Fundamentando-se nas perspectivas teóricas da análise do discurso de linha francesa e da psicanálise lacaniana, busca-se investigar o significante corpo em uma paciente anoréxica. Considerando-se que o caráter primordial do significante se exerce em relação ao sujeito, buscamos compreender o sujeito anoréxico através da investigação do significante corpo. O material analisado foi constituído por uma entrevista semi-estruturada, realizada com uma paciente diagnosticada como anoréxica, em tratamento no Hospital das Clínicas de Ribeirão Preto da Faculdade de Medicina da Universidade de São Paulo. De acordo com os referenciais teóricos, a análise dos dados foi qualitativa e obedeceu ao paradigma indiciário. A análise da entrevista permitiu-nos observar que o significante \"corpo\" atrelou-se aos significantes \"peso\" e \"alimentação\" em uma mesma cadeia: como \"a única coisa que eu consigo controlar na minha vida\". O significante corpo constituiu, para o sujeito, a via encontrada na busca por sua alteridade. Desse modo, essa cadeia significante veio compor a ordem da identidade e da alteridade, sob a égide do (sem)controle. Concluímos que a queixa muda da anoréxica, enunciada sob o comportamento da recusa alimentar, era dirigida ao Outro como uma tentativa de alcançar sua alteridade. / Basing theoretical perspectives of analysis on the discourse of the Lacanian and the French line of psychoanalysis, the body signifier of an anorexic patient was investigated. Remembering that the primordial character of the signifier exerts an influence on the subject, we attempted to understand the anorexic individual through an investigation of body signifiers. The analyzed material was formed from a semi-structured interview of a patient diagnosed as anorexic, who was being treated in the Teaching Hospital das Clínicas, University of São Paulo, Ribeirão Preto. According to theoretical references, data analysis was qualitative and followed the indicated paradigm. Analysis of the interview allowed us to observe that the body signifier was linked to the ?weight? and ?feeding? signifiers in a single chain, as ?the only thing that I can control in my life?. The body signifier constituted, for the individual, the way the patient found to identify her alterity. Thus, this signifier chain established the order of the identity and alterity, by the support of (lack of)control. In conclusion, the silent complaint of anorexia, confirmed by the behavior of refusing to eat, is directed at the ?Big Other? in an attempt to attain alterity.

