Physical activity and body composition in outpatients recovering from anorexia nervosa and healthy controls.

The study aimed to compare differences in physical activity, the relationship between physical activity and body composition, and seasonal variation in physical activity in outpatients with anorexia nervosa (AN) and healthy controls. Physical activity (CM-AMT) and time spent in different intensities of 10 female individuals with AN and 15 female controls was assessed across three seasons along with the percentage body fat. The two groups did not differ in their physical activity and both demonstrated seasonal variation.

Bacterial infections in anorexia nervosa: delayed recognition increases complications.

Objective: We compared the natural history of bacterial infection in patients with anorexia nervosa (AN) with controls, and assessed which of a range of patient characteristics were associated with infection, fever response, and the rate of infectious complications in AN patients.

Method: The charts of 311 consecutive hospital admissions of AN patients were reviewed. Patients who had a bacterial infection while in the hospital were compared with the AN patients who did not have an infection, with respect to a range of demographic and disease variables.

Assessing quality of life in eating disorder patients.

Objective: To examine quality of life among subgroups of eating disorder patients.

Method: Self-report questionnaires which included two quality of life measures were completed by 87 individuals referred for treatment to the Australian Capital Territory Eating Disorders Day Program. Health-related quality of life, as measured by the Medical Outcomes Study 12-item Short Form Mental Component Summary scale, and subjective quality of life, as measured by subscales of the World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF), were compared among individuals who received the diagnosis of anorexia nervosa purging subtype (n = 15), anorexia nervosa restricting subtype (n = 19), bulimia nervosa (n = 40) and binge eating disorder (n = 10), and among a general population sample of young adult women employed as a control group (n = 495).

Randomized controlled trial of olanzapine in the treatment of cognitions in anorexia nervosa.

Objective: Recovery from anorexia nervosa is confounded by intrusive anorectic cognitions and rituals. It has been observed that olanzapine, an atypical antipsychotic, can reduce this anorexic rumination. A pilot study was designed to test the effectiveness of olanzapine in this role.

Disability associated with community cases of commonly occurring eating disorders.

Objective: To examine disability associated with community cases of the more commonly occurring eating disorders and with particular eating disorder behaviours.

Method: Self-report questionnaires, which included measures of eating disorder symptoms and impairment in everyday functioning, were completed by 495 female residents of the Australian Capital Territory region aged between 18 and 45 years. A structured interview for the assessment of eating disorders was completed by a subgroup (n = 208) of participants.

Serotonergic and dopaminergic systems in anorexia nervosa: a role for atypical antipsychotics?

Objective: To review serotonergic and dopaminergic system function in anorexia nervosa in terms of potential modulation by atypical antipsychotic medications.

Method: A systematic review of clinical, neurobiological and functional neuroimaging findings of serotonergic and dopaminergic system activity in anorexia nervosa was conducted via MEDLINE, PsycINFO and EMBASE psychiatry databases, with a critical review of dysregulation of these systems as therapeutic targets for atypical antipsychotics, in context of evidence regarding the utility and efficacy of these medications in this syndrome.

Results: There is evidence of persistently altered serotonergic and dopaminergic function in anorexia nervosa independent to weight-recovery.

Mode of delivery, but not questionnaire length, affected response in an epidemiological study of eating-disordered behavior.

Background And Objectives: The effects of questionnaire length and mode of delivery on response rates were examined in an epidemiological study of eating-disordered behavior.

Methods: Short (8 pages) and long (14 pages) questionnaires were posted or hand-delivered to a community sample of 802 women. Nonrespondents who received the first questionnaire by hand delivery received a reminder letter and replacement questionnaire by post; those who received the initial questionnaire by post were further randomized to receive the first reminder by hand delivery or by post, in short or long form.

Can psychiatric terminology be translated into legal regulation? The anorexia nervosa example.

Objective: To explore the tension between the definition of mental illness in clinical psychiatry and its embodiment in legislation applied by tribunals reviewing decisions to treat.

Method: Severe anorexia nervosa is used as a case exemplar of the tension between the appropriate narrative to express the clinical imperative to treat and the law's focus on finer technical language which secures individual civil rights and liberties. Australian and international experience is reviewed.

Australian and New Zealand clinical practice guidelines for the treatment of anorexia nervosa.

Background: The Royal Australian and New Zealand College of Psychiatrists is co-ordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Ministry of Health. This CPG covers anorexia nervosa (AN).

Method: The CGP team consulted with scientists, clinicians, carers and consumer groups in meetings of over 200 participants and conducted a systematic review of meta-analyses, randomized controlled trials and other studies.

Temporal stability of the Eating Disorder Examination Questionnaire.

Objectives: The current study examined the stability and internal consistency of the Eating Disorder Examination Questionnaire (EDE-Q) in a general population sample.

Methods: The EDE-Q was administered to a community sample of women aged 18-45 on two occasions, with a median test-retest interval of 315.0 days.

Beliefs of women concerning causes and risk factors for bulimia nervosa.

Objective: To examine the beliefs of women concerning causes and risk factors for eating-disordered behaviour.

