Advances in the Aetiology and Treatment of Anorexia Nervosa

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (15 June 2022) | Viewed by 12158

Special Issue Editor


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Guest Editor
1. Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
2. Department of Mental Health, St Vincent's Hospital, Melbourne, Australia
3. Department of Mental Health, Austin Health, Melbourne, Australia
Interests: anorexia nervosa; eating disorders; body image; neuro-bio-psycho-social mechanisms; biomarkers; eye movements; treatment

Special Issue Information

Dear Colleagues,

The efficacy of treatments for anorexia nervosa is limited by our understanding of the underlying mechanisms that contribute to the development and maintenance of the illness. This Special Issue focuses on the neuro-bio-psycho-social factors and mechanisms that contribute to anorexia nervosa, as well as novel treatment studies that target the underlying aetiology of the illness.

In this Special Issue, original research articles and reviews are welcome. Research should be focused on neurobiological, biological, psychological or sociocultural aspects that contribute to the development or maintenance of anorexia nervosa; or treatment studies that focus on targeting the neurobiological, biological, psychological or sociocultural factors thought to contribute to the development or maintenance of anorexia nervosa.

I look forward to receiving your contributions and creating a Special Issue that will provide insight into the advances made in our understanding of the aetiology and treatment of anorexia nervosa.

Dr. Andrea Phillipou
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anorexia nervosa
  • aetiology
  • development
  • maintenance
  • mechanisms
  • treatment
  • neurobiological
  • biological
  • psychological
  • sociocultural

Published Papers (5 papers)

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Editorial

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2 pages, 158 KiB  
Editorial
Advances in the Aetiology and Treatment of Anorexia Nervosa
by Andrea Phillipou
J. Clin. Med. 2022, 11(20), 6068; https://doi.org/10.3390/jcm11206068 - 14 Oct 2022
Cited by 1 | Viewed by 1157
Abstract
Anorexia nervosa (AN) is a complex psychiatric disorder [...] Full article
(This article belongs to the Special Issue Advances in the Aetiology and Treatment of Anorexia Nervosa)

Research

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12 pages, 267 KiB  
Article
Diet, Digestion, and the Dietitian: A Survey of Clinicians’ Knowledge, Attitudes and Practices to Advance the Treatment of Gastrointestinal Disturbances in Individuals with Anorexia Nervosa
by Madeline L. West, Caitlin McMaster, Claire L. Young, Mohammadreza Mohebbi, Susan Hart, Heidi M. Staudacher, Amy Loughman, Anu Ruusunen and Tetyana Rocks
J. Clin. Med. 2022, 11(19), 5833; https://doi.org/10.3390/jcm11195833 - 30 Sep 2022
Cited by 1 | Viewed by 2269
Abstract
Despite advances in treatment of anorexia nervosa (AN), current therapeutic approaches do not fully consider gastrointestinal disturbances (GID), often present in AN. Addressing GID, both symptoms and disorders, is likely to improve treatment adherence and outcomes in people with AN. GID are complex [...] Read more.
Despite advances in treatment of anorexia nervosa (AN), current therapeutic approaches do not fully consider gastrointestinal disturbances (GID), often present in AN. Addressing GID, both symptoms and disorders, is likely to improve treatment adherence and outcomes in people with AN. GID are complex and are linked to a range of factors related to eating disorder symptomology and can be impacted by nutritional treatment. It is not known which dietetic practices are currently used to address GID in AN. Therefore, this survey aimed to explore the perceived knowledge, attitudes, and practices (KAP) of Australian dietitians treating AN and co-occurring GID. Seventy dietitians participated by completing an online survey. Knowledge scores were calculated based on correct responses to knowledge items (total: 12 points); and two groups were generated: higher knowledge (≥10 points, n = 31) and lower knowledge (≤9 points, n = 39). A greater proportion of dietitians with higher knowledge recognized the role of GID in pathogenesis of AN (p = 0.002) and its impact on quality of life (p = 0.013) and screened for GID (p ≤ 0.001), compared with those with lower knowledge. These results suggest that attitudes and practices toward patients presenting with AN and GID differ depending on level of knowledge. This may have important implications for treatment outcomes for individuals with AN and GID. Full article
(This article belongs to the Special Issue Advances in the Aetiology and Treatment of Anorexia Nervosa)
7 pages, 253 KiB  
Article
Can Cognitive Flexibility and Clinical Perfectionism Be Used to Identify People with Anorexia Nervosa?
by Stephanie Miles, Maja Nedeljkovic and Andrea Phillipou
J. Clin. Med. 2022, 11(7), 1954; https://doi.org/10.3390/jcm11071954 - 31 Mar 2022
Cited by 5 | Viewed by 2236
Abstract
Poor cognitive flexibility and perfectionism are common features in anorexia nervosa (AN). The current study aimed to investigate cognitive flexibility and clinical perfectionism as potential predictors of AN. Twenty women with a current diagnosis of AN (M age = 28.25, SD = [...] Read more.
Poor cognitive flexibility and perfectionism are common features in anorexia nervosa (AN). The current study aimed to investigate cognitive flexibility and clinical perfectionism as potential predictors of AN. Twenty women with a current diagnosis of AN (M age = 28.25, SD = 7.62) and 170 community participants with no lifetime history of an eating disorder (M age = 29.23, SD = 9.88) took part in an online cross-sectional study that included self-report questionnaires of cognitive flexibility and clinical perfectionism. It was found that compared to the community sample, women with AN self-reported significantly poorer cognitive flexibility and significantly greater clinical perfectionism. In a regression model, clinical perfectionism (but not self-reported cognitive flexibility) significantly predicted group membership. The specificity and sensitivity of the model were high. These preliminary findings indicate that clinical perfectionism may represent a key feature of AN and may accurately discriminate between participants with and without AN, though more research is required. Full article
(This article belongs to the Special Issue Advances in the Aetiology and Treatment of Anorexia Nervosa)