Os transtornos alimentares se caracterizam por comportamentos inadequados no consumo e padrão alimentar, além de crenças equivocadas sobre alimentação, que ocasionam uma piora da qualidade nutricional. Os Transtornos alimentares são determinados por uma etiologia multifatorial, onde os fatores socioculturais, as diferenças étnicas e psicossociais, associados à vulnerabilidade biológica, tem grande importância no desencadeamento, manutenção e perpetuação dos sintomas alimentares. Na Anorexia Nervosa o medo intenso ou mórbido de engordar representa o aspecto psicopatológico central desta doença. Estes pacientes caracterizam-se por uma excessiva perturbação da imagem corporal e pela busca incessante da magreza. Em função do medo de engordar, são incapazes de manter o peso em medidas ideais, além de apresentarem comportamentos alimentares inadequados na intenção de perpetuar o baixo peso. Para a compreensão dinâmica da personalidade destes pacientes é de extrema importância o conhecimento da personalidade na patogênese e patoplastia deste transtorno. Neste sentido, o Inventário de Temperamento e Caráter avalia fatores de temperamento e caráter aplicados à percepção dos traços de personalidade de pacientes com o transtorno alimentar, no caso, Anorexia Nervosa. Este trabalho teve como o objetivo avaliar os traços de personalidade, segundo o Inventário de Temperamento e Caráter (ITC), em pacientes com anorexia nervosa e compara-los a um grupo controle. Os RESUMO resultados indicaram que estes pacientes apresentam características sóciodemográficas de uma população jovem, com início do transtorno na adolescência, composta por mulheres, de etnia branca e solteiras. Os pacientes com Anorexia Nervosa diferenciam-se do grupo controle devido à presença de sintomatologia depressiva moderada pelo BDI. Além disso, na avaliação de personalidade confirmou-se a presença de elevados traços em esquiva ao dano e diminuídos em autodirecionamento nos pacientes com AN comparados aos controles normais. Houve diferenciação entre o grupo restritivo e purgativo na dimensão busca de novidades. A exclusão de pacientes com sintomatologia depressiva grave não interferiu na análise dos resultados dos traços de personalidade. / The eating disorders are characterized by behavior not good in consumption and dietary patterns, and wrong beliefs about diet that cause a worser nutritional quality. The Eating disorders are determined by a multifactorial etiology, where the sociocultural factors, psychosocial and ethnic differences associated to the biological vulnerability, have been great importance in triggering, maintenance and perpetuation of food´s symptoms. In anorexia nervosa the intense fear or morbid to be fat is the psychopathological central aspect of this disease. These patients are characterized by an excessive disturbance of theirs body image and the incessant quest for thinness. Depending on the fear of fat, are unable to keep the weight on measures ideals, and doing inadequate eat in order to perpetuate the low weight. To understand the dynamics of personality of these patients is very important knowledge of the personality and patoplasty in the pathogenesis of this disorder. In this case the Inventory of Temperament and Character value factors of temperament and character applied to the perception of the personality traits of patients with the eating disorder, in the case, anorexia nervosa. This study have been evaluate how the traits of personality, according to the inventory of Temperament and Character (ITC) in patients to anorexia nervosa and compares them to a control group. The results indicated that these patients present social-demographic characteristics of a young population, beginning the disorder in adolescence, composed of women, which ethnic white and single. Patients with anorexia nervosa are differentiated from the ABSTRACT control group because of the presence of moderate depressive symptoms by BDI. Also, the personality avaliation is confirmed the presence of high traits damage and reduced in selfdirection in patients with AN compared with normal controls. There was differentiation between the restrictive group and purgative in a dimension a search of news. The exclusion of patients with severe depressive symptoms had not been interfered in the analysis of the results in a personality traits.

Orientador: José Sterza Justo / Banca: Cássia Regina Rodrigues Varga / Banca: Cristina Amélia Luzio / Resumo: A anorexia tem-se despontado como um dos grandes sintomas da atualidade. Especialmente entre jovens, a recusa radical da alimentação, associada a uma busca por um ideal de corpo esbelto, pode levar a situações extremas de emagrecimento, chegando, em alguns casos, a causar a própria morte. O aumento da incidência de anorexia fez com que as ciências da saúde e os serviços públicos a tomassem como uma de suas grandes preocupações. Diversas pesquisas surgiram, tentando compreender melhor a anorexia e aprimorar as técnicas de intervenção. Da mesma forma, os serviços públicos começaram a tratá-la com maior prioridade, em alguns casos, até criando ambulatórios especializados. Esta pesquisa visa a analisar os sentidos da anorexia produzidos, principalmente, pela literatura científica sobre o assunto e expressos em algumas narrativas de pacientes com esse diagnóstico. Para tanto, fizemos um levantamento do conceito e histórico da anorexia, detendo-nos, primeiramente, em Freud e psicanalistas que abordam diretamente o assunto, considerando ainda a descrição psiquiátrica dessa problemática. Posteriormente, buscamos autores da atualidade que tratam do problema, não apenas da ótica estrita da Psicanálise, mas também daqueles que analisam a anorexia como sintoma do nosso tempo. Ao lado das leituras, realizamos um trabalho de campo, mediante entrevistas com anoréxicas atendidas em um Programa de Transtornos Alimentares ligado a uma Faculdade de Medicina. Ao final, dividimos o material em temas, os quais possibilitaram uma aproximação a essa problemática, tanto do ponto de vista teórico, quanto por meio dessas experiências empíricas. Notamos que o ponto de vista dos autores pesquisados é diferente, principalmente em relação ao tratamento... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Anorexia has become one of the great symptoms of the present time. Especially among the youth, the radical refusal to eat, associated with the search for an ideal slim body, which may lead to extreme situations of weight loss, in some cases, resulting in death. The increased rate of anorexia has prompted the health sciences and public services to make it one their great concerns. Multiple research works have been conducted to better understand anorexia and improve the intervention techniques. In the same way, the public services began to treat it with greater priority, in some cases, to the extent of creating specialized outpatient facilities. This research has the purpose of analyzing the significance of anorexia, mainly produced by scientific literature on the subject and expressed in some narrations of patients with this diagnostic. Therefore, we made a survey of the concept and historical study of anorexia, beginning with Freud and psychoanalysts who directly address the subject, also considering the psychiatric description of this issue. Subsequently, we searched current authors on the problem, not only from the strict view of Psychoanalysis but also those who analyze anorexia as a symptom of our time. Simultaneously, we executed a field work through interviews with anorexics treated in a Program of Eating Disorders connected to a Faculty of Medicine. Lastly, we divided the material into topics, which made possible a close approach this problematic issue, from the theoretical point of view as well as these empirical experiments. We observed that the point of view of the researched authors is different, especially regarding the treatment of anorexia. It is a complex subject, which has multiple aspects that cannot be summarized... (Complete abstract click electronic access below) / Mestre

