Factors associated with disordered eating behaviours in adolescents with Type 1 diabetes.

AIMS: To assess the occurrence of disordered eating behaviours in teenagers with Type 1 diabetes and to compare characteristics according to level of disordered eating behaviours. METHODS: In this cross-sectional study, we collected adolescents' demographic and diabetes management data by parent-youth interview and chart review. Teenagers completed psychosocial surveys, including the Diabetes Eating Problem Survey-Revised (DEPS-R), a diabetes-specific measure of disordered eating behaviours. We categorized teenagers according to level of disordered eating behaviours: low, DEPS-R score <10; moderate, DEPS-R score 10-19; and high, DEPS-R score ≥20. RESULTS: The 178 teenagers (48% girls) were aged 14.9±1.3 years, with diabetes duration of 7.4±3.7 years. Most (59%) had low, 26% had moderate, and 15% had high levels of disordered eating behaviours. Several biomedical and psychosocial characteristics differed by level of disordered eating behaviours. There were more girls in the moderate (62%) and high (65%) than in the low level of disordered eating behaviours group (37%; P=0.003) and more obese teenagers in the moderate (13%) and high (27%) groups than in the low group (4%; P=0.0003). Frequency of daily blood glucose monitoring decreased (P=0.0006) and HbA1c level increased (P=0.01) with greater level of disordered eating behaviours. A greater level of disordered eating behaviours was also associated with poorer treatment adherence, more negative affect regarding blood glucose monitoring, poorer quality of life, and more depressive symptoms (all P<0.0001), along with more diabetes-specific family conflict (P=0.01). CONCLUSIONS: Identifying teenagers with Type 1 diabetes who have moderate and high levels of disordered eating behaviours may prevent progression to eating disorders and substantial morbidity by directing support and intervention efforts to those in need.

Episodio maniaco tóxico por el "Cocktail ruso" / No disponible

En las últimas décadas nuevos flujos inmigratoriosde diferentes países europeos han llegado a nuestro país. Con ellos llegan formas de adicción hasta ahora desconocidaspor nosotros. En esta nota clínica se presenta elcaso de un varón joven de 36 años procedente del Este que ingresó en un servicio de Psiquiatría con una clínicamaniaca franca. El paciente había estado consumiendouna mezcla de sustancias conocida como el "Cóctel ruso". Además de la clínica psiquiátrica, presentaba signos neurológicos que consistían en una disartria, una afectación de la marcha de tipo ataxia cerebelosa y unos movimientos coreiformes de brazos en reposo. El cuadro clínico que presentó este paciente caracterizado por clínica neuropsiquiátrica, síndrome extrapiramidaldistintivo, cambios en la señal de la resonancia magnética nuclear cranial en los ganglios basales y niveles de manganeso en el rango alto de la normalidad orientaron el diagnóstico hacia un episodio maníacotóxico por manganeso (AU)

In last decades, new immigration has come from different European countries to our area. Some forms of addiction unknown to us came with them. This clinicalnote reports the case of a 36 years old man native of East Europe, who was admitted to psychiatrist service with maniac syndrome. The patient was taking a mixtureof substances known as "Russian Cocktail". Inaddition to the psychiatric symptoms also presents neurologicalsigns, which consisted of a dysarthria, cerebellarataxic gait and choreiform movements of arms atrest.The syndrome presented by this patient was characterisedby clinical neuropsychiatric, extrapiramidal syndrome,signal changes of cranial MRI in the basal gangliaand manganese levels in the high normal range. Allthis findings suggested the diagnoses of maniac episodeby manganese(AU)