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In the earliestdiagnostic criteria for AN, bulimicbehaviour such as binging, vomitingand using laxatives was seen as apossible consequence of AN ratherthan a separate disorder. In ,however special diagnostic criteriafor bulimia nervosa BN were developed.

In the DSM-IV-TRcriteria were also introduced for binge eating disorder BED ,that is, having recurrent binges not compensated by purgingbehaviour and often resulting in excess weight and obesity. For that fernando perez svorio metimas a transdiagnostic approach of EDs hasbeen developed. Most EDs are found inyoung women aged years. For men, however, the bodyideal is not being slim but having strong muscles. The questionis whether muscle dysmorphia can be seen as seen as a malevariant of AN.

Because EDs have severe consequences early diagnosisand effective treatment are very important. A problem, however,is that in the first stage EDs patients deny having eatingproblems, or feel too ashamed to seek help.

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Their disturbedeating behaviour is not yet experienced as a problem but asa solution for underlying problems such as low self esteem,negative body image and lack of emotion regulation and socialcoping strategies. In the first period of their ED patients are notmotivated for treatment, because they are afraid of losing theircontrol over food, gaining weight, and becoming fat.

Sooner or later ED patients are confronted with severephysical consequences such as emaciation, tiredness, lowbody temperature, amenorrhoea, abdominal pain, sore throat,osteoporosis, fertility problemspsychological consequences such as obsessive and compulsive thoughts about food andweight, lack of concentration, negative emotions, depression,suicidal thoughtsand social consequences such as distrust ofothers, isolation, and being unable to continue their educationor job.

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Confronted with these effects they often becomemotivated for treatment. Motivational interviewing can bevery helpful at this stage. ED patients are often first diagnosed and treated by a GPor psychologist. Severe EDs patients are admitted to a hospitalor a clinic for EDs.

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For BN cue-exposure is used in order to preventbinging and purging. Although antidepressants can helpto reduce binges and depression, medication is not the coretreatment for EDs. Effective treatments for EDs are cognitivebehavioural treatment, psychodynamic therapy, interpersonaltherapy, body oriented therapy and emotion-focused treatment. For young ED patients family therapy is very important. Recently mindfulness, acceptance and commitment therapy ACTand compassion therapy have proved fernando perez svorio metimas be usefulstrategies in the treatment of EDs.

Because of a lack of consensusabout the criteria for recovery these percentages vary greatlybetween different studies, which makes a comparison betweenoutcome studies debatable. For full recovery and prevention ofrelapse after treatment it is important that not only the disturbedeating behaviour is normalized and the physical consequences arereduced, but also the underlying problems are tackled. Importantcriteria for recovery from ED are healthy eating behaviour andweight, a positive body attitude, more self-esteem, and betteremotion regulation and social coping strategies.

She finished herPh. She did research at prevention of ED, risk factors and risk groups, chronicED, criteria for recovery and the process of recovery.

She has written several books about EDs, some together with Prof. Vandereycken from the LeuvenUniversity in Belgium. In a new book about Guidelines for Recovery from Eating Fernando perez svorio metimas will be published. Address for correspondence: Dr. The results of thisstudy indicate that long term treatment with antipsychoticmedication in females is likely to increase prolactin andto be associated hypo-gonadal state.

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Plasma prolactinlevels correlated positively with dose of antipsychotic andnegatively associated with SHBG concentrations in femalebut not male patients. In our report we do not provide dataon prolactin concentrations; however, changes in SHBGconcentrations were more evident in female patients.

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Our study has several limitations. We did not have placebotreated patients group for SHBG comparison.

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Therefore, wecannot conclude if changes in SHBG concentrations areassociated with psychosis or with effects of antipsychoticdrugs. In the future studies all factors, affecting SHBGconcentrations should be taken into account and the widerrange of endocrine measurements should be investigated. To compare different effects of specific antipsychotics onendocrine function of psychotic patients the larger samplesize is needed. In conclusions, the results of our study support earlierfindings that antipsychotics provide effective treatmentfor acute psychotic episode but may lead to endocrineabnormalities, such as decrease in SHBG concentrations.

Women are more vulnerable to this side effect of antipsychotictreatment, especially when treated with haloperidol. Theseverity of psychosis negatively correlates with SHBGconcentrations in men.

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Lieberman J. AmJ Psychiatry ; Antipsychotic-induced weight gain: a review of the literature. Journal ofClinical Psychiatry ;— Risperidone-associated diabetes mellitus:a pharmacovigilance study. Pharmacotherapy ;— A survey of reports of quetiapine-associatedhyperglycemia and diabetes mellitus. J Clin Psychiatry ;— Phenomenology of and risk factors for new-onset diabetes mellitusand diabetic ketoacidosis associated with atypical antipsychotics: an analysis of 45 publishedcases.

Annals of Clinical Psychiatry ;— The effects of antipsychotic therapy on serum lipids: a comprehensivereview.

Schiz Res ;— Sathyaprakash R, Henry RR. Hyperglycemia with antipsychotic treatment.

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Current DiabetesReports ;—5. Newcomer JW. Second-generation atypical antipsychotics and metabolic effects: acomprehensive literature review. CNS Drugs ;— Acute psychosis related to insufficient of thyroidfunction: a case report.

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Biological Psychiatry and Psychopharmacology ; 10 2 Brain development, XI: sexual dimorphism image,neuro. Am J Psychiatry ; Anthony M, Berg MJ.


Biologic and molecular mechanisms for sex differences inpharmacokinetics, pharmacodynamics, and pharmacogenetics, part I. Biologic and molecular mechanisms for sex differences inpharmacokinetics, pharmacodynamics, and pharmacogenetics, part II. Int J Toxicol ; — Weight gain with clozapine compared to first generationantipsychotic medications.

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Schizophr Bull ; Acute weight gain, gender, and therapeuticresponse to antipsychotics in the treatment of patients with schizophrenia. BMC Psychiatry; Gender-specific effect ofmetabolic syndrome on rate adjusted QT interval in middle-aged participants of an atherosclerosisprevention program.

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Wien Klin Wochenschr ; Drici MD, Clément N. Is gender a risk factor for adverse drug reactions? The example of druginducedlong QT syndrome. Drug Saf ; Sex differences inventricular repolarization: from cardiac fernando perez svorio metimas to torsades de pointes. Fundam ClinPharmacol ; Gender differences in the metabolic syndromeand their role for cardiovascular disease.

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Clin Res Cardiol ; Circ J ; Clin Exp Pharmacol Physiol; — Psychoneuroendocrinology ; 28 suppl 2 — Seeman MV. Secondary effects of antipsychotics: women at greater risk than men. SchizophrBull Sep;35 5 Gender Differences in the Prescribing of Antipsychotic Drugs. Am J Psychiatry; Anderson DC, Sex-hormone-binding globulin. Clinical Endocrinology 3: 69— Receptors for androgenbindingproteins: internalization and intracellular signalling. J Steroid Biochem Mol Biol ;—5.