings suggest that it should be necessary to pay attention to the screening of eating disorders, and the findings also reveals that psychological treatment of eating disorders among women with PCOS is relevant.

Background and Aims: The aim of the ESPAD (European School Survey Project on Alcohol and other Drugs) study - launched in 1995 and repeated in every four years - is to collect representative data on alcohol and drug consumption patterns of the 16 year old population, in as many European countries as possible., Method: The survey followed standardized methodology to gain comparable data in every participating country. Students fill in the self-report questionnaire during a school lesson. Beside the compulsory core-question blocks, the Hungarian survey in 2011 contained questions on behavioral addictions (online gaming, internet, eating disorders and gambling) as well. All classes were included into the sample pool, where at least 10% of the students were born in 1995. Data collection took place between 1-20 March 2011. The sample was representative in terms of type of school; class and geographic location., Results: Data was gathered from 370 classes and resulted in 8570 questionnaires. Only 0,96 percent of the total collected data was unreliable. Obtained data is valid and reliable; and can be compared to data from previous years, as well as to data from other ESPAD countries. Representative data on behavioral addictions is highly valuable, because our current knowledge is limited on this domain.

Body dysmorphic disorder causes significant suffering and serious impairment in psychosocial functions. However, this disease with dangerous risks is scarcely mentioned in the Hungarian medical literature. The objective of the author is to give a detailed review about this almost unknown, but relatively common disorder. The serious disorder of body perception is in the centre of symptoms, leading to social isolation, anxiety, depression and obsessive-compulsive phenomena. The disorder often remains unrecognized because of the lack of insight of disease. Comorbidity with affective disorders, anxiety disorders, personality disorders, eating disorders, alcoholism and substance use disorders is common. The life quality of affected patients is bad, the risk of suicide or violence is high. Biological, psychological and sociocultural factors play an important role in the etiopathogenesis of the disorder. Imaging techniques and neuropsychological measures revealed changes characteristic for the disease. Childhood abuse and neglect, appearance-related critical remarks, stressors and the impact of media are also supposed to have role in the development of the disorder. The point prevalence is 0.7-2.5% in the general population, however, in special groups such as in tertiary students, psychiatric, dermatological and cosmetic surgery patients the prevalence rates may be much higher. Typically, the disease begins in early adolescence, and it persists and deteriorates without treatment, showing a chronic course. By means of pharmacotherapy and/or psychotherapy long-during improvement or full recovery can be achieved within a relatively short period of time.

Introduction: Some groups of professionals (models, actresses, ballet dancers, jockeys and athletes) are considered as risk populations for eating disorders and body image disorders. We assume that those working in the beauty industry may also be a high risk group for developing eating disorders, as their work is closely related to beauty and fashion., Methods: Eating disorders were assessed using the Eating Attitudes Test and the Eating Behaviour Severity Scale, and the tests for assessment of body image included the Human Figure Drawings Test, the Body dissatisfaction subscale of the Eating Disorders Inventory, the Body Attitudes Test, and the Body Investment Scale., Results: Questionnaire data of 543 subjects were analysed. The study sample comprised 128 models from Transylvania (5 males, 123 females) and 167 models from Hungary (10 males, 157 females). These groups were compared with control groups in Transylvania and Hungary, consisting of 148 (25 males, 123 females) subjects in Transylvania and 101 subjects (5 males, 95 females) in Hungary. Weight reducing methods, such as dieting, exercise, the use of appetite suppressants and diuretics, were significantly more prevalent in the group of models. The mean total score and the scores of the Dieting and Bulimia subscales were higher in the group of models in comparison with the control group. The prevalence of clinical and subclinical eating disorders was higher in the group of models. The percentage of subjects scoring above the cut-off score on the Body Dissatisfaction Scale of the Eating Disorder Inventory was higher in the Hungarian control group. The Hungarian control subjects scored higher on the General Body Dissatisfaction Scale of the Body Attitudes Test. Models invest more money and time in their body care. The above results suggest that working in beauty industry may pose an increased risk of developing eating disorders.

Introduction: Eating Disorders are often considered to be culture-bound syndromes, occurring mainly in industrialized Western countries. In the last decade several epidemiologic studies were published in Eastern European countries, indicating that eating disorders are wide-spread also in this region. The present paper is an epidemiological study of eating disorders in Romania and analyses the prevalence of eating disorders and some pathological eating behaviours in secondary school samples from Romania., Methods: A total of 2,396 secondary school adolescents from Romania (1,140 male, 1,256 female) 1,312 Hungarians and 1,084 Romanians were surveyed., Results: The prevalence of AN was 0.6% in the Romanian female population and no clinical cases of AN were found in the Hungarian female sample. As for subclinical AN, the rate in the Hungarian female sample was 0.4% and in the Romanian one 1.9%. The prevalence of BN was 1% in the Hungarian and 1.3% in the Romanian female sample. The prevalence of subclinical BN in the Hungarian female sample was 0.8% and for the Romanian female sample it was 0.7%. We did not find clinical or subclinical AN in the male sample but the prevalence of BN was 0.2% in the Hungarian male sample. The subclinical BN was 0.3% in the Hungarian male sample and 0.5% in the Romanian male sample., Conclusions: The results stress the importance of eating disorders also in Romania. This may be due to the identification process with Western values.

