The prevalence of eating disorders (EDs) and comorbid psychiatric disorders in adolescents: a two-stage community-based study.

OBJECTIVE: The aims of this study were to determine the prevalence of eating disorders (EDs) in adolescents and the prevalence of comorbid psychiatric disorders in adolescents with EDs. METHOD: During stage 1 of the study the Eating Attitude Test (EAT) was administered to 2907 randomly selected adolescent students. During stage 2 of the study students with an EAT score >30 underwent a clinical interview and those diagnosed with an ED (based on DSM-IV criteria) were included in the ED group. The control group included students that were age- and sex-matched with the ED group, were not diagnosed with an ED, and had an EAT score <30. Psychiatric comorbidity in the ED and control groups was evaluated using the Structured Clinical Interview for DSM-III-R (outpatient and non-patient forms). Additionally, a demographic data form, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were administered to all the participants. RESULTS: In total, 68 (9 male and 59 female) of the 2907 students met the diagnostic criteria for an ED. Point prevalence rates were as follows: anorexia nervosa: 0.034%; bulimia nervosa: 0.79%: eating disorder not otherwise specified: 1.51%; binge eating disorder: 0.99%; any ED: 2.33%. None of the male participants were diagnosed with anorexia nervosa or bulimia nervosa. In all, 8 male students were diagnosed with binge eating disorder. The prevalence of comorbid psychiatric disorders was higher in the ED group. Major depression was the most prevalent comorbid disorder in the ED group, followed by generalized anxiety disorder and social phobia. The body mass index, and BDI, BAI, and EAT scores were higher in the ED group than in the control group. CONCLUSION: The results of this study show that whereas the point prevalence rate for EDs among all the participants was 2.3%, it was 4.03% among the female participants. Moreover, ED not otherwise specified was the most prevalent ED, and binge eating disorder was the most common ED among the males. The prevalence rates in the present study are similar to those observed in Western countries, except for the prevalence rate for anorexia nervosa, which in the present study was lower. Major depression and generalized anxiety disorder were the most prevalent comorbid disorders in the ED group.

Anxiety of young female athletes with disordered eating behaviors.

The aim of this study was to investigate the prevalence rate of disordered eating behaviors in young female athletes and to compare the anxiety levels of the athletes with or without disordered eating behaviors. Female athletes (n=243) of 15 to 25 years old from the city, Edirne, in Turkey participated our study. Disordered eating behaviors and anxiety levels of participants were evaluated by the Eating Attitudes Test (EAT-40) and State-Trait Anxiety Inventory. Disordered eating behaviors was reported as 40 (16.7%) among all athletes. Both state and trait anxiety scores were higher in athletes with disordered eating behaviors than the athletes without disordered eating behaviors (p=0.01). The athletes who engage in leanness and non leanness sports were reported as having similar EAT-40 scores and anxiety scores. In conclusion, athletes with disordered eating behaviors have higher state and trait anxiety scores.

Sleep deprivation induced anxiety and anaerobic performance.

The aim of this study was to investigate the effects of sleep deprivation induced anxiety on anaerobic performance. Thirteen volunteer male physical education students completed the Turkish version of State Anxiety Inventory and performed Wingate anaerobic test for three times: (1) following a full-night of habitual sleep (baseline measurements), (2) following 30 hours of sleep deprivation, and (3) following partial-night sleep deprivation. Baseline measurements were performed the day before total sleep deprivation. Measurements following partial sleep deprivation were made 2 weeks later than total sleep deprivation measurements. State anxiety was measured prior to each Wingate test. The mean state anxiety following total sleep deprivation was higher than the baseline measurement (44.9 ± 12.9 vs. 27.6 ± 4.2, respectively, p = 0.02) whereas anaerobic performance parameters remained unchanged. Neither anaerobic parameters nor state anxiety levels were affected by one night partial sleep deprivation. Our results suggest that 30 hours continuous wakefulness may increase anxiety level without impairing anaerobic performance, whereas one night of partial sleep deprivation was ineffective on both state anxiety and anaerobic performance. Key pointsShort time total sleep deprivation (30 hours) increases state anxiety without any competition stress.Anaerobic performance parameters such as peak power, mean power and minimum power may not show a distinctive difference from anaerobic performance in a normal sleep day despite the high anxiety level induced by short time sleep deprivation.Partial sleep deprivation does not affect anxiety level and anaerobic performance of the next day.

[Combination therapy using sertraline with sleep deprivation and light therapy compared to sertraline monotherapy for major depressive disorder]. / Majör depresyonda sertralin ile birlikte uygulanan uyku yoksunlugu ve isik tedavisinin etkinliginin sertralin tedavisi ile karsilastirilmasi.

