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Orthorexia nervosa: cultural product or mental illness/Ortorexia nervoasa: produs cultural sau boala psihica?

INTRODUCTION

Each epoch has had another dominant form of manifestation of anxiety; if the late nineteenth century--early twentieth century, anxiety took the form of hysteria and neurosis, it is currently wearing the mask of eating disorders.

Turning on the TV or surfing the Internet, we are faced with the inevitable concern of the excess body weight compared with healthy eating, organic, vegan recipes and raw-vegan diet. As the average weight of Americans increases and obesity is becoming an increasingly pressing problem in the world, the image of the ideal beauty becomes, more and more, emaciated. This discrepancy contributes to the formation of a real storm of perfectionism and low self-esteem, which amplifies eating disorders (1).

DEFINITION OF THE CONCEPT

Orthorexia nervosa is a new concept, described by the doctor Steven Bratman, in 1997. The concept has its origins in Greek, orthos meaning "right", "just" and orexis--"hunger", "appetite". Orthorexia nervosa stands for the obsession to eat healthy (2). Unlike patients with anorexia or bulimia, which are concerned about the amount of food ingested, patients with orthorexia nervosa are concerned about the quality of food consumed. That's why the obsession with purely biological food and stores selling it leads to a particular lifestyle. In extreme cases, the obsessive and compulsive characteristics of orthorexia nervosa cross the borders of normality and start to dominate the person's life. Thus, it can lead to the adoption of very strict diet leading to the cancellation of essential nutrients. The restrictive diets and genuine food plans, combined with an attitude of superiority over those who do not accept these concepts and an obsessive phobic behavior, define the essence of orthorexia nervosa. The concern for the quality of food and eating healthy is the centre piece of this disorder (3).

There are currently no inclusion of orthorexia nervosa among the eating disorders, not yet being established its mental disease character. However, there is increasingly more clinical reports that show that this phenomenon develops. Orthorexia nervosa is thus a new and controversial concept (2).

TOOLS OF EVALUATION

There have been developed two tools for assessing orthorexia nervosa. The Bratman test is mainly based on clinical experience, its validity not being investigated. In 2005, Donini have developed ORTHO-15 Scale based on the Bratman's test. Even this instrument includes items not specific to orthorexia nervosa, making their validity questionable. Thus the ORTHO-11 Scale, the only update in a foreign language of ORTHO-15 was developed after removal of four nonspecific items to orthorexia nervosa based on statistical considerations. Psychometric properties of ORTHO-15 were partly examined by the authors of the original test. Because there was not well-defined group of individuals with orthorexia nervosa, Donini has proposed a cut-off point to differentiate patients with orthorexia nervosa from those who don't have it, based on the relationship between ORTHO-15 scores and phobic obsessive personality traits, measured with Minnesota Multiphasic Personality Inventory. A further limitation represents the inadequate description of the methods of scoring (2, 8, 11).

ORTHO-15 is an assessment tool of orthorexia nervosa, composed of 15 items with multiple answers (always, often, sometimes, never). The items aim the selection, preparation, eating, effect and attitude towards what is considered a healthy diet of the subjects concerned. The authors of the original test assumed three factors: cognitive-rational (items 1, 5, 6, 11, 12, 14), clinical (items 3, 7, 8, 9, 15) and emotional (2.4,10:13) (2.3).

CAUSES, SIGNS AND FEATURES

Although there is still no clear criteria for the classification of orthorexia nervosa, there is a controversion over its inclusion in the eating disorders group or in the obsessive-phobic disorders. Donini considered that orthorexia nervosa can only be diagnosed in the presence of eating disorders ("health fanatic") and the phobic-obsessive personality traits (6).

Following clinical trials that tried to facilitate a better understanding of the characteristics of orthorexia nervosa, it was observed that the main difference between a person with this disorder and a person aware of the need to maintain their health is extreme concern, that becomes an obsession for the quality of the food, and also the critical attitude towards the entourage who doesn't follow a healthy diet according to their point of view. Orthorexia nervosa starts where diet becomes an "escape" from ones existence, daily activities are dominated by planning, purchasing and preparation of healthy food. Violation of these self-imposed rules, leading to intense anxiety, feelings of guilt and shame, and is followed, most of the times by more stringent food restrictions. Orthorexia nervosa relates to a false sense of safety (preventing illness), the urge to exercise control over one's life (eliminating the unpredictable), a masked conformism (food philosophy of helping to shape the sub-conscious integration into a cultural model accepted of what an ideal body should be) and also with a search for spirituality and identity and a desire to restrain oneself from different things (10).