Review

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17 pages, 1612 KiB  
Review
How Can Animal Models Inform the Understanding of Cognitive Inflexibility in Patients with Anorexia Nervosa?
by Kaixin Huang and Claire J. Foldi
J. Clin. Med. 2022, 11(9), 2594; https://doi.org/10.3390/jcm11092594 - 5 May 2022
Cited by 3 | Viewed by 2459
Abstract
Deficits in cognitive flexibility are consistently seen in patients with anorexia nervosa (AN). This type of cognitive impairment is thought to be associated with the persistence of AN because it leads to deeply ingrained patterns of thought and behaviour that are highly resistant [...] Read more.
Deficits in cognitive flexibility are consistently seen in patients with anorexia nervosa (AN). This type of cognitive impairment is thought to be associated with the persistence of AN because it leads to deeply ingrained patterns of thought and behaviour that are highly resistant to change. Neurobiological drivers of cognitive inflexibility have some commonalities with the abnormal brain functional outcomes described in patients with AN, including disrupted prefrontal cortical function, and dysregulated dopamine and serotonin neurotransmitter systems. The activity-based anorexia (ABA) model recapitulates the key features of AN in human patients, including rapid weight loss caused by self-starvation and hyperactivity, supporting its application in investigating the cognitive and neurobiological causes of pathological weight loss. The aim of this review is to describe the relationship between AN, neural function and cognitive flexibility in human patients, and to highlight how new techniques in behavioural neuroscience can improve the utility of animal models of AN to inform the development of novel therapeutics. Full article
(This article belongs to the Special Issue Advances in the Aetiology and Treatment of Anorexia Nervosa)
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17 pages, 2028 KiB  
Review
The Role of Glial Cells in Regulating Feeding Behavior: Potential Relevance to Anorexia Nervosa
by Linda Frintrop, Stefanie Trinh, Jochen Seitz and Markus Kipp
J. Clin. Med. 2022, 11(1), 186; https://doi.org/10.3390/jcm11010186 - 30 Dec 2021
Cited by 10 | Viewed by 2761
Abstract
Eating behavior is controlled by hypothalamic circuits in which agouti-related peptide-expressing neurons when activated in the arcuate nucleus, promote food intake while pro-opiomelanocortin-producing neurons promote satiety. The respective neurotransmitters signal to other parts of the hypothalamus such as the paraventricular nucleus as well [...] Read more.
Eating behavior is controlled by hypothalamic circuits in which agouti-related peptide-expressing neurons when activated in the arcuate nucleus, promote food intake while pro-opiomelanocortin-producing neurons promote satiety. The respective neurotransmitters signal to other parts of the hypothalamus such as the paraventricular nucleus as well as several extra-hypothalamic brain regions to orchestrate eating behavior. This complex process of food intake may be influenced by glia cells, in particular astrocytes and microglia. Recent studies showed that GFAP+ astrocyte cell density is reduced in the central nervous system of an experimental anorexia nervosa model. Anorexia nervosa is an eating disorder that causes, among the well-known somatic symptoms, brain volume loss which was associated with neuropsychological deficits while the underlying pathophysiology is unknown. In this review article, we summarize the findings of glia cells in anorexia nervosa animal models and try to deduce which role glia cells might play in the pathophysiology of eating disorders, including anorexia nervosa. A better understanding of glia cell function in the regulation of food intake and eating behavior might lead to the identification of new drug targets. Full article
(This article belongs to the Special Issue Advances in the Aetiology and Treatment of Anorexia Nervosa)
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