Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment: impact of adequate weight restoration on outcome
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Hamburg
Kovač
2002
|
| Schriftenreihe: | Schriften zur medizinischen Psychologie
1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | Zugl.: Trier, Univ., Diss., 2000 |
| Beschreibung: | XX, 211 S. graph. Darst. |
| ISBN: | 3830004982 |
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Datensatz im Suchindex
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| adam_text | vii
Table of Contents
Acknowledgments v
Table of Contents vii
List of Tables xiii
List of Figures xvii
Abstract xix
1. Introduction 1
2. Literature Review 3
2.1. Anorexia Nervosa as a Public Health Problem 3
2.1.1. The Clinical Picture of Anorexia Nervosa 3
2.1.1.1. Symptoms 3
2.1.1.2. Epidemiology 4
2.1.1.3. Burden to Health Services 5
2.1.2. Cpmorbidity 7
2.1.2.1. Psychiatric Comorbidity 7
2.1.2.2. Somatic Comorbidity 9
2.1.3. The Course of Anorexia Nervosa 11
2.1.3.1. Outcome and Prognosis 11
2.1.3.2. Mortality and Chronicity 12
2.1.3.3. Predictors of Outcome 12
2.2. Follow Up Studies in Anorexia Nervosa 14
2.2.1. The Significance of Follow Up Investigations 14
2.2.2. Classical Long Term Follow Up Studies 14
2.2.3. Methodological Requirements 16
2.2.4. Examples of Methodologically Robust Follow Up Studies 18
2.3. The Challenge of Treatment 23
2.3.1. Hospital Refeeding 23
2.3.2. Compliance 24
2.4. The Advisability of Full Weight Restoration 25
2.5. The Impact of Refeeding on Body Composition 27
2.5.1. Total Body Nitrogen 27
2.5.2. Bone Mineral Density 28
2.5.3. Total Body Potassium 30
2.6. Benefits of the Current Study 31
2.7. Statement of the Problem and Hypotheses 34
2.7.1. Aims 34
2.7.2. Hypotheses 35
3. Method 37
3.1.Design 37
3.2. Subjects 38
3.2.1. Subjects in Initial Study 38
3.2.2. Subjects in Follow Up Study 40
viii
3.2.2.1. Criteria for Inclusion in Follow up Study 40
3.2.2.2. Recruitment of Subjects 41
3.2.2.3. Characteristics of Subject Population 42
3.2.3. Dropouts 43
3.3. Ethical Considerations 45
3.3.1. Ethical Approval 45
3.3.2. Informed Consent 45
3.3.3. Potential Risks 45
3.4. Treatment 46
3.5. Procedure 48
3.5.1. Full Assessment 48
3.5.2. Partial Assessment 49
3.5.2.1. Pregnancy 49
3.5.2.2. Questionnaires Only 49
3.6. Measures 50
3.6.1. Clinical Data Level 51
3.6.1.1. Measurement of Height and Weight 51
3.6.1.2. Semi Structured Interview 51
3.6.2. Biological Data Level 52
3.6.2.1. In Vivo Neutron Capture Analysis (IVNCA) 52
3.6.2.2. Dual Energy X Ray Absorptiometry (DEXA) 53
3.6.2.3. Whole Body * K Counting 55
3.6.2.4. Bioelectrical Impedance Analysis (BIA) 56
3.6.2.5. Skinfold Measurement 57
3.6.3. Psychological Data Level 58
3.6.3.1. Composite International Diagnostic Interview (CIDI) 58
3.6.3.2. Eating Disorder Examination (EDE) 59
3.6.3.3. Eating Disorder Inventory (EDI) 60
3.6.3.4. Eating Attitudes Test (EAT) 61
3.6.3.5. Beck Depression Inventory (BDI) 62
3.6.3.6. State Trait Anxiety Inventory (STAI) 63
3.6.3.7. General Health Questionnaire (GHQ) 65
3.6.4. Global Data Level 66
3.6.4.1. Morgan Russell Outcome Assessment Schedule 66
3.7 Statistics 68
3.7.1 Data Analysis 68
3.7.2 Power Considerations 70
4. Results 71
4.1. Outcome 71
4.1.1. Clinical Data Level 7]
4.1.1.1. Body Weight » ~» ~Z!^! !! ZZ ! 3i
4.1.1.2. Process of Recovery/Illness 76
4.1.1.3. Reproductive Function 80
4.1.2. Biological Data Level 82
4.1.2.1. Total Body Nitrogen » !! ! ^ . . !1 !!82
4.1.2.2. Bone Mineral Density 84
ix
4.1.2.3. Total Body Potassium 86
4.1.2.4. Body Composition 88
4.1.2.4.1. Fat and Lean Body Mass 88
4.1.2.4.2. Total Body Water 92
4.1.3. Psychological Data Level 93
4.1.3.1. DSM III R Diagnosis 93
4.1.3.2. Dieting Disorder Related Psychopathology 98
4.1.3.3. Depression 102
4.1.3.4. Anxiety 104
4.1.3.5. General Adjustment 105
4.1.4. Global Data Level 106
4.1.4.1. General Outcome 106
4.1.4.2. Average Outcome 108
4.2. Relationships between Outcome Parameters 109
4.2.1. Relationship between Dieting Disorder Outcome and
Biological Parameters 109
4.2.2. Relationship between Total Body Nitrogen and
Bone Mineral Density 112
4.2.3. Relationship between Current Body Mass Index and
Other Outcome Parameters 113
4.2.3.1. Total Body Nitrogen 113
4.2.3.2. Bone Mineral Density 115
4.2.3.3. Total Body Potassium 117
4.2.3.4. Percentage Body Fat 119
4.2.3.5. Number of Admissions 120
4.2.3.6. Depression and Anxiety 120
4.2.4. Relationship between Dieting Disorder Outcome and
Psychological Parameters 120
4.2.5. Relationship between Social Adaptation and Depression 123
4.2.6. Relationship between Reproductive Function and Bone Status 123
4.2.7. Relationship between Number of Admissions and
Nitrogen Index and Percentage Body Fat 124
