European Child & Adolescent Psychiatry

, Volume 3, Issue 3, pp 197–207 | Cite as

Anorexia nervosa: Recent research findings and implications for clinical practice

  • Maria Råstam
Clinical Section


In this paper, recent anorexia nervosa research is reviewed with the specific goal of identifying findings that have bearings on clinical management strategies for this particular group of eating disordered patients.


Anorexia Nervosa Eating Disorder Bulimia Nervosa Stam Mitral Valve Prolapse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Dans cet article, les résultats de recherches récentes sont rapportés dans le but spécifique d’identifier les résultats qui peuvent influencer les stratégies de traitement clinique pour ce groupe particulier de patients présentant des troubles alimentaires.


In dieser Arbeit werden die rezenten Forschungsergebnisse zur Anorexia nervosa übersichtlich dargestellt mit dem Ziel, solche Befunde zu identifizieren, die für klinische Behandlungskonzepte dieser besonderen Gruppe von eßgestörten Patienten von Bedeutung sind.


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  1. Arendt, J., Bhanji, S., Franey, C. & Mattingly, D. (1992). Plasma melatonin levels in anorexia nervosa.British Journal of Psychiatry, 161, 361–364.PubMedGoogle Scholar
  2. Bakan, R., Birmingham, C.L., Aeberhardt, L. & Goldner, E.M. (1993). Dietary zinc intake of vegetarian and non-vegetarian patients with anorexia nervosa.International Journal of Eating Disorders, 13, 229–233.PubMedCrossRefGoogle Scholar
  3. Ballard, C.G., Handy, S., McGibben, L., Mohan, R.N.C. & Silveira, W.R. (1993). Eating disorder in a 6-year-old Asian girl with ethyl malonic adipic aciduria.International Journal of Eating Disorders, 13, 245–248.PubMedCrossRefGoogle Scholar
  4. Beglin, S.J. & Fairburn, C.G. (1992). Women who choose not to participate in surveys on eating disorders.International Journal of Eating Disorders, 12, 113–116.CrossRefGoogle Scholar
  5. Bessler, H., Karp, L., Notti, I., Apter, A., Tyano, S., Djaldetti, M. & Weizman, R. (1993). Cytokine production in anorexia nervosa.Clinical neuropharmacology, 16, 237–243.PubMedCrossRefGoogle Scholar
  6. Bourke, M.P., Taylor, G.J., Parker, J. & Bagby, R.M. (1992). Alexithymia in women with anorexia nervosa: A preliminary investigation.British Journal of Psychiatry, 161, 240–243.PubMedGoogle Scholar
  7. Bryant-Waugh, R. & Lask, B. (1991). Anorexia nervosa in a group of Asian children living in Britain.British Journal of Psychiatry, 158, 229–233.PubMedGoogle Scholar
  8. Bryant-Waugh, R., Knibbs, J., Fosson, A., Kaminski, Z. & Lask, B. (1988). Long term follow up of patients with early onset anorexia nervosa.Archives of Disease in Childhood, 63, 5–9.PubMedGoogle Scholar
  9. Casper, R.C. (1990). Personality features of women with good outcome from restricting anorexia nervosa.Psychosomatic Medicine, 52, 156–170.PubMedGoogle Scholar
  10. Clarke, D.J. & Yapa, P. (1991). Phenylketonuria and anorexia nervosa.Journal of Mental Deficiency Research, 35, 165–170.PubMedGoogle Scholar
  11. Copeland, P.M. (1989). Diuretic abuse and central pontine myelinolysis.Psychotherapy Psychosomatics, 52, 101–105.Google Scholar