Defendemos nesta dissertação que formas radicais de controle de si pela superação do sofrimento físico e das necessidades corporais são respostas subjetivas à configuração do modo de vida social contemporâneo. Modo de vida cujo núcleo está no que autores marxistas chamam de alienação e de fetichismo da mercadoria. Procuraremos examinar o fenômeno que em psiquiatria ganhou o nome de anorexia nervosa ou anorexia mental como uma dessas respostas que, ao mesmo tempo em que renega esse modo de vida, acaba por reafirmar algumas de suas premissas centrais. / We intend to defend that radical forms of self-control by overcoming physical suffering and bodily needs are subjective responses to the contemporary form of life. Form of life which core lies in what Marxist authors call alienation and commodity fetishism. We will seek to examine the phenomena in psychiatry called \"anorexia nervosa\" or \"anorexia mental\" as one of those responses that, at the same time denies this form of life, and, on the other hand, reaffirms some of its central assumptions.

Esta pesquisa parte da constatação clínica de que os sujeitos anoréxicos apresentam subjetividades uniformizadas e uma propensão à homogeneidade discursiva e atitudinal entre si. Tal identidade levanta a hipótese sobre a presença de um tipo de contágio psíquico entre as pacientes anoréxicas. Consideramos a epidemia anoréxica como um movimento coletivo definido por uma mesma narrativa de sofrimento, que possui uma frequência significativamente relevante, entre mulheres jovens, de aproximadamente 0,4% ao ano. Investigamos o conceito de identificação em Freud e em Lacan, e encontramos comentadores que tratam da identificação na anorexia, sugerindo a presença de um tipo especial de identificação necessário para explicar a noção de epidemia anoréxica. Tal hipótese nos levou simultaneamente a um modelo epidemiológico psicanalítico para certas formas de sofrimento que se propagam, historicamente, sob a forma de um contágio psíquico. Localizamos a epidemia anoréxica na identificação imaginária, do estádio do espelho, e a relacionamos ao discurso do capitalista e a uma comunidade de gozo. O fracasso da identificação narcísica nas anorexias severas mais especificamente as falhas na constituição da unidade da imagem é responsável por um excesso no plano da identificação imaginária entre as anoréxicas, que se identificam com o semblante do sintoma. Os sujeitos nas anorexias severas fazem epidemia para se livrarem do saber inconsciente, e se fixam num gozo autístico, que exclui o Outro. A psicanálise que se propõe a tratar o sofrimento, e não o sintoma aborda o que fica de fora da comunidade de gozo. Como resultado, postulamos que o conceito de identificação na epidemia anoréxica é importante para o tratamento institucional da anorexia, incluindo a fundamentação de projetos terapêuticos / This research is based on the clinical finding that anorexic subjects show, among them, standardized subjectivities and a tendency to homogeneity in discourse and attitude. That identity leads to the hypothesis of the presence of a type of psychic transmition among anorexic patients. We have considered anorexic epidemics as a groupal movement defined by the same suffering narrative, with significantly relevant frequency among young women, of approximately 0.4% per year. We have investigated the concept of identification in Freud and in Lacan theories and found commentators who treat anorexia identification suggesting the presence of a special type of identification necessary to explain the notion of anorexic epidemics. Simultaneously, such hypothesis has led us to a psychoanalytic epidemiologic model for certain forms of suffering historically spread as psychic transmition. We have found the anorexic epidemics in the imaginary identification of the mirror stage and established its relationship to the capitalist discourse and to a joy community. Failure of a narcissist identification in severe anorexics more specifically failures in the constitution of the image unit , is responsible for excess in the level of the imaginary identification among anorexics who identify themselves with the symptom semblance. The subjects in severe anorexia make epidemics to become free from the unconscious knowledge, and stick to an autistic joy which excludes the Other. The Psychoanalysis that proposes treating the suffering and not the symptom, addresses to what is outside the joy community. As a result of this research, we have postulated that the concept of identification in anorexic epidemics is important to the institutional treatment of anorexia and serves as basis for therapeutic projects

