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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There have been numerous reports in the recent literature suggesting a relationship between diabetes mellitus and the eating disorders. In the current investigation, 97 pediatric diabetes patients were administered a modified version of the Eating Habits Questionnaire, which included items specific to diabetes mellitus based on DSM-III-R criteria. None of this sample were diagnosed as anorexic and only one patient was diagnosed as currently bulimic. Possible reasons for the higher prevalence rates reported for other samples are discussed.
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PMID:Insulin-dependent diabetes mellitus and eating disorders: a prevalence study. 218 55

A number of recent studies suggest that diabetes mellitus confers a high risk for the development of anorexia nervosa or bulimia nervosa. In order to test this hypothesis, 56 women with IDDM and 60 non-diabetic female controls were studied. All subjects completed the Eating Attitudes Test (EAT), and the Bulimic Investigatory Test, Edinburgh (BITE). The subjects were interviewed in order to obtain clinical and demographic information as well as to determine test validity. The DSM-III-R criteria of anorexia nervosa and bulimia nervosa were used. Four items were removed from the original EAT in order to eliminate possible bias related to IDDM. The results did not support the hypothesis that eating disturbances occur more frequently in IDDM-patients. Six criteria are proposed to improve the methodological standards of future studies in order to facilitate comparison of results.
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PMID:Insulin-dependent diabetes mellitus: a risk factor in anorexia nervosa or bulimia nervosa? An empirical study of 116 women. 223 87

Case reports and empirical studies suggest that young women with insulin-dependent diabetes mellitus (IDDM) may be at high risk for developing eating disorders. In this study, self-reports of binge eating and purging from 59 IDDM women (aged 18-30 yr) were obtained. Most participants (58%) reported that they went on eating binges, and 12% met the DSM-III criteria for a diagnosis of bulimia. Nearly 40% admitted to controlling their weight by insulin purging, and 13.5% reported purging by other means. A group of bulimic participants had mean scores on an eating disorder questionnaire in the pathological range. Bulimic symptoms were positively related to reports of hospitalizations, episodes of ketoacidosis, and psychological symptoms. Implications of these results on the medical management of young women with IDDM are discussed.
Diabetes Care 1989 Oct
PMID:Binge eating and purging in young women with IDDM. 279 24

Little is known about the course of affective illnesses in patients with diabetes or in other physically ill patients. We report a follow-up study of 37 diabetic adults with major depression (according to DSM-III), 28 (76%) of whom were located and reinterviewed 5 yr after the index evaluations. At follow-up, 18 (64%) of the 28 depressed patients had experienced an episode of major depression within the previous 12 mo; 12 of these patients satisfied diagnostic criteria for depression at the time of reevaluation. The 18 patients with recurrent depression had a mean of 4.2 depressive episodes over the 5-yr period. An additional 4 patients met criteria for current dysthymic disorder, bringing the number to 22 (79%) of the total patients ill with affective disorder during the 5-yr follow-up period. In contrast, the likelihood of symptomatic affective disorder was only 10% over the same follow-up period in a comparison group of diabetic subjects without depression at the index evaluation (P less than .001). Occurrence of depressive episodes appeared independent of diabetes complications because both the depressed and comparison groups had similar rates of neuropathy, retinopathy, and nephropathy. These data suggest that the natural course of depression in diabetes is malevolent, possibly more so than depression in the medically well.
Diabetes Care 1988 Sep
PMID:Depression in adults with diabetes. Results of 5-yr follow-up study. 321 66

Recent case reports have suggested an association between anorexia nervosa and/or bulimia with insulin-dependent diabetes mellitus (IDDM). Fifty-eight females aged fifteen to twenty-two with IDDM for more than one year were assessed for the presence of eating disorders. Patients were screened for eating and weight pathology using the Eating Disorder Inventory (EDI) and Eating Attitudes Test-26 (EAT-26). Glycosylated hemoglobin (HbA1) was measured to assess metabolic control. Subjects who scored above the cut-off points associated with eating and weight pathology were interviewed. Clinically significant eating and weight pathology was found in 20.7 percent of the population. Of these subjects, anorexia nervosa was found in 6.9 percent and the syndrome of bulimia, based on DSM-III criteria, was found in 6.9 percent. In patients with bulimia, there was a strong inverse correlation between bulimic symptoms and metabolic control. These findings suggest that anorexia nervosa may be more common in female adolescents with IDDM than in nondiabetic populations and that bulimic symptoms may be a risk factor for poor metabolic control.
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PMID:Eating disorders in female adolescents with insulin dependent diabetes mellitus. 345 20