  12. DaCosta, M. & Halmi, K.A. (1992). Classification of anorexia nervosa: Question of subtypes.International Journal of Eating Disorders, 11, 305–313.CrossRefGoogle Scholar
  13. Dolan, B., Lacey, J.H. & Evans, C. (1990). Eating behaviour and attitudes to weight and shape in British women from three ethnic groups.British Journal of Psychiatry, 157, 523–528.PubMedCrossRefGoogle Scholar
  14. El-Badri, S.M. & Lewis, M.A. (1991). Anorexia nervosa associated with Klinefelters syndrome.Comprehensive Psychiatry, 32, 317–319PubMedCrossRefGoogle Scholar
  15. Folsom, V., Krahn, D., Nairn, K., Gold, L., Demitrack, M.A. & Silk, K.R. (1993). The impact of sexual and physical abuse on eating disordered and psychiatric symptoms: A comparison of eating disordered and psychiatric inpatients.International Journal of Eating Disorders, 13, 249–257.PubMedCrossRefGoogle Scholar
  16. Garner, D.M. & Garfinkel, P.E. (1979). The eating attitudes test: An index of the symptoms of anorexia nervosa.Psychological Medicine, 9, 273–279.PubMedGoogle Scholar
  17. Geracioti, T.D., Liddle, R.A., Altemus, M., Demitrack, M.A. & Gold, P.W. (1992). Regulation of appetite and cholecystokinin secretion in anorexia nervosa.American Journal of Psychiatry, 149, 958–961.PubMedGoogle Scholar
  18. Greenberg, W.M., Shah, P.J. & Vakharia, M. (1992). Anorexia nervosa / bulimia and central pontine myelinolysis.General Hospital Psychiatry, 14, 357–358.PubMedCrossRefGoogle Scholar
  19. Gillberg, C. & Coleman, M. (1992).The Biology of the Autistic Syndromes. Second Edition. New York: Cambridge Press.Google Scholar
  20. Gillberg, C., Råstam, M. & Gillberg, I.C. (1994a). Anorexia nervosa: Physical health and neurodevelopment at 16 and 21 years.Developmental Medicine and Child Neurology, 36, 567–575.PubMedCrossRefGoogle Scholar
  21. Gillberg, C., Råstam, M. & Gillberg, I.C. (1994b). Anorexia nervosa: Who sees the patients and who do the patients see?Acta Paediatrica. In press.Google Scholar
  22. Gillberg, I.C., Råstam, M. & Gillberg, C. (1994a). Anorexia nervosa 6 years after onset. Part I: Personality disorders.Comprehensive Psychiatry. Accepted for publicationGoogle Scholar
  23. Gillberg, I.C. & Råstam, M. & Gillberg, C. (1994b). Anorexia nervosa outcome: Six year controlled longitudinal study of 51 cases including a population cohort.Journal of the American Academy of Child and Adolescent Psychiatry, 33, 729–739.PubMedCrossRefGoogle Scholar
  24. Gwirtsman, H.E., Kaye, W.H., George, D.T., Carsosella, N.W., Greene, R.C. & Jimerson, D.C. (1989). Hyperamylasemia and its relationship to binge-purge episodes: Development of a clinically relevant laboratory test.Journal of Clinical Psychiatry, 50, 196–204.PubMedGoogle Scholar
  25. Gwirtsman, H.E., Guze, B.H., Yager, J. & Gainsley, B. (1990). Fluoxetine treatment of anorexia nervosa: An open clinical trial.Journal of Clinical Psychiatry, 51, 378–382.PubMedGoogle Scholar
  26. Gwirtsman, H.E., Prager, J & Henkin, R. (1993). Case report of anorexia nervosa associated with Wilsons disease.International Journal of Eating Disorders, 13, 241–244.PubMedCrossRefGoogle Scholar
  27. Halmi, K.A., Eckert, E., Marchi, P., Sampugnaro, V., Apple, R. & Cohen, J. (1991). Comorbidity of psychiatric diagnoses in anorexia nervosa.Archives of General Psychiatry, 48, 712–718.PubMedGoogle Scholar
