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Elisabet Wentz

Publications and source records attributed to Elisabet Wentz.

9 recordsLinked to original sources

The impact of ADHD and autism spectrum disorders on temperament, character, and personality development.

OBJECTIVE: The authors describe personality development and disorders in relation to symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders. METHOD: Consecutive adults referred for neuropsychiatric investigation (N=240) were assessed for current and lifetime ADHD and autism spectrum disorders and completed the Temperament and Character Inventory. In a subgroup of subjects (N=174), presence of axis II personality disorders was also assessed with the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). RESULTS: Patients with ADHD reported high novelty seeking and high harm avoidance. Patients with autism spectrum disorders reported low novelty seeking, low reward dependence, and high harm avoidance. Character scores (self-directedness and cooperativeness) were extremely low among subjects with neuropsychiatric disorders, indicating a high overall prevalence of personality disorders, which was confirmed with the SCID-II. Cluster B personality disorders were more common in subjects with ADHD, while cluster A and C disorders were more common in those with autism spectrum disorders. The overlap between DSM-IV personality disorder categories was high, and they seem less clinically useful in this context. CONCLUSIONS: ADHD and autism spectrum disorders are associated with specific temperament configurations and an increased risk of personality disorders and deficits in character maturation.

Adult↗

Fertility and history of sexual abuse at 10-year follow-up of adolescent-onset anorexia nervosa.

OBJECTIVE: We studied fertility and history of child sexual abuse (CSA) in a representative group of anorexia nervosa (AN) cases. METHOD: Fifty-one adolescent-onset AN cases recruited after community screening and 51 matched comparison cases were interviewed 10 years after reported AN onset, at mean age 24 years, regarding children, miscarriages, and fertility problems. They completed anonymously the Finkelhor self-report questionnaire regarding history of CSA. RESULTS: There were few fertility problems in our AN population. There was a tendency towards more subjects in the AN group to give birth to a child (10 AN and 4 comparison mothers). The prevalence of CSA was equal between groups. For example, 6% in each group had experienced CSA before the age of 10 years, and 14% of the AN and 12% of the comparison cases reported CSA. DISCUSSION: Infertility and history of CSA may not be overrepresented in a population-based AN sample at long-term follow-up.

Adolescent↗

Childhood onset neuropsychiatric disorders in adult eating disorder patients. A pilot study.

BACKGROUND: Autism spectrum disorders (ASD) have been suggested to be overrepresented in anorexia nervosa. This study aimed to explore the comorbidity of ASD and other childhood onset neuropsychiatric disorders (COND) [attention-deficit/hyperactivity disorder (AD/HD) and tic disorders] in a group of severe eating disorder (ED) patients. METHOD: Thirty female ED patients from a specialist hospital clinic were examined on measures tapping into COND and personality disorders. RESULTS: In our group of longstanding ED, 53% had at least one COND diagnosis; 23% had ASD, 17% had AD/HD, and 27% had a tic disorder. CONCLUSIONS: These preliminary data suggest that COND may be common in patients with severe ED and should be kept in mind when treating these patients.

Adolescent↗

Bone density 11 years after anorexia nervosa onset in a controlled study of 39 cases.

OBJECTIVE: To evaluate bone mineral density (BMD) and body composition 11 years after the onset of anorexia nervosa (AN). METHOD: Thirty-nine AN subjects (36 females, 3 males), selected from a population-based sample, and 46 matched controls (COMP; 43 females, 3 males) were examined by using double-energy X-ray absorptiometry (DXA). Only 2 women still had AN. None of the men had AN. RESULTS: The females in the AN and COMP groups did not differ regarding BMD, nor was there a difference across female groups concerning body mass index (BMI). The female AN group had a significantly lower percentage of body fat. BMD among females in the AN group was related to lowest BMI ever. There was an inverse relationship between lumbar BMD and AN duration. DISCUSSION: Low BMD is not overrepresented among weight-restored AN patients at long-term follow-up compared with healthy women. However, the inverse relationship between BMD and AN duration may be indicative of a risk for osteopenia in patients with subchronic and chronic AN.

Adolescent↗

Outcome of teenage-onset anorexia nervosa in a Swedish community-based sample.

