Abstract
The need to treat the acute onset of anorexia nervosa in a specialty unit is wel known, but nevertheless, even “clinically recovered” patients show a high rate of relapse. The aim of our study was to re-evaluate various clinical (hemoglobin, transferrin, insulin-like growth factor I, TSH, PRL, gonadotropins and 17β-estradiol) and psychiatric [semistructured interview Eating Disorder Inventory (EDI) Test] parameters in 19 female anorexic patients hospitalized in our department from 1983 to 1993 (with a 9-year median prior to the present study) for the treatment of anorexia nervosa, and to compare these results with those of a previous follow-up per formed on the same subjects in 1993. In the present evaluation, no significant variation was found among the clinical, nutritional and hormonal parameters when compared to those of the first follow-up in which all parameters had improved with the exception of the PRL levels, which were significantly low. Meanwhile, the percentage of patients with spontaneous menses increased significantly from 50% to 70%, while the number of patients on psychopharmacological therapy decreased significantly throughout the study. Furthermore the percentage o patients with altered (severe or mild) EDI profiles decreased to 50%. This study emphasizes the positive prognostic role of hospitalization and intensive care in a cohort of anorexic patients. The present study, in addition to demonstrating both a general maintenance of body weigh acquired over the years, albeit in the lower normal range, and an increase in the percentage o patients with a regular menstrual cycle, also highlights the persistence of psychiatric abnormalities in a large number of patients, even in those diagnosed as “clinically recovered”, thus suggesting the need for long-term psychiatric care.
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References
Garner D.M.: Pathogenesis of anorexia nervosa. Lancet, 341, 631–634, 1993.
Herzog D.B., Copeland P.M.: Eating disorders. N. Engl. J. Med., 313, 295–303, 1985.
Kaplan A.S.: Day hospital treatment for anorexia nervosa and bulimia nervosa. Eat. Dis. Rev., 2, 1–3, 1991.
Beumont P.J.V., Russel J.D., Touyz S.W.: Treatment of anorexia nervosa. Lancet, 341, 1645–1640, 1993.
Rosenvige J.H., Mouland S.O.: Outcome and prognosis of anorexia nervosa: a retrospective study of 41 subjects. Br. J. Psychiatry, 156, 92–97, 1990.
Eckert E.D., Halmi K.A., Marchi P., Grove W., Crosby R.: Ten years follow-up of anorexia nervosa: clinical course and outcome. Psychol. Med., 25, 143–156, 1995.
Herzog D.B., Nussbaum K.M., Marmor A.K.: Comorbidity and outcome in eating disorders. Psychiatr. Clin. North Am., 19, 843–859, 1996.
Strober M., Freeman R., Morrel W.: The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10-15 years in a prospective study. Int. J. Eat. Disord., 22, 339–360, 1997.
Rasore E., Gabrielli F., Traversa C., Uva V., Foppiani L., Giusti M.: On mental anorexia and its therapy: clinical considerations and catamnestic examinations during a period of psychiatric counselling. 2nd International Rome Symposium on Eating Disorders: Advancement in Diagnosis and Treatment of Anorexia Nervosa, Bulimia and Obesity, Rome 28–30 January 1993, Proceedings Book, p.170–177.
Foppiani L., Uva V., Falivene M., Valenti S., Traversa C., Rasore E., Giusti M.: Anoressia nervosa: follow-up di parametri nutrizionali, ormonali e psichiatrici. Minerva Med., 86, 537–542, 1995.
Garner D.M.: Eating Disorder Inventory-2: Professional manual, psychological assessment resources. Odessa FL, 1991.
Giusti M., Torre R., Traverso L., Cavagnaro P., Attanasio R., Giordano G.: Endogenous opiod blockade and gonadotropin secretion: role of pulsatile luteinizing hormone-releasing hormone administration in anorexia nervosa and weight loss amenorrhea. Fertil. Steril., 49, 797–801, 1988.
Giusti M., Foppiani L., Ponzani P., Cuttica C.M., Falivene M.R., Valenti S.: Hexarelin is a stronger GH-releasing peptide than GHRH in normal cycling women but not in anorexia nervosa. J. Endocrinol. Invest., 20, 257–263, 1997.
Kotsuji F., Kubo M., Takeuchi Y., Tominaga T.: Alternate-day GnRH therapy for ovarian hypofunction induced by weight loss: treatment of six patients who remained amenorrhoeic after weight gain. Clin. Endocrinol. (Oxf), 39, 641–448, 1993.
Bohnet H.G., Dahlen H.G., Wuttke W., Schneider H.P.: Hyperprolactinemic anovulatory syndrome. J. Clin. Endocrinol. Metab., 42, 132–143, 1976.
Bouchard P., Lagoguey M., Brailly S., Schaison G.: Gonadotropin-releasing hormone pulsatile administration restores luteinizing hormone pulsatility and normal testosterone levels in males with hyperprolactinemia. J. Clin. Endocrinol. Metab., 60, 258–262, 1985.
Hotta M., Shibasaki T., Masuda A., Imaki T., Demura H., Ling N., Shizume K.: The responses of plasma adrenocorticotropin and cortisol to corticotropin-releasing hormone (CRH) and cerebrospinal fluid immunoreactive CRH in anorexia nervosa. J. Clin. Endocrinol. Metab., 62, 319–324, 1986.
Docter R., Krenning E.P., De Jong M., Hennerman G.: The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin. Endocrinol., 39, 499–518, 1993.
Kiyohara K., Tamai H., Takaichi Y., Nakagawa T., Kumagai L.F.: Decreased thyroidal triiodothyronine secretion in patients with anorexia nervosa: influence of weight recovery. Am. J. Clin. Nutr., 50, 767–772, 1989.
Matsubara M., Koyanagawa Y., Odagaki E., Nakagawa K.: Plasma transferrin levels in abnormal endocrine states. II: The changes in various endocrine states. Horm. Metab. Res., 21, 334–337, 1989.
Muller EE.: The control of somatotropic function. Physiol. Rev., 67, 963–1052, 1987.
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Foppiani, L., Luise, L., Rasore, E. et al. Frequency of recovery from anorexia nervosa of a cohort patients re-evaluated on a long-term basis following intensive care. Eat Weight Disord 3, 90–94 (1998). https://doi.org/10.1007/BF03339994
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DOI: https://doi.org/10.1007/BF03339994