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.

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.

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.

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).

What kind of illness is anorexia nervosa?

With the best will in the world, it is difficult not to become disillusioned with the diagnostic system for eating disorders. Although repeatedly revised, diagnostic criteria such as those of DSM-IV or ICD10 are inadequate to describe the patient's condition. This essay critically appraises the historical development of eating disorders and challenges the widely held notion that bulimia nervosa and anorexia nervosa share a common psychopathology.

Pattern of birth in anorexia nervosa. II: A comparison of early-onset cases in the southern and northern hemispheres.

Objective: In the northern hemisphere, people with anorexia nervosa are more likely to be born in the spring and early summer, particularly when environmental temperature at assumed time of conception is warmer. This study investigates whether there is a comparable effect in the southern hemisphere (Australia), where seasonal and temperature patterns are reversed.

Method: Date of birth and temperature at assumed time of conception were collected for 199 Australian and 259 UK patients with early-onset anorexia nervosa.