  28. Herholz, K., Krieg, J.C., Emrich, H.M., Pawlik, G., Beil, C., Pirke, K.M., Pahl, J.J., Wagner, R., Wienhard, K., Ploog, D. & Heiss, W.D. (1987). Regional cerebral glucose metabolism in anorexia nervosa measured by positron emission tomography.Biological Psychiatry, 22, 43–51.PubMedCrossRefGoogle Scholar
  29. Herzog, D.B., Keller, M.B., Sacks, N.R., Yeh, C.J. & Lavori, P.W. (1992). Psychiatric comorbidity in treatment-seeking anorexics and bulimics.Journal of the American Academy of Child and Adolescent Psychiatry, 31, 810–818.PubMedGoogle Scholar
  30. Herzog, W., Minne, H., Deter, C., Leidig, G., Schellberg, D., Wüster, C., Gronwald, R., Sarembe, E., Kröger, F., Bergmann, G., Petzold, E., Hahn, P., Schepank, H. & Ziegler, R. (1993). Outcome of bone mineral density in anorexia nervosa patients 11.7 years after first admission.Journal of Bone and Mineral Research, 8, 597–605.PubMedGoogle Scholar
  31. Holden, N.L. (1991). Adoption and eating disorders: A high-risk group?British Journal of Psychiatry, 158, 829–833.PubMedGoogle Scholar
  32. Holland, A.J., Sicotte, N. & Treasure, J. (1988) Anorexia nervosa: Evidence for a genetic basis.Journal of Psychosomatic Research, 32, 561–571.PubMedCrossRefGoogle Scholar
  33. Humphrey, L.L. (1989). Observed family interactions among subtypes of eating disorders using structural analysis of social behaviour.Journal of Consulting and Clinical Psychology, 57, 206–214.PubMedCrossRefGoogle Scholar
  34. Husain, M.M., Black, K.J., Doraiswamy, P.M., Shah, S.A., Rockwell, W.J.K., Ellinwood, E.H. Jr. & Krishnan, K.R.R. (1992). Subcortical brain anatomy in anorexia and bulimia.Biological Psychiatry, 31, 735–738.PubMedCrossRefGoogle Scholar
  35. Jacquin, P., Ouvry, O. & Alvin, P. (1992). Fatal water intoxication in a young patient with anorexia nervosa.Journal of Adolescent Health, 13, 631–633.PubMedCrossRefGoogle Scholar
  36. Kaplan, A.S., Goldbloom, D.S., Woodside, D.B., Swinson, R.P., Kennedy, S.H. & Rakowski, H. (1991). Mitral valve prolapse in eating and panic disorder: A pilot study.International Journal of Eating Disorders, 10, 531–537.CrossRefGoogle Scholar
  37. Kaye, W.H., Gwirtsman, H.E., George, D.T. & Ebert, M.H. (1991a). Altered serotonin activity in anorexia nervosa after long-term weight restoration. Does elevated cerebrospinal fluid 5-hydroxyindoleacetic acid level correlate with rigid and obsessive behavior?Archives of General Psychiatry, 48, 556–562.PubMedGoogle Scholar
  38. Kaye, W.H., Weltzin, T.E., Hsu, L.K.G. & Bulik, C.M. (1991)). An open trial of fluoxetine in patients with anorexia nervosa.Journal of Clinical Psychiatry, 52, 464–471.PubMedGoogle Scholar
  39. Kinzl, J., Biebl, W. & Herold, M. (1993). Significance of vomiting for hyperamylasemia and sialadenosis in patients with eating disorders.International Journal of Eating Disorders, 13, 117–124.PubMedCrossRefGoogle Scholar
  40. Kiriike, N., Iketani, T., Nakanishi, S., Nagata, T., Inoue, K., Okuno, M., Ochi, H. & Kawakita, Y. (1992). Reduced bone density and major hormones regulating calcium metabolism in anorexia nervosa.Acta Psychiatrica Scandinavica, 86, 358–363.PubMedCrossRefGoogle Scholar
  41. Kornreich, L., Shapira, A., Horev, G., Danziger, Y., Tyano, S. & Mimouni, M. (1991). CT and MR evaluation of the brain in patients with anorexia nervosa.American Journal of Neuroradiology, 12, 1213–1216.PubMedGoogle Scholar
