Avaliação da influência da pandemia de Covid-19 no risco de desenvolvimento de transtornos alimentares em mulheres / Assessment of the influence of the Covid-19 pandemicon the risk of developing eating disorders in women

Objetivo: verificar a influência da pandemia de Covid-19 no risco de desenvolvimento de transtornos alimentares em mulheres. Metodologia: pesquisa quantitativa, com mulheres com acesso ao computador, a celular e à internet. A coleta de dados foi realizada a partir de um questionário on-line contendo 60 perguntas, com respostas fechadas, que visavam conhecer a sua relação com a alimentação. Foram verificados o consumo alimentar e o risco de desenvolvimento de anorexia nervosa (Eating Attitudes Test - EAT-26) e bulimia nervosa (Bulimic Investigatory Test, Edinburgh- BITE). Resultados: participaram da pesquisa 92 mulheres, sendo que 81,50% (n=75) referiram que ficaram em casa durante a pandemia. Sobre a ingestão de alimentos, 45,70% (n=42) relataram que consumiram diariamente frutas e hortaliças, 55,40% (n=51) ingeriram de 1 a 2 vezes/semana bolachas, salgadinhos, doces e guloseimas e 62,00% (n=57) consumiam embutidos pelo menos 1 vez/semana. Ainda, 18,50% (n=17) apresentaram risco para o desenvolvimento de anorexia nervosa e 83,60% (n=73) risco de bulimia nervosa. Entretanto, analisando se esse risco estava associado à pandemia, verificou-se que não houve diferença significativa entre o grupo que permaneceu em casa e o grupo que saiu para trabalhar (p > 0,05). Conclusão: portanto, grande parte das voluntárias apresentaram um risco de desenvolver algum transtorno alimentar, entretanto, não houve uma relação entre o possível risco de desenvolver transtornos alimentares influenciado pela pandemia.

Objective: to verify the influence of the Covid-19 pandemic on the risk of developing eating disorders in women. Methodology: quantitative research, with women with access to a computer, cell phone and internet. Data collection was carried out using an online questionnaire containing 60 questions, with closed answers, which aimed to understand their relationship with food. Food consumption Abstract and the risk of developing nervous anorexia (Eating Attitudes Test - EAT-26) and nervous bulimia (Bulimic Investigatory Test, Edinburgh - BITE) were verified. Results: 92 women participated in the research, with 81.50% (n=75) reporting that they stayed at home during the pandemic. Regarding food intake, 45.70% (n=42) reported that they consumed fruits and vegetables daily, 55.40% (n=51) ate cookies, snacks, sweets and sweets 1 to 2 times/week and 62, 00% (n=57) consumed sausages at least once/week. Furthermore, 18.50% (n=17) were at risk for developing nervous anorexia and 83.60% (n=73) were at risk for nervous bulimia. However, analyzing whether this risk was associated with the pandemic, it was found that there was no significant difference between the group that remained at home and the group that went out to work (p > 0.05). Conclusion: therefore, most of the volunteers presented a risk of developing an eating disorder, however, there was no relationship between the possible risk of developing eating disorders influenced by the pandemic.

Diagnosis and treatment of eating disorders in children and adolescents

Abstract Objectives To provide a narrative review of the main eating disorders (ED), specifically focusing on children and adolescents. This review also aims to help the pediatrician identify, diagnose, and refer children and adolescents affected by this medical condition and inform them about the multidisciplinary treatment applied to these disorders. Data source The research was conducted in the Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (Medline) databases via PubMed and Embase. Consolidated Guidelines and Guidebooks in the area were also included in the review to support the discussion of ED treatment in childhood and adolescence. Data synthesis ED are psychiatric condition that usually begins in adolescence or young adulthood but can occur at any time of life, including in childhood, which has been increasingly frequent. Pediatricians are the first professionals to deal with the problem and, therefore, must be well trained in identifying and managing these disorders, which can be severe, and determine physical complications and quality of life of patients and their families. Conclusion ED has shown an increase in prevalence, as well as a reduction in the age of diagnosed patients, requiring adequate detection and referral by pediatricians. The treatment requires a specialized multidisciplinary team and is generally long-lasting for adequate recovery of affected individuals.

Efectos Adversos Hematológicos Asociados con Olanzapina en Adolescentes con Anorexia Nerviosa: Reporte de 3 Casos / Haematological Adverse Effects Associated with Olanzapine in Adolescents with Anorexia Nervosa: Three Case Reports

RESUMEN Objetivos: Describir los efectos adversos hematológicos en adolescentes con anorexia nerviosa que toman olanzapina. Métodos: Reporte de serie de casos. Reporte de caso: En los casos reportados (2 mujeresy1varón) se evidenciaron alteraciones de las series sanguíneas tras el inicio de olanzapina y una recuperación rápida de los valores de plaquetas y neutrófilos tras la suspensión del fármaco. Los valores bajos de hemoglobina persistieron más que en las otras series. Dichas alteraciones se hicieron más ostensibles al incrementarse la dosis de olanzapina a 5 mg/día (dosis inicial, 2,5mg/día). Cabe resaltar que antes del inicio del psicofármaco 2 de los pacientes ya tenían valores en la banda de la neutropenia leve, que fueron empeorando a medida que se instalaba el antipsicótico. En uno de los pacientes solo se redujeron los valores de neutrófilos junto con anemia leve. Conclusiones: Este es el primer reporte de casos de alteraciones hematológicas en adolescentes con anorexia nerviosa que toman olanzapina, y se hallaron valores de pancitopenia en 2 de los 3 casos estudiados. Se debería considerar una mayor vigilancia hematológica en dicha población al iniciar el tratamiento con olanzapina y replantear nuestros conocimientos en cuanto a la frecuencia de dichos efectos secundarios.

ABSTRAC Objectives: To describe haematological adverse effects in adolescents with anorexia nervosa who are taking olanzapine. Methods: Case series report. Case report: The reported cases (two female patients and one male) were found to have blood test abnormalities after starting olanzapine and to rapidly recover their platelet and neutrophil values after the drugwas discontinued. Low haemoglobin values persisted longer than observed in other series. These abnormalities became more noticeable when the dose of olanzapine was increased to 5 mg/day (initial dose 2.5mg/day). It should be noted that two of the patients already had values indicative of mild neutropenia before they started the antipsychotic drug, and that these worsened as they continued taking the drug. In one of the patients there was only a decrease in neutrophil values, as well as mild anaemia. Conclusions: This first case series of haematological abnormalities in adolescents with anorexia nervosa who are taking olanzapine found values corresponding to pancytopenia in two of the three cases reported. It would be worthwhile to consider heightening haematological surveillance in this population when starting treatment with olanzapine and rethinking our knowledge regarding the frequency of these side effects.

