The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Archives of Clinical Psychiatry |
Texto Completo: | https://www.revistas.usp.br/acp/article/view/144882 |
Resumo: | Background Delusional characteristics have been largely ignored in patients suffering from anorexia nervosa (AN). Objectives To review the literature on delusional features in AN from phenomenological, neurobiological, and clinical viewpoints. Methods Data were obtained through searches of Medline, PubMed, SciELO and Cochrane Library. Results Distorted beliefs in AN may range from an overvalued idea to an overt delusion, involving affective, personality and/or psychotic disorders. Studies confirm alterations in monoaminergic systems. It has also been seen a decreased integration of visual/proprioceptive information, and alterations in neural networks involved in body processing. It is known that body image distortion may present “delusional proportions” as a consequence of great concern about body. Concomitantly, “embodied defence hypothesis” has been proposed. Restrictive AN exhibits higher levels of delusionality, and a particular delusional type of AN has been suggested, associated with a worse long-term outcome. Low doses of atypical antipsychotics are recommended combined with cognitive techniques. Discussion Delusional thinking in AN is likely a dynamic and dimensional phenomenon that can vary, both in nature and/or severity, whereas high insight levels, before and after refeeding, result in positive outcomes. Neurobiological research on this topic must be encouraged, since clinical and phenomenological approaches are comparatively more frequently reported. |
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The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectivesAnorexia nervosadelusionsbody imageneurobiologyphenomenology Background Delusional characteristics have been largely ignored in patients suffering from anorexia nervosa (AN). Objectives To review the literature on delusional features in AN from phenomenological, neurobiological, and clinical viewpoints. Methods Data were obtained through searches of Medline, PubMed, SciELO and Cochrane Library. Results Distorted beliefs in AN may range from an overvalued idea to an overt delusion, involving affective, personality and/or psychotic disorders. Studies confirm alterations in monoaminergic systems. It has also been seen a decreased integration of visual/proprioceptive information, and alterations in neural networks involved in body processing. It is known that body image distortion may present “delusional proportions” as a consequence of great concern about body. Concomitantly, “embodied defence hypothesis” has been proposed. Restrictive AN exhibits higher levels of delusionality, and a particular delusional type of AN has been suggested, associated with a worse long-term outcome. Low doses of atypical antipsychotics are recommended combined with cognitive techniques. Discussion Delusional thinking in AN is likely a dynamic and dimensional phenomenon that can vary, both in nature and/or severity, whereas high insight levels, before and after refeeding, result in positive outcomes. Neurobiological research on this topic must be encouraged, since clinical and phenomenological approaches are comparatively more frequently reported.Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria2018-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/acp/article/view/14488210.1590/0101-60830000000148Archives of Clinical Psychiatry; v. 45 n. 1 (2018); 15-21Archives of Clinical Psychiatry; Vol. 45 No. 1 (2018); 15-21Revista de Psiquiatria Clínica; Vol. 45 Núm. 1 (2018); 15-211806-938X0101-6083reponame:Archives of Clinical Psychiatryinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/acp/article/view/144882/139109Copyright (c) 2018 Archives of Clinical Psychiatryinfo:eu-repo/semantics/openAccessBehar, RosaArancibia, MarceloGaete, María IsabelSilva, HernánMeza-Concha, Nicolás2018-03-29T16:34:04Zoai:revistas.usp.br:article/144882Revistahttp://www.hcnet.usp.br/ipq/revista/index.htmlPUBhttps://old.scielo.br/oai/scielo-oai.php||archives@usp.br1806-938X0101-6083opendoar:2018-03-29T16:34:04Archives of Clinical Psychiatry - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
title |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
spellingShingle |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives Behar, Rosa Anorexia nervosa delusions body image neurobiology phenomenology |
title_short |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
title_full |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
title_fullStr |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
title_full_unstemmed |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
title_sort |
The delusional dimension of anorexia nervosa: phenomenological, neurobiological and clinical perspectives |
author |
Behar, Rosa |
author_facet |
Behar, Rosa Arancibia, Marcelo Gaete, María Isabel Silva, Hernán Meza-Concha, Nicolás |
author_role |
author |
author2 |
Arancibia, Marcelo Gaete, María Isabel Silva, Hernán Meza-Concha, Nicolás |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Behar, Rosa Arancibia, Marcelo Gaete, María Isabel Silva, Hernán Meza-Concha, Nicolás |
dc.subject.por.fl_str_mv |
Anorexia nervosa delusions body image neurobiology phenomenology |
topic |
Anorexia nervosa delusions body image neurobiology phenomenology |
description |
Background Delusional characteristics have been largely ignored in patients suffering from anorexia nervosa (AN). Objectives To review the literature on delusional features in AN from phenomenological, neurobiological, and clinical viewpoints. Methods Data were obtained through searches of Medline, PubMed, SciELO and Cochrane Library. Results Distorted beliefs in AN may range from an overvalued idea to an overt delusion, involving affective, personality and/or psychotic disorders. Studies confirm alterations in monoaminergic systems. It has also been seen a decreased integration of visual/proprioceptive information, and alterations in neural networks involved in body processing. It is known that body image distortion may present “delusional proportions” as a consequence of great concern about body. Concomitantly, “embodied defence hypothesis” has been proposed. Restrictive AN exhibits higher levels of delusionality, and a particular delusional type of AN has been suggested, associated with a worse long-term outcome. Low doses of atypical antipsychotics are recommended combined with cognitive techniques. Discussion Delusional thinking in AN is likely a dynamic and dimensional phenomenon that can vary, both in nature and/or severity, whereas high insight levels, before and after refeeding, result in positive outcomes. Neurobiological research on this topic must be encouraged, since clinical and phenomenological approaches are comparatively more frequently reported. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/acp/article/view/144882 10.1590/0101-60830000000148 |
url |
https://www.revistas.usp.br/acp/article/view/144882 |
identifier_str_mv |
10.1590/0101-60830000000148 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/acp/article/view/144882/139109 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Archives of Clinical Psychiatry info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Archives of Clinical Psychiatry |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria |
dc.source.none.fl_str_mv |
Archives of Clinical Psychiatry; v. 45 n. 1 (2018); 15-21 Archives of Clinical Psychiatry; Vol. 45 No. 1 (2018); 15-21 Revista de Psiquiatria Clínica; Vol. 45 Núm. 1 (2018); 15-21 1806-938X 0101-6083 reponame:Archives of Clinical Psychiatry instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Archives of Clinical Psychiatry |
collection |
Archives of Clinical Psychiatry |
repository.name.fl_str_mv |
Archives of Clinical Psychiatry - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||archives@usp.br |
_version_ |
1800237624173002752 |