The International Eating Disorder Institute has developed a number of features of the manifestation of orthorexia nervosa from the limited statistical literature and clinical cases reports. Thus, the patient comes to plan the menu for more than 24 hours in advance, for a long period of time, dominating his daily activities. As the patient spends more time and resources on quality control and provenance of the food that they ingest, the quality of their life decreases by the highly rigid and restrictive character it becomes. Also, in severe cases, can lead to social isolation even by refusing to eat somewhere other than home, where the patient believes it can have absolute control over the origin, quality and preparation of food. The general attitude is critical to people who do not share their belief about food. However, the patient reports his value in the ability to maintain his lifestyle considered ideal. Any deviation from this creates feelings of guilt, leading to lower self-esteem and anxiety symptoms, thus causing even greater strictness and rigidity of his self-imposed rules. The patient assigns an exaggerated importance of healthy eating, beginning to refer to it as "pure", "clean", "right" and rejecting the other foods that he considers as true enemies (4, 5, 12).

Sometimes, the food choices are so restrictive in variety and caloric value, that it becomes unhealthy, causing an ironic twist for those concerned with diet and, hence, a healthy lifestyle.

According to a review that analysed 11 studies, the average prevalence in the general population of ortorhexia nervosa is 6.9 % and between 35 and 57.8 % in high-risk populations: medical professionals (especially dieticians), artists, athletes (7, 9). Unlike anorexia nervosa and bulimia, which are significantly more common among women, ortorhexia nervosa occurs more often in men. Other risk factors include features of obsessive-compulsive disorder and other eating disorders and also increased socioeconomic status (4).

Among the main causes of the onset of ortorhexia are family habits, social trends, recent illnesses and finding a negative information about a certain food. However, the literature forwarded the hypothesis that orthorexia nervosa installs easily on land by premorbid obsessive-compulsive personality disorder, a tendency to perfectionism, rigor, rigidity and intolerance (4, 5). Also, the literature submits the hypothesis that ortorhexia nervosa installs easily on a patient with a susception to an obsessive-compulsive disorder, a tendency to perfectionism, rigor, rigidity and intolerance (4, 5).

DISCUSSIONS

Orthorexia nervosa is a new concept that can remain a simple consequence of the current socio-cultural cliches dictated by the stringent images of an ideal lifestyle, or can pass the test of time, being ranked among mental disorders, and also being classified as an eating disorder or as a manifestation of an obsessivecompulsive disorder. On one hand, orthorexia nervosa is a disruption of eating behavior that is potentially threatening in the long-term to health by various deficiencies given by the absence of important nutrients and also has the worst consequences in social integration, given by the tendency to isolation, criticism and intolerance towards those who don't share the same views. In this way, it finds its correspondence in the general definition of eating disorders. On the other hand, ortorhexia nervosa has an obsessive component about the quality of ingested food, that gets to bring greater satisfaction in menu planning and even the ritualization of the menu than by actually eating. Also, it becomes time consuming, the patient's existence being focused around rigorous analysis of each food (Figure no. 1). Any deviation of those rules brings great anxiety, reinforcing the idea of an obsessive component present and even a phobic (towards the food considered harmful) component of ortorhexia nervosa.

CONCLUSION

Despite the fact that ortorhexia nervosa is currently having an uncertain status, being at the border between normal and pathological, although, now it has not found its proper place, being situated between eating and obsessive-compulsive disorders, ortorhexia nervosa is not a purely theoretical concept, but a reality with plurifactorial causes, becoming more and more common between medical professionals, raising real concerns about its impact on physical health, quality of life and also social integration. This phenomenon leaves us the following question: Is orthorexia nervosa simply a cultural[micro]product or a true mental illness?

[FIGURE 1 OMITTED]

ACNOWLEDGEMENTS AND DISCLOSURE

The authors declare that they have no potential conflicts of interest to disclose.

