PURPOSE: The purpose of this study was to develop the day hospital program for Korean eating disorders patients and to examine the effect of the day hospital program on improving frequency of binging and purging, eating disorders symptoms, self-esteem, and depression. METHOD: The subjects were 24 binge eaters visited at eating disorders clinic "M". They participated in a modified day hospital program based on the Toronto Day Hospital Program. All subjects completed the Eating Disorders Inventory(EDI)-2, Rosenberg Self-Eesteem Scale, Beck Depression Inventory(BDI) at pre and post intervention, and recorded daily food records. RESULT: In paired t-test analysis, frequency of binging and purging, self-esteem, depression, and 11 sub-scales of EDI-2(drive for thinness, bulimia, body dissatisfaction, ineffectiveness, interoceptive awareness, perfectionism, interpersonal distrust, maturity fear, asceticism, impulse regulation, social insecurity) were significantly improved after treatment. CONCLUSION: The results of this study suggest that the day hospital program for Korean eating disorders patients may be an effective initial approach to overcoming various eating disorders symptoms. Further studies should investigate longer term outcome data using a larger sample.
Adult ; Bulimia/therapy ; *Day Care ; Eating Disorders/*therapy ; Female ; Humans

Acupuncture Therapy ; Aged ; Feeding and Eating Disorders ; therapy ; Humans ; Male

One of the true success stories in clinical neurosciences over the last 30 or so years has been the development of effective drug therapies of several psychiatric disorders including schizophrenia. It is true that the effects of drug are not disease-specific. However, it if logical to find medications that will be effective in eating disorders. In spite of many limitations, some tentative conclusions regarding the role of medications in the treatment of eating disorders can now be drawn. These conclusions as a whole revealed the following ; 1) There were no clear difference in efficacy among the various drugs used. 2) Short-term abstinence rates are about 30%, and overall reductions in bulimic behavior are about 70%. 3) A significant relapse rate(30-45%) is observed if patients are followed for 4-6 months. 4) There are few predictors of who will respond to these medications. 5) Dropout rates tend to be high, in part because of side effects and in part because of some patients' attitudes toward medication use. 6) The doses used in these treatment studies have generally been similar to those employed in the treatment of depression, and with a single exception which the high-dose regimen (60 mg of fluoxetine) was clearly superior to the loll dose (20 mg of fluoxetine). However, Wakeling(1995) suggested that the pharmacotherapy for eating disorders clearly had some limited beneficial effects, at least in the short term and that many unanswered questions remained related to the acceptability of this form of treatment, the unwanted effects of drugs and the longer-term efficacy. He also insisted that at the present level of knowledge, pharmacotherapy should not be used as a sole treatment approach but only within an overall treatment programme. In clinical practice, pharmacotherapy is frequently used in the treatment of eating disorders in combination with various psychotherapuetic approaches. Therefore, the clinicians, who engage in the treatment of patients with eating disorders, should be able to identify the patients for whom drug therapy is desirable and be accustomed to the differences with the pharmacotherapy of other psychiatric patients. The author will review the results of previous studies on pharmacotherapy for eating disorders and demonstrate several important issues in the practice of pharmacotherapy for the patients with eating disorders.
Depression ; Drug Therapy* ; Feeding and Eating Disorders* ; Eating* ; Humans ; Logic ; Neurosciences ; Patient Dropouts ; Recurrence ; Schizophrenia

OBJECTIVETo explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder.

METHODSPeabody Picture Vocabulary Test (PPVT), Gesell development scales (Gesell), Wechsler Intelligence Scale for Preschool Children (WPPSI) and speech test were performed for 62 children at the ages of 3 to 8 years with lingua-apical articulation disorder. PPVT was used to measure receptive vocabulary skills. GESELL and WPPSI were utilized to represent cognitive and non-verbal ability. The speech test was adopted to assess the speech development. The children received speech therapy and auxiliary oral-motor functional training once or twice a week. Firstly the target sound was identified according to the speech development milestone, then the method of speech localization was used to clarify the correct articulation placement and manner. It was needed to change food character and administer oral-motor functional training for children with oral motor dysfunction.

