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Medical Considerations and Consequences of Eating Disorders. 饮食失调的医学考虑因素和后果。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20230042
Jennifer L Carlson, Diana C Lemly
{"title":"Medical Considerations and Consequences of Eating Disorders.","authors":"Jennifer L Carlson, Diana C Lemly","doi":"10.1176/appi.focus.20230042","DOIUrl":"10.1176/appi.focus.20230042","url":null,"abstract":"<p><p>Eating disorders may result in medical complications that affect every body system with both acute and chronic consequences. Although some medical complications may require acute medical hospitalization to manage, other complications, such as low bone mineral density, may not present until malnutrition has become chronic. It is critical for team members to be aware of the early clinical signs of malnutrition and disordered eating behaviors, as well as longer-term complications that may affect their patients. When identifying eating disorder concerns, appropriate colleagues from the medical, nutrition, and psychiatric fields can be engaged in order to collaborate on stabilizing and improving the health of patients.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Practice Assessment Tool for the Care of Patients With Eating Disorders. 饮食失调患者护理实践评估工具》。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20240009
Laura J Fochtmann, Jennifer Medicus, Seung-Hee Hong
{"title":"Practice Assessment Tool for the Care of Patients With Eating Disorders.","authors":"Laura J Fochtmann, Jennifer Medicus, Seung-Hee Hong","doi":"10.1176/appi.focus.20240009","DOIUrl":"10.1176/appi.focus.20240009","url":null,"abstract":"<p><p>Eating disorders are characterized by significant disturbances in eating patterns associated with negative attitudes toward one's body, weight, and shape. They are associated with an increased risk of mortality and morbidity as well as significant health, economic, and psychosocial burdens. Additionally, individuals with eating disorders often hesitate to seek treatment and symptoms may be difficult to ascertain without structured assessment. The <i>American Psychiatric Association</i> <i>Practice Guideline for the Treatment of Patients With Eating Disorders</i> aims to enhance knowledge and increase the appropriate use of interventions for eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder, thereby improving the quality of care and treatment outcomes. To this end, this evidence-based Performance in Practice tool can facilitate the implementation of a systematic approach to practice improvement for the care of individuals with eating disorders. This practice assessment activity can also be used in fulfillment of Continuing Medical Education and ABPN Continuing Certification, Improvement in Medical Practice.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eating Disorders: Out With the Old and in With the New. 饮食失调：旧的不去，新的不来。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20240015
Jennifer L Derenne
{"title":"Eating Disorders: Out With the Old and in With the New.","authors":"Jennifer L Derenne","doi":"10.1176/appi.focus.20240015","DOIUrl":"https://doi.org/10.1176/appi.focus.20240015","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rethinking Therapeutic Strategies for Anorexia Nervosa: Insights From Psychedelic Medicine and Animal Models. 重新思考神经性厌食症的治疗策略：来自迷幻医学和动物模型的启示。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.24022012
Claire J Foldi, Paul Liknaitzky, Martin Williams, Brian J Oldfield
{"title":"Rethinking Therapeutic Strategies for Anorexia Nervosa: Insights From Psychedelic Medicine and Animal Models.","authors":"Claire J Foldi, Paul Liknaitzky, Martin Williams, Brian J Oldfield","doi":"10.1176/appi.focus.24022012","DOIUrl":"https://doi.org/10.1176/appi.focus.24022012","url":null,"abstract":"<p><p>Anorexia nervosa (AN) has the highest mortality rate of any psychiatric disease, yet available pharmacological treatments are largely ineffective due, in part, to an inadequate understanding of the neurobiological drivers that underpin the condition. The recent resurgence of research into the clinical applications of psychedelic medicine for a range of mental disorders has highlighted the potential for classical psychedelics, including psilocybin, to alleviate symptoms of AN that relate to serotonergic signaling and cognitive inflexibility. Clinical trials using psychedelics in treatment-resistant depression have shown promising outcomes, although these studies are unable to circumvent some methodological biases. The first clinical trial to use psilocybin in patients with AN commenced in 2019, necessitating a better understanding of the neurobiological mechanisms through which psychedelics act. Animal models are beneficial in this respect, allowing for detailed scrutiny of brain function and behavior and the potential to study pharmacology without the confounds of expectancy and bias that are impossible to control for in patient populations. We argue that studies investigating the neurobiological effects of psychedelics in animal models, including the activity-based anorexia (ABA) rodent model, are particularly important to inform clinical applications, including the subpopulations of patients that may benefit most from psychedelic medicine. Appeared originally in <i>Front Neurosci</i> 2020; 14:43.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Building Confidence in Discussing Genetics With Patients With Eating Disorders and Their Families. 树立与饮食失调患者及其家属讨论遗传学的信心。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20230040
Cynthia M Bulik
{"title":"Building Confidence in Discussing Genetics With Patients With Eating Disorders and Their Families.","authors":"Cynthia M Bulik","doi":"10.1176/appi.focus.20230040","DOIUrl":"10.1176/appi.focus.20230040","url":null,"abstract":"<p><p>Many individuals with eating disorders and their family members are well-informed about advances in science that could affect the treatment and outcome of these illnesses. They appropriately apply this knowledge to evaluate available treatments and advocate for the best possible evidence-based care. They ask hard questions that many clinicians are often ill-prepared to answer. Genetics has advanced our understanding of eating disorders and provides a novel lens through which to understand these pernicious illnesses. Clinicians can now update their understanding of the etiology of eating disorders and abandon outdated etiological theories, some of which have done harm to patients and their families. Without becoming expert in psychiatric genetics, psychiatrists and other mental health care professionals can develop a general overview of the science, understand what it can and cannot offer, incorporate genetic factors into their case conceptualizations, and boost their confidence in discussing these topics with patients and families.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Innovative and Emerging Treatments for Anorexia Nervosa. 厌食症的创新和新兴疗法。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20230041