  42. Krieg, J.C., Holthoff, V., Schreiber, W., Pirke, K.M. & Herholz, K. (1991). Glucose metabolism in the caudate nuclei of patients with eating disorders, measured by PET.European Archives of Psychiatry and Clinical Neuroscience, 240 331–333.PubMedCrossRefGoogle Scholar
  43. Kronvall, P., Fahy, T.A., Isaksson, A., Theander, S. & Russell, G.F.M. (1992). The clinical relevance of salivary amylase monitoring in bulimia nervosa.Biological Psychiatry, 32, 156–163.PubMedCrossRefGoogle Scholar
  44. Lask, B., Fosson, A., Rolfe, U. & Thomas, S. (1993). Zinc deficiency and childhood-onset anorexia nervosa.Journal of Clinical Psychiatry, 54, 63–66.PubMedGoogle Scholar
  45. Lautenbacher, S., Barth, K., Friess, E., Strian, F., Pirke, K.M. & Krieg, J.C. (1991b). Dieting and pain sensitivity: A validation of clinical findings.Physiology and Behavior, 50, 629–631.PubMedCrossRefGoogle Scholar
  46. Lautenbacher, S., Pauls, A.M., Strian, F., Pirke, K.M. & Krieg, J.C. (1991a). Pain sensitivity in anorexia nervosa and bulima nervosa.Biological Psychiatry, 29, 1073–1078.PubMedCrossRefGoogle Scholar
  47. Lee, S. (1991). Anorexia nervosa in Hong Kong: A Chinese perspective.Psychological Medicine, 21, 703–711.PubMedGoogle Scholar
  48. Le Grange, D., Eisler, I., Dare, C. & Russell, G.F.M. (1992). Evaluation of family treatments in adolescent anorexia nervosa: A pilot study.International Journal of Eating Disorders, 12, 347–357.CrossRefGoogle Scholar
  49. Liew, V.P., Frisken, K.W., Touyz, S.W., Beumont, P.J.V. & Williams, H. (1991). Clinical and microbiological investigations of anorexia nervosa.Australlian Dental Journal, 36, 435–441.Google Scholar
  50. Lucas, A.R., Beard, C.M., O’Fallon, W.M. & Kurland, L.T. (1991). 50-year trends in the incidence of anorexia nervosa in Rochester, Minn: A population-based study.American Journal of Psychiatry, 148, 917–922.PubMedGoogle Scholar
  51. McCluskey, S.E. & Lacey, J.H. (1992). Anorexia nervosa in a patient with XY gonadal dysgenesis.British Journal of Psychiatry, 160, 114–116.PubMedGoogle Scholar
  52. Miyamoto, H., Sakuma, K., Kumagai, K., Ichikawa, T. & Koizumi, J. (1992). Auditory brain stem response (ABR) in anorexia nervosa.Japanese Journal of Psychiatry and Neurology, 46, 673–679.PubMedGoogle Scholar
  53. Morgan, H. & Russell, G.F.M. (1975). Value of family background and clinical features as predictors of long term outcome in anorexia nervosa: Four-year follow-up study of 41 patients.Psychological Medicine, 5, 355–371.PubMedGoogle Scholar
  54. Mumford, D.B. & Whitehouse, A.M. (1988). Increased prevalence of bulimia nervosa among Asian school-girls.British Medical Journal, 297, 718.PubMedGoogle Scholar
  55. Palmer, R.L. & Oppenheimer, R. (1992). Childhood sexual experiences with adults: A comparison of women with eating disorders and those with other diagnoses.International Journal of Eating Disorders, 12, 359–364.CrossRefGoogle Scholar
  56. Patton, G.C. & King, M.B. (1991). Epidemiological study of eating disorders: Time for a change of emphasis.Psychological Medicine, 21, 287–291.PubMedGoogle Scholar
