Anorexia nervosa is characterized by distortion of body image and profound weight loss due to self starvation. So, the patients are easily diagnosed with history and interview. We experienced a patient who had suffered for prolonged vomiting and profound weight loss without definite distorted body image, but had accompanied by autonomic dysfunction. Thus, we report a case with a brief review of literatures.
Anorexia Nervosa* ; Anorexia* ; Body Image ; Humans ; Starvation ; Vomiting ; Weight Loss

OBJECTIVES: This study compared cognitive-behavioral traits related to eating behaviors, obsessive-compulsive traits, and depression levels in bulimic subjects with and without a history of anorexia nervosa according to the perspective that there are common diagnostic transitions over time in subgroups of eating disorders (anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). METHODS: We compared EDI-2, MOCI, and BDI scores between the bulimic group with a history of anorexia (n=98), the bulimic group without a history of anorexia (n=99), and the non-clinic group (n=100) by ANOVA. RESULTS: The bulimic group with a history of anorexia showed significantly higher scores on four of the EDI-2 subscales (Ineffectiveness, Interoceptive Awareness, Impulse Regulation and Social Insecurity) than the other two groups. They also indicated significantly higher scores on both the MOCI subscale 'rumination' and BDI than both the other groups. CONCLUSION: These findings suggest that it is important to consider a prior history of anorexia nervosa in order to understand symptom severity in patients with bulimia. Psychological variables such as ineffectiveness, impulse regulation, social insecurity, rumination, and depression are crucial to consider while treating bulimics with a history of anorexia.
Anorexia ; Anorexia Nervosa ; Bulimia ; Bulimia Nervosa ; Depression ; Feeding and Eating Disorders ; Feeding Behavior ; Female ; Humans

Many therapeutic approaches for treafment of binge eating problem including cognitive-behavioral therapy, behavior therapy, focal psychotherapy. psychoanalysis, nutritional counseling, family intervention, psychoeducation, and medication have value. Nevertheless, current research suggest that the most important approant approach to date is a specific form of cognilive-behavioral therapy designed ariginally for patients with bulimia nervosa and recently adapfed for those with binge eating disorder and anorexia nervosa. But it is also important to stress that cognitive-behavioral therapy is not panacea, some patients fail to benefit and others made only limited gains. So there is a need for clinician not only to carefully assess the patient status before freatment start but also to become familiar with and be able to introduce other therapeutic approach.
Anorexia Nervosa ; Behavior Therapy ; Binge-Eating Disorder ; Bulimia Nervosa ; Bulimia* ; Counseling ; Humans ; Psychoanalysis ; Psychotherapy

OBJECTIVES: To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. METHODS: One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. RESULTS: In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. CONCLUSIONS: Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.
Age of Onset ; Anorexia Nervosa* ; Bulimia ; Bulimia Nervosa* ; Eating ; Eating Disorders ; Female ; Humans ; Mothers ; Parents*

In young adolescent girls, anorexia nervosa is a significant cause of weight loss, and hospital admissions among children and adolescents. Anorexia nervosa is a life-threatening disorder, with about one-third of deaths caused by cardiac complications. A high rate of pericardial effusion has been recently reported in patients with anorexia nervosa, although relatively few cases require pericardiocentesis. Here, we describe three patients with anorexia nervosa who were diagnosed with large pericardial effusions. To prevent cardiac tamponade, pericardiocentesis was performed in two girls.
Adolescent ; Anorexia ; Anorexia Nervosa ; Cardiac Tamponade ; Child ; Humans ; Pericardial Effusion ; Pericardiocentesis ; Weight Loss

Gelatinous transformation of the bone marrow is rarely found and characterized by accumulation of hyaluronic acid, fat atrophy and associated with bone marrow hypoplasia. This process has been reported to occur in severely malnourished patients. We report an anorexia nervosa patient showing pancytopenia and hypoplastic bone marrow associated with gelatinous transformation. Pathogenesis of this lesion remains unclear.
Anorexia Nervosa* ; Anorexia* ; Atrophy ; Bone Marrow* ; Gelatin* ; Humans ; Hyaluronic Acid ; Pancytopenia