Effect of Tuina Massage on Gastric Motility and Gastric Emptying in Children with Anorexia Nervosa / 中医杂志

ObjectiveTo explore the possible mechanism of pediatric tuina therapy in treating anorexia nervosa. MethodsTotally 120 children with anorexia nervosa were randomly divided into a tuina group and a medication group， with 60 cases in each group. Sixty healthy children undergoing physical examinations were recruited as the healthy control group. Children in the tuina group received traditional pediatric tuina therapy， while those in the medication group received orally chewed Jianwei Xiaoshi tablets. Each treatment course lasted for 7 days， with a 1-day interval between courses， and a total of 4 courses were administered. Before and after treatment， seven indicators including gastric motility frequency， gastric area， gastric area 30 minutes after drinking， anterior-posterior diameter and area during gastric fundus dilation， anterior-posterior diameter and area during gastric fundus contraction were measured using a color Doppler ultrasound diagnostic instrument in children from the healthy control group， tuina group， and medication group. Additionally， gastric emptying rate at 30 minutes， changes in anterior-posterior diameter and area during gastric fundus contraction， and changes in gastric area were compared. ResultsThis study ultimately included 60 healthy children in the control group， 59 children in the tuina group， and 51 children in the medication group. Compared with the control group at baseline， the gastric area and the anterior-posterior diameter and area during gastric fundus contraction increased， while the gastric emptying rate， gastric motility frequency， and changes in anterior-posterior diameter during gastric fundus contraction decreased in both the tuina group and medication group， with only a decrease in gastric area during gastric fundus contraction observed in the tuina group （P＜0.05）. Compared with baseline， after treatment， the gastric emptying rate， gastric motility frequency， and changes in anterior-posterior diameter and area during gastric fundus contraction increased in the tuina group， while the gastric area and area during gastric fundus contraction decreased 30 minutes after treatment； in the medication group， gastric motility frequency and changes in anterior-posterior diameter during gastric fundus contraction increased， while the area during gastric fundus contraction decreased （P＜0.05 or P＜0.01）. Compared with the medication group after treatment， the gastric area decreased 30 minutes after treatment， while the gastric emptying rate and gastric motility frequency increased （P＜0.05）. ConclusionThe possible mechanism of pediatric tuina therapy in treating anorexia nervosa is to promote gastric motility and gastric emptying， thereby improving gastrointestinal dysfunction in children.

Thinning of the retinal nerve fiber and choroidal layers in adolescents with anorexia nervosa: A controlled study

ABSTRACT Purpose: We aimed to evaluate retinal nerve fiber and choroidal layer alterations in adolescents with anorexia nervosa using spectral-domain optical coherence tomography. Methods: Thirty patients with anorexia nervosa and 30 healthy adolescents aged 12-18 years were included in this study. Their age, sex, body mass index, anorexia nervosa type, disease duration, and spectral-domain optical coherence tomography data were recorded. Results: Central macular thickness and retinal nerve fiber layer thickness in the temporal and inferior regions were significantly lesser in patients with anorexia than in healthy controls (p<0.05). Moreover, significant choroidal thinning around the foveal and subfoveal regions in patients with anorexia was observed (p<0.05). In addition, a statistically significant relation between the increase in disease duration and the thinning of the inferior retinal nerve fiber layer was detected (p<0.05). Conclusion: The retinal nerve fiber layer and choroidal layer thicknesses were lesser in patients with anorexia than in healthy controls. Screening for retinal indices might prevent the development of irreversible retinal pathologies in adolescents with anorexia nervosa. In addition, thinning of the retinal nerve fiber and choroidal layers could reflect structural or functional changes in the brain of adolescents with anorexia nervosa.

Comportamento de risco para transtornos alimentares, percepção da imagem corporal e consumo alimentar em adolescentes praticantes de judô / Risk behavior for eating disorders, perception of body image and food consumption in adolescent judo practitioners

RESUMO Objetivo Avaliar o consumo alimentar, comportamento de risco para transtornos alimentares e percepção da imagem corporal em adolescentes praticantes de judô. Métodos Estudo transversal com adolescentes judocas participantes da Federação Paranaense de Judô. Os dados foram coletados por meio de um questionário on-line, contendo os instrumentos Body Shape Questionnaire (BSQ) para avaliar percepção da imagem corporal, o Eating Attitudes Test (EAT-26) para identificar comportamentos de risco para transtornos alimentares e o Recordatório alimentar de 24 horas para análise da ingestão alimentar. A insatisfação com o peso corporal foi obtida pelo relato dos que gostariam de ganhar ou perder peso. Resultados Participaram 57 judocas de ambos os sexos, maioria sexo masculino (54,3%; n=31). Ausência de comportamento de risco para transtorno alimentar (63,1%; n=36) e insatisfação com a imagem corporal (75,4%; n=43) foram prevalentes entre os judocas. Entre os que apresentaram insatisfação com a imagem corporal (36,8%; n=14), observou-se que 9 (15,78%) também mostraram comportamento alimentar de risco para transtornos alimentares pelo teste EAT-26 (p=0,002). Houve associação entre insatisfação com o peso e comportamento de risco para TA (p=0,034), representado pelo EAT positivo para 26,31% (n=15) dos adolescentes. Identificou-se valores de ingestão alimentar insuficientes de energia e carboidratos, bem como consumo elevado de proteínas, e inadequação na ingestão para a maioria dos micronutrientes. Conclusão A maioria dos atletas não apresentou comportamento de risco para TA e estavam satisfeitos com sua imagem corporal. Diate da inadequação no consumo alimentar, destaca-se a importância das ações de educação alimentar e nutricional voltadas para este público.

ABSTRACT Objective To evaluate food consumption, risk behavior for eating disorders and perception of body image in adolescents who practice judo. Methods Cross-sectional study with adolescents practicing judo, participants of the Paraná Federation of Judo. For data collection, an online questionnaire was used, containing questions related to characterization and anthropometric data, the Body Shape Questionnaire (BSQ) instruments to assess body image perception, the Eating Attitudes Test (EAT-26) to identify behaviors risk factors for eating disorders and the 24-hour food recall to assess food intake. Dissatisfaction with body weight was obtained by reporting those who would like to gain or lose weight. Results 57 judokas of both sexes participated, mostly male (54.3%; n=31). Absence of risk behavior for eating disorders (63.1%; n=36) and dissatisfaction with body image (75.4%; n=43) were prevalent among judokas. Among the adolescents who were dissatisfied with their body image (36.8%; n=14), it was observed that 9 (15.78%) also showed risky eating behavior for eating disorders by the EAT-26 test (p=0.002). There was an association between dissatisfaction with weight and risk behavior for ED (p=0.034), represented by positive EAT for 26.31% (n=15) of adolescents. Insufficient food intake values of energy and carbohydrates, as well as high protein consumption, and inadequate intake for the largest of micronutrients were identified. Conclusion Most athletes did not present risk behavior for ED and were satisfied with their body image. Among those classified as dissatisfied with their body image, the degrees identified are mostly mild to moderate. The analysis of food consumption showed inadequacy for most of the nutrients evaluated, emphasizing the importance of food and nutrition education actions aimed at this public.

