Effects of a short-term reduction in brain serotonin synthesis on the availability of the soluble leptin receptor in healthy women.

Serotonin (5-HT) and the hormone leptin have been linked to the underlying neurobiology of appetite regulation with evidence coming from animal and cellular research, but direct evidence linking these two pathways in humans is lacking. We examined the effects of reduced brain 5-HT synthesis due to acute tryptophan depletion (ATD) on levels of soluble leptin receptor (sOb-R), the main high-affinity leptin binding protein, in healthy adults using an exploratory approach. Women, but not men, showed reduced sOb-R concentrations after ATD administration. With females showing reduced baseline levels of central 5-HT synthesis compared to males diminished brain 5-HT synthesis affected the leptin axis through the sOb-R in females, thereby potentially influencing their vulnerability to dysfunctional appetite regulation and co-morbid mood symptoms.

Self-perceived stigmatization in female patients with anorexia nervosa--results from an explorative retrospective pilot study of adolescents.

BACKGROUND: The stigma of mental illness has been identified as an important barrier to treatment and recovery. Previous research reported the stigmatization of individuals with eating disorders by both health professionals and the general public. The aim of this pilot study was to empirically assess the previous stigmatization and discrimination experiences of young female patients with anorexia nervosa (AN) using a retrospective explorative approach. METHODS: An in-house questionnaire that was developed to survey experiences of stigmatization was mailed to 75 former adolescent patients with AN. The mean time of assessment after discharge was 5.6 ± 1.2 years. The patients were asked to respond anonymously. The response rate was approximately 48% (n = 36). RESULTS: Feelings that society held negative stereotypes of individuals with AN, concrete experiences of stigmatization and discrimination, and rejection by peers were reported. A remarkable degree of self-stigmatization, as indexed by high rates of agreement to stigmatizing statements, was detected. Approximately one third of the participants reported delayed initiation of treatment due to fear of stigmatization and discrimination. CONCLUSION: Stigmatization plays a decisive role in young patients with AN and impacts their motivation to seek professional help and engage in treatment. Clinicians should be aware of the stigmatization related to eating disorders and its burden for affected patients.

[Anesthesia in patients with anorexia nervosa and bulimia nervosa]. / Anästhesie bei Patienten mit Anorexia nervosa und Bulimia nervosa.

Eating disorders are typical diseases of adolescence and early adulthood. About 1-3% of female juveniles suffer from anorexia nervosa (AN) or bulimia nervosa (BN). Today AN is still the psychiatric disease with the highest mortality rate. The peri-operative mortality rate of patients suffering from AN is in the range up to 15%. The beginning of AN is a lingering process and the majority of patients show increasingly restrictive eating habits ending in cachexia. Patients are obsessed by the predominant idea of being obese in spite of having a significant underweight. Patients suffering from bulimia break the strict regimen by eating enormous amounts of high calorie food. Such eating attacks are followed by weight reducing measures, mostly vomiting. Most of the physical changes caused by AN are due to starvation and loss of weight. The most significant medical complications are alterations of the cardiovascular system accompanied by decreasing contractility of the heart, bradycardia, electrocardiographic changes as well as disequilibrium of electrolytic and water balance. Most of these symptoms can be reversed by putting on weight.

[Psychological education as a group process for parents of adolescents with eating disorders]. / Psychoedukation als Gruppenangebot für Eltern essgestörter Jugendlicher.

Psychoeducation is a well-established component of cognitive-behavioral therapy in adult patients with eating disorders. This paper describes a group model of psychoeducation that has been offered by our department for the past two years to parents of adolescent patients with anorexia and bulimia nervosa. According to their own reports, parents appreciate this means of support to help them cope with their child's illness.

[Sleep disorders and child and adolescent psychiatric illnesses]. / Schlafstörungen bei kinder- und jugendpsychiatrischen Erkrankungen.

As a symptom of many psychiatric disorders of childhood and adolescence, sleep disturbances often complicate the course and treatment of the underlying disorder. A somatic aetiology, e.g., as in Kleine-Levin syndrome or narcolepsy, may lead to diagnostic misinterpretations. It is not clear whether specific alterations of sleep architecture already exist in this age group and are thus trait markers for psychiatric disorders. Although it is well-known that sleep problems in adults, especially insomnia, are important in the later development of depressive syndromes, it is not clear whether persistent sleep problems during childhood constitute markers of vulnerability for psychiatric disorders. This review demonstrates interactions between sleep disturbances and psychiatric disorders of childhood and adolescence and their importance for assessment and therapy.

[Tuberous sclerosis and organic bipolar disorder in a 15-year-old adolescent]. / Tuberöse Sklerose und organische bipolare Störung bei einer 15jährigen Jugendlichen.

We present the case of a 15-year-old girl with tuberous sclerosis who developed rapid cycling bipolar disorder under treatment with the anticonsulvant oxcarbazepine. Because of first occurrence of grand mal-seizures combined treatment with Valproate became necessary, but failed to prevent relapses of bipolar disorder. Mood stabilization was noticed under additional treatment with lithium, which was complicated by an increase of serum potassium.