The treatment consensus of anorexia nervosa in the last century was to remove the patient from her family and home surroundings. A great range of treatment from prescribing hormonal extracts to prefrontal leucotomy has been tried. Although in former decades many quite different forms of treatment have been described and advocated for anorexia nervosa, there is today consensus concerning the overall management of the disorder. But there still remains a widespread clinical opinion that inpatient treatment is necessary for some as a means of reliably increasing weight. Over the last hundred years the management of anorexia nervosa has changed. Treatment has shifted from medical wards, through to psychiatric wards and now, following the trends in all of medicine, towards community care in Western society. In Korea, case reports of anorexia nervosa and related articles have been published since the late seventies. Recently several epidemiological studies and clinical reports suggested increasing rate of eating disorders including anorexia nervosa in Korea. However, systematic approaches for these patients have not been tried in Korea. The author introduces the treatment model for inpatients with anorexia nervosa of Johns Hopkin's Hospital, Maudsley Hospital, and St. John's Mercy Medical Center. The author also introduces treatment experience with anorexic inpatient at Seoul Paik Hospital.
Anorexia Nervosa* ; Anorexia* ; Consensus ; Diethylpropion ; Feeding and Eating Disorders ; Humans ; Inpatients* ; Korea ; Psychosurgery ; Seoul

Anorexia nervosa is a kind of dietary disorder which causes amenorhea, weight loss, behavioral changes, and its hormonal status is typical hypogonadotrophic hypogonadism. The patients with anorexia nervosa showed many hormonal and chemical abonormal findings, like decresed follicular stimulating hormone, decreased lutealizing hormone and estrogen, increased cortisol, hypokalemia, hypercarotenemia. But tissue mineral contents of anorexia nervosa were not reported. We experience the typical increase of tissue copper contents in three anorexia nervosa patients in recent days, so report them with reviews of literatures.
Anorexia ; Anorexia Nervosa ; Copper ; Estrogens ; Hair ; Humans ; Hydrocortisone ; Hypogonadism ; Hypokalemia ; Weight Loss

Spontaneous pneumomediastinum (PM) is an uncommon condition in which free air enters the mediastinum. This usually occurs either through esophageal tears after vigorous vomiting, or after alveolar rupture subsequent to a rapid increase in intra-alveolar pressure. Spontaneous PM is a rare entity in anorexia nervosa (AN) and self-induced vomiting is often the cause of PM in patients with AN. We experienced a case of spontaneous PM in an anorexic adolescent, in whom vomiting was not the cause of PM.
Adolescent ; Anorexia Nervosa* ; Anorexia* ; Diethylpropion ; Humans ; Mediastinal Emphysema* ; Mediastinum ; Rupture ; Subcutaneous Emphysema ; Tears ; Vomiting

The purpose of this study was to investigate the relationship between eating disorders, depression, and body dissatisfaction of middle aged women. Data was collected from June 1 to June 30, 1999 by means of a structured uestionnaire. The subjects for this study were 99 middle aged women between the ages of 35 and 59, recruited from Seoul, Kyungido. The instruments were the BDI(Beck Depression Inventory) developed by Beck(1973), Eating Disorder Inventory(1997) developed by Garner & Garfinkel, Halm, Falk& Schwartz, Shin Mi Young. The instruments were the Body Dissatisfaction(1997) developed by Garner, Olstead & Polivy, Han osoo, yoo hee jung, shin Mi Young. The data was analyzed by the SPSS/PC program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient.The results of this study are as follows 1. The mean body weight and height of the subjects were 57.49kg, 158.62cm.2. Depending upon BMI, the obesity subjects were 18.2% and the rest(81.8%) were under weight or normal. More than 70% of the normal weight subjects(71 subjects) perceived their weight as overweight.3. The total mean scores of anorexia nervosa were higher than bulimia nervosa. The total mean scores of eating disorders was 2.13.4. The total mean scores of depression was 1.50.5. The total mean scores of body dissatisfaction was 3.30. 6. There was a positive correlation between depression and eating disorders(r= .267, p<0.01)and, between body dissatisfaction and eating disorders(r=.273, p<0.01).There was not a significant correlation between depression and body dissatisfaction.According to the present study eating disorders in middle aged women developed because of the tendency to have negative perceptions of their bodies.
Anorexia Nervosa ; Body Weight ; Bulimia Nervosa ; Depression* ; Feeding and Eating Disorders* ; Eating* ; Female ; Gyeonggi-do ; Humans ; Middle Aged* ; Obesity ; Seoul