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Elzakkers I.F.F.M.,Altrecht Mental Health Institute | Danner U.N.,Altrecht Mental Health Institute | Hoek H.W.,Altrecht Mental Health Institute | Hoek H.W.,Parnassia Bavo Psychiatric Institute | And 5 more authors.
International Journal of Eating Disorders | Year: 2014

Objective Compulsory in-patient refeeding of patients with severe anorexia nervosa (AN) has caused considerable controversy. The effects of such treatment on longer-term outcome are not well known. The objective of this article is to review the evidence on the outcome of compulsory treatment for AN.Method Three large databases were searched for studies regarding compulsory treatment in AN.Results Detained patients have more severe symptoms and comorbidity and a longer duration of inpatient stay. In the short term compulsory refeeding in AN appears to be beneficial, but the longer term effects remain uncertain. Clinicians report no worsening of the therapeutic relationship after compulsory treatment.Discussion In severe cases of AN where the patient refuses life-saving treatment compulsory treatment needs to be considered. Future research should focus on the longer term effects of compulsory treatment and also on questions related to mental capacity in AN. © 2014 Wiley Periodicals, Inc.

Danner U.N.,Altrecht Mental Health Institute | Danner U.N.,University Utrecht | Ouwehand C.,University Utrecht | Van Haastert N.L.,University Utrecht | And 2 more authors.
European Eating Disorders Review | Year: 2012

Objective The purpose of the current study was to examine decision making in female patients with binge eating disorder (BED) in comparison with obese and normal weight women. Method In the study, 20 patients with BED, 21 obese women without BED and 34 healthy women participated. Decision making was assessed using the Iowa Gambling Task (IGT). Several questionnaires were administered measuring binge eating severity, sensitivity for punishment and reward, and self-control. Results The findings indicated that the BED and obese group performed poorly on the IGT. Participants who have BED and are obese did not improve their choice behaviour over time, whereas participants with normal weight showed a learning effect. An association between IGT performance and binge eating severity was found. Conclusion This study demonstrates that patients with BED display decision-making deficits on the IGT comparable with other forms of disordered eating. Future research should focus on unravelling the processes underlying the deficits. © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

Verhagen L.A.W.,University Utrecht | Verhagen L.A.W.,University of Cologne | Egecioglu E.,Gothenburg University | Luijendijk M.C.M.,University Utrecht | And 4 more authors.
European Neuropsychopharmacology | Year: 2011

Using the rodent activity-based anorexia (ABA) model that mimics clinical features of anorexia nervosa that include food restriction-induced hyperlocomotion, we found that plasma ghrelin levels are highly associated with food anticipatory behaviour, measured by running wheel activity in rats. Furthermore, we showed that ghrelin receptor (GHS-R1A) knockout mice do not anticipate food when exposed to the ABA model, unlike their wild type littermate controls. Likewise, food anticipatory activity in the ABA model was suppressed by a GHS-R1A antagonist administered either by acute central (ICV) injection to rats or by chronic peripheral treatment to mice. Interestingly, the GHS-R1A antagonist did not alter food intake in any of these models. Therefore, we hypothesize that suppression of the central ghrelin signaling system via GHS-R1A provides an interesting therapeutic target to treat hyperactivity in patients suffering from anorexia nervosa. © 2010.

Keizer A.,University Utrecht | Smeets M.A.M.,University Utrecht | Dijkerman H.C.,University Utrecht | van den Hout M.,University Utrecht | And 3 more authors.
Psychiatry Research | Year: 2011

Body image disturbances are central to anorexia nervosa (AN). Previous studies have focused mainly on attitudinal and visual aspects. Studies on somatosensory aspects thus far have been scarce. We therefore investigated whether AN patients and controls differed in tactile perception, and how this tactile body image related to visual body image and body dissatisfaction. The Tactile Estimation Task (TET) measured tactile body image: Two tactile stimuli were applied to forearm and abdomen, and, while blindfolded, participants estimated the distance between the two tactile stimuli between their thumb and index finger. The Distance Comparison Task (DCT) measured visual body image. Compared to controls (n=25), AN patients (n=20) not only visualized their body less accurately, but also overestimated distances between tactile stimuli on both the arm and abdomen, which might reflect a disturbance in both visual and tactile body image. High levels of body dissatisfaction were related to more severe inaccuracies in the visual mental image of the body, and overestimation of tactile distances. Our results imply that body image disturbances in AN are more widespread than previously assumed as they not only affect visual mental imagery, but also extend to disturbances in somatosensory aspects of body image. © 2011 Elsevier Ireland Ltd.

Smink F.R.E.,Parnassia Bavo Psychiatric Institute | Van Hoeken D.,Parnassia Bavo Psychiatric Institute | Hoek H.W.,Parnassia Bavo Psychiatric Institute | Hoek H.W.,University of Groningen | And 2 more authors.
Current Psychiatry Reports | Year: 2012

Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals. © The Author(s) 2012.

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