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Women With Co-occurring Disorders
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Tricia L. Chandler, Tara G. Matthews, Fredrick Dombrowski
Symptoms of depression and anxiety can be impacted by various hormonal changes that occur naturally throughout a women’s life. Around the age of menopause and beyond, women are found to be more at risk for symptoms of depression and anxiety (Mulhall et al., 2018). While changes in hormones can be somewhat expected, these hormone changes can be accompanied by other physical symptoms such as hot flashes and changes in mood. Consequently, these changes can be misinterpreted as a mental health diagnosis. Additionally, women who use substances prior to menopause may increase their substance use to cope with such changes (Milic et al., 2018). While the changes that women experience in menopause can be subtle and are primarily associated with reproductive functioning, cognitive shifts in focus and interests can also change through this life stage (Greendale et al., 2020). As women age after menopause, additional health concerns must be addressed, especially as women experience decreased bone density at higher rates than men, making them at higher risk for broken bones and osteoporosis (Kelly et al., 2019). Those who live with osteoporosis may be at greater risk of anxiety due to concerns about broken bones and at a higher risk for opiate use disorder as painkillers can be prescribed to manage pain associated with a broken bone. Ongoing linkage with a primary care physician should be recommended for all clients receiving care for mental health and substance use disorders. Women-specific care is also needed as these natural changes can impact substance use and co-occurring disorders.
Pseudohypoparathyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Ambika P. Ashraf, Todd D. Nebesio
Bone density is usually increased. Due to the selective involvement of PTH in the proximal renal tubule, patients with PHP1B without skeletal resistance to PTH at the bone can develop parathyroid bone disease. Long-standing secondary hyperparathyroidism with chronic hypocalcemia and 1,25(OH)2D deficiency has been associated with tertiary hyperparathyroidism in these patients.
Diagnosis
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
The raw density information is converted into a patient's T-score and Z-score. The T-score measures the patient's bone density in comparison to a normal population of younger people and is used to estimate the risk of developing a fracture. The World Health Organization (WHO) defined thresholds levels for the diagnosis of osteopenia and osteoporosis. Osteopenia is defined as a T-score of –1 to –2.5 (1–2.5 standard deviations below the mean). Osteoporosis is defined as a T-score less than –2.5 (greater than 2.5 standard deviations below the mean).
Emerging therapeutic targets for anorexia nervosa
Published in Expert Opinion on Therapeutic Targets, 2023
Female patients with anorexia nervosa often display profound alterations in the hypothalamic-pituitary-gonadal axis, while data in male patients are very limited [71]. It is to note that especially estrogen has not only been implicated in menstrual cycle and reproductive capability but also cognitive functions as amenorrhea was associated with cognitive deficits [72]. A randomized controlled trial comparing transdermal 17ß-estradiol plus cyclic medroxyprogesterone orally to placebo for 18 months investigated the effects on anxiety using the State-Trait Anxiety Inventory for Children, and eating disorder pathology using Eating Disorders Inventory-2 and Body Shape Questionnaire in adolescents with anorexia nervosa. Estrogen replacement resulted in decreased anxiety trait scores, whereas state anxiety was not altered [73]. Similarly, no effect was observed on eating disorder pathology (EDI-2 and BSQ-34) [73]. Lastly, body mass index did not differ from placebo after estrogen/progesterone treatment [73]. This should be followed up in further investigations. It is to note that estrogen supplementation might also exert beneficial effects on bone density.
Establishment of reference intervals for bone turnover markers in healthy Chinese older adults
Published in Annals of Human Biology, 2023
Li-Li Sun, Rong-Rong Cao, Jin-Di Wang, Guo-Long Zhang, Fei-Yan Deng, Shu-Feng Lei
BMD (g/cm2) was measured by dual-energy X-ray absorptiometry densitometers (Prodigy, USA) at three skeletal sites: the lumbar spine (LS, vertebrae L1-L4), femoral neck (FN), and total hip (TH). The instrument was operated by professionally trained radiology medical staff, and quality control was strictly carried out by using the lumbar prosthesis provided by the manufacturer before daily measurement. T-scores were automatically calculated by software as the number of standard deviations below the average for young adults at peak bone density (World Health Organization 2003). OP (T ≤ −2.5), osteopenia (−1 < T value < −2.5), and normal BMD (T value ≥ − 1) were defined according to the WHO recommendations (Kanis and Kanis 1994). Both OP and osteopenia were defined as the abnormal bone mass in this study.
An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa
Published in South African Journal of Clinical Nutrition, 2021
Carin Napier, Heleen Grobbelaar, Wilna Oldewage-Theron
Bone health is a common health issue during ageing, especially for women.54 Elderly people are more vulnerable compared with other-aged population groups in terms of osteoporosis. Osteoporosis is a bone health problem characterised by low bone mass and micro-architectural deterioration, and increases the risk of bone fragility and fracture.55 There are many risk factors, which include both irreversible and modifiable factors, that contribute to low bone density. The risk of osteoporosis has a positive association with increased age, family history, female gender, oestrogen deficiency, amenorrhea, vitamin D deficiency, low intakes of calcium, chronic diseases, leading a sedentary lifestyle, and excessive smoking and alcohol consumption. Among the many factors that affect bone health and healthy ageing, healthy lifestyle behaviours (dietary intake and physical activity) are recognised as modifying factors to improve bone health in the elderly. Calcium intake is low among the elderly in SA.31