OBJECTIVE: Bright light therapy is effective and well tolerated in seasonal affective disorder and some studies reported an antidepressant effect of bright light also in non-seasonal depression. On the other hand, total sleep deprivation leads to a rapid and marked improvement of mood in 60% of depressed patients. Combinations of antidepressant medication with those somatic therapies are generally indicated. The aim of this study was to compare the efficacy of the combination of sertraline and partial sleep deprivation or light therapy with sertraline monotherapy in the treatment of major depression. METHOD: Thirty-seven patients with major depressive disorder were randomly allocated into 3 treatment groups. Thirteen were treated with sertraline and late partial sleep deprivation, 13 with sertraline and bright light therapy and 11 sertraline monotherapy as a control group. Outcome measures included daily (first 15 days) and weekly Hamilton Rating Scale for Depression and biweekly Hamilton Anxiety Rating Scale. RESULTS: Partial sleep deprivation group improved significantly and more rapidly. Accelerated treatment response was shown in sleep deprivation group that improvement was observed after the third day. Bright light and sleep deprivation combinations with sertraline were more effective than sertraline monotherapy for accompanied anxiety in depression. CONCLUSION: Late partial sleep deprivation in combination with sertraline can accelerate and increase the treatment response in non-seasonal major depressive disorder.

Prevalence of the female athlete triad in edirne, Turkey.

The aim of this study was to determine the prevalence of the female athlete triad, which is a clinical condition defined as the simultaneous occurrence of disordered eating, amenorrhea, and osteopenia and/or osteoporosis in female athletes. A total number of 224 female athletes from Edirne city participated in our study. Eating attitudes test (EAT 40) and a self-administered questionnaire were used to assess disordered eating behavior and menstrual status respectively. The participants having both disordered eating and amenorrhea were performed dual energy x-ray absorptiometry to evaluate bone mineral density. Thirty seven subjects (16.8%) had disordered eating behavior and 22 subjects (9.8%) were reported to have amenorrhea. Six athletes (2.7%) met two criteria (disordered eating and amenorrhea) of the triad. Of these, only three athletes met all components of the triad. We have found that the prevalence rate of female athlete triad was 1.36% among young Turkish female athletes. Female athletes have under considerable risk for the disordered eating and amenorrhea components of the triad. Key PointsThe prevalence rate of the occurrence of whole criteria of the female athlete triad was 1.36 % in young Turkish athletes in Edirne.Female athletes who met whole criteria of female athlete triad are more prone to the eating disorders.The occurrence of disordered eating behavior was higher in female athletes according to general population.Amenorrhea prevalence was significantly higher in female athletes who had disordered eating.

Cotard's syndrome with schizophreniform disorder can be successfully treated with electroconvulsive therapy: case report.

We report a case of Cotard's syndrome associated with psychotic symptoms. A 27-year-old man was admitted to hospital with the diagnosis of schizophreniform disorder. His presenting symptoms, which had started 1 month before hospital admission, were somatic delusions of gastrointestinal and cardiovascular malfunction and the absence of a stomach, which resulted in a decrease in weight from 75 kg to 63 kg in 1 month. Cranial computed tomographic images showed dilatation of the lateral and third ventricles, whereas magnetic resonance imaging revealed central atrophy and lateral ventricle dilatation. Single- photon emission computed tomography demonstrated left temporal, left frontal and left parietal hypoperfusion. The patient did not respond to antipsychotic therapies, but he was successfully treated with electroconvulsive therapy. This report emphasizes that Cotard's syndrome may be accompanied by lesions of the left hemisphere and that electroconvulsive therapy could be the first-line therapy in such patients with psychotic disorder.

Aortic aneurysm and electroconvulsive therapy in elderly depressive patient.

We report the case of a 67-year-old single man with aortic aneurysm whose depression was successfully treated with electroconvulsive therapy. Metoprolol succinate was used for blood pressure control, and there were no cardiovascular side effects and no significant increase in blood pressure detected.

Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder.

RATIONALE: Over the last 15 years, an increasing body of evidence has suggested a causal relationship between depression and the immunological activation and hypersecretion of pro-inflammatory cytokines, such as interleukin-1, interleukin-6 and tumor necrosis factor-alpha (TNF-alpha). However, little is known about the probable relationship of serum TNF-alpha with major depressive disorder (MDD). OBJECTIVE: To assess whether serum TNF-alpha levels could be associated with the clinical course of MDD. SUBJECTS AND METHODS: TNF-alpha and C-reactive protein (CRP) serum concentrations, erythrocyte sedimentation rate, and leukocyte count were measured in 26 MDD patients and in 17 controls. The measurements were repeated following 6 weeks of antidepressant treatment with selective serotonin re-uptake inhibitors. Psychopathological improvement and the severity of depression were evaluated with the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI). RESULTS: On admission, serum TNF-alpha and leukocyte count were significantly higher in MDD patients compared to controls ( P<0.001 and P=0.005, respectively). With the antidepressant treatment, both HAMD and BDI scores decreased significantly (P<0.001 for both). Comparison of pre- and post-treatment measurements revealed that TNF-alpha, CRP, and leukocyte count decreased to levels comparable with those of the control subjects ( P<0.001, P=0.01, and P=0.01, respectively). CONCLUSIONS: The results emphasized that some immunological parameters, such as CRP, leukocyte count and TNF-alpha, are significantly involved in the clinical course and treatment response in MDD. TNF-alpha in particular could be considered as a potential state marker in MDD.