Method: Face-to-face interviews were conducted with a community sample of 208 women aged 18-45 years. Respondents were presented with a vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa (BN) and were asked to indicate whether each of several factors was 'very likely', 'likely' or 'not likely' to be a cause of the problem described, which factor was most likely to be a cause, and whether particular subgroups of people would be 'more likely', 'less likely' or 'equally likely' to have or develop the problem described.

Nonresponse bias in a general population survey of eating-disordered behavior.

Objective: To investigate nonresponse bias in a two-phase epidemiologic study of eating-disordered behavior.

Method: Self-report questionnaires were delivered to a community sample of women aged 18-45 drawn from the electoral roll. Follow-up interviews were completed with a subgroup of respondents.

Beliefs of the public concerning the helpfulness of interventions for bulimia nervosa.

Objective: To examine the beliefs of women concerning the helpfulness of various possible interventions for bulimia nervosa.

Method: Face-to-face interviews were conducted with a community sample of 208 women aged 18-45 years. Respondents were presented with a vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa and were asked to indicate whether various persons, treatments, medications, and self-help activities would be helpful, harmful, or neither helpful nor harmful for the person described.

Beliefs of women concerning the severity and prevalence of bulimia nervosa.

Background: Few studies have examined attitudes towards eating-disordered behaviour among women in the general population.

Methods: A vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa (BN) was presented to a community sample of women aged 18-45. Respondents (n = 208) were asked a series of questions concerning the severity and prevalence of the problem described.

Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples.

In order to examine the concurrent and criterion validity of the questionnaire version of the Eating Disorders Examination (EDE-Q), self-report and interview formats were administered to a community sample of women aged 18-45 (n = 208). Correlations between EDE-Q and EDE subscales ranged from 0.68 for Eating Concern to 0.

Do people with anorexia nervosa use sauna baths? A reconsideration of heat-treatment in anorexia nervosa.

The paper addresses the absence of reports about the sauna use among the weight loss strategies of patients with anorexia nervosa (AN). Because AN entails a relentless pursuit of thinness, it might be expected that these patients would frequently resort to saunas. The paper sustains that the absence of reports should not be taken to mean that sauna use is irrelevant to AN.

Randomized controlled trial of warming in anorexia nervosa.

Objective: To determine if warming therapy increases the rate of weight gain in patients with anorexia nervosa (AN) who are hospitalized for refeeding.

Method: Patients admitted to an eating disorders unit of a university teaching hospital were randomized to treatment and control arms. All patients wore a heating vest for 3 hr a day for 21 days.

An international collaborative database: its use in predicting length of stay for inpatient treatment of anorexia nervosa.

Objective: We describe the establishment of an Australasian multisite research database for inpatient treatment of anorexia nervosa (AN). Using this database, the second aim of this study is to investigate the extent to which length of stay (LOS) in participating facilities could be predicted at admission from patient, clinical, and site variables.

Method: Standardized demographic and clinical data were collated for 213 admission episodes involving 154 participants over a 20 month period from five Australian and one New Zealand specialist treatment centres.

Gene-gene interaction between the monoamine oxidase A gene and solute carrier family 6 (neurotransmitter transporter, noradrenalin) member 2 gene in anorexia nervosa (restrictive subtype).

We earlier found an association between anorexia nervosa (AN) restrictive subtype (AN-R) and an inserted sequence within the NETpPR, a polymorphic region located in the promoter of the solute carrier family 6 (neurotransmitter transporter, noradrenalin) member 2 (SLC6A2) gene. To further examine the noradrenergic system in AN-R we performed an association study with a functional polymorphism (MAOA-uVNTR) in the promoter of the monoamine oxidase A (MAOA) gene. Since monoamine oxidase A metabolises noradrenalin, a positive association with the MAOA gene would be biologically plausible.

GPs managing patients with eating disorders. A tiered approach.

Background: General practitioners take on varying levels of responsibility for patients who have eating disorders. Roles appear to be tiered, from simply identifying illness and referring the patient on, to acting as care coordinator, providing medical and psychological treatment and/or continuing care.

Objective: Every GP has some level of responsibility toward this patient group.

Reduced febrile response to bacterial infection in anorexia nervosa patients.

Objective: To report a reduced febrile response to bacterial infections in anorexia nervosa (AN) patients.

Method: Four cases were obtained from a retrospective review of charts from the St. Paul's Hospital Eating Disorders Program (Vancouver, Canada).

Investigation of epistasis between the serotonin transporter and norepinephrine transporter genes in anorexia nervosa.

Weight-restored patients with anorexia nervosa (AN) respond favorably to the selective serotonin reuptake inhibitor fluoxetine, which justifies association studies of the serotonin transporter gene (SLC6A4, alias SERT) and AN. Case-control studies suggest that the least transcriptionally active allele of the SERT gene promoter polymorphism (5-HTTLPR) has an increased frequency in AN patients. However, this finding was not replicated with 55 trios (AN child+parents) and the transmission disequilibrium test (TDT).

Comparison of group and individual cognitive-behavioral therapy for patients with bulimia nervosa.

Objective: The clinical effectiveness of group and individual cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) was compared.

Method: Sixty BN patients from hospitals and general practitioners in Sydney, Australia, were allocated randomly to group or individual CBT. Forty-four completed treatment (n = 22 in group CBT and n = 22 in individual CBT).