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Anoressia, bulimia, obesità. Disturbi dell'alimentazione e del peso corporeo da 0 a 14 anni
No full textDISTURBI DELL’ALIMENTAZIONE DI LUNGA DURATA. ASPETTI PSICOPATOLOGICI E SCELTA DEL LIVELLO DI CURA
No full textClinical and subthreshold eating disorders: case detection in adolescent schoolgirls.
No full textThe point prevalence of eating disorders was investigated in schoolgirls from lower socio-economic classes and a method of case detection was tested. A two-stage procedure (self-report measures and interviews) was followed. All girls meeting at least one of the following three criteria were recruited as possible cases: EAT > or = 30, BMI 24 and EAT > or = 20. The Mann-Whitney's two-tailed test and the chi-square test were used to assess the significance of differences between the possible cases and the others and between the false positives and the cases. A diagnosis of eating disorder was made for 24 subjects (8.1%): 5 (1.7%) with bulimia nervosa and 19 (6.4%) with eating disorders not otherwise specified (EDNOS). Of the 24 girls with eating disorders only 16 had high EAT40 scores (> or = 30). The other 8 cases were identified by the help of other criteria that proved to be useful. Furthermore we found data on five self-report instruments (EAT40, EDI, SCANS, SCL90, SEI). On almost all the scales, the possible cases obtained scores significantly different from the others. On the contrary, we did not find any instrument able to discriminate between false positives and cases
Concurrent validity of the Disordered Eating Questionnaire (DEQ) with the Eating Disorder Examination (EDE) clinical interview in clinical and non clinical samples
No full textThe aim of the present study was to evaluate the concurrent validity, specificity and sensitivity of the Disordered Eating Questionnaire (DEQ). The DEQ is a brief questionnaire (24 items), that can be used for epidemiological screenings. It addresses face valid questions to evaluate frequency and intensity of disordered eating attitudes and behaviors over a time frame of three months. The study was conducted using a cross-sectional design. The DEQ was completed by 190 eating disordered patients (73 patients with Anorexia, 48 with Bulimia, 11 with Binge Eating Disorder, 48 with Eating Disorders Not Otherwise Specified, 10 recovered patients) and 88 healthy controls. In the whole group, DEQ scores were highly correlated with the scores of the Eating Disorder Examination (EDE 12.0D). Sensitivity and specificity were evaluated. In the female subsample, the ROC curves indicate that a cut-off score of 30 allows to obtain a sensitivity of 82% and a specificity of 68%. A formative approach of Structural Equationing Model confirm the construct validity of the instrument. The DEQ confirm to be a valid and reliable instrument, whose sensitivity and specificity is comparable to that of the EAT-40 even though it has fewer items
Validità discriminante e concorrente di un breve questionario per la valutazione dei comportamenti alimentari disturbati (DEQ, Disordered Eating Questionnaire)
No full textSmoking cessation and body weight
No full textA great attention is presently paid to smoking cessation and pharmacotherapy combined with counselling has been found to achieve the highest rate of smoking cessation. Smoking cessation is associated with weight gain and this may reduce compliance in a subset of smokers. In a previous research we evaluated the efficacy of a combined Group Counselling therapy and Bupropion therapy and we identified some outcome predictors.The aim of the present study is to evaluate the effects of smoking cessation on body weight during a one-year follow-up period. From January 2001 to December 2005, 587 volunteers (263 males and 324 females) who wanted to quit smoking were recruited by our unit. After an individual motivational interview subjects started a Six-week Group Counselling Program (SGCP) for smoking cessation and ten days before the “quitting day” were asked to begin a seven-week pharmacotherapy consisting of 300 mg Bupropion SR/daily (BT). Prior to admission to the program subjects were submitted to a physical examination by the medical staff and underwent a structured interview about their smoking history. The amount of exhaled CO was taken as a further measure of the smoking habit. Some psychometric instruments were administered: the Fagerström Tolerance Questionnaire (FTQ), the Severity of Dependence Scale (SDS) and the Three Factor Eating Questionnaire (TFEQ). Subjects were called in by counsellors after 3, 6 and 12 months to check their current smoking habit and body weight. Of the 229 subjects who accepted BT only 115 subjects completed the seven-week cycle of therapy (BT-COMP group) whereas the remaining 114 subjects discontinued medication (BT-NONCOMP group) but continued to attend SGCP. According to a previous report (3) both BT groups achieved a higher abstinence rate if compared to the sole SGCP. At the one-year follow-up abstinence rates were 65.4% and 47.4% in BT-COMP and BT-NONCOMP groups, respectively, whereas 39.7% was the quit rate of the SGCP sole group. We evaluated the increasing body weight in the three groups of subjects (SGCP only, BT-COMP e BT NONCOMP) according to gender and to the results of the one-year abstinence. Subjects who did not smoke after 12 months (nonS) are compared with those who were still smokers (S). Females and males non-smokers revealed - at five-week abstinence and at one-year follow-up - a weight gain significantly higher if compared with S of the same sex. Several different studies have shown that a great many people believe that smoking helps control weight and ex-smokers risk weight gain. Unfortunately, this widespread opinion is an accurate one and contributes to making difficult to quit this dangerous habit. Eating more food, particularly more sweet food, and a decrease in metabolic rate are the main causes. Our data suggest that seven-week BT is not a protective factor in increasing body weight. Regular aerobic exercise and nutritional counselling may be helpful to minimize weight gain after quitting smoking. Psychometric measures seem to be weak predictors of weight gain
Metabolic-nutritional-psychological rehabilitation of obesity
No full textObesity incidence and prevalence rates are extremely high and growing, in both sexes and in all age groups. The consequences on physical and psychological status, on disability, on the quality of life call for complex and coordinated action strategies, both in terms of primary prevention and in terms of treatment and secondary prevention. The definition of these strategies must concern authorities in charge of public health, research centres, scientific societies, basic and specialist health facilities. On the basis of international scientific literature and experiences carried out in Italy, the rehabilitation approach proves to be the most appropriate for the treatment of obesity: it is best suited for the chronic features and the presence of co-morbidity and disabilities and the need to have various professionals involved in the treatment. This approach must be adjusted to the clinical, functional and psychological features of the patient and must become intensive when the level of seriousness and co-morbidity of obesity is high, when the psychic status is particularly fragile and disturbed, when the impact on disability and the quality of life of the patient is burdensome and invalidating
Motivazione alla cura, motivazione al cambiamento
No full textIl concetto di motivazione comprende il complesso di fattori che orientano e muovono scelte e condotte di ogni essere umano. Nel trattamento di molte malattie - in particolare di quelle croniche o di lunga durata - è essenziale costruire, sostenere e mantenere l’alleanza terapeutica e la motivazione alla cura e al cambiamento di comportamenti dannosi. Il diabete di tipo 1 e 2, l’obesità, i disturbi dell’alimentazione e, in genere, le dipendenze patologiche sono fra le condizioni morbose che richiedono più attenzione ai problemi motivazionali
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