Amanda E Downey, Sasha Gorrell
{"title":"Innovative and Emerging Treatments for Anorexia Nervosa.","authors":"Amanda E Downey, Sasha Gorrell","doi":"10.1176/appi.focus.20230041","DOIUrl":"10.1176/appi.focus.20230041","url":null,"abstract":"<p><p>Unlike psychopharmacologic interventions for other psychiatric conditions, few medications have emerged as helpful in improving eating disorder cognitions and evidence-based psychotherapies fail many patients. Novel treatments are urgently needed to address anorexia nervosa (AN), which is increasingly prevalent and difficult to treat. This article provides an overview of preliminary investigations into cannabidiol, psilocybin therapy, ketamine and the ketogenic diet, transcranial magnetic stimulation, and vagus nerve stimulation in individuals with AN. These pilot studies underscore the need for larger clinical trials that include more participant diversity in order to rapidly translate findings to real-world clinical practice.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anorexia Nervosa Across the Lifespan: A Review of Recent Literature. 跨生命周期的神经性厌食症：最新文献综述。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20230037
Nandini Datta, Kristene Hossepian, Isabella Xie, Hazal Yagmur Gurcan, Solveig Behr, Marina Pouliadi, Christina Miranda
{"title":"Anorexia Nervosa Across the Lifespan: A Review of Recent Literature.","authors":"Nandini Datta, Kristene Hossepian, Isabella Xie, Hazal Yagmur Gurcan, Solveig Behr, Marina Pouliadi, Christina Miranda","doi":"10.1176/appi.focus.20230037","DOIUrl":"10.1176/appi.focus.20230037","url":null,"abstract":"<p><p>In this review, the authors provide an update on the understanding of anorexia nervosa (AN) across the lifespan. Focusing on key pieces of literature from the past 5 years, this review summarizes recent updates to <i>DSM-5</i> within the domain of AN, including the addition of a new AN diagnosis: atypical anorexia. Additional sections covered in this review include improvements in the epidemiological understanding of AN across the developmental spectrum, treatment approaches that have been established as gold standard as well as new directions recently explored in treatment, and recent advancements in the biopsychosocial underpinnings of AN. Altogether, although this review captures several advancements in the field's overall conceptualization of AN, several key areas of treatment and diagnostic capacity continue to require additional focus and research.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bulimia Nervosa and Binge-Eating Disorder Across the Lifespan. 神经性贪食症和暴饮暴食症的一生。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20240001
Brittany E Matheson
{"title":"Bulimia Nervosa and Binge-Eating Disorder Across the Lifespan.","authors":"Brittany E Matheson","doi":"10.1176/appi.focus.20240001","DOIUrl":"10.1176/appi.focus.20240001","url":null,"abstract":"<p><p>This article aims to review the current evidence-based psychotherapy and psychopharmacological treatments for adults and youths with bulimia nervosa (BN) and binge-eating disorder (BED). Treatments for adults and for children and adolescents are discussed separately, including developmental considerations in the management of these disorders among youths. Although several evidence-based psychotherapy and psychopharmacological treatment options have been established for adults with BN or BED, there is much less empirical support for the management of these eating disorders among children and adolescents. This review concludes by discussing promising modalities and innovations, highlighting the potential utility of integrating technology into treatment approaches. Despite decades of treatment development and testing, a sizable proportion of individuals with BN or BED do not respond to the current evidence-based treatments, highlighting the need for continued research in these domains. Future research should focus on testing psychotherapy treatments among diverse samples in large, randomized controlled trials, as well as on treatments that can be easily scaled and implemented in community settings.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eating Disorders: Updates and Innovations. 饮食失调症：更新与创新。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.24022009
{"title":"Eating Disorders: Updates and Innovations.","authors":"","doi":"10.1176/appi.focus.24022009","DOIUrl":"10.1176/appi.focus.24022009","url":null,"abstract":"","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychopharmacology Review for Eating Disorders Among Children, Adolescents, and Adults. 儿童、青少年和成年人饮食失调的精神药理学综述》。
Focus (American Psychiatric Publishing) Pub Date : 2024-07-01 Epub Date: 2024-06-28 DOI: 10.1176/appi.focus.20230043
Zinnia Ali, Jennifer Couturier
{"title":"Psychopharmacology Review for Eating Disorders Among Children, Adolescents, and Adults.","authors":"Zinnia Ali, Jennifer Couturier","doi":"10.1176/appi.focus.20230043","DOIUrl":"10.1176/appi.focus.20230043","url":null,"abstract":"<p><p>This article reviews the latest research on pharmacological management of eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and avoidant/restrictive food intake disorder. Recent literature for both youth and adult populations obtained through a PubMed search was included. American Psychiatric Association guidelines, National Institute for Health and Care Excellence guidelines, Canadian practice guidelines, and World Federation of Societies of Biological Psychiatry guidelines were also included. First-line recommendations were focused on therapy because the evidence for medication management of eating disorders continues to be limited. Some limited evidence was found for antipsychotic use for AN, selective serotonin reuptake inhibitors and topiramate use for BN, and stimulant and topiramate use for BED. Further medication trials are needed to help with complex eating disorder presentations in adults and youth.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11231477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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