RESULTSThe 62 cases with the apical articulation disorder were classified into four groups. The combined pattern of the articulation disorder was the most common (40 cases, 64.5%), the next was apico-dental disorder (15 cases, 24.2%). The third was palatal disorder (4 cases, 6.5%) and the last one was the linguo-alveolar disorder (3 cases, 4.8%). The substitution errors of velar were the most common (95.2%), the next was omission errors (30.6%) and the last was absence of aspiration (12.9%). Oral motor dysfunction was found in some children with problems such as disordered joint movement of tongue and head, unstable jaw, weak tongue strength and poor coordination of tongue movement. Some children had feeding problems such as preference of eating soft food, keeping food in mouths, eating slowly, and poor chewing. After 5 to 18 times of therapy, the effective rate of speech therapy reached 82.3%.

CONCLUSIONThe lingua-apical articulation disorders can be classified into four groups. The combined pattern of the articulation errors is the most common one. Most of the apical sounds are replaced by velar sounds. The speech localization method is very useful in the therapy of apical articulation disorder. For children with feeding problems and oral motor dysfunction, it is needed to improve food texture and administer oral motor skill training.

Articulation Disorders ; classification ; complications ; therapy ; Child ; Child Development ; Child, Preschool ; Feeding and Eating Disorders of Childhood ; complications ; therapy ; Humans ; Intelligence Tests ; Language Tests ; Motor Skills Disorders ; therapy ; Speech Therapy

Since Russell described bulimia nervosa as an independent and distinctive eating problem, it has been regarded as one of the rapidly increasing problems during the past two decades in Western society. However, in the past few years, the number of reports concerning eating disorders have increased in developing countries including Korea with the rapid introduction of the Western culture accompanied by economic development. Most individuals suffering from bulimia nervosa can be treated as outpatients. Patients with uncomplicated bulimia nervosa rarely require hospitalization and may achieve clinical improvement with nutritional management or counseling, individual or group cognitive-behavioral therapy(CBT), behavioral techniques, and interpersonally oriented or psychodynamically oriented psychotherapies. However, in clinical practice, CBT with nutritional counseling or inter-personal psychotherapy is a usual method chosen for the treatment of such patients in combination with pharmacotherapy. This review aimed at giving a compact and systemized account of the clinical guidelines that we consider essential in the management of patients with bulimia nervosa. The author also introduced treatment experience with bulimic patients at Seoul Paik Hospital.
Bulimia Nervosa* ; Bulimia* ; Counseling ; Developing Countries ; Drug Therapy ; Eating ; Feeding and Eating Disorders ; Economic Development ; Hospitalization ; Humans ; Korea ; Outpatients ; Psychotherapy ; Seoul

The occurrence of eating disorders in Chinese adolescents is increasing. However the cause, diagnosis, treatment and prognosis of this disorder are rarely reported by pediatricians. This paper investigated the cause and treatment of six cases of eating disorders in adolescent patients. The medical data of six cases of eating disorders in the Shanghai Children's Medical Center from January 2003 to September 2005 were retrospectively reviewed. The patients were 5 girls and 1 boy, whose onset ages ranged from 12.4 to 15.8 years. They were initially referred to the clinic between 12.9 to 16.7 years, with a course of disease varying from three to twelve months. The patients' body mass index (BMI) varied from 9.07 to 17.0. Four out of the six patients were hospitalized because of low temperature, low blood pressure, bradycardia, dehydration and multiple systems damages. The other two were treated in the out-patient clinic. Based on the medical history and physical examination as well as laboratory findings, five of them were diagnosed with anorexia nervosa and the other one were bulimia nervosa. All of the patients were under the care of a team consisting of pediatricians, dietitians, psychiatrists and nurses. When the patients whose vital signs were unstable, medical treatment focused on life sustention and they were kept on beds compulsively and given nutrition transfusion. Meanwhile cognition and behavior therapy was administered to help the patients find out the internal and environmental factors related to the development of this disorder, establish a new conception of healthy weight, and correct their abnormal eating behaviors. The patients who had a severe distortion of body image and a big resistance to the treatment were additionally administered with psychiatry drugs. After treatment, three patients set up a healthy eating behavior, their body weights gradually recovered and they had no relapse during a 1-year follow-up. The other three patients retained some abnormal eating behaviors and their body weights were always below normal. It was found that eating disorders in adolescents may be triggered by some environmental factors, such as comments on body shape from their peers, fashion influence, academic pressures, and problems in communication. Since the patients' abnormal eating behaviors were masked or neglected by parents at the early stage of the disease and the clinical presentations were related to multiple systems, it is difficult to make an early diagnosis and treatment. It is important to improve the pediatricians' knowledge of eating disorders of adolescents and perform cooperation between a multidisciplinary team for the early diagnosis and treatment of this disorder.
Adolescent ; Child ; Feeding and Eating Disorders ; etiology ; psychology ; therapy ; Female ; Humans ; Male