Thesis (M.A.)--Georgia State University, 2007. / Cynthia Hoffner, committee chair; Jaye Atkinson, Mary Ann Romski, committee members. Electronic text (90 p.) : digital, PDF file. Title from file title page. Description based on contents viewed Dec. 14, 2007. Includes bibliographical references (p. 67-74).

The purpose of this study was to investigate the presentation and outcome of anorexia nervosa (AN) within the pediatric population. A retrospective chart review of individuals who were admitted for the first time to hospital between 2000-2005 for treatment of AN was completed. Individuals were classified as Early Pediatric AN (admitted <14 years old) or Later Pediatric AN (≥14 years old). It was hypothesized that the Early Pediatric AN group would have a less severe presentation, as measured by percent ideal body weight (%IBW) and medical stability at admission, and better outcome as measured by rate of weight gain post-discharge, number of hospitalizations and the Morgan-Russell General Outcome Scale rating. The study contained a total of 207 cases, larger than many previous studies in pediatric AN. The study found that younger age at presentation was associated with admission at a higher %IBW but not medical stability. Age at presentation did not predict rate of weight gain or rehospitalization; however, the Early Pediatric AN group had a better outcome on the Morgan-Russell scale.

The purpose of this study was to investigate the presentation and outcome of anorexia nervosa (AN) within the pediatric population. A retrospective chart review of individuals who were admitted for the first time to hospital between 2000-2005 for treatment of AN was completed. Individuals were classified as Early Pediatric AN (admitted <14 years old) or Later Pediatric AN (≥14 years old). It was hypothesized that the Early Pediatric AN group would have a less severe presentation, as measured by percent ideal body weight (%IBW) and medical stability at admission, and better outcome as measured by rate of weight gain post-discharge, number of hospitalizations and the Morgan-Russell General Outcome Scale rating. The study contained a total of 207 cases, larger than many previous studies in pediatric AN. The study found that younger age at presentation was associated with admission at a higher %IBW but not medical stability. Age at presentation did not predict rate of weight gain or rehospitalization; however, the Early Pediatric AN group had a better outcome on the Morgan-Russell scale.