REFERENCES

(1.) http://www.psychiatrictimes.com/authors/marie-sacco-phd, Orthorexia Nervosa: Disease That Masquerades as Health

(2.) When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary, Varga, M., Thege, B. K., Dukay-Szabo, S., Tury, F., van Furth, E. F. BMC Psychiatry. 2014 Feb 28;14:59. doi: 10.1186/1471-244X-14-59

(3.) Adaptation of the ORTHO-15 test to Polish women and men, Brytek-Matera, A., Krupa, M., Poggiogalle, E., Donini, L. M., Eat Weight Disord. 2014 Mar;19(1):69-76. doi: 10.1007/s40519-014-0100-0. Epub 2014 Jan 22

(4.) [Orthorexia nervosa and if s background factors], Varga, M., Dukay-Szabo, S., Tury, F., Ideggyogy Sz. 2013 Jul 30;66(78):220-7. Review. Hungarian

(5.) Evidence and gaps in the literature on orthorexia nervosa, Varga, M., Dukay-Szabo, S., Tury, F., van Furth, E. F., Eat Weight Disord. 2013 Jun;18(2):103-11. doi: 10.1007/s40519-013-0026-y. Epub 2013 Apr 12. Erratum in: Eat Weight Disord. 2013 Jun; 18(2):113. van Furth Eric, F. [corrected to van Furth, Eric F.]

(6.) [Orthorexia--a new diagnosis?], Janas-Kozik, M., Zejda, J., Stochel, M., Brozek, G., Janas, A., Jelonek, I., Psychiatr Pol. 2012 May-Jun; 46(3):441-50. Review. Polish

(7.) Orthorexia nervosa: a frequent eating disordered behavior in athletes, Segura-Garcia, C., Papaianni, M. C., Caglioti, F., Procopio, L., Nistico, C. G., Bombardiere, L., Ammendolia, A., Rizza, P., De Fazio, P., Capranica, L., Eat Weight Disord. 2012 Dec;17(4):e226-33. doi: 10.3275/8272. Epub 2012. Feb 21

(8.) Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO15), Ramacciotti, C. E., Perrone, P., Coli, E., Burgalassi, A., Conversano, C., Massimetti, G., Dell'Osso, L., Eat Weight Disord. 2011 Jun;16(2):e127-30

(9.) Eating behaviour and eating disorders in students of nutrition sciences, Korinth, A., Schiess, S., Westenhoefer, J., Public Health Nutr. 2010 Jan;13(1):32-7. doi: 10.1017/S1368980009005709. Epub 2009, May 12

(10.) [Orthorexia nervosa. A new eating behavior disorder?], Catalina Zamora, M. L., Bote Bonaechea, B., Garcia Sanchez, F., Rios Rial, B., Actas Esp Psiquiatr. 2005 Jan-Feb;33(1):66-8. Spanish

(11.) Orthorexia nervosa: validation of a diagnosis questionnaire, Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M., Cannella, C., Eat Weight Disord. 2005 Jun;10(2):e28-32

(12.) www.iedinstitute.com

(13.) Kaplan & Sadock--Manual de buzunar de psihiatrie clinica, Sadock, B. J., Sadock, V. A, editia a IlI-a, Ed. Medicala, 2001

(14.) DSM-5, American Psychiatric Association, 2013
Table I. Signs of orthorexia nervosa according to International
Eating Disorder Institute (12)

1. Planning of the daily menu with more than 24 hours in advance;

2. Greater satisfaction given by the alleged virtues of eating
healthy than that of actually eating the food;

3. Decreased quality of life in proportion to the increase in food
quality;

4. Increased rigidity and self-critical attitude towards food diet;

5. Define self-esteem and one's own value by the quality of food
ingested;

6. Critical attitude towards people who do not share the same
beliefs about food;

7. Excessive control over food origin;

8. Feelings of guilt when consuming food considered "incorrect";

9. Healthy food is described as being "pure", "clean", "right".


INTRODUCERE

Fiecare epoca a avut o alta forma dominanta de manifestare a anxietatii; daca la sfarsitul secolului al XIX-lea--inceputul secolului al XXlea, anxietatea imbraca forma isteriei si a nevrozei, in prezent, aceasta poarta masca tulburarilor alimentare.

Deschizand televizorul sau navigand pe Internet, ne confruntam, inevitabil, cu o preocupare excesiva fata de greutatea corporala, fata de alimentatia sanatoasa, bio, retete si diete vegane sau raw-vegane. Pe masura ce greutatea medie a americanilor creste, iar obezitatea devine o problema tot mai stringenta la nivel mondial, imaginea frumusetii ideale devine tot mai emaciata. Aceasta discrepanta contribuie la formarea unei veritabile furtuni de perfectionism si stima de sine scazuta, amplificand tulburarile alimentare (1).