Cuidados maternos primários e gênese dos transtornos alimentares na perspectiva de mães de jovens com anorexia e bulimia / Primary maternal care and the genesis of eating disorders from the perspective of mothers of young people with anorexia and bulimia / Atención materna primaria y génesis de los trastornos alimentarios desde la perspectiva de madres de personas con anorexia y bulimia

A teoria psicanalítica postula que as raízes emocionais dos transtornos alimentares (TAs) remontam à relação precoce mãe-filha. Este estudo qualitativo teve como objetivo investigar os significados atribuídos por mães de pacientes com anorexia e bulimia às experiências de gravidez, parto, puerpério e cuidados básicos oferecidos às filhas nos primeiros anos de vida. Participaram sete mães cujas filhas encontravam-se em seguimento em um serviço especializado para TAs. Os dados foram coletados por meio de entrevista aberta e organizados em categorias de acordo com a análise temática reflexiva. Os resultados foram discutidos à luz da Teoria do Amadurecimento Emocional de Winnicott. As experiências relacionadas à maternidade e aos cuidados maternos foram marcadas por frustrações e emoções negativas, com poucas recordações de vivências gratificantes advindas da assunção ao papel de mãe. São discutidas as repercussões emocionais da não elaboração de conflitos transgeracionais recebidos das gerações anteriores e transmitidos sem transformação pelas mães, o que contribui para inibir o amadurecimento emocional das filhas, guardando possível relação com a vulnerabilidade aos sintomas de TAs. (AU)

Psychoanalytic theory postulates that the emotional foundations of eating disorders (EDs) rest in the early mother-daughter relationship. This qualitative study aimed to investigate the meanings attributed by mothers of patients with anorexia and bulimia to the experiences of pregnancy, childbirth, puerperium, and basic care provided to their daughters in the first years of life. Participants included 7 mothers whose daughters were being treated in a specialized service for EDs. Data were collected by open interviews and organized into categories according to reflexive thematic analysis. Results were discussed in light of Winnicott's Theory of Human Maturation. The experiences related to motherhood and maternal care were marked by frustrations and negative emotions, with few memories of rewarding experiences with the assumption of the maternal role. The potential repercussions arising from the non-elaboration of intergenerational conflicts inherited and transmitted without transformation by mothers were discussed. These implications could potentially hinder the emotional maturation of daughters, establishing a close relation with the symptoms of EDs. (AU)

La teoría psicoanalítica postula que las bases emocionales de los trastornos alimentarios (TAs) descansan en la relación temprana madre-hija. Este estudio cualitativo tuvo como objetivo investigar los significados atribuidos por madres de pacientes con anorexia y bulimia a las vivencias del embarazo, parto, puerperio y cuidados básicos brindados a sus hijas en los primeros años de vida. Participaron siete madres cuyas hijas estaban siendo atendidas en un servicio especializado en TAs. Los datos fueron recolectados por entrevista abierta y organizados en categorías de acuerdo con el análisis temático reflexivo. Los resultados fueron discutidos a la luz de la Teoría del Desarrollo Emocional de Winnicott. Las experiencias relacionadas con la maternidad y el cuidado materno estuvieron marcadas por frustraciones y emociones negativas, con pocos recuerdos de experiencias gratificantes con la asunción del rol materno. Se discuten las posibles repercusiones de la no elaboración de conflictos transgeneracionales recibidos y transmitidos sin transformación por parte de las madres, lo que contribuye a inhibir la maduración emocional de las hijas, guardando una estrecha relación con los síntomas de los TAs. (AU)

Conductas alimentarias de riesgo en jóvenes adultos de dos comunas de la región de Ñuble en Chile durante pandemia Covid-19

Objetivo: Analizar las conductas alimentarias de riesgo, en relación al estado nutricional y actividad física en jóvenes adultos durante la pandemia COVID-19 en las comunas de Chillán y Chillán Viejo. Método: Diseño observacional y transversal. Se obtuvo una muestra de 184 adultos jóvenes de ambos sexos, que residían en dos comunas de la región de Ñuble (Chile) durante el periodo de confinamiento por la pandemia COVID-19. Se les aplicó un cuestionario de antecedentes personales y la escala SCOFF que evalúa el riesgo de trastornos de la conducta alimentaria (TCA). Resultados: Se encontró un 37,16% de riesgo para TCA (IC 95%: 30,23 - 44,63%). El riesgo de trastornos de la conducta alimentaria tuvo relación con las variables: actividad física (p = 0,01 análisis bivariante) y estado nutricional (p = 0,03, análisis ajustado). Conclusión: Se logró identificar una proporción superior a la registrada en la literatura y los factores asociados a TCA eran los que se esperaban encontrar.

Objective: To analyze risky eating behaviors in relation to nutritional status and physical activity in young adults during the COVID-19 pandemic in the communes of Chillán and Chillán Viejo. Methods: Observational and cross-sectional design. A sample of 184 young adults of both sexes, who lived in two communes in the Ñuble region (Chile) during the period of confinement due to COVID-19 pandemic, was obtained. A personal history questionnaire and the SCOFF scale that assesses the risk of eating behavior disorders (EDs) were applied. Results: A 37.16% risk for ED was found (95% CI: 30.23 - 44.63%). The risk of eating behavior disorders was related to the variables: physical activity (p=0.01 bivariate analysis) and nutritional status (p=0.03, adjusted analysis). Conclusion: It was possible to identify a higher proportion than that recorded in the literature and the factors associated with eating disorders were those that were expected to be found.

Enteral nutrition and refeeding syndrome in a patient with anorexia nervosa and COVID-19

Introduction: the evidence on the health problem-related prevalence of COVID-19 is an emergency. Case report: we present the case of a 28-year-old woman who had had a behavioral eating disorder (BED) since age 12. Her body mass index (BMI) was 13.6 kg/m2. She was hospitalized for a respiratory condition (bronchospasm) due to COVID-19, with supplementary oxygen at two liters. During her stay, she refused food and was started on standard enteral nutrition via a naso-gastric tube. She developed refeeding syndrome (RFS), which was managed with electrolytes, and her enteral diet was changed to a low-carbohydrate high-protein diet. She received psychological therapy through video calls, recovered, and was discharged to home. Discussion: refeeding complications increase when a high caloric rate is begun. The standard enteral formula has 54% carbohydrates, which contributes to the risk of developing RFS. The consequences of BED and COVID-19 are unknown, and it is likely to become more evident over time. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2626).