BAKGRUND: Anorexia nervosa är latin och betyder ”nervös aptitlöshet” och det som präglar sjukdomen är självförvållad svält. Sjukdomen börjar vanligtvis med en bantning för att gå ned i vikt som spårar ur.  Anorexia nervosa förkommer hos cirka 1 % unga kvinnor, vilka också är de som drabbas i störst utsträckning. En rad allvarliga somatiska komplikationer kan ses till följd av sjukdomen som i svåra fall kan leda till döden.  Sjukdomen är individuell och det finns av den anledningen ingen självklar behandling. SYFTE: Syftet med studien är att beskriva kvinnors upplevelser av vändpunkter vid anorexia nervosa efter tillfrisknande. METOD: Fem självbiografier analyserades med hjälp av kvalitativ innehållsanalys. RESULTAT: Den kvalitativa innehållsanalysen resulterade i fyra kategorier som beskrev vändpunkter vid anorexia nervosa efter tillfrisknande: Sjukdomsinsikt, Motivation, Tillit samt Beslut. Tillfriskningsprocessen har visat sig vara individuell och olika kvinnor i studien har upplevt olika kombinationer av de nämnda vändpunkterna i tillfrisknandet. DISKUSSION: Sjukdomsinsikt har visat sig vara den viktigaste vändpunkten vid tillfrisknande i anorexia nervosa. Om en person inte vet om att hon eller han är sjuk, är det svårt att bli frisk. / BACKGROUND: Anorexia nervosa is latin for “nervous appetite lose” and what characterizes the disease is self-starvation. It usually starts with dieting to lose weight which loses control. Anorexia nervosa exists in about 1 % of all young women, and young women are also in the front of the disease. A number of serious somatic complications can follow the disease which in severe cases can cause death. The disease is individual and there is no obvious treatment. AIM: The aim of the study is to describe woman’s experiences of the turning-points in anorexia nervosa after recovery. METHOD: Five autobiographies were analyzed with qualitative content analysis. RESULTS: Qualitative analyses revealed four core categories who described the turning points of recovery in anorexia nervosa: Awareness of disease, Motivation, Trust and Decision. The recovery has proved to be individual and different women in the study have experienced different combinations of those turning-points for recovery. DISCUSSION: Awareness of disease provides to be the most essential turning-point for recovery in anorexia nervosa. If a person doesn’t know she or he is sick, there is no reason to get well.

Bakgrund: Anorexia nervosa innebär att under en tid avsiktligen undvika intag av kaloririk föda. Ofta går även kroppsaktiviteten till överdrift. Statistik visar på att en procent av Sveriges befolkning i åldrarna 13-30 har diagnosen. Då sjukdomen inte är ovanlig är det av stor vikt att sjuksköterskan har kunskap om sjukdomen och personernas upplevelse. Syfte: Personers upplevelse av att leva med anorexia nervosa. Metod: En systematisk och strukturerad litteraturstudie. Resultat: Det var lättare att underhålla anorexin än att ta tag i sjukdomen på grund utav ett inre kaos av känslor. Att leva med ständig kontroll och identifiera sig med sjukdomen var vanligt. Stöd från personal och närstående var av betydelse och brist på detta upplevdes som negativt i återhämtningen. Diskussion: Personerna med anorexia nervosa upplevde det som att de skapade en ny identitet som gav de mening med livet. Personerna önskade att få förståelse och stöd från närstående och personal, för att kunna tillgodose sig en god återhämtning. Slutsats: För att uppnå en optimal omvårdnad krävs det att sjuksköterskan utgår från en personcentreradvård och ökar sin förståelse för anorexia nervosa. / Background: Anorexia nervosa means that for a time deliberately avoid intake of high calorie foods, and where physical activity is an exaggeration. As statistics show that one percent of the Swedish population aged 13-30 are diagnosed with anorexia nervosa, it is of great importance that nurses are knowledgeable about the disease and the individual’s experience. Purpose: Persons with experience of living with anorexia nervosa. Method: A systematic and structured literature. Results: It was easier to maintain anorexia than fighting the disease because out of an inner turmoil of emotions. Living with constant control and identify oneself with the disease was common. Support from professionals and family were important and the lack of this was perceived as a negative in the recovery. Discussion: The persons with anorexia nervosa experienced it as if they created a new identity that gave meaning to life. The people wanted to get understanding and support from family and staff, in order to reach recovery. Conclusion: To achieve optimal care requires that the nursing is based on a person-centered care as well as a deeper understanding of the meaning of living with anorexia nervosa