The Epidemic of Anorexia Nervosa: Myth or Reality?
Filipa Mucha Vieira2012, Relevant topics in Eating Disorders
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Abstract
studied. Metaanalytic studies were also included. Key search terms relating to epidemiology and ED were used. Follows is a review the main obstacles in this field, as we believe they strongly contribute to the main discrepancies found in the results.
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Anorexia Nervosa as a Modern Disease: A Comparative Study of Different Disciplines
Procedia - Social and Behavioral Sciences, 2013
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The case for biology in the aetiology of anorexia nervosa
Psychological Medicine, 1994
The case for biology in the aetiology of anorexia nervosa 1 It is now common to view anorexia nervosa as a multi-determined syndrome in which physical, psychological, family and sociocultural factors interact to produce the illness. Such a compromise position is difficult to refute. However, the components of this complex model neither explain nor account for the epidemiological and clinical features of the condition. A popular cultural thesis is that the victim of anorexia nervosa is struggling to change her body in an attempt to deal with the contradictory requirements of the female role in late twentiethcentury Western societies (Chernin, 1986; Orbach, 1986; Edwards, 1987). However, this thesis cannot account for the numerous clear descriptions of the condition which date from the middle of the nineteenth century (Marce, 1860; Gull, 1873; Lasegue, 1873), or even earlier (Morton, 1694). A common assumption held by many who argue for the importance of socio-cultural factors, is that there have been marked increases in the incidence of anorexia nervosa, over the last two or three decades. The evidence that anorexia nervosa, as opposed to bulimic disorders, has increased in incidence in parallel with the vast social changes of the last two centuries is, however, controversial. Although there is no doubt that case registers show an increase in anorexia nervosa over the last few decades (Kendell et al. 1973; Jones et al. 1980; Szmukler et al. 1986; Willi et al. 1990) this is probably an artefact, due to increased awareness of the condition and recognition of its psychological basis. When rigorous case-finding procedures were used (Lucas et al. 1988) no significant trends in incidence were found in the 45 years spanning from 1930 to 1979, although in a later paper which included the years 1980-5 a twofold increase in 15-24-year-old females was found (Lucas et al. 1991). The vivid case descriptions of anorexia nervosa in Hong Kong (Lee, 1991) serve to remind us that the form of the illness does vary between cultures; 'fear of fatness', in particular, is not universal. It was argued, at the NIMH-sponsored conference on cultural issues for DSM-IV, that anorexia nervosa can be found in developing countries if this criterion is omitted (Littlewood, 1992). At the same conference the proposal to classify anorexia nervosa as a 'culture bound' category was rejected. It is possible that the prevalence of anorexia nervosa is reduced in non-Western cultures but definitive studies have not been performed; rather, there has been a large series of case reports
Epidemiology and Course of Anorexia Nervosa in the Community
American Journal of Psychiatry, 2007
Objective: Most previous studies of the prevalence, incidence, and outcome of anorexia nervosa have been limited to cases detected through the health care system, which may bias our understanding of the disorder's incidence and natural course. The authors sought to describe the onset and outcomes of anorexia nervosa in the general population.
Anorexia Nervosa: an Overview
Anorexia Nervosa has been a long-standing, much researched problem in modern medicine and psychology, with researchers, medical experts, psychology experts and media specialists trying to find a suitable answer for questions such as, why does anorexia develop, what is its main demographic, how does society affect the potential for anorexia development etc. While research has been done not only on popular discourse of anorexia nervosa, as well as the medical and clinical aspects and manifestations of the disease, the varying symptomatology of this disorder as well as the abundance of backgrounds it stems from in different patients, have made it hard to pin anorexia down. As of today, an official description and diagnostic assessment exist, yet instances of so-called "atypical" anorexia are becoming more frequent with the societal phenomena that spur on the development of the illness.