El Rol de los Trastornos de Conducta Alimentaria sobre la Periodontitis: Breve Revisión Sistemática de Estudios Observacionales

Los trastornos de conducta alimentaria tienen efectos importantes sobre la salud oral destacándose entre estos por su alta prevalencia la anorexia y bulimia. Evaluar los efectos de la anorexia y bulimia sobre la periodontitis. Se realizó una búsqueda electrónica entre 2017 y 2021 en las bases datos Medline a través de Pubmed, Dentistry & Oral Sciences Source, Scopus, Springer y Biblioteca Virtual en Salud, donde con la estrategia de búsqueda "Anorexia OR Bulimia AND periodontal disease". Se recuperaron 101 registros potencialmente elegibles de los cuales luego de aplicar los criterios de elegibilidad se seleccionaron tres estudios de diseño observacional, cuyos resultados mostraron una asociación de la bulimia y anorexia con la incidencia de complicaciones orales en pacientes ambulatorios, donde la condición periodontal parece ser significativamente peor comparada con pacientes sanos emparejados por sexo y edad, siendo estos hallazgos de alta calidad metodológica o bajo riesgo de sesgo. La anorexia y la bulimia generan un alto impacto sobre la calidad de vida relacionada a la salud oral específicamente sobre el desarrollo de periodontitis. Sin embargo, se requieren de nuevos estudios que logren explicar en su totalidad esta posible relación.

Eating disorders have important effects on oral health, anorexia and bulimia standing out among them due to their high prevalence. To evaluate the effects of ano- rexia and bulimia on periodontitis. An electronic search was carried out between 2017 and 2021 in the Medline databases through Pubmed, Dentistry & Oral Sciences Source, Scopus, Springer and Virtual Health Library, where with the search strategy "Anorexia OR Bulimia AND periodontal disease". 101 potentially eligible records were retrieved from which, after applying the eligibility criteria, three observational design studies were selected, whose results showed an association of bulimia and anorexia with the incidence of oral complications in outpatients, where periodontal condition appears to be significantly worse compared to healthy patients matched for sex and age, these results being of high methodological quality or low risk of bias. Anorexia and bulimia have a high impact on health-related quality of life oral specifically on the development of periodontitis.However, it is required They want new studies that fully explain this possible relationship.

Atuação da Enfermagem com pacientes acometidos de transtornos alimentares: análise de filmes e documentários / Nursing performance with patients suffering from eating disorders: analysis of films and documentaries / Cuidados de enfermería con pacientes que sufren trastornos alimentarios: análisis de películas y documentales

Objetivo: analisar a atuação da Enfermagem junto a pacientes com transtornos alimentares em filmes sobre o assunto. Método: trata-se de um estudo descritivo-exploratório desenvolvido a partir de dados secundários. Utilizaram-se a base de dados cinematográfica Internet Move Database e descritores em português e inglês, que foram: "anorexia", "bulimia" e/ou "transtornos alimentares". Adotaram-se como critérios de inclusão: criações audiovisuais produzidas entre 1998 e 2020; o conteúdo estar disponível nas plataformas de streaming elencadas; as criações terem áudio e/ou legendas em português; e o filme ter alguma cena com o profissional de Enfermagem. Seis mídias atenderam a esses critérios e foram analisadas a partir de um roteiro que investiga a abordagem da Enfermagem no tratamento dos transtornos alimentares. Para elencar a produção mais indicada para finalidade didática, foram considerados seis critérios objetivos. Resultados: a maioria dos enredos veiculou a Enfermagem de modo estereotipado e com pouca autonomia, além de atribuir uma postura de "mau" ou "bom ajudante do médico" a esses profissionais. Embora nenhum enredo tenha atendido a todos os critérios objetivos de maneira satisfatória, a produção audiovisual que correspondeu à maior parte dos critérios foi aquela indicada para a finalidade didática. Conclusão: as produções, de um modo geral, condizem mais com o modelo médico assistencialista, na qual o enfermeiro desenvolve ações de prevalência tecnicistas, de supervisão e desintegradas da equipe multiprofissional em detrimento do modelo biopsicossocial, o qual demanda raciocínio clínico, pensamento crítico e conhecimento científico fundamentado.(AU)

Objective: to analyze the performance of Nursing with patients with eating disorders in films about the subject. Method: this is a descriptive-exploratory study developed from secondary data. The film database Internet Move Database and descriptors in Portuguese and English were used, which were: "anorexia", "bulimia" and/or "eating disorders". The following inclusion criteria were adopted: audiovisual creations produced between 1998 and 2020; the content is available on the listed streaming platforms; the creations have audio and/or subtitles in Portuguese; and the film has a scene with the Nursing professional. Six media met these criteria and were analyzed based on a script that investigates Nursing's approach to the treatment of eating disorders. To list the most suitable production for didactic purposes, six objective criteria were considered. Results: most plots conveyed Nursing in a stereotyped way and with little autonomy, in addition to attributing a "bad" or "good doctor's helper" attitude to these professionals. Although no plot met all the objective criteria satisfactorily, the audiovisual production that met most of the criteria was the one indicated for didactic purposes. Conclusion: the productions, in general, are more in line with the medical care model, in which the nurse develops actions that are technical, supervisory, and disintegrated from the multidisciplinary team to the detriment of the biopsychosocial model, which demands clinical reasoning, critical thinking and grounded scientific knowledge.(AU)

Objetivo: analizar los cuidados de enfermería frente a pacientes con trastornos alimentarios en películas sobre el tema. Método: se trata de un estudio descriptivo-exploratorio desarrollado a partir de datos secundarios. Se utilizó la base de datos cinematográfica "Internet Move Database" y las palabras clave en portugués e inglés, las cuales fueron: "anorexia", "bulimia" y/o "trastornos alimentarios". Fueron adoptados los siguientes criterios de inclusión: creaciones audiovisuales producidas entre los años 1998 y 2020; el contenido estar disponible en las plataformas de streaming listadas; tener audio y/o subtítulos en portugués; y alguna escena con el profesional de Enfermería. Seis medios cumplieron estos criterios y fueron analizados a...(AU)

Sintomas de transtornos alimentares em acadêmicos de medicina / Symptoms of eating disorders in medical students

Objetivo: avaliar os sintomas de transtornos alimentares em estudantes do Curso de Medicina do Centro Universitário Christus. Métodos: o estudo foi realizado com acadêmicos do quarto semestre do curso de Medicina. Utilizou-se um questionário sociodemográfico e antropométrico e os instrumentos Eating Atitudes Test (EAT-26); Binge Eating Scale (BES); e Sick Control One Stone Fat Food Questionnaire (SCOFF). Resultados: participaram do estudo 78 alunos, sendo 54 pessoas do sexo feminino (69,23%). A média de idade dos participantes foi de 22 (±4,7) anos, e o IMC médio foi de 24,33 (±4,11) kg/m2. Quanto ao SCOFF, 38,46% dos participantes apresentaram elevada probabilidade de transtorno alimentar, 14,10% apresentaram alto risco para desenvolverem transtornos alimentares segundo o EAT-26, e 12,82% apresentaram escores sugestivos de presença de compulsão alimentar moderada mediante o uso da BES. Conclusão: os transtornos alimentares e os comportamentos alimentares alterados foram identificados entre os acadêmicos de medicina. Assim, são necessárias intervenções de educação em saúde e de apoio psicológico para esta população, objetivando reduzir o risco de desenvolvimento de transtornos alimentares.