DEFINIREA CONCEPTULUI

Ortorexia nervoasa este un nou concept, descris de medicul Steven Bratman, in anul 1997. Notiunea isi are originile in limba greaca, orthos insemnand "corect", "drept", iar orexis, "foame", "apetit". Ortorexia nervoasa denumeste obsesia pentru alimentatia sanatoasa (2). Spre deosebire de pacientii cu anorexie sau cu bulimie, care sunt preocupati de cantitatea de alimente ingerate, pacientii cu ortorexie nervoasa sunt preocupati de calitatea alimentelor consumate. Astfel, obsesia pentru alimente pur biologice si pentru magazinele care le comercializeaza conduce la crearea unui stil de viata particular. In cazurile extreme, caracteristicile obsesive si compulsive ale ortorexiei nervoase trec granitele patologicului si ajung sa domine viata persoanei. Astfel, se poate ajunge pana la adoptarea unor diete extrem de stricte, avand ca ecou suprimarea unor nutrienti esentiali. Dieta restrictiva si veritabilele planuri alimentare, combinate cu o atitudine de superioritate fata de cei care nu adera la aceste concepte si un comportament obsesiv-fobic definesc esenta ortorexiei nervoase.

Preocuparea pentru calitatea mancarii si pentru a manca sanatos reprezinta elementul central al acestei tulburari (3).

Nu exista, in prezent, nicio categorizare a ortorexiei nervoase printre tulburarile alimentare, nefiind inca stabilit nici caracterul de tulburare psihica a acesteia. Cu toate acestea, exista din ce in ce mai multe rapoarte clinice, care arata ca acest fenomen ia amploare. Ortorexia nervoasa este, astfel, un concept nou si controversat (2).

INSTRUMENTE DE EVALUARE

S-au elaborat doua instrumente pentru evaluarea ortorexiei nervoase. Testul Bratman se bazeaza, in special, pe experienta clinica, validitatea sa nefiind insa investigata. In anul 2005, Donini si colaboratorii au dezvoltat Scala ORTHO-15 bazata pe testul lui Bratman. Chiar si acest instrument include itemi nespecifici ortorexiei nervoase, facandu-i validitatea indoielnica. Astfel, Scala ORTHO-11, singura actualizare intr-o limba straina a lui ORTHO15, a fost elaborata in urma inlaturarii a patru itemi nespecifici ortorexiei nervoase, pe baza unor considerente statistice. Proprietatile psihometrice ale lui ORTHO-15 au fost examinate doar partial de catre autorii testului original. Din cauza faptului ca nu s-a beneficiat de un grup bine definit de indivizi cu ortorexie nervoasa, Donini si colaboratorii au propus un element de discriminare pentru a diferentia pacientii cu ortorexie nervoasa de cei fara, pe baza interrelatiei dintre scorurile OTHO-15 si trasaturile de personalitate obsesiv-fobice, masurate cu Minnesota Multiphasic Personality Inventory. O limitare suplimentara o reprezinta descrierea inadecvata a metodelor de scorare (2, 8, 11).

ORTHO-15 este un instrument de evaluare a ortorexiei nervoase, cuprinzand 15 itemi cu raspuns multiplu (mereu, frecvent, uneori, niciodata). Itemii vizeaza selectarea, prepararea, consumul, efectul si atitudinea fata de ce este considerat o alimentatie sanatoasa de catre subiectii vizati. Autorii testului original si-au asumat trei factori: cel cognitiv-rational (itemii 1, 5, 6, 11, 12, 14), cel clinic (itemii 3, 7, 8, 9, 15) si cel emotional (2, 4, 10, 13) (2, 3).

CAUZE, SEMNE, PARTICULARITATI

Cu toate ca nu exista inca criterii clare de clasificare a ortorexiei nervoase, este in curs o controversa legata de incadrarea acesteia fie in grupul tulburarilor alimentare, fie in cel al tulburarilor obsesiv-fobice. Donini considera ca ortorexia nervoasa poate fi diagnosticata doar in prezenta tulburarilor de comportament alimentar ("health fanatic"), cat si a unor trasaturi de personalitate obsesiv-fobice (6).