PURPOSE: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. METHODS: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. RESULTS: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (β=1.57, p=.023) and did not use physical measures (β= −1.23, p=.041) as coping methods were under the high risk of nutritional disorders. CONCLUSION: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.
Antiemetics ; Child ; Drug Therapy ; Eating ; Female ; Genital Neoplasms, Female ; Humans ; Inpatients ; Malnutrition ; Methods* ; Nausea* ; Nutrition Disorders ; Nutritional Status* ; Vomiting*

Acid ingestion causes a coagulative necrosis of the surface epithelium of the upper gastromtestinal tract. Its late sequence is luminal stenosis which frequently requires surgical repair. Nevertherless, in many cases, non-operative dilatation of luminal stenosis have been applicated, such as bouginations, balloon dilatations, endoscopic laser therapy, endoscopic electrocoagulation, endescopic microwave coagulation. These methods may give some considerable benefits in unoperable cases. Recently, we experienced a case of a 60-year-old man who had severe corrosive esophageal and gastric angular strictures by accidentally ingested hydrochloric acid and after many tiems of application of non-operative dilatation was able to have normal diet without dysphagia. So, we report this case with a review of literatures.
Constriction, Pathologic* ; Deglutition Disorders ; Diet ; Dilatation* ; Eating ; Electrocoagulation ; Epithelium ; Humans ; Hydrochloric Acid ; Laser Therapy ; Microwaves ; Middle Aged ; Necrosis ; Phenobarbital

Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.
Anxiety Disorders/prevention & control/therapy ; Databases, Factual ; Dementia/prevention & control/therapy ; Eating Disorders/prevention & control/therapy ; *Exercise ; Humans ; Mental Disorders/prevention & control/*therapy ; Mood Disorders/prevention & control/therapy ; Motor Activity ; Obsessive-Compulsive Disorder/prevention & control/therapy ; Schizophrenia/prevention & control/therapy ; Substance-Related Disorders/prevention & control/therapy

Anorexia nervosa, bulimia and other related eating disorders are a heterogenous group of psychiatric disorders whose prevalence rates reach 0.5-1.0% for anorexia nervosa and 1.0-3.0% for bulinmia nervosa. Anorexia nervosa is characterized by a refusal to maintain a minimally normal body weight and bulimia is characterized by repeated episodes of binge eating, misuse of laxatives. diuretics or other medications ; fasting and excessive exercise. A disturbance in perception of body shape and weight is an essential feature of both disorders. Patients with eating disorders may have numerous medical, hypothalamic endocrine, metabolic and nutritional abnormalities. There have been several conceptual models to explain the etiology of eating disorders These are socio-cultural, family pathological, individual psychodynamic, developmental psychobiologiccl, primary hypothalamic dysfunctional, cognitive-behavioral and affective disorder theories. Among these thoeries, this paper attempts to review the biological theory and pharmacotherapy in eating disorders. Specifically, this review deals with physiology of eating behavior, neurotransmitter regulation of appetite and eating bvehavior, disturbances in brcin neurotransmitter system, neuroendocrine findings in anorexia nervosa and bulimia nervosa. and finally pharmacotherapy. Based on this review, future directions for research are also sutggested.
Anorexia Nervosa ; Appetite ; Biology* ; Bulimia ; Bulimia Nervosa ; Disulfiram ; Diuretics ; Drug Therapy* ; Feeding and Eating Disorders* ; Eating* ; Fasting ; Feeding Behavior ; Humans ; Ideal Body Weight ; Laxatives ; Mood Disorders ; Neurosecretory Systems ; Neurotransmitter Agents ; Physiology ; Prevalence