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In recent years, the definition, clinical characteristics, and psychological aspects of anorexia nervosa (AN) have undergone notable changes, influenced by various factors such as biology, psychology, and the environment. The COVID-19 pandemic is one such external factor that has been preliminarily identified as affecting the clinical presentation of AN. This study specifically aims to assess the alterations in psychological and medical features observed in individuals with AN during the pandemic. This study is a retrospective case review of 252 people diagnosed with AN from two different cohorts: 2010–2012 and 2021. A comparison of psychological and medical data was conducted to identify specific differences in the initial clinical evaluation. Additionally, different effects of the pandemic on age cohorts were assessed, with a focus on distinctions between adolescents and adults. Results revealed that the pandemic cohort had a higher number of new cases, with patients being younger...
Topic-The Conundrum of Anorexia Nervosa
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Journal of the American Academy of Child and Adolescent Psychiatry, 1994
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Systematic review of prospective studies assessing risk factors to predict anorexia nervosa onset
Journal of eating disorders, 2023
Background According to case-control studies, a multitude of factors contribute to the emergence of anorexia nervosa (AN). The present systematic review examines prospective studies specifically designed to evaluate the prediction of AN onset. Methods According to the ARMSTAR 2 and PRISMA 2020 checklists, the PubMed, PsycINFO and Cochrane databases were searched. The methodological quality of the studies was assessed with the Downs and Black checklist. Results Three articles concerning prospective studies of the general population were ultimately included in the review. The methodological quality of these studies was not optimal. Bidirectional amplification effects were observed between risk factors, some of which could have a relative predictive force as low bodyweight or body dissatisfaction. Even if not included according to specified criteria for this systematic review 11 longitudinal studies, with retrospective analysis of AN onset' prediction, were also discussed. None of these studies asserted the predictive value of particular risk factors as low body weight, anxiety disorders or childhood aggression. Conclusions To date there are insufficient established data to propose predictive markers of AN onset for predictive actions in pre-adolescent or adolescent populations. Future work should further evaluate potential risk factors previously identified in case-control/retrospective studies within larger prospective investigations in preadolescent populations. It is important to clearly distinguish predisposing factors from precipitating factors in subjects at risk of developing AN.
Eating disorders - anorexia as an interdisciplinary problem
2019
Eating disorders are a serious medical and social problems. The most commonly recognized eating disorders are anorexia nervosa (AN) and bulimia nervosa, now classified as a behavioral disorders. Anorexia nervosa is a disease involving intentional body weight reduction, distorted body image and the dysmorphophobia, often with concomitant depression and social withdrawal. Understanding anorexia is not only limited to a food or a body weight. Underlying disorders include: emotional issues, undetermined identity, a negative self-image, etc. AN has a reported prevalence in woman of 0,5-1%, and 0.05-0.1% in men. Prevalence rate among polish girls under 18 years old is 0.8%-1.8%. 113 The etiology of this disorder is multifactorial and unclear. The predisposing factors include: genetic factors, personality disorders, specific family patterns (overprotection, avoiding conflicts) and high economic status. Diagnosis of AN is a challenge. Symptomatology is variable, including: behavior changes, psychological and somatic symptoms, specific biochemical and hormonal abnormalities. A treatment is multidisciplinary and multi-stage, comprising: (1) the life saving therapy (prevention of dehydration, electrolyte imbalance and cachexia), (2) restoration of normal body weight, (3) adjuvant pharmacotherapy, (4) psychotherapy. The efficacy of treatment is unsatisfactory. Anorexia has the highest mortality rate of all mental disorders: after 15-20 years the mortality prevalence rate is 19-20%, mainly as a result of cardiovascular complications and suicides.
Management and treatment of anorexia nervosa: a retrospective cohort study
2015
Purpose: The main aims of the present study were to present an Anorexia Nervosa (AN) treatment program offered in a major university hospital in Portugal, and to determine the influence of body mass index (BMI) at admission, on outcome. Our hypothesis is that patients with higher severity, based on current BMI, may have worst prognosis with poorest outcome. Methods: The sample included data from case records of 121 patients seen consecutively for the first time at our center, between 2008 and 2012. So we performed a retrospective cohort study which included data collected at admission and at 2 follow-up years.