4.3. Impact of Index Weight Restoration on Outcome Parameters 124
4.3.1. Clinical Outcome 124
4.3.1.1. Body Mass Index 124
4.3.1.2. Number of Admissions and Time to Relapse 125
4.3.1.3. Reproductive Function 126
4.3.2. Biological Outcome 127
4.3.2.1. Total Body Nitrogen 127
4.3.2.2. Bone Mineral Density 128
4.3.2.3. Total Body Potassium 130
4.3.2.4. Body Composition 131
4.3.3. Psychological Outcome 131
4.3.3.1. DSM III R Diagnosis 131
4.3.3.2. Dieting Disorder Related Psychopathology 134
4.3.3.3. Depression and Anxiety 136
4.3.3.4. General Adjustment 137
X
4.3.4. Global Outcome 138
4.3.5. Post Hoc Power Analyses 139
4.4. Other Relationships 140
4.4.1. Age and Weight 140
4.4.2. Length of Index Admission and Weight 141
4.4.3. Duration of Illness before Index Admission
and Dieting Disorder Outcome 141
4.4.4. Dieting Disorder Outcome and Time to Relapse 142
4.4.5. Aspects of Treatment/Patient Variables and Time to Relapse 145
4.5. Comparison of Participants with Controls from Initial Study 146
4.6. Outcome in Dropouts 147
4.7. Chronic Patients 150
4.7.1. Clinical Data Level 150
4.7.2. Biological Data Level 152
4.7.3. Psychological Data Level 154
4.7.4. Global Data Level 160
5. Discussion 163
5.1. Summary and Integration of Results 163
5.1.1. Hypothesis I 164
5.1.2. Hypothesis 2 165
5.1.3. Hypothesis 3 165
5.1.4. Hypothesis 4 166
5.1.5. Hypothesis 5 167
5.1.6. Hypothesis 6 168
5.1.7. Hypothesis 7 169
5.1.8. Additional Findings 169
5.2. Explanation for Findings 171
5.2.1. Hypothesis 1 171
5.2.2. Hypothesis 2 171
5.2.3. Hypothesis 3 172
5.2.4. Hypothesis 4 ]72
5.2.5. Hypothesis 5 172
5.2.6. Hypothesis 6 174
5.2.7. Hypothesis 7 174
5.2.8. Additional Findings 175
5.3. Integration of Findings with Past Literature 176
5.3.1. Convergent Findings 176
5.3.2. Divergent Findings 178
5.4. Limitations of the Current Research ! . Z! Z!!! l l80
5.5. Implications for Future Research and Treatment I !! . !! 181
5.6. Conclusion jgj
6. References jg^
xi
7. Appendices 199
7.1. Appendix A: Contact Letter 199
7.2. Appendix B: Participant Information Sheet 200
7.3. Appendix C: Consent Form 202
7.4. Appendix D: Result Letter 204
7.5. Appendix E: Dieting Disorder Examination (DDE) 205
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| spelling | Gross, Gaby Verfasser aut Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome Gaby Gross Hamburg Kovač 2002 XX, 211 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Schriften zur medizinischen Psychologie 1 Zugl.: Trier, Univ., Diss., 2000 Längsschnittuntersuchung (DE-588)4034036-3 gnd rswk-swf Anorexia nervosa (DE-588)4002144-0 gnd rswk-swf Katamnese (DE-588)4029923-5 gnd rswk-swf Therapieerfolg (DE-588)4126073-9 gnd rswk-swf (DE-588)4113937-9 Hochschulschrift gnd-content Anorexia nervosa (DE-588)4002144-0 s Therapieerfolg (DE-588)4126073-9 s Katamnese (DE-588)4029923-5 s Längsschnittuntersuchung (DE-588)4034036-3 s DE-604 Schriften zur medizinischen Psychologie 1 (DE-604)BV014128303 1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009603363&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Gross, Gaby Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome Schriften zur medizinischen Psychologie Längsschnittuntersuchung (DE-588)4034036-3 gnd Anorexia nervosa (DE-588)4002144-0 gnd Katamnese (DE-588)4029923-5 gnd Therapieerfolg (DE-588)4126073-9 gnd |
| subject_GND | (DE-588)4034036-3 (DE-588)4002144-0 (DE-588)4029923-5 (DE-588)4126073-9 (DE-588)4113937-9 |
| title | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome |
| title_auth | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome |
| title_exact_search | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome |
| title_full | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome Gaby Gross |
| title_fullStr | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome Gaby Gross |
| title_full_unstemmed | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome Gaby Gross |
| title_short | Longitudinal study of patients with Anorexia Nervosa 6 to 10 years after treatment |
| title_sort | longitudinal study of patients with anorexia nervosa 6 to 10 years after treatment impact of adequate weight restoration on outcome |
| title_sub | impact of adequate weight restoration on outcome |
| topic | Längsschnittuntersuchung (DE-588)4034036-3 gnd Anorexia nervosa (DE-588)4002144-0 gnd Katamnese (DE-588)4029923-5 gnd Therapieerfolg (DE-588)4126073-9 gnd |
| topic_facet | Längsschnittuntersuchung Anorexia nervosa Katamnese Therapieerfolg Hochschulschrift |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009603363&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV014128303 |
| work_keys_str_mv | AT grossgaby longitudinalstudyofpatientswithanorexianervosa6to10yearsaftertreatmentimpactofadequateweightrestorationonoutcome |