In urma unor studii clinice menite sa faciliteze o mai buna intelegere a caracteristicilor ortorexiei nervoase, s-a observat ca principala diferenta dintre o persoana cu aceasta tulburare si o persoana constienta de necesitatea mentinerii propriei sanatati este preocuparea extrema, care merge pana la obsesie, pentru calitatea mancarii, precum si atitudinea critica fata de anturajul care nu urmeaza o dieta sanatoasa conform acceptiunii lor. Ortorexia nervoasa incepe acolo unde dieta devine o "evadare" din propria existenta, activitatile cotidiene fiind dominate de planificarea, achizitionarea si prepararea produselor alimentare sanatoase. Incalcarea acestor reguli autoimpuse conduce la anxietate intensa, sentimente de vinovatie si de rusine si este urmata, de cele mai multe ori, de restrictii alimentare si mai stringente. Ortorexia nervoasa se relationeaza cu un sentiment iluzoriu de siguranta (previne imbolnavirea), cu nevoia imperioasa de a exercita un control absolut asupra propriei vieti (eliminarea imprevizibilului), un conformism mascat (filosofia alimentara ajutand, intr-o forma subconstienta, integrarea intr-un model cultural acceptat a ceea ce inseamna un corp frumos) si, totodata, cu o cautare a spiritualitatii si a identitatii, precum si cu o dorinta de autoprivatiune (10).

International Eating Disorder Institute a elaborat o serie de caracteristici ale manifestarii ortorexiei nervoase pe baza putinelor date statistice din literatura, cat si a cazurilor clinice raportate. Astfel, pacientul ajunge sa isi planuiasca meniul cu mai mult de 24 de ore in avans, pe o perioada indelungata de timp, acest aspect dominandu-i activitatile cotidiene. Pe masura ce pacientul investeste mai mult timp si resurse in controlul calitatii si provenientei alimentelor pe care le ingera, calitatea vietii sale scade, prin caracterul extrem de rigid si de restrictiv pe care il capata. De asemenea, in cazurile mai severe, se poate ajunge chiar la izolare sociala, prin refuzul de a mai manca in alta parte decat acasa, acolo unde pacientul considera ca poate avea un control absolut asupra provenientei, calitatii si modului de preparare a mancarii. Atitudinea generala este una critica fata de persoanele care nu-i impartasesc crezul alimentar. Totodata, pacientul isi raporteaza propria valoare la capacitatea de a-si mentine stilul de viata considerat ideal. Orice abatere de la acesta creeaza sentimente de vinovatie, duce la scaderea stimei de sine si la manifestari anxioase, determinand, in consecinta, o si mai mare rigurozitate si rigiditate a regulilor alimentare autoimpuse. Pacientul atribuie o importanta exagerata alimentatiei sanatoase, ajungand sa se refere la aceasta ca fiind "pura", "curata", "corecta" si respingand celelalte alimente pe care le considera ca veritabili inamici (4, 5, 12).

Uneori, alegerile alimentare sunt atat de restrictive ca varietate, cat si ca valoare calorica, incat devin nesanatoase, determinand o turnura ironica pentru persoanele preocupate de o dieta si, implicit, de un stil de viata sanatos.

Conform unei publicatii de tip review, care analizeaza 11 studii, prevalenta medie a ortorexiei nervoase in populatia generala este de 6,9 % si intre 35 si 57,8 %, in populatiile cu risc inalt: profesionisti din domeniul medicinii (in special dieteticienii), artisti, sportivi (7, 9). Spre deosebire de anorexia nervoasa si de bulimie, care sunt net mai frecvente in randul populatiei feminine, ortorexia nervoasa apare mai des la barbati. Alti factori de risc includ trasaturile obsesiv-compulsive, alte tulburari alimentare, precum si statutul socio-economic crescut (4).

Printre cauzele precipitante ale debutului ortorexiei sunt citate obiceiurile familiale, tendintele sociale, bolile recente, precum si aflarea unei informatii negative despre un aliment. Totodata, literatura inainteaza ipoteza conform careia ortorexia nervoasa se instaleaza mai usor pe un teren premorbid de personalitate obsesiv-compulsiva, cu tendinta la perfectionism, rigurozitate, rigiditate si intoleranta (4, 5).

