Bulimia nervosa in adolescents: treatment, eating pathology and comorbidity

Background: Bulimia nervosa (BN) is occurring with increasing frequency among adolescents. Yet, few studies have undertaken to detail the clinical presentation, or investigate different treatments for adolescents with BN. Objective: In this article, we 1) review our current knowledge of BN in adolescents, both in terms of clinical presentation and treatment possibilities, and 2) describe a cohort of adolescent bulimics in terms of eating pathology and comorbidity.Subjects: Twenty-seven consecutive referrals for adolescent BN to The University of Chicago Hospitals are presented here (mean age=16.2 yrs, sd+1.4). These patients are among the first to be evaluated for participation in an ongoing randomized controlled trial of two psychosocial treatments. Measures: Eating pathology was measured with the Eating Disorders Examination (EDE), while the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) was used to establish comorbid psychiatric diagnoses. Results: Our findings indicate that this cohort is quite diverse in terms of ethnicity and family environment. Rates of comorbid depression are much higher in our cohort than in a comparable sample of adult BN. In most other respects, the clinical presentation of BN in our sample of adolescents appears to be similar to that in adults. Conclusion: Comorbidity and adolescent developmental status are two obvious factors that should be taken into account in the evaluation of effective treatments for adolescent BN.South African Psychiatry Review - August 200

Inhibition in task switching: The reliability of the n-2 repetition cost

The n-2 repetition cost seen in task switching is the effect of slower response times performing a recently completed task (e.g. an ABA sequence) compared to performing a task that was not recently completed (e.g. a CBA sequence). This cost is thought to reflect cognitive inhibition of task representations and has been well replicated (Koch, Gade, Schuch, & Philipp, 2010). As such, the n-2 repetition cost has started to be used as a measure of individual differences in inhibitory control (e.g. Whitmer & Banich, 2007); however, the reliability of this measure has not been investigated in a systematic manner. The current study addressed this important issue. Seventy-two participants performed three task switching paradigms; participants were also assessed on rumination traits and processing speed-measures of individual differences potentially modulating the n-2 repetition cost. We found significant n-2 repetition costs for each paradigm. However, split-half reliability tests revealed that this cost was not reliable at the individual-difference level. Neither rumination tendencies nor processing speed predicted this cost. We conclude that the n-2 repetition cost is not reliable as a measure of individual differences in inhibitory control

Parameters affecting ion intensities in transmission-mode Direct Analysis in Real-Time mass spectrometry

A survey of the effect of temperature, transmission module material and analysis time on ion intensities in transmission mode direct analysis in real time mass spectrometry is presented. Ion intensity profiles obtained for two related compounds are similar when analysed separately but are very different when analysed as a mixture

Patterns of expressed emotion in adolescent eating disorders

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135121/1/jcpp12594.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135121/2/jcpp12594_am.pd

A test of the DSM-5 severity specifier for bulimia nervosa in adolescents: Can we anticipate clinical treatment outcomes?

OBJECTIVE:This study tested clinical utility of the DSM-5 severity specifier for bulimia nervosa (BN) in predicting treatment response among adolescents (N = 110) within a randomized clinical trial of two psychosocial treatments. METHOD:Analyses grouped individuals meeting criteria for BN diagnosis by baseline severity, per DSM-5. Associations among baseline severity classification and BN behavior (i.e., binge eating and compensatory behavior) and eating disorder examination (EDE) Global scores at end-of-treatment (EOT), 6- and 12-month follow-up were examined. RESULTS:Associations between severity categories with BN symptoms were not significant at EOT, or follow-up. Test for linear trend in BN behavior was significant at EOT, F = 5.23, p = 0.02, without demonstrating a linear pattern. Relation between severity categories with EDE Global scores was significant at 6-month follow-up, F = 3.76, p = 0.01. Tests for linear trend in EDE Global scores were significant at EOT, F = 5.40, p = 0.02, and at 6 months, F = 10.73, p = 0.002, with the expected linear pattern. DISCUSSION:Findings suggest the DSM-5 BN severity specifier holds questionable utility in anticipating outpatient treatment response in adolescents with BN. The specifier may have improved ability to predict attitudinal rather than behavioral treatment outcomes

Fatal COVID-19 infection in a patient with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency: A case report

Long-chain fatty-acyl CoA dehydrogenase deficiency (LCHADD) is an inborn error of long chain fatty acid oxidation with various features including hypoketotic hypoglycemia, recurrent rhabdomyolysis, pigmentary retinopathy, peripheral neuropathy, cardiomyopathy, and arrhythmias. Various stresses trigger metabolic decompensation. Coronavirus disease 2019 (COVID-19) is a pandemic caused by the RNA virus SARS-CoV-2 with diverse presentations ranging from respiratory symptoms to myocarditis. We report a case of a patient with LCHADD who initially presented with typical metabolic decompensation symptoms including nausea, vomiting, and rhabdomyolysis in addition to mild cough, and was found to have COVID-19. She developed acute respiratory failure and refractory hypotension from severe cardiomyopathy which progressed to multiple organ failure and death. Our case illustrates the need for close monitoring of cardiac function in patients with a long-chain fatty acid oxidation disorder

Impact of Head Motion on the Assistive Robot Expressiveness - Evaluation with Elderly Persons

International audienceIn the near future, robots will support human to perform tasks in many domains (industrial, domestic, educational and health tasks).Such robot behaviors need to take into account the social interaction between robot and human.In this context, we focus on the expressiveness of a moving head for an assistive robot for the elderly.We designed a new moving head for the Kompaï companion robot.On one hand, this new head improves its perception capabilities.On the other hand, we expect to jointly increase its social skills and thus its acceptability.This new head is composed of a tablet to animate a virtual face according to 4 facial expressions and a mechanical neck with 4 degrees of freedom to enhance the robot's expression.Before improving face expressions and adding more complex head movements, it is essential to evaluate the combination of simple head movements with virtual face expressions. A study was held jointly with physicians (psychologists, ergonomists) at the Broca Hospital in Paris to assess the impact to combine head movements with virtual face expressions, and the global acceptability of the Kompaï head by the elderly