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Query: UMLS:C0038187 (starvation)
 24,951 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the case of a woman with bulimia nervosa, several personality disorders, and a past history of anorexia nervosa who deliberately induced an abortion via self-imposed starvation and vigorous exercise. Her history reveals severe obsessive-compulsive and narcissistic personality disorders as well as a lifelong pattern of denial of affect and illness.
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PMID:Self-induced abortion in a bulimic woman. 819 13

The occurrence of a transient neurogenic stutter in a male anorexic patient is described. The stutter developed following a prolonged period of starvation, and during refeeding the patient recovered from the stuttering behavior. The patient was not receiving any drugs known to cause stuttering, and it is postulated that the stutter developed as a result of the gross impairment of brain function secondary to chronic starvation. A review of the literature has failed to reveal any information on anorexia nervosa as a cause of neurogenic (acquired) stuttering.
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PMID:Transient neurogenic stuttering. 829 35

Several reviews of the history of anorexia nervosa have concluded that weight phobia, a basic diagnostic criterion for the disorder, did not emerge as a predominant motive for food refusal until around 1930. In addition, investigators have reported cases of self-starvation without apparent weight phobia in non-Western cultures. Three explanations have been proposed for these findings: 1) patients who do not demonstrate a definite weight phobia are in fact suffering from an eating disorder not otherwise specified, 2) weight phobia has been overlooked or concealed, and 3) there has been a transformation in the content of anorexia nervosa in the West and an analogous situation may be occurring in the developing countries. The authors conclude that a change in the core features of anorexia nervosa in Western cultures since 1930 can be demonstrated. They explore the question of whether anorexia nervosa would be the same illness if the criterion of weight phobia were not required and conclude that anorexia nervosa may be conceptualized in several different ways without including the phenomenon of weight phobia or body image disturbance. Finally, they recommend that because the desire for thinness appears to be culture-bound, anorexia nervosa is the best disorder to use in examining the influence of culture on psychopathology. Therefore, cases of self-starvation in non-Western cultures should be studied carefully because they may clarify the core features of anorexia nervosa.
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PMID:Is weight phobia always necessary for a diagnosis of anorexia nervosa? 837 48

Anorexia nervosa (AN) and bulimia nervosa (BN) are potentially fatal eating disorders which primarily affect adolescent females. Differentiating eating disorders from primary gastrointestinal (GI) disease may be difficult. GI disorders are common in eating disorder patients, symptomatic complaints being seen in over half. Moreover, many GI diseases sometimes resemble eating disorders. Inflammatory bowel disease, acid peptic diseases, and intestinal motility disorders such as achalasia may mimic eating disorders. However, it is usually possible to distinguish these by applying the diagnostic criteria for eating disorders and by obtaining common biochemical tests. The primary features of AN are profound weight loss due to self starvation and body image distortion; BN is characterized by binge eating and self purging of ingested food by vomiting or laxative abuse. GI complications in eating disorders are common. Recurrent emesis in BN is associated with dental abnormalities, parotid enlargement, and electrolyte disturbances including metabolic alkalosis. Hyperamylasemia of salivary origin is regularly seen, but may lead do an erroneous diagnosis of pancreatitis. Despite the weight loss often seen in eating disorders, serum albumin, cholesterol, and carotene are usually normal. However, serum levels of trace metals such as zinc and copper often are depressed, and hypophosphatemia can occur during refeeding. Patients with eating disorders frequently have gastric emptying abnormalities, causing bloating, postprandial fullness, and vomiting. This usually improves with refeeding, but sometimes treatment with pro-motility agents such as metoclopromide is necessary. Knowledge of the GI manifestations of eating disorders, and a high index of suspicion for one condition masquerading as the other, are required for the correct diagnosis and management of these patients.
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PMID:Gastrointestinal and nutritional aspects of eating disorders. 840 9

Anorexia nervosa is known as a psychiatric disorder. Many practitioners seem unaware that a patient in a starvation state is cognitively impaired and thus a poor candidate for psychotherapy. Weight restoration is a prerequisite to other treatment modalities. Many practitioners and all patients fail to recognize this illness because of a prevailing cultural idealization of thinness. Since these patients initially seem so compliant in treatment, valuable time is lost by those who fail to understand the patient's deceptiveness and the life-threatening potential of the disease.
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PMID:Anorexia nervosa visited and revisited: weight is the issue. 843 93