DISCUTII

Ortorexia nervoasa este un concept nou care poate ramane o simpla consecinta a unor clisee socio-culturale actuale, dictate de imaginile exigente ale unui stil de viata ideal, sau poate trece proba timpului, clasandu-se in randul tulburarilor psihice, urmand a se stabili incadrarea acesteia fie ca tulburare alimentara, fie ca manifestare a tulburarii obsesiv-compulsive. Pe de o parte, ortorexia nervoasa constituie o perturbare a comportamentului alimentar, care, pe termen lung, este potential amenintatoare pentru sanatatea fizica prin diversele carente date de absenta unor principii alimentare, cat si pentru functionarea psihosociala, data de tendinta la izolare si de atitudinea critica si intoleranta fata de anturajul care nu impartaseste aceleasi opinii. Astfel, isi gaseste corespondent in definirea generala a tulburarilor alimentare. Pe de alta parte, ortorexia nervoasa are o componenta obsesiva legata de calitatea alimentelor ingerate, care ajunge sa aduca o mai mare satisfactie prin planuirea si chiar ritualizarea meniului decat prin mancatul in sine. Totodata, devine o mare consumatoare de timp, existenta pacientului concentrandu-se in jurul analizei riguroase a fiecarui aliment in parte (figura nr. 1). Orice abatere aduce cu sine anxietate marcata, intarind ideea componentei obsesive si chiar fobice (fata de alimentele considerate nocive) a ortorexiei nervoase (10, 13, 14).

CONCLUZII

In ciuda faptului ca ortorexia nervoasa are, in prezent, un statut incert, aflandu-se la granita dintre normal si patologic, cu toate ca deocamdata, aceasta nu si-a gasit cea mai adecvata incadrare, situandu-se intre tulburarile alimentare si tulburarile obsesiv-compulsive, ortorexia nervoasa nu este o notiune pur teoretica, ci o realitate cu determinare plurifactoriala, din ce in ce mai frecvent intalnita de specialistii din domeniul medical, ridicand veritabile probleme cu privire la consecintele sale asupra starii de sanatate fizica, cat si a calitatii vietii si a functionarii sociale. Acest fenomen ramane un subiect de studiu deschis, mentinandu-se dilema: ortorexia nervoasa este un simplu produs cultural sau o adevarata boala psihica?

[FIGURA 1 OMITIR]

Ilinca Untu--M. D., Drd., "Gr. T. Popa" University of Medicine and Pharmacy, Iasi; Resident in psychiatry, "Socola" Clinical Psychiatric Hospital, Iasi, Romania

Roxana Chirita--M. D., Ph. D., Professor, Department of Psychiatry, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi; Senior Psychiatrist, "Socola" Clinical Psychiatric Hospital, Iasi, Romania

Dania Andreea Radu--M. D., Drd., "Gr. T. Popa" University of Medicine and Pharmacy, Iasi; Resident in psychiatry, Clinical Psychiatric Hospital, Iasi, Romania

Anamaria Ciubara--M. D., Ph. D., Assistant Professor, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Department of Psychiatry; Psychiatrist, "Socola" Clinical Psychiatric Hospital, Iasi, Romania

Lucian Stefan Burlea--M. D., Ph. D., Postdoctoral researcher, Assistant Professor, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania

Ilinca Untu--Doctorand, Universitatea de Medicina si Farmacie "Gr. T. Popa", Iasi; Medic Rezident Psihiatru, Spitalul Clinic de Psihiatrie "Socola", Iasi, Romania

Roxana Chirita--Profesor universitar, Universitatea de Medicina si Farmacie "Gr. T. Popa", Iasi; Medic Primar Psihiatru, Spitalul Clinic de Psihiatrie "Socola", Iasi, Romania

Dania Andreea Radu--Doctorand, Universitatea de Medicina si Farmacie "Gr. T. Popa", Iasi; Medic Rezident Psihiatru, Spitalul Clinic de Psihiatrie "Socola", Iasi, Romania

Anamaria Ciubara--Sef de Lucrari, Universitatea de Medicina si Farmacie "Gr. T. Popa", Iasi; Medic Specialist Psihiatru, Spitalul Clinic de Psihiatrie "Socola", Iasi, Romania

Lucian Stefan Burlea--M. D., Ph. D., Cercetator post-doctoral, Asistent universitar, Universitatea de Medicina si Farmacie "Gr. T. Popa", Iasi, Romania

MULTUMIRI SI DEVOALARI

Autorii declara ca nu au potentiale conflicte de interese declarate in legatura cu acest articol.