In a prospective long-term outcome study of a representative sample of teenage-onset anorexia nervosa (AN), 51 individuals with AN, recruited after community screening, were contrasted with 51 matched comparison cases at a mean age of 24 years (10 years after AN onset). All 102 cases had been examined at age 16 and 21 years. At 24 years all probands were interviewed regarding mental and physical health, and overall outcome was assessed. Ten-year outcome of teenage-onset AN seemed to be relatively favourable in that half of all cases were free from eating disorder (ED) and other axis I disorder. There were no deaths. However, one in four in the AN group had a persisting ED, 3 of whom still had AN. Lifetime diagnoses of affective disorders and obsessive-compulsive disorder (OCD) were overrepresented in the AN group. Affective disorders coincided with the ED, and were not a problem after recovery from the ED. On the other hand, OCD, OCPD (obsessive-compulsive personality disorder), and/or autism spectrum disorder continued to characterise more than one-third of the AN cases. One in six of the AN group had persistent problems with social interaction and obsessive compulsive behaviours from childhood into early adult years. Half the AN group had a poor overall outcome. These were subjects with either persisting ED or lifelong problems with social interaction and obsessive compulsive behaviour.

Adolescent↗

Association between a polymorphism of the 5-HT2C receptor and weight loss in teenage girls.

Receptors of the 5-HT2C subtype are assumed to be involved in the influence of serotonin on food intake. A polymorphism in the coding region of the gene for this receptor, resulting in a cysteine to serine substitution, has been reported. Fifty-seven somatically healthy teenage girls displaying weight loss and 91 normal-weight girls of the same age, all recruited by means of a population-based screening study, were compared with respect to this polymorphism. Subjects in the weight loss group displayed a higher frequency of the serine allele than those in the comparison group (23.7% vs. 7.7%, p =.0001). Seventy-two percent of the weight loss girls fulfilled the diagnostic criteria of anorexia nervosa, whereas 28% did not; when these two groups were separately analyzed, both differed significantly from controls with respect to serine allele frequency. The results support the notion that the studied gene may be involved in the regulation of food intake in young women.

Adolescent↗

Mobius sequence--a Swedish multidiscipline study.

Mobius sequence/syndrome is a rare disorder characterized by congenital palsy of the 6th and 7th cranial nerves. Other cranial nerves may be affected, skeletal and orofacial anomalies and mental retardation occur. The aims were to determine the frequency of associated clinical characteristics and to identify any pregnancy or environmental factors in patients with Mobius sequence. A prospective study of 25 Swedes with apparent involvement of the 6th and 7th cranial nerves was performed and 25 patients, 1 month to 55 years old, were examined. Obvious associated systemic anomalies observed included: limb malformations (10), Poland anomaly (2), hypodontia (7), microglossia (6), cleft palate (4), hearing impairment (5) and external ear malformation (1). Pronounced functional abnormalities were observed involving facial expression (16), speech (13), eating and swallowing (12) and difficulty in sucking in infancy (11). Six patients had an autistic syndrome, one an autistic-like condition, and mental retardation was found in all these patients. No common aetiological cause was found but their mothers' pregnancy histories revealed a history of benzodiazepines (1), bleeding during pregnancy (8), spontaneous abortion (7) and chorion villus sampling in the second month of pregnancy (1). In conclusion, many patients had multiple problems with eating and communication resulting from facial palsy, cleft palate and tongue anomalies. Autism and mental retardation was diagnosed in one-third of the patients. Awareness of the wide spectrum of manifestations in Mobius sequence will assist in identification of the associated malformations and functional problems that are often seen and result in better care of the children.

Abducens Nerve Diseases↗

[Somatic complications of anorexia nervosa in children and adolescents. Prognosis is good if the patient achieves normal weight within a couple of years].

This article presents an overview of somatic complications in anorexia nervosa in children and adolescents. Cardiovascular-, gastrointestinal-, and endocrine- complications are often observed as a consequence of starvation in anorexia nervosa, Prolongation of QT interval can cause fatal arrhythmias. Checking levels of serum electrolytes, phosphate and magnesium daily during initial phase of refeeding is necessary to avoid the Refeeding syndrome. The activity of the thyroid gland and the gonads is depressed. The patients will remain or return to a prepubertal status with poor growth and low levels of sex hormones. This, in addition to low IGF-I, low adrenal androgens and lack of energy, may result in subnormal development of bone density. If anorexia nervosa starts early in life and continues for many years there will not be a full recovery, resulting in osteoporosis and a decrease of final height. The other complications however have a good prognosis when food intake is normalised.

Adolescent↗