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Objectives: We attempted to assess bone mineralization and the frequency of fractures occurrence in women with a history of treatment of anorexia nervosa (AN) in adolescence. Material and methods: 47 women (age 20-36.8 years) were re-examined 6.33-21,2 years after the onset of AN symptoms. Bone mineral density (BMD) of total body, lumbar spine, femoral neck, total hip (DXA) and densitometric Vertebral Fracture Assessment (VFA) were performed on 46 of women and BAP, P1NP, CTX, estradiol, testosterone, cortisol, IGF-1, leptin, DHEA-S on 45 of women entered for the current study. Current BMD results were compared with available baseline results from the time of hospitalization. Results: Currently BMD Z-score <-1 examined at any location occurred in 28 from 46 women (including Z-score <-2 in 5 women). In 11 from 12 women with reduced BMD at the time of hospitalization current total body BMD was within the normal range. Lumbar spine BMD was normalized or improved respectively in 5 and 6 from 15 women. Currently increased levels/activity of bone formation markers: P1NP in 27 (60%) and BAP in 28 women (62.2%) were observed. In 7 women (15.6%) increased values of bone formation markers with increased marker of bone resorption (CTX) occurred. Osteoporotic fractures and fractures in the spine in VFA were not observed during the observation period. Conclusions: Despite early treatment of adolescent-onset AN and good outcomes of the treatment, decreased BMD was currently present in 60.9% of women. During follow-up normalization or significant improvement in BMD results (total body, lumbar spine) were observed in majority of cases. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to find relationship between obsessive-compulsive symptoms and level and characteristic of physical activity among patients with anorexia nervosa (AN). Material and methods. 76 female patients, aged 14.8 +/ - 1.8 years with AN completed the Polish version of the Leyton Obsessional Inventory-Child Version (LOI-CV). In order to assess the level and type of physical activity, Physical Activity Questionnaire was developed. Results. 35 (46%) subjects were qualified to HR group (Obsessive-Compulsive Disorder "High-risk group") (25 or more points on the Interference Score of LOI-CV) and 41 (54%) to nHR group (no "High-risk group"). nHR patients spent less studying in a standing position, significantly more often used elevators rather than stairs and, according to their parents, devote less time for physical activity. Positive correlation between the caregiver's perception of patient's weekly activity and the number of "YES" answers in LOI-CV, positive trend between Patient's Activity Index or summarised Activity Index and the number of "YES" answers in LOI-CV were found. We also found negative correlation between the time spent studying at school and the number of "YES" answers in LOI-CV. Conclusions. The results show that there is a connection between obsessive-compulsive symptoms and the hyperactivity in AN patients. [ABSTRACT FROM AUTHOR]

Objective: to assess the prevalence of obsessive-compulsive disorder (OCD) or OC symptoms in patients with anorexia nervosa (AN) and to find a possible relationship between the presence of OC symptoms and the course of AN. Method: 137 adolescent female patients with AN, aged 14,8 +/- 1,8 years, completed the Polish version of the LOI-CV. Two groups, High-risk (HR) and no High-risk (nHR), were defined according to the cut-off score of LOI-CV. The diagnosis of OCD was confirmed with the Polish version of K-SADS-PL. The relationship between the number and intensity of OC symptoms and the following data were analyzed: age of onset and on admittance to a psychiatric facility, weight loss, BMI on admittance and its changes, age of first menstruation, time of amenorrhea and of restitution of menses, length of treatment and number of relapses. Results: OCD was not diagnosed in any subject, but 25% of the examined patients had OC symptoms which qualified them to High-risk group. Differences in HR and nHR groups were found between duration of AN before hospitalization, age and body mass after release from hospital. Negative correlation was found between "Yes" Score and Interference Score in LOI-CV and the age of patient at the time of release from hospital. Conclusions: the results of our study do not support the observations about a high cooccurrence of AN and OCD, but indicate the frequent co-occurrence of OK symptoms. [ABSTRACT FROM AUTHOR]

Objective: to assess the prevalence of obsessive-compulsive disorder (OCD) or OC symptoms in patients with anorexia nervosa (AN) and to find a possible relationship between the presence of OC symptoms and the course of AN., Method: 137 adolescent female patients with AN, aged 14.8 +/- 1.8 years, completed the Polish version of the LOI-CV. Two groups, High-risk (HR) and no High-risk (nHR), were defined according to the cut-off score of LOI-CV. The diagnosis of OCD was confirmed with the Polish version of K-SADS-PL. The relationship between the number and intensity of OC symptoms and the following data were analyzed: age of onset and on admittance to a psychiatric facility, weight loss, BMI on admittance and its changes, age of first menstruation, time of amenorrhea and of restitution of menses, length of treatment and number of relapses., Results: OCD was not diagnosed in any subject, but 25% of the examined patients had OC symptoms which qualified them to High-risk group. Differences in HR and nHR groups were found between duration of AN before hospitalization, age and body mass after release from hospital. Negative correlation was found between "Yes" Score and Interference Score in LOI-CV and the age of patient at the time of release from hospital., Conclusions: the results of our study do not support the observations about a high co-occurrence of AN and OCD, but indicate the frequent co-occurrence of OK symptoms.

Osteoporosis is a frequent complications of anorexia nervosa (AN). The etiology of osteoporosis in AN is multifactorial. Multiaxial hormonal disturbances and chronic undernutrition cause decrease or the lack of increase of bone mineral density (BMD), expected in adolescence. Both processes result from increased resorption and insufficient bone formation and/or mineralization. Decreased BMD persist in adult patients with a history of AN in the adolescence. There are no guidelines concerning treatment of osteoporosis in AN. The authors present review of the literature concerning bone metabolism in AN.

Anorexia nervosa (a.n.) is a mental disorder connected with the high mortality coming up to 18%. The death causes are suicide and somatic complications resulting from cachexy, laxatives and diuretics abuse, which occurs in some patients and from vomiting provocation. The digestive tract complications are considered to be the death causes in a.n, as well. Among the surgical complications, which usual occur in the initial period of the intensive nutrition the most serious and frequent ones are oesophageal rupture in the course of vomiting provocation (Boerhaave's syndrome) and the syndrome of compression of the horizontal part of the duodenum, by the mesentery (superior mesenteric artery syndrome) leading to the gastrectasia and possible gastric necrosis and perforation. In this paper the review of the current literature concerning the digestive tract complications in a.n. has been made. Also, the courses of the diseases and the complications requiring surgical intervention in 3 patients treated between 1998 and 2000 in the Department of Child Psychiatry and the Department of Cardiosurgery of the Medical University of Warsaw have been discussed. The patients developed segmental enteritis, gastrectasia caused by the superior mesenteric artery syndrome and small intestine strangulation. The early surgical intervention in the latter case and the proper maintenance treatment in two other ones allowed to avoid more serious complications. The authors postulate profound analysis of the abdominal complaints from the point if view of surgical complications in anorectic patients in the initial period of their hospital treatment and consideration of the complete parenteral hyperalimentation in the extremely debilitated to avoid life threatening digestive tract complications.