Objective: this study aimed to evaluate the symptoms of eating disorders in medical students at Centro Universitário Christus. Methods: the study was carried out with fourth-semester medical students. A sociodemographic and anthropometric questionnaire was used, the Eating Attitudes Test (EAT-26) instruments; Binge Eating Scale (BES); and Sick Control One Stone Fat Food Questionnaire (SCOFF). Results: 78 students participated in the study, 54 of whom were female (69.23%). The mean age of the participants was 22 (±4.7) years and the mean BMI was 24.33 (±4.11) kg/m2. As for the SCOFF, 38.46% of the participants had a high probability of having an eating disorder, 14.10% had a high risk of developing eating disorders according to the EAT-26, and 12.82% had scores suggestive of the presence of moderate binge eating using BES. Conclusion: eating disorders and altered eating behaviors were identified among medical students. Thus, health education and psychological support interventions are needed for this population, aiming to reduce the risk of developing eating disorders.

Tratamento dos transtornos alimentares: perfil sociodemográfico, desfechos e fatores associados / Eating disorders treatment: sociodemographic profile, outcomes and associated factors

RESUMO Objetivo: Avaliar o perfil dos pacientes com transtornos alimentares (TAs) atendidos por um serviço especializado e investigar os fatores associados ao desfecho do tratamento. Métodos: Estudo retrospectivo, realizado com dados de pacientes com TAs que fizeram seguimento em um serviço especializado, desde a sua criação, em 1982, até 2019. Foram coletadas informações, nos prontuários médicos, referentes ao primeiro atendimento, de natureza sociodemográfica, clínica e antropométrica, e ao desfecho do tratamento. Resultados: Foram incluídos 271 pacientes. A amostra foi predominantemente do sexo feminino (89,7%), com idade média de 21,5 ± 9 anos, sem companheiro (86,9%) e diagnóstico de anorexia nervosa (AN) (65,7%), e o índice de massa corporal mais frequente foi de magreza (53,9%). A metade dos indivíduos tinha comorbidades psiquiátricas (50,6%), e 88,5% dos pacientes (n = 100) dos 113 prontuários com essa informação realizaram tratamento anterior. O tempo médio de tratamento foi de 2,16 ± 3,25 anos (1 mês a 40 anos). O abandono foi o desfecho terapêutico mais prevalente na amostra (68,3%). O maior tempo de tratamento e a realização de tratamento anterior reduziram a taxa de abandono, de forma significativa (p = 0,0001 e p = 0,0101, respectivamente). Para os pacientes com diagnóstico de transtorno de personalidade, a média de encaminhamento/inassistência foi 4,47 vezes maior (p = 0,0003). Conclusões: O perfil dos pacientes foi composto por mulheres adultas jovens, estudantes, sem companheiro, com AN, magreza e comorbidades psiquiátricas. A taxa de abandono foi elevada, e os fatores associados foram o tempo de tratamento e a realização de tratamento anterior. Além disso, transtornos de personalidade foram associados a encaminhamento para outro serviço e alta por inassistência.

ABSTRACT Objective: To evaluate the profile of patients with eating disorders (ED) treated by a specialized service and to investigate the factors associated with the treatment outcome. Methods: Retrospective study, with data from patients with ED who were followed up at a specialized service, since its creation, in 1982, until 2019. Information of a sociodemographic, clinical, anthropometric nature and the outcome of the treatment were collected from the medical records regarding the first consultation. Results: Two hundred and seventy one patients were included. The sample was predominantly female (89.7%), with a mean age of 21.5 ± 9 years, without a partner (86.9%), diagnosis of anorexia nervosa (AN) (65.7%) and the most frequent body mass index was thinness (53.9%). Half of the individuals had psychiatric comorbidities (50.6%) and 88.5% (n = 100) of the 113 medical records with this information had undergone previous treatment. The mean treatment time was 2.16 ± 3.25 years (1 month to 40 years). Dropout was the most prevalent therapeutic outcome in the sample (68.3%). Longer treatment time and having undergone previous treatment significantly reduced the dropout rate (p = 0.0001 and p = 0.0101, respectively). For patients diagnosed with a personality disorder, the mean referral/lack of assistance was 4.47 times higher (p = 0.0003). Conclusions: The patients' profile consisted of young adult women, students, single, with AN, thinness and psychiatric comorbidities. The dropout rate was high, and the predictors associated with this outcome were treatment time and previous treatment for ED. In addition, personality disorders were associated with referral to another service and discharge due to lack of assistance.

Transtornos alimentares: vivências de mulheres acima de 30 anos / Eating disorders: experiences of women aged over 30 years / Trastornos alimentarios: experiencias de mujeres de más de 30 años

O objetivo deste estudo foi compreender como mulheres adultas (acima de 30 anos) diagnosticadas com transtornos alimentares (TAs) vivenciam o adoecer. Trata-se de um estudo qualitativo, descritivo e exploratório, desenvolvido com base no referencial teórico-metodológico da Análise Fenomenológica Interpretativa (AFI). Participaram seis mulheres, com idades entre 34 e 65 anos, atendidas em um serviço especializado. Os dados foram coletados por meio de entrevista aberta, de inspiração fenomenológica, na modalidade remota. As entrevistas foram audiogravadas, transcritas e analisadas seguindo os passos da AFI. Duas categorias temáticas foram identificadas: "Vivendo antes do adoecer" e "Encontrando-se doente." Constatou-se que os sintomas tiveram início anteriormente à vida adulta e que houve dificuldade na confirmação do diagnóstico. Na perspectiva das participantes, conviver com a sintomatologia ficou mais complicado em função de particularidades de manejo dos sintomas na vida adulta, e a idade é percebida como um fator que impacta e dificulta ainda mais a recuperação. As participantes relataram desesperança em relação ao futuro, apesar de a maioria reconhecer melhoras no quadro clínico ao longo do tempo e de valorizar a relação de confiança estabelecida com a equipe multiprofissional.(AU)

