Clinical and personality characteristics of adolescents with anorexia nervosa with or without non-suicidal self-injurious behavior.

PURPOSE: About one-fifth of patients with anorexia nervosa (AN) engage in non-suicidal self-injury (NSSI). This study examined clinical and temperament profile of female adolescents with both disorders (AN+NSSI) as compared with peers with AN only. METHODS: A consecutive sample of 73 female adolescents with AN (mean age: 13.77 years), who had been admitted to inpatient or day-hospital services, received clinical, cognitive, and temperament/character evaluations. Of them, 32 met DSM-5 criteria also for NSSI. Assessments included demographics, standard nutrition parameters, Youth Self-Report (YSR), Wechsler Intelligence Scale for Children IV (WISC-IV), Temperament and Character Inventory (TCI), and Global Assessment of Functioning (GAF). RESULTS: No differences were detected between AN+NSSI and AN in demographics, body mass index, or age at onset of AN. AN+NSSI had higher rate of binging and purging, higher YSR scores for both internalizing and externalizing psychopathology, lower total IQ, and lower Self-directedness and Cooperativeness scores. CONCLUSIONS: These data suggest that adolescents with AN+NSSI have psychopathological, cognitive and overall character features that differ from patients with AN only. These characteristics may have implications for treatment and outcome.

[Adherence to therapy in patients on hemodialysis]. / Adesione alla terapia del paziente in emodialisi.

The percentage of patients on dialysis who do not adhere to their dietary and therapeutic regimens ranges from 25% to 86%. These data are relevant because nonadherence to the prescribed diet affects the mortality and morbidity of these patients. The aim of this study was to evaluate some indicators of nonadherence to drug therapy and diet. Patients showing serum potassium levels >6 mEq/L, serum phosphate levels >5.5 mg/dL, or interdialysis weight gain >5.7% of their body weight were considered as nonadherent. Behaviors, habits and adherence to prescribed therapies were investigated by administering a drug and diet questionnaire to the patients. The percentages of values exceeding the nonadherence threshold were 16.4% for potassium, 30.2% for phosphate, and 7.5% for weight gain. The weight gain index was significantly related to both potassium (p<0.01) and phosphate (p<0.05) indexes. Age was inversely correlated with non -adherence indexes of both phosphate (p<0.05) and weight gain (p<0.05). Residual diuresis was associated with better adherence to potassium (p<0.01). Factor analysis of the questionnaire suggested a 4-factor solution. None of these subscales were correlated with nonadherence indexes. ''Continuity in the intake of drugs'' showed a correlation with the ''trust in the drugs'' factor (p<0.01). Measurements of nonadherence remain a crucial step for understanding the impact on patients' quality of life.