  57. Pigott, T.A., Altemus, M., Rubenstein, C.S., Hill, J.L., Bihari, K., LHeureux, F., Bernstein, S. & Murphy, D.L. (1991). Symptoms of eating disorders in patients with obsessive-compulsive disorder.American Journal of Psychiatry, 148, 1552–1557.PubMedGoogle Scholar
  58. Powers, P.S., Schocken, D.D., Feld, J., Holloway, J.D. & Boyd, F. (1991). Cardiac function during weight restoration in anorexia nervosa.International Journal of Eating Disorders, 10, 521–530.CrossRefGoogle Scholar
  59. Råstam, M. & Gillberg, C. (1991). The family background in anorexia nervosa: A population-based study.Journal of the American Academy of Child and Adolescent Psychiatry, 30, 283–289.PubMedGoogle Scholar
  60. Råstam, M. (1992). Anorexia nervosa in 51 Swedish children and adolescents: Pre-morbid problems and comorbidity.Journal of the American Academy of Child and Adolescent Psychiatry, 31, 819–829.PubMedCrossRefGoogle Scholar
  61. Råstam, M., Gillberg, C. & Garton, M. (1989). Anorexia nervosa in a Swedish urban region: A population-based study.British Journal of Psychiatry, 155, 642–646.PubMedGoogle Scholar
  62. Råstam, M., Gillberg, C. & Wahlström, J. (1991). Chromosomes in anorexia nervosa: A study of 47 cases including a population-based group.Journal of Child Psychology and Psychiatry, 32, 695–701.PubMedCrossRefGoogle Scholar
  63. Råstam, M., Gillberg, I.C. & Gillberg, C. (1994). Anorexia Nervosa 6 Years after Onset. Part II: Comorbid psychiatric problems.Comprehensive Psychiatry. Accepted for publication.Google Scholar
  64. Rathner, G. & Messner, K. (1993). Detection of eating disorders in a small rural town: An epidemiological study.Psychological Medicine, 23, 175–184.PubMedGoogle Scholar
  65. Ratnasuriya, R.H., Eisler, I., Szmukler, G.I., & Russell, G.F.M. (1991). Anorexia nervosa: Outcome and prognostic factors after 20 years.British Journal of Psychiatry, 158, 495–502.PubMedGoogle Scholar
  66. Rothenberger, A., Blanz, B. & Lehmkuhl, G. (1991). What happens to electrical brain activity when anorectic adolescents gain weight?European Archives of Psychiatry and Clinical Neuroscience, 240, 144–147.PubMedCrossRefGoogle Scholar
  67. Rubenstein, C.S., Pigott, T.A., LHeureux, F., Hill, J.L. & Murphy, D.L. (1992). A preliminary investigation of the lifetime prevalence of anorexia and bulimina nervosa in patients with obsessive compulsive disorder.Journal of Clinical Psychiatry, 53, 309–314.PubMedGoogle Scholar
  68. Russell, G.F.M., Szmukler, G.I., Dare, C. & Eisler, I. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa.Archives of General Psychiatry, 44, 1047–1056.PubMedGoogle Scholar
  69. Schmidt, U., Tiller, J. & Treasure, J. (1993). Self-treament of bulimia nervosa: A pilot study.International Journal of Eating Disorders, 13, 273–277.PubMedCrossRefGoogle Scholar
  70. Schmidt, U., Jiwany, A. & Treasure, J. (1993). A controlled study of alexithymia in eating disorders.Comprehensive Psychiatry, 34, 54–58.PubMedCrossRefGoogle Scholar
  71. Seeman, E., Szmukler, G.I., Formica, C., Tsalamandris, C. & Mestrovic, R. (1992). Osteoporosis in anorexia nervosa: The influence of peak bone density, bone loss, oral contraceptive use, and exercise.Journal of Bone and Mineral Research, 7, 1467–1474.PubMedCrossRefGoogle Scholar
  72. Seeman, E., Young, N., Szmukler, G.I., Tsalamandris, C. & Hopper, J.L. (1993). Risk factors for osteoporosis.Osteoporosis International, 3 (Suppl. 1), 40–43.PubMedCrossRefGoogle Scholar