The goal of this paper is to draw conclusions about the usefulness of the standard EEG in psychiatry. In general, two thirds of psychiatric referrals for an EEG are expected to provide useful information. The emphasis in schizophrenia is placed on left-sided abnormalities, especially on the left temporal area. In mood disorders the emphasis is on right-sided foci, in addition to the controversial 6/sec spike and wave complexes, small sharp spikes and positive spikes. In the acute stage of alcoholism, a relationship is seen between the degree of intoxication and the amount of slow activity, while in the chronic stage an increase in slow activity is seen, but another change is fast activity on the temporal areas. During withdrawal a low seizure threshold can be seen as irregular bilateral spike and wave complexes. During abstinence 2-4 yr may be required before slow wave sleep is normal in all regards. Among the organic mental syndromes, delirium shows slow activity, except in delirium tremens, which often is associated with a normal record with fast activity. In dementia the prevalence of EEG abnormalities is related to the degree of impairment. After five sessions of ECT diffuse slow waves are often seen. In other conditions, among developmental disorders about one half of autistic children show abnormalities and epileptiform activity is not uncommon. Mild nonspecific abnormalities are seen in about 40% of dyslexics and also in behavior disorders. Anxiety disorders include anorexia nervosa, showing abnormal background activity related to the effect of starvation on cerebral metabolism. In panic attacks paroxysmal activity can be seen. In borderline personality positive spikes have been (again) associated with impulsivity and 6/sec spike and wave complexes with interpersonal problems. Of the drugs of abuse psilocybin and phencyclidine are often associated with generalized epileptiform patterns and with marijuana the alpha shows a decreased frequency with increased amplitude. Typically, an increase in slow activity is seen with psychotropic drugs if there is a change in the level of awareness. Finally, distinctive personality traits are, at times, seen in temporal lobe epilepsy and the phenomenon of "forced normalization" may appear when seizures stop and psychotic symptoms appear.
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PMID:A review of the usefulness of the standard EEG in psychiatry. 871

Norepinephrine and its metabolites were studied in various body fluids (plasma, urine and cerebrospinal fluid) of patients with anorexia nervosa, bulimia nervosa and healthy young women. The reaction of plasma norepinephrine to different stimuli like orthostatic challenge, test meals, standardized exercise, mental challenge tests etc. were studied. All results indicate a reduced noradrenergic activity in the central and peripheral nervous system of patients with eating disorders. The clinical consequences of these changes are hypotension, bradicardia, hypothermia and depression. Evidence is presented that the reduced activity of the sympathetic nervous system is caused by starvation (anorexia nervosa) or intermittent dieting (bulimia nervosa).
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PMID:Central and peripheral noradrenalin regulation in eating disorders. 873 14

Starvation-induced alterations of neuropeptide activity probably contribute to neuroendocrine dysfunctions in anorexia nervosa. For example, CRH alterations contribute to hypercortisolemia and NPY alterations may contribute to amenorrhea. Alterations of these peptides as well as opioids, vasopressin, and oxytocin activity could contribute to other characteristic psychophysiological disturbances, such as reduced feeding, in acutely ill anorexics. Such neuropeptide disturbances could contribute to the vicious cycle that has been hypothesized to occur in anorexia nervosa. That is, the consequences of malnutrition perpetuate pathological behavior.
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PMID:Neuropeptide abnormalities in anorexia nervosa. 873 16

Based on Ritenbaugh's 1982 definition, this essay reconsiders the status of anorexia nervosa as a Western culture-bound syndrome (CBS). It argues that anorexia nervosa, in its culturally reconstructed fat phobic form, is no longer bound to specific Western localities. Instead, it may be conceived as being grounded in the transnational culture of 'modernity', characterized by an internationalised socio-economic stratum now found in many rapidly urbanising parts of the world, and composed of increased affluence, as well as the globalization of fat phobia and diffusion of biomedical technology. Although the treatment implication of Ritenbaugh's CBS concept may appear to be misplaced from the clinician's pragmatic perspective, its salience for clarifying the interaction of individual and cultural concerns in self-starvation, as well as for fostering a needed self-scrutiny in psychiatry, is affirmed. A critique of the dialectical relationship between culture and psychopathology is then put forward. This addresses the apparently conflicting role of anorexia nervosa in enacting as well as combating the cultural pursuit of thinness, and ends by highlighting the inadvertent influence of the biomedical establishment in propagating the condition with measures intended, ironically, for preventing it.
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PMID:Reconsidering the status of anorexia nervosa as a western culture-bound syndrome. 874 5

We have observed seven initially obese individuals who, during the course of a strenuous weight-reduction program, developed diabetes mellitus: non-insulin-dependent diabetes mellitus in five cases and insulin-dependent diabetes mellitus in two cases. None had any sign of prior diabetic symptoms. Although weight reduction is encouraged in obesity, crash diets without proper medical surveillance may have deleterious effects. This sequence of induction of diabetes has not previously been reported in the medical literature. The metabolic situation in extremely low-calorie diets may be comparable to that in starvation. An attempt is made to explain our observation concerning the induction of a diabetic state during such diets, on the basis of increased insulin resistance in states of starvation and anorexia nervosa, with a concomitant role in stress hormones.
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PMID:Starvation diet and very-low-calorie diets may induce insulin resistance and overt diabetes mellitus. 877 29


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