Univ.-Prof. Dr. Andreas Karwautz
Liste der Publikationen samt kurzer Zusammenfassung
1) Eating and Weight Disorders 2003; 8: 88-94
Eating disorders and type 1 diabetes mellitus in adolescence: a review.
Grylli V, Karwautz A, Hafferl-Gattermayer, Schober E:
One of the main difficulties in managing type 1 diabetes mellitus (T1DM) in the
young is nutritional treatment. Studies have shown that adolescents
(particularly adolescent girls and young women) have an increased risk for
clinical and sub-clinical eating disorders. Adjustment to the nutritional
regimen and, consequently, to the management of the disease in adolescence seems
to involve a complex interplay of various psychosocial and biological aspects.
The aim of this review is to consider the relationship between T1DM and eating
disorders in adolescence in the light of some important biological psychological
and familial factors. Further research is required in order to detect the degree
of the interactions between these factors in adolescents with T1DM.
2) Wiener Klinische Wochenschrift 2004; 116/7-8: 230-234.
OBJECTIVES: To investigate prevalence and clinical manifestations of DSM-IV
clinical eating disorders and subsyndromal eating problems among adolescents
with type-1 diabetes. METHOD: A clinical sample of 251 adolescents with type-1
diabetes was recruited from multiple centres. Of these adolescents, 199 (96
girls and 103 boys--79.3% participation rate) with a mean age of 14.1 years (SD:
2.6) were screened for eating disorders and then underwent DSM-IV-based clinical
assessment of eating disorders by interview. RESULTS: 11.5% of the girls and
none of the boys with type-1 diabetes had DSM-IV eating disorders, whereas 13.5%
of the girls and 1% of the boys had subsyndromal problems of eating and shape.
Girls with both type-1 diabetes and a clinical or subclinical eating disorder
had a significantly higher body-mass index than those without eating problems.
CONCLUSION: This Austrian study supports cumulative international evidence that
among youths with type-1 diabetes, adolescent girls and especially those having
a higher body mass are particularly vulnerable for manifesting pathology of
eating, weight and shape. Thus, this particular population requires screening of
eating behaviour and relevant psychopathology, close monitoring, and
psychosocial interventions through cooperative efforts of specialised centres.
3) Journal of Pediatric Psychology 2005, 30, 197-206
Eating disorders and eating problems among adolescents with type 1 diabetes: exploring relationships with temperament and character.
Grylli V, Hafferl-Gattermayer A, Wagner G, Schober E, Karwautz A
Objective To determine temperament and character among adolescents with type 1 diabetes with and without disordered eating. Method A clinical sample of 199 adolescents from multiple centers with a mean age of 14.1 (SD, 2.5) years were screened and diagnosed for eating disorders. Assessed were temperament and character as conceptualized by Cloninger, glycemic control, and depression. Results Adolescent patients with clinical eating disorders or subthreshold eating problems had significantly higher mean scores in harm avoidance and lower mean scores in self-directedness. Harm avoidance remained significant even after controlling for depressive pathology. Discussion This study is the first to show evidence that among youths (in particular, girls) with type 1 diabetes, there is an association between low selfdirectedness, high harm avoidance, and the presence of eating, weight, and shape pathology. For these particular youths, important implications for clinical practice are outlined.
4) Journal of Psychosomatic Research 2005; 59: 65-72.
Coping and quality of life in adolescents with type 1-diabetes with and without an eating problem.
Grylli V, Wagner G, Hafferl-Gattermayer A, Schober E, Karwautz A:
Objectives: To evaluate coping styles and quality of life in youth with type 1 diabetes with and without eating disorders and to identify relationships between these variables in each group. Methods: Adolescents were evaluated for eating disorders with a two-stage diagnostic procedure. Adolescents with and without eating disorders then provided data on coping styles and on subjective well-being. Results: Adolescents with type 1 diabetes and disordered eating behavior reported more often blaming themselves, resorting to wishful thinking and poorer physical and psychosocial quality of life than adolescents with type 1 diabetes without disordered eating behaviour. Specific coping strategies were also positively linked with quality of life and metabolic control. Conclusions: Eating disorders and disordered eating behavior in adolescents with type 1 diabetes seem to be associated with certain negative and avoidant coping strategies and with impeded physical and bio-psychosocial well-being.
5) Der Mediziner, 2004, 9: 6-9
Essstörungen und gestörtes Essverhalten bei Jugendlichen PatientInnen
Hafferl-Gattermayer Andrea, Grylli Vasileia, Gudrun Wagner, Edith Schober, Andreas Karwautz.