This study aimed to understand the experience of illness of adult women (over 30 years) diagnosed with eating disorders (ED). This is a qualitative, descriptive, and exploratory study, using Interpretative Phenomenological Analysis (IPA) as theoretical and methodological framework. A sample of six women aged 34-64 years, assisted in a specialized service, were recruited to complete a phenomenological in-depth open interview. The data were remotely collected. Interviews were audio-recorded, transcribed and analyzed following the IPA. Two thematic categories were identified: "Living before the illness" and "Finding about the illness." It was found that the symptoms started before adulthood and that there was difficulty establishing the diagnosis. Living with the symptoms became more complicated due to particularities of symptom management in adulthood and age is perceived as a factor that impacts recovery and makes it even more difficult. The participants reported hopelessness about the future, although most recognized improvements in the clinical condition over time and valued the trusting relationship they established with the multiprofessional team.(AU)

El objetivo de este estudio fue comprender las experiencias de las mujeres adultas (mayores de 30 años) diagnosticadas con trastornos alimentarios (TA) respecto a la enfermedad. Se trata de un estudio cualitativo, descriptivo y exploratorio, desarrollado a partir del marco teórico y metodológico del Análisis Fenomenológico Interpretativo (AFI). Participaron seis mujeres, con edades de entre 34 y 65 años, atendidas en un servicio especializado. Los datos se recogieron mediante entrevistas abiertas, de inspiración fenomenológica, en la modalidad a distancia. Las entrevistas fueron grabadas en audio, transcritas y analizadas siguiendo los pasos del AFI. Se identificaron dos categorías temáticas: "Vivir antes de enfermar" y "Encontrarse enfermo." Se constató que los síntomas comenzaron antes de la edad adulta y que hubo dificultades de establecer el diagnóstico. La convivencia con síntomas se complicó debido a las particularidades del manejo de los síntomas en la vida adulta y la edad se percibe como un factor que influye y dificulta aún más la recuperación. Los participantes manifestaron desesperanza sobre el futuro, aunque reconocieron mejoras en el cuadro clínico con el paso del tiempo y valoraron la relación de confianza establecida con el equipo multiprofesional.(AU)

Distúrbios alimentares e seus fatores genéticos: revisão de literatura / Eating disorders and their genetic factors: literature review / Trastornos alimentarios y sus factores genéticos: revisión de la literatura

Diversas condições psiquiátricas apresentam influência de fatores genéticos, e dentre essas condições encontram-se os distúrbios alimentares: anorexia nervosa, bulimia nervosa e transtorno de compulsão alimentar. Os distúrbios previamente citados apresentam influência genética ligadas à hereditariedade, sendo que cada um deles apresenta características distintas quanto às suas manifestações clínicas, tratamento e diagnóstico. A importância da investigação deste tema e seu objetivo relaciona-se com o propósito de contribuir para elucidar quanto às características gerais dos principais distúrbios alimentares e seus fatores genéticos através da: etiologia, sinais e sintomas, diagnóstico e tratamento e que venha a possibilitar, futuramente, novos estudos com resultados para novas medidas terapêuticas. Como base da pesquisa, foi levantada a seguinte problemática: "Quais as características gerais dos principais distúrbios psiquiátricos, etiologia, sinais e sintomas, diagnóstico e tratamento?". Portanto, realizou- se uma uma busca ativa através dos descritores: "transtorno de compulsão alimentar"; "distúrbios alimentares"; "bulimia nervosa" e "anorexia nervosa", adquiriu-se material pelas fontes: SciELO, ELSEVIER, GOOGLE ACADÊMICO, PUBMED, MEDSCAPE e pelo periódico Arquivos e Ciências da Saúde da UNIPAR. Com isso, foi adquirido material suficiente para concluir a influência genética perante tais distúrbios, além de elucidar suas principais características, tendo assim caráter educativo e científico.

Several psychiatric conditions have genetic factors influence, and among these conditions are eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder. The previously mentioned disorders have a genetic influence linked to heredity, each one of them having different characteristics as to their clinical manifestations, treatment and diagnosis. The importance of research on this topic and its objective is related to the purpose of contributing to elucidate the general characteristics of the main eating disorders and their genetic factors through: etiology, signs and symptoms, diagnosis and treatment and that will make possible, in the future, new studies with results for new therapeutic measures. As a basis for the research, the following issue was raised: "What are the general characteristics of the main psychiatric disorders, etiology, signs and symptoms, diagnosis and treatment?". Therefore, an active search was carried out through the descriptors: "binge eating disorder"; "eating disorders"; " nervous bulimia" and " nervous anorexia", material was acquired by the sources: SciELO, ELSEVIER, GOOGLE ACADEMIC, PUBMED, MEDSCAPE and by UNIPAR's Archives and Health Sciences. With this, sufficient material was acquired to conclude the genetic influence in the face of such disturbances, besides elucidating its main characteristics, thus having an educational and scientific character.

Varios trastornos psiquiátricos tienen factores genéticos que influyen, y entre estos trastornos se encuentran los trastornos de la alimentación: anorexia nerviosa, bulimia nerviosa y trastorno por atracón. Los trastornos mencionados tienen una influencia genética vinculada a la herencia, cada uno de ellos con características diferentes en cuanto a sus manifestaciones clínicas, tratamiento y diagnóstico. La importancia de la investigación sobre este tema y su objetivo se relaciona con el propósito de contribuir a dilucidar las características generales de los principales trastornos de la conducta alimentaria y sus factores genéticos a través de: etiología, signos y síntomas, diagnóstico y tratamiento y que posibilitarán, en el futuro, nuevos estudios con resultados para nuevas medidas terapéuticas. Como base para la investigación se planteó la siguiente cuestión: "¿Cuáles son las características generales de los principales trastornos psiquiátricos, etiología, signos y síntomas, diagnóstico y tratamiento?". Por lo anterior, se realizó una búsqueda activa a través de los descriptores: "trastorno por atracón"; "trastornos de la conducta alimentaria"; "bulimia nerviosa" y "anorexia nerviosa", material adquirido por las fuentes: SciELO, ELSEVIER, GOOGLE ACADEMIC, PUBMED, MEDSCAPE y por Archivos y Ciencias de la Salud de UNIPAR. Con ello, se adquirió material suficiente para concluir la influencia genética ante tales alteraciones, además de dilucidar sus principales características, teniendo así un carácter educativo y científico.

Remote consultation with people with eating disorders during the COVID-19 pandemic / Consulta remota a las personas con trastornos alimenticios durante la pandemia de COVID-19 / Consulta remota a pessoas com transtornos alimentares durante a pandemia de COVID-19

ABSTRACT Objectives: to analyze subjective experiences related to adaptation to remote care by users with eating disorders during the COVID-19 pandemic. Methods: a descriptive study with a qualitative approach conducted with users of an eating disorders outpatient clinic. A semi-structured remote interview was applied using the Google Meet application. The data were submitted to lexical analysis using ALCESTE software and discussed in the light of scientific evidence. Results: the remote appointment is a positive strategy but not a substitute for the face-to-face modality. The research cited financial savings, closer contact with professionals, and flexibility of service schedules as advantages. It pointed out the difficulty in clinical evaluation concerning weight, vital signs, and poor mastery of technology as limitations. Final Considerations: the study induces discussion about the systematization of remote care, which, during the COVID-19 pandemic, were responsible for providing a greater sense of support to people with eating disorders.

