ABSTRACT
In order to investigate similarities and differences between Eating Disorder Not Otherwise Specified (EDNOS) and Anorexia Nervosa (AN) and Bulimia Nervosa (BN), we studied a consecutive series of 189 female outpatients attending two Eating Disorder Units. The data were collected by means of interviews (Eating Disorder Examination, EDE 12.0D), the Structured Diagnostic Interview for DSM III-R, (SCID), and self-reported questionnaires (Beck Depression Inventory, BDI, and State and Trait Anxiety Inventory, STAI 1-2). The diagnosis of EDNOS was as frequent as that of AN and BN (43.8% versus 43.2%). There were no significant differences between EDNOS and AN/BN patients in terms of their general and specific psychopathological features, but significant differences were observed between bulimic-like and anorectic-like EDNOS patients, as well as between those with AN and BN. In conclusion, in our clinical setting, the patients with EDNOS and those with typical eating disorders have similar psychopathological features, thus suggesting that EDNOS patients should be further divided into two groups, anorectic-like (similar to AN) and bulimic-like (similar to BN) patients.
Subject(s)
Behavioral Symptoms/psychology , Feeding and Eating Disorders/psychology , Outpatients/psychology , Adolescent , Adult , Female , Humans , PrognosisABSTRACT
The recent epidemiologic studies report extremely varied rates for social phobia (SP). One of the reasons for this may be the difficulty in diagnosing SP, the boundaries of which are uncertain. A community survey was carried out using doctors with experience in clinical psychiatry as interviewers, and a clinical diagnostic instrument. Two thousand three hundred and fifty-five people (out of the 2,500 randomly selected from the population) living in Sesto Fiorentino, a suburb of Florence, Italy, were interviewed by their own general practitioner, using the MINI plus six additional questions. Six hundred and ten of the 623 subjects that were found positive for any form of psychopathology at the screening interview, and 57 negative subjects, were re-interviewed by residents in psychiatry using the Florence Psychiatric Interview (FPI). The FPI is a validated composite instrument that has the format of a structured clinical research record. It was found that 6.58% of subjects showed social anxiety not attributable to other psychiatric or medical conditions during their life. Social or occupational impairments meeting DSM-IV diagnostic requirements for SP was detected in 76 subjects (lifetime prevalence = 3.27%). Correction for age raises the lifetime expected prevalence to 4%. Sex ratio was approximately (F:M) 2:1. The most common fear was speaking in public (89.4%), followed by entering a room occupied by others (63.1%) and meeting with strangers (47.3%). Eighty-six point nine percent of subjects with SP complained of more than one fear. The mean age of onset (when the subjects first fully met DSM-IV criteria for SP) was 28.8 years, but the first symptoms of SP usually occurred much earlier, with a mean age of onset at 15.5 years. Ninety-two percent of cases with SP also showed at least one other co-morbid psychiatric disorder during their life. Lifetime prevalence of avoidant personality disorder (APD) was 3.6%. Forty-two point nine percent of cases with SP also had APD, whereas 37.9% of cases with APD developed SP.
Subject(s)
Drug Utilization/statistics & numerical data , Family Practice/statistics & numerical data , Mental Disorders/epidemiology , Phobic Disorders/drug therapy , Phobic Disorders/epidemiology , Adolescent , Adult , Age Distribution , Age of Onset , Anti-Anxiety Agents/therapeutic use , Antidepressive Agents/therapeutic use , Comorbidity , Female , Humans , Italy/epidemiology , Male , Personality Disorders/epidemiology , Phobic Disorders/diagnosis , Phobic Disorders/psychology , Population Surveillance , Prevalence , Psychiatric Status Rating Scales , Sampling Studies , Severity of Illness Index , Sex DistributionABSTRACT
The efficacy of venlafaxine and fluoxetine in the treatment of atypical anorexia nervosa (AN) was compared in a controlled trial. A consecutive series of 24 atypical anorectic females was assigned to either venlafaxine (75 mg/day) or fluoxetine (40 mg/day) plus cognitive-behavioural therapy (CBT). Eating Disorder Examination (EDE12.0D), Beck Depression Inventory (BDI) and State and Trait Anxiety Inventory (STAI) scores were compared before and after 6 months of treatment. Venlafaxine and fluoxetine determined an increase of body mass index (BMI) and a significant reduction of EDE12.0D and BDI scores; venlafaxine alone reduced STAI scores. It would seem that venlafaxine is as effective as fluoxetine when combined with CBT in the treatment of atypical AN.