This study examined sexual dysfunction in diabetic women. Eighty-one insulin-treated diabetic women were interviewed and administered standardized questionnaires. Using criteria derived from the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.) (DSM-III; American Psychiatric Association, Washington, D.C., 1980), 38 (47%) of the women were diagnosed with sexual dysfunction and 43 (53%) did not report sexual problems. The more frequently reported sexual problems were inhibited sexual excitement, inhibited sexual desire, and dyspareunia. Diabetic women with sexual dysfunction were more depressed, more stereotyped in their sex-role definitions, and less satisfied in their sexual relationships than those without sexual dysfunction. The two groups did not differ in metabolic control, insulin dose, duration of diabetes, or frequency of diabetic complications (e.g., neuropathy, etc.). Results suggest that diabetes may be associated with inhibited sexual excitement and dyspareunia in women. Both psychological and physiological concomitants of sexual dysfunction in diabetic women should be considered in diagnostic and treatment programs.
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PMID:Sexual dysfunction in diabetic women. 374 98

An unselected sample of 46 female adolescents with insulin-dependent diabetes mellitus (IDDM) for more than one year were assessed systematically for the presence of anorexia nervosa and bulimia. These disorders and their partial syndromes were found in 19.5% of this population. Anorexia nervosa and bulimia diagnosed on the basis of DSM-III criteria were each found in 6.5% of the population representing approximately a 6-fold and 2-fold increase respectively in the expected prevalence for similar nondiabetic individuals. Bulimic symptoms were associated with poor metabolic control as reflected in blood levels of glycosylated hemoglobin (HbAl). These findings have important implications both for the pathogenesis of anorexia nervosa and bulimia and for the management of some cases of IDDM with unstable metabolic control.
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PMID:Anorexia nervosa and bulimia in female adolescents with insulin dependent diabetes mellitus: a systematic study. 386 38

Children, like adults and parents, depend on primary care physicians to identify, treat, or refer those with mental disorders. Mental health concerns are also germane to the growing number of chronically ill children in pediatric care. This paper focuses on: 1) the level of agreement between children and parents about the presence of a mental disorder and the impact of informant on case identification; and 2) the extent to which pediatricians agree with reports by chronically ill children and/or their parents regarding such problems. The study sample includes 112 children, ages 9 to 18, with cancer, cystic fibrosis, inflammatory bowel disease, and insulin-dependent diabetes and a control group of 35 healthy subjects. Subject and a parent were interviewed separately using a highly standardized, structured interview that generates DSM-III-R diagnoses by computer algorithms. Pediatricians completed a questionnaire asking about the presence of any mental disorders. Agreement between parent and child was poor for both groups. In the medically ill group, more cases were identified by the parent interview than by child interview alone for all types of disorders. In contrast, children in the comparison group more often reported symptoms sufficient for a diagnosis than did their parents. The difference in prevalence between the two groups was significant only for the parent-identified cases, and physicians were more likely to recognize child-identified disorders. The choice of informant(s) has clear implications for case identification and case recognition in both clinical care and research in pediatric settings.
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PMID:Mental disorders in chronically ill children: case identification and parent-child discrepancy. 800 96

Forty-one adults with established hypopituitarism and deficiency of growth hormone (GHD) were compared to an age and sex-matched group with another chronic metabolic disorder (diabetes mellitus) using standardized psychiatric rating and diagnostic measures. Nineteen (46%) of the GHD group were identified as definite psychiatric cases compared with 10 (24%) of the diabetics (odds ratio 1:9:1). The most frequent DSM III-R axis I psychiatric diagnoses were major depression (32% GHD patients and 10% of diabetic patients) and dysthymia. The risk of being a psychiatric case showed an association with duration of illness in the diabetic group, but not in the GHD group. Biochemical indices were not related to the risk of being a case in either group. Hypopituitarism is associated with a higher prevalence of psychiatric disturbance than can be attributed solely to the presence of a chronic disorder.
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PMID:Psychiatric morbidity in adults with hypopituitarism. 774 79

Among 251 patients examined 3 months after the onset of acute ischemic stroke, we diagnosed dementia in 66 (26.3%) by using modified DSM-III-R criteria based on neuropsychological, neurological, functional, and psychiatric examinations. We used a logistic regression model to derive odds ratios (ORs) for clinical factors independently related to dementia in this cross-sectional sample. Dementia was significantly associated with age, education, and race. A history of prior stroke (OR = 2.7) and diabetes mellitus (OR = 2.6) was also independently related to dementia, but hypertension and cardiac disease were not. Stroke features associated with dementia included lacunar infarction compared with all other subtypes combined (OR = 2.7) and hemispheric laterality in relation to brainstem or cerebellar location. There was a predominance of dementia in patients with left-sided lesions (OR = 4.7), an effect not explained by aphasia. Dementia was especially common with infarctions in the left posterior cerebral and anterior cerebral artery territories. A major dominant hemispheral syndrome (reflecting size and laterality) was also independently associated with dementia (OR = 3.9). We suggest that dementia after ischemic stroke is a result of multiple independent factors, including both small subcortical and large cortical infarcts especially involving the left medial frontal and temporal regions, with additional contributions by demographic and vascular risk factors.
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PMID:Clinical determinants of dementia related to stroke. 849 36


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