RESUMEN Objetivos: analizar experiencias subjetivas relacionadas a la adaptación a la atención remota por usuarios con trastornos alimenticios durante la pandemia de COVID-19. Métodos: estudio descriptivo de abordaje cualitativo realizado con usuarios de un ambulatorio especializado en trastornos alimenticios. Fue aplicada una entrevista semiestructurada remota, utilizándose el aplicativo Google Meet. Los datos fueron sometidos al análisis lexical mediante software ALCESTE y discutidos a la luz de las evidencias científicas. Resultados: la consulta remota es una estrategia positiva, pero no substitutiva de la presencial. Ventajas como economía financiera, mayor contacto con los profesionales y flexibilización de horarios de atenciones fueron citadas. Dificultad de evaluación clínica en relación al peso, signos vitales y poco dominio de tecnología fueron apuntados como limitaciones. Consideraciones Finales: el estudio induce la discusión sobre sistematización de atenciones remotas, las cuales, durante la pandemia de COVID-19, fueron responsables por fornecer mayor sensación de soporte a personas con trastornos alimenticios.

RESUMO Objetivos: analisar as experiências subjetivas relacionadas à adaptação ao atendimento remoto por usuários com transtornos alimentares durante a pandemia de COVID-19. Métodos: estudo descritivo de abordagem qualitativa realizado com usuários de um ambulatório especializado em transtornos alimentares. Foi aplicada uma entrevista semiestruturada remota, utilizando-se o aplicativo Google Meet. Os dados foram submetidos à análise lexical por meio do software ALCESTE e discutidos à luz das evidências científicas. Resultados: a consulta remota é uma estratégia positiva, mas não substitutiva da modalidade presencial. Vantagens como economia financeira, maior contato com os profissionais e flexibilização de horários de atendimentos foram citadas. Dificuldade de avaliação clínica em relação ao peso, sinais vitais e pouco domínio da tecnologia foram apontados como limitações. Considerações Finais: o estudo induz a discussão sobre sistematização dos atendimentos remotos, os quais, durante a pandemia de COVID-19, foram responsáveis por fornecer maior sensação de suporte às pessoas com transtornos alimentares.

Características de la alimentación en adolescentes diagnosticados con anorexia nerviosa: Una revisión narrativa

Introducción: La anorexia nerviosa es un trastorno psiquiátrico de alta prevalencia en mujeres y que comúnmente se inicia en la adolescencia. Esta es definida sobre la base de tres criterios: restricción energética en relación con los requerimientos nutricionales acompañado de bajo peso, el miedo intenso a la ganancia de peso y a la alteración de la percepción de su peso o constitución, según lo descrito por el manual de diagnóstico y estadístico de los desórdenes mentales. Objetivo: Describir la alimentación en adolescentes diagnosticados con anorexia nerviosa. Material y Métodos: Se realizó una revisión narrativa de la literatura de estudios observacionales que informaran sobre características de la dieta en adolescentes diagnosticados con anorexia nerviosa, en un período sin intervención dietoterapéutica. La búsqueda bibliográfica se realizó en la interfaz PubMed de MEDLINE y la interfaz de Web of Science Core Colletion. Se incluyeron artículos en inglés, español y portugués, entre 2010 y 2020. Desarrollo: Algunos estudios analizaron la alimentación de pacientes adolescentes con anorexia nerviosa (AN), demostrando una restricción de la ingesta energética y de ciertos micronutrientes. Por otra parte, estudios han apreciado que la ingesta de proteínas estaba sobre las recomendaciones diarias para el grupo etario. Conclusiones: Esta revisión detectó una restricción energética y una alta ingesta proteica. Por otra parte, la ingesta de lípidos y carbohidratos es inferior en sujetos con AN frente a población sana, aun cuando se mantienen dentro de las recomendaciones diarias para la edad.

Introduction: Anorexia nervosa is a psychiatric disorder of high prevalence in women that commonly begins in adolescence. It is defined on the basis of three criteria: energy restriction in relation to nutritional requirements accompanied by underweight, intense fear of weight gain and altered perception of their weight or constitution, as described by the Diagnostic and Statistical Manual of Mental Disorders. Objective: To describe feeding in adolescents diagnosed with anorexia nervosa. Material and Methods: A narrative literature review of observational studies reporting dietary characteristics in adolescents diagnosed with anorexia nervosa, in a period without dietary intervention, was conducted. The literature search was conducted in the PubMed interface of MEDLINE and the Web of Science Core Colletion interface. Articles published in English, Spanish and Portuguese, between 2010 and 2020 were included. Development: Some studies analyzed the diet of adolescent patients with anorexia nervosa (AN), showing a restriction of energy intake and certain micronutrients. On the other hand, studies have found that protein intake was above the daily recommendations for the age group. Conclusions: This review detected energy restriction and high protein intake. In contrast, lipid and carbohydrate intake is lower in subjects with AN compared to the healthy population, even though they remain within the daily recommendations for age.

Probióticos como tratamiento psiconutricional para la anorexia nerviosa. Una revisión sistemática / Probiotics as a psychonutritional treatment for anorexia nervosa. A systematic review

Resumen Se afirma que la anorexia nerviosa es sinónimo de una comunidad microbiana intestinal desregula da. Al parecer, existen diferencias notables en la composición de la microbiota de las personas con anorexia nerviosa en comparación con personas sanas. Por otro lado, se advierte que los probióticos modifican la microbiota y mejoran el bienestar mental y síntomas intestinales, pero actualmente no se han documentado los resultados de aquellos estudios que evidencien la eficacia de los probióticos en la terapia psiconutricional de la anorexia nerviosa. Por lo anterior, se realizó una revisión siste mática con el objetivo de identificar estudios que suministraron probióticos a personas con anorexia nerviosa y analizar sus efectos en el tratamiento. El método incluyó los procedimientos de la Medi cina Basada en Evidencia y la declaración PRISMA (lista de verificación con dominios que incluye el documento de elaboración y diagrama de flujo) a través del formato PICO. Se encontraron siete estu dios que demuestran efectos positivos en la recuperación del peso corporal, salud mental e intestinal y respuesta antiinflamatoria. La escasa información al respecto representa un área de oportunidad para establecer protocolos de investigación que indaguen más acerca de los efectos de los probióticos en la recuperación de personas con anorexia nerviosa.