Objective: This report summarizes recent clinically relevant findings concerning gynecological psychosomatic symptoms of eating disorders the implications for psychiatric diagnosis and management., Method: The author conducted selective reviews of the literature from the last 15 years., Results: Malnutrition, low body weight are also an important cause of anovulation and amenorrhoea. Eating disorders such as anorexia nervosa, bulimia nervosa are associated with potential negative consequences during pregnancy, including higher rates of miscarriage, low birth weight, obstetric complications and post partum depression., Conclusion: The most suitable treatment for infertility secondary to weight related amenorrhoea or anovulation is therefore dietary rather than induction of anovulation. This highlights the importance of early detection and treatment by primary care teams. There is a need to develop preventive intervention strategies.

The authors summarize the Central and East European epidemiological data of eating disorders. These demonstrate that eating disorders are not exclusively characteristic to Western societies. In this respect the comparison of newer data to those which were performed before the political changes in 1989-1990 is especially valuable. Formerly in a Hungarian university sample the prevalence of bulimia was 1-1.3% among females, 0-0.8% among males, and this was higher than the prevalence of 0.6% in Austrian females, or 0% in German Democratic Republic. After the social changes similar data were found in several East European countries. This corroborates the culture-change idea of eating disorders. The transition to a Western market economy and the process of globalization is an experiment to evaluate the effect of sociocultural factors. The values and norms (e.g. thinness ideal) come closer to the Western culture, and mass media have a significant impact in this process.

Menstrual disorders are among the most frequent somatic complications and symptoms of eating disorders. Since 1972 amenorrhea has been registered among the diagnostic criteria of anorexia nervosa (AN). Although such a criterion is not essential for establishing a case of bulimia nervosa (BN), international research has, on several occasions, described menstruational disorders (in 95% of the cases) and amenorrhea (in 20% of the cases). This study was designed to assess the prevalence of eating disorders connected to menstruational disturbances having no organic causes. Our method was the following: the test was carried out via questionnaires (ANIS, BCDS, BITE, EDI, BDI) completed by patients of endocrine surgery of two gynecological out-patient wards. We have found the following (n = 75) prevalence figures: AN: 4%, BN: 12% while the total prevalence of clinical and subclinical eating disorder syndromes was at 44%. Our findings, are in line with other international findings.

In a recent multicentre study it turned out that both clinical and subclinical eating disorders are more prevalent in Hungarian college students than among their Austrian and German counterparts. Now the prevalence of eating disorders was assessed in a population of Hungarian workers. From 1800 working females and males 762 returned the questionnaires; data of 689 subjects (571 females and 118 males) were analysed. Among females the prevalence rates of bulimia nervosa (according to DSM-III-R), subclinical bulimia nervosa and subclinical anorexia nervosa are 0.7% (n = 4), 5.3% (n = 30) and 0.7% (n = 4), respectively. In males two persons (1.7%) met DSM-III-R criteria for bulimia nervosa, three (2.5%) were identified as having subclinical bulimia nervosa and two (1.7%) subclinical anorexia nervosa. No case of clinical anorexia nervosa was found. So the overall prevalences of clinical and subclinical eating disorder syndromes are 6.7% for females and 5.9% for males in the working population. These disorders that mostly remain hidden in the population under study do not seem to be quite recent. These rather unfavorably high prevalence rates can be explained by the tendency for over-identification with Western norms and values; in addition, in the group of workers, the risk factors are supposed to be combined with the relative lack of protective factors.

The authors carried out a two-stage survey (screening and interview phase) among 538 medical students (248 males, 290 females) relating to eating attitudes and eating disorders. In the screening phase detection of eating disorders based upon body weight data, the Anorexia Nervosa Inventory for Self-rating, the Eating Disorder Inventory, and the Eating Behaviour Severity Scale. The screening did not revealed anorectic subjects, while subclinical anorexia nervosa could be found in 0.4% of males, and in 0.3% of females. The prevalence of bulimia nervosa was 0% in males, 0.3% in females, that of subclinical bulimia nervosa was 1.2% in males, 3.8% in females. Interview was performed with 38 high risk subjects, corroborating screening data. The results correspond well to former Hungarian data, and reach the morbidity of Western industrialized countries.