Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to understand the psychopathology of severe anorexia nervosa (AN), and determine appropriate therapeutic approaches, a clinical study was conducted on 13 patients with severe AN who were hospitalized and were treated with intravenous hyperalimentation (IVH). The patients were divided into three types based on their clinical symptoms and initiating factors: Type I (Restricting Type; "Non-dieters"), Type II (Restricting Type: "Dieters"). Type III (Binge-eating/Purging Type). The clinical features of each type were evaluated. Based on this evaluation, the basic approach and the role of IVH in the treatment of each type are described as follows. Type I: The patients experience loss of appetite and subsequently, suffer involuntary weight loss as a result of psychological or physical stresses at school and/or home. Since the patients do not intentionally restrict food intake, they cannot explain the loss of appetite. The age at onset of this type is the youngest among the three groups. The patients are introverted, passive and not good at expressing their emotions. Therefore, it is often difficult to deepen the emotional commitment further. It is possible to understand the pathology of Type I through the psychosomatic model. IVH therapy promotes benign regression for Type I patients, so that the mother-child relationship may be restored. As the therapeutic progress, the mother child relationship occasionally become ambivalent. In such a case, it is important for the treatment team to support independent activities of the patients. Type II: The patients lose weight by intentionally restricting necessary food intake for reasons such as beauty or sports. Any experience of failure in studies or sports or trouble in complex personal relations can trigger the onset of AN. Weight loss is looked as a great achievement, whereas weight gain is recognized as a serious failure of self-control. Since type II patients understand the necessity of receiving treatment, it is possible to establish a trusting relationship during therapy. Their prognosis is generally good. The psychotherapeutic approach for Type II patients is most effective in the context of a weight gain program utilizing behavior therapy. It is important for the therapist to integrate psychological approach with physiological approach using IVH, and to modify cognitive distortion and body image disturbance. Type III: The patients have regularly engaged in binge eating or purging (or both) in the progress of AN. But as they intensely fear becoming fat, they refuse to maintain a minimally normal body weight. Therefore, they exhibit recurrently inappropriate compensatory behavior in order to prevent weight gain. In the therapeutic sessions, they often become ambivalent and unstable, showing dissatisfaction and reacting strongly against their therapists. The age at onset is the oldest of the three types. The prognosis is not good in many cases. IVH therapy may be required only in life-threatening situation for Type III patients. And severe bulimic patients may require sufficient drug treatment. The patients should be trained for interpersonal relationships at the day care unit or the occupational therapy unit. And they should be encouraged to adapt to real life.
 ...
PMID:[Clinical study of severe anorexia nervosa: the role of intravenous hyperalimentation therapy]. 917 Sep 82

A preliminary exploration of the etiological factors that may contribute to the relationship between eating disorder symptoms and personality disorder traits is reported based on a general-population twin sample of 221 pairs. Symptoms of eating disorder, assessed using the Health Information Questionnaire (HIQ), formed 3 factors: Concern for Overeating, Purging, and Body Mass Index (BMI). Modest genetic influences were observed on Concern for Overeating, possible non-additive genetic effects on Purging, and substantial additive genetic effects for BMI. Substantial nonshared environmental effects occurred with the Concern with Overeating and Purging scales, and common environmental effects were noted for the Concern with Overeating scale. Personality disorder traits were assessed using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). Phenotypic, genetic, and environmental correlations between the HIQ scales and higher-order personality disorder factors were modest. The strongest relationship was between Concern with Overeating and Emotional Dysregulation. Relationships among DAPP-BQ basic trait scales and eating disorder symptoms were modest and relatively non-specific. The strongest relationships were with the Concern with Overeating scale. Purging also showed a modest relationship with affective lability and self-harm.
 ...
PMID:Etiological relationships between eating disorder symptoms and dimensions of personality disorder. 1686 29