Abstract Anorexia nervosa is claimed to be synonymous with a dysregulated gut microbial community. The re appear to be notable differences in the composition of the microbiota of people with anorexia nervosa compared to healthy people. On the other hand, it is noted that probiotics modify the mi crobiota and improve mental well-being and intestinal symptoms, but currently the results of those studies that show the efficacy of probiotics in the psycho-nutritional therapy of anorexia nervosa have not been documented. A systematic review was carried out with the aim of identifying studies that provided probiotics to people with anorexia nervosa and analyzing their effects on treatment. The method included the procedures of Evidence-Based Medicine and the PRISMA statement (chec klist with domains that includes the elaboration document and flowchart) through the PICO format. Seven studies were found that demonstrate positive effects on body weight regain, mental and gut health, and anti-inflammatory response. The scarce information in this regard represents an area of opportunity to establish research protocols that investigate more about the effects of probiotics on the recovery of people with anorexia nervosa.

Síntomas conductuales y emocionales de adolescentes que consultan a un programa especializado de trastornos de la conducta alimentaria / Behavioural and Emotional Symptoms of Adolescents Consulting a Specialised Eating Disorders Programme

RESUMEN Introducción: Los trastornos de la conducta alimentaria (TCA) son afecciones complejas de origen multifactorial que tienen como principal característica la preocupación excesiva por el peso y la forma del cuerpo, que causa gran malestar y afectación física llevando a una disminución de la calidad de vida y alteraciones de la funcionalidad del paciente y su entorno social. El objetivo de este estudio es describir los síntomas de orden emocional y conductual de los adolescentes que consultan en la ciudad de Bogotá a un programa especializado en TCA. Métodos: Estudio observacional y descriptivo de corte transversal, para el que se reclutó a pacientes de 11-19 arios con diagnóstico de TCA. Resultados: Se incluyeron 40 pacientes con diagnóstico de TCA, el 92% mujeres. El promedio de edad de los pacientes fue 16,6 ± 1,9 años. El 57% de los pacientes viven en hogar biparental y el 30%, en hogar monoparental. El 72% de la población tenía un rendimiento académico excelente. El 50% de los pacientes estaban moderadamente enfermos. El 60% estaba en tratamiento farmacológico con ISRS. El 65% de los pacientes cumplían criterios clínicos de trastorno de ansiedad; el 30%, de trastorno depresivo; el 22,5%, de problemas de agresividad, y el 17,5%, de conducta delictiva. El 72,5% de la muestra muestra criterios clínicos de síntomas internalizantes y el 42,5%, de síntomas externalizantes, y la mayoría de ellos son pacientes con diagnóstico de bulimia nerviosa. Conclusiones: Los pacientes con bulimia nerviosa obtuvieron en los diferentes síntomas de orden emocional y conductual puntuaciones superiores que con los demás trastornos alimentarios. Esta entidad ofrece mayor psicopatología, la cual se debe examinar rigurosamente al momento de la atención clínica, buscando disminuir el impacto funcional que estos síntomas generan en el individuo.

ABSTRACT Introduction: Eating disorders (EDs) are complex conditions of multifactorial origin. Their main characteristic is excessive concern about body weight and shape, which causes great discomfort and physical problems and leads to a decrease in quality of life and alterations in the patient's functionality social environment. The objective of this study is to describe the emotional and behavioural symptoms of adolescents who consult a specialised ED programme in the city of Bogota. Methods: Observational, descriptive, cross-sectional study, for which patients between 11 and 19 years old with an ED diagnosis were recruited. Results: Forty patients with an ED diagnosis were included, of which 92% were female. The mean age of the patients was 16.6 ± 1.9 years; 57% of patients live in a two-parent home and 30% in a single-parent home; 72% of the sample had excellent academic performance; 50% were moderately ill; 60% received pharmacological management with SSRIs; 65% of patients met clinical criteria for anxiety disorder, 30% for depressive disorder; 22.5% had aggression problems; 17.5% criminal behaviour; 72.5% of the sample met clinical criteria for internalising symptoms and 42.5% for externalising symptoms, the majority being patients with a diagnosis of bulimia nervosa. Conclusions: Patients with bulimia nervosa obtained higher scores in the different emotional and behavioural symptoms than those with other eating disorders. This condition is associated with greater psychopathology, which must be examined rigorously at the time of clinical care, seeking to reduce the functional impact that these symptoms generate on the individual.

Actitudes de los profesionales de la salud mental ante la capacidad y el internamiento no voluntario en anorexia nerviosa: construcción, validación y resultados del cuestionario ACINOVAN / Mental Health Professionals' Attitudes Towards Mental Competency and Involuntary Commitment in Anorexia Nervosa: Construction, Validation and Results of the Acinovan Questionnaire

RESUMEN Introducción: La anorexia nerviosa es un trastorno grave que causa tasas elevadas de morbilidad y mortalidad. La aplicación de una intervención no voluntaria solo es legalmente admisible si el paciente no es competente. Sin embargo, la evaluación de su capacidad puede ser extremadamente compleja. Ello conlleva que la decisión final pueda verse influida por las actitudes individuales del facultativo. Objetivo: Crear y validar empíricamente un cuestionario en español que permita medir la actitud hacia la capacidad y el internamiento no voluntario y comparar entre grupos categóricos. Métodos: Formaron la muestra 338 profesionales de salud mental. Los ítems fueron validados por grupos de expertos. Se realizaron un análisis factorial exploratorio y comparaciones grupales. Resultados: Se obtuvo un modelo de 13 ítems formado por 3 factores: prointervención, ausencia de capacidad y cronicidad. Los profesionales tienden a creer en la ausencia de capacidad y la necesidad de la intervención no voluntaria, así como en la idoneidad diferencial en virtud de la cronicidad. El respaldo previo a intervenciones involuntarias se relacionó significativamente con los factores prointervención y ausencia de capacidad y la formación en bioética, con la cronicidad. Conclusiones: El instrumento resultante es válido y fiable. Puede ser útil a profesionales, pacientes y sociedad.

ABSTRACT Introduction: Anorexia nervosa is a serious disorder that causes high rates of morbidity and mortality. Involuntary treatments are only legally admissible if the patient is not competent. However, assessing their capacity can be really complex. This implies that the final decision might be influenced by the individual attitudes of the physician. Objective: To create and empirically validate a questionnaire in Spanish that makes it possible to measure the attitude towards capacity and involuntary commitment and compare between categorical groups. Methods: The sample consisted of 338 mental health professionals. The items were validated by groups of experts. An exploratory factor analysis and group comparisons were carried out. Results: Favourable evidence was obtained of a 13-item model consisting of three factors: pro-intervention, lack of capacity and chronicity. Professionals tend to believe in the lack of capacity and the need for involuntary interventions, as well as differential suitability due to chronicity. Having ever supported involuntary interventions was significantly related to the pro-intervention and lack of capacity factors, and training in bioethics to chronicity. Conclusions: The resulting instrument is valid and reliable. Its use can be useful to professionals, patients and society.