  73. Sharp, C.W. & Freeman, C.P.L. (1993). The medical complications of anorexia nervosa.British Journal of Psychiatry, 162, 452–462.PubMedGoogle Scholar
  74. Stacher, G., Abatzi-Wenzel, T.-A., Wiesnagrotzki, S., Bergmann, H., Schneider, C. & Gaupmann, G. (1993). Gastric emptying, body weight and symptoms in primary anorexia nervosa. Long-term effects of cisapride.British Journal of Psychiatry, 162, 398–402.PubMedGoogle Scholar
  75. Steiger, H. & Zanko, M. (1990). Sexual traumata among eating-disordered, psychiatric, and normal female groups.Journal of Interpersonal Violence, 5, 74–86.CrossRefGoogle Scholar
  76. Strober, M., Lampert, C., Morrell, W., Burroughs, J., & Jacobs, C. (1990). A controlled family study of anorexia nervosa: Evidence of familial aggregation and lack of shared transmission with affective disorders.International Journal of Eating Disorders, 9, 239–253.CrossRefGoogle Scholar
  77. Tamai, H., Takemura, J., Kobayashi, N., Matsubayashi, S., Matsukura, S., & Nakagawa, T. (1993). Changes in plasma cholecystokinin concentrations after oral glucose tolerance test in anorexia nervosa before and after therapy.Metabolism, 42, 581–584.PubMedCrossRefGoogle Scholar
  78. Thienemann, M. & Steiner, H. (1993). Family environment of eating disordered and depressed adolescents.International Journal of Eating Disorders, 14, 43–48.PubMedCrossRefGoogle Scholar
  79. Treasure, J. & Holland, A.J. (1990). Genetic vulnerability to eating disorders: Evidence from twin and family studies. In H. Remschmidt & M.H. Schmidt (Eds.),Child and Youth Psychiatry: European Perspectives, Vol. 1 (pp. 59–68). Lewiston, NY: Hogrefe and Huber Publishers.Google Scholar
  80. Treasure, J. & Holland, A.J. (1992).The aethiology of anorexia nervosa: Evidence from discordant twins. Paper presented at the 2nd International Symposium on Disorders of Eating Behaviour in Pavia, Italy.Google Scholar
  81. Vandereyken, W., Kog, E. & Vanderlinden, J. (1989) The family approach to eating disorders. New York: PMA Publishing Corp.Google Scholar
  82. Walsh, B.T., Wong, L.M., Pesce, M.A., Hadigan, C.M. & Bodourian, S.H. (1990). Hyperamylasemia in bulimia nervosa.Journal of Clinical Psychiatry, 51, 373–377.PubMedGoogle Scholar
  83. Whitaker, A., Davies, M., Shaffer, D., Johnson, J., Abrams, S., Walsh, B.T. & Kalikow, K. (1989). The struggle to be thin: A survey of anorexic and bulimic symptoms in a non-referred adolescent population.Psychological Medicine, 19, 143–163.PubMedCrossRefGoogle Scholar
  84. Williams, P., Hand, D. & Tarnopolsky, A. (1982). The problem of screening for uncommon disorders—A comment on the Eating Attitudes Test.Psychological Medicine, 12, 431–434.PubMedGoogle Scholar
  85. Wolkind, S. & Rutter, M. (1985). Sociocultural Factors. In M. Rutter & L. Hersov (Eds.),Child and Adolescent Psychiatry. Modern Approaches (Second Edition). Oxford: Blackwell Scientific Publications.Google Scholar

Copyright information

© Hogrefe & Huber Publishers 1994

Authors and Affiliations

  • Maria Råstam
    • 1
  1. 1.Department of Clinical Neuroscience, Section of Child and Adolescent Psychiatry, Annedals ClinicGöteborg UniversityGöteborgSweden

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