BIBLIOGRAFIE

(1.) http://www.psychiatrictimes.com/authors/marie-sacco-phd, Orthorexia Nervosa: Disease That Masquerades as Health

(2.) When eating healthy is not healthy: orthorexia nervosa and its measurement with the ORTO-15 in Hungary, Varga, M., Thege, B. K., Dukay-Szabo, S., Tury, F., van Furth, E. F. BMC Psychiatry. 2014 Feb 28;14:59. doi: 10.1186/1471-244X-14-59

(3.) Adaptation of the ORTHO-15 test to Polish women and men, Brytek-Matera, A., Krupa, M., Poggiogalle, E., Donini, L. M., Eat Weight Disord. 2014 Mar;19(1):69-76. doi: 10.1007/s40519-014-0100-0. Epub 2014 Jan 22

(4.) [Orthorexia nervosa and if s background factors], Varga, M., Dukay-Szabo, S., Tury, F., Ideggyogy Sz. 2013 Jul 30;66(78):220-7. Review. Hungarian

(5.) Evidence and gaps in the literature on orthorexia nervosa, Varga, M., Dukay-Szabo, S., Tury, F., van Furth, E. F., Eat Weight Disord. 2013 Jun; 18(2):103-11. doi: 10.1007/s40519-013-0026-y. Epub 2013 Apr 12. Erratum in: Eat Weight Disord. 2013 Jun; 18(2):113. van Furth Eric, F. [corrected to van Furth, Eric F.]

(6.) [Orthorexia--a new diagnosis?], Janas-Kozik, M., Zejda, J., Stochel, M., Brozek, G., Janas, A., Jelonek, I., Psychiatr Pol. 2012 May-Jun; 46(3):441-50. Review. Polish

(7.) Orthorexia nervosa: a frequent eating disordered behavior in athletes, Segura-Garcia, C., Papaianni, M. C., Caglioti, F., Procopio, L., Nistico, C. G., Bombardiere, L., Ammendolia, A., Rizza, P., De Fazio, P., Capranica, L., Eat Weight Disord. 2012 Dec;17(4):e226-33. doi: 10.3275/8272. Epub 2012. Feb 21

(8.) Orthorexia nervosa in the general population: a preliminary screening using a self-administered questionnaire (ORTO15), Ramacciotti, C. E., Perrone, P., Coli, E., Burgalassi, A., Conversano, C., Massimetti, G., Dell'Osso, L., Eat Weight Disord. 2011 Jun;16(2):e127-30

(9.) Eating behaviour and eating disorders in students of nutrition sciences, Korinth, A., Schiess, S., Westenhoefer, J., Public Health Nutr. 2010 Jan;13(1):32-7. doi: 10.1017/S1368980009005709. Epub 2009, May 12

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(12.) www.iedinstitute.com

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(14.) DSM-5, American Psychiatric Association, 2013

Correspondence:

ANAMARIA CIUBARA

"Socola" Clinical Psychiatric Hospital No. 36 Sos. Bucium, code 700282, Iasi, Romania

Phone: +40 232 430 920/int. 142

E-mail: anamburlea@yahoo.com

Date of Submission: December, 18, 2013

Acceptance: January, 22, 2014

Corespondenta:

ANAMARIA CIUBARA

Spitalul Clinic de Psihiatrie "Socola" Soseaua Bucium nr. 36, cod 700282, Iasi, Romania

Tel.: +40 232 430 920/int. 142

E-mail: anamburlea@yahoo.com

Primit: Decembrie, 18, 2013

Acceptat: ianuarie, 22, 2014
Tabel 1: Semne ale ortorexiei nervoase conform International Eating
Disorder Institute (12)

1. Planuirea meniului zilnic cu mai mult de 24 ore in avans;

2. Satisfactie mai mare data de presupusa virtute a mancatului
sanatos decat cea oferita de consumarea alimentelor in sine;

3. Scaderea calitatii vietii proportional cu cresterea calitatii
alimentelor;

4. Rigiditate crescuta si atitudine autocritica fata de dieta
alimentara;

5. Definirea stimei de sine si a propriei valori prin calitatea
alimentelor ingerate;

6. Atitudine critica fata de persoanele care nu impartasesc acelasi
crez alimentar;

7. Control excesiv asupra provenientei mancarii;

8. Sentimente de vinovatie la consumul de alimente "incorecte";

9. Descrierea mancarii considerate sanatoase ca fiind "pura",
"curata", "corecta".
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Author:Untu, Ilinca; Chirita, Roxana; Radu, Dania Andreea; Ciubara, Anamaria; Burlea, Lucian Stefan
Publication:Bulletin of Integrative Psychiatry
Article Type:Report
Date:Jun 1, 2014
Words:4397
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