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A follow-up study on anorexia nervosa: clinical features and diagnostic outcome
European Psychiatry, 1991
SummaryThirty-one patients, 30 girls and 1 boy, who had suffered from anorexia nervosa, were re-evaluated at a minimum of 4 years (mean 7.6 years) after onset. Follow-up information was based on a semi-structured interview and 2 self-evaluation questionnaires, EAT-26 (1979) and HSCL-90 (1976). As well as using the Garfinkel and Garner criteria (1977) for assessing outcome, 2 psychiatrists independently evaluated the psychiatric state using DSM III criteria. The results demonstrated that 54.8% of the sample had a positive and 45% (including 3 deaths) a poor outcome. Of the 25 subjects interviewed, 20% presented chronic anorexia. Seventy-two percent, on the other hand, showed an evolution in clinical diagnosis, meeting the criteria for a mental disorder other than anorexia nervosa: Affective Disorders (40%), Somatoform Disorder (16%), Anxiety Disorder (12%), and Bulimia (8%). Two variables were significant, in terms of poor long-term prognosis: a larger number of hospitalizations for ...
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ijmtst, 2022
Anorexia nervosa is a serious mental disorder with a characteristic appearance. It can affect people of all ages, genders, sexual orientations, races, and ethnicities, but it is especially dangerous for adolescent girls and young adult women. Anorexia is caused by a combination of psychological, societal, and biological variables, and there is no single cause. Anorexia nervosa affects about 0.5-1.0 percent of women over the world. Previous research suggested that anorexia nervosa is a condition that exclusively affects women in Western countries; however, recent research has showed that it is more common in boys than previously assumed.The higher rate of anorexia nervosa in western countries compared to non-western countries was explained by cultural differences, as western culture places a high priority on thinness in young women. Being skinny, on the other hand, is socially unacceptable in most non-western cultures. Although anorexia nervosa is primarily a problem in Western countries, current data suggests that it is spreading to non-Western countries in both genders. This phenomenon was explained by a number of factors, including Western media attention, social and parental pressure, genetic and biochemical variables, and other psychological problems including such sexual abuse and poor self are also contributors.
Risk factors for anorexia nervosa: a national cohort study
The International journal of eating disorders, 2003
To identify possible risk factors for anorexia nervosa through national registers. The study includes the entire Swedish population of 989,871 individuals born between 1973 and 1982. Patients with anorexia nervosa were identified through the Swedish Hospital Discharge Register from November 1990 to December 1999. Information about sociodemographic, perinatal, and psychosocial variables was obtained from different national registers. Attributable risk (AR) was calculated for potential risk factors. Females had the highest AR for hospital admission because of anorexia nervosa (89.2%). Another important risk factor was having parents born in northern, central, or eastern Europe (AR: 49.3%). Psychosocial risk factors also were associated with an increased risk for anorexia nervosa (AR: 7.6%), whereas perinatal complications had an AR of only 3.6%. The most important risk factors were related to the sociocultural context of the individual, thus supporting hypotheses of a sociocultural et...
Anorexia Nervosa: Demographic and Clinical Features in 94 Cases
Psychosomatic Medicine, 1974
A comprehensive chart study was made of numerous clinical and demographic features in 94 patients with anorexia nervosa. Unlike other large series, this survey included the pediatric age group. A significantly greater maternal and paternal age at time of the patient's birth and a greater incidence of both low and high birth weights compared with the general population was found. A relatively high occurrence of premorbid feeding problems was present. Anxiety and obsessive-compulsive traits were frequent premorbid symptoms. Precipitating events were identified more frequently in patients with a greater age at onset of illness. Characteristic behavior noted during the course of this illness is described.
Follow-up studies of anorexia nervosa: a review of four decades of outcome research
Psychological Medicine, 1991
In 1983 we presented a systematic analysis of the available literature on the course of anorexia nervosa (Steinhausen Glanville, 1983 a). The survey was based on 45 English and German language studies published between 1953 and 1981. During the past decade there has been a striking increase of publications related to eating disorders in general. This pertains as well to follow-up studies on anorexia nervosa. In addition to studies compiled in our previous report, we were able to locate another 22 follow-up studies published in major English and German language journals between 1981 and 1989
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