In the enchanting setting of Ponza, as every year, neuroradiologists and neurologists gather to talk about topics of fundamental importance.
To Dr. Gniuli again this year the task of a clinical framing focused on the physio-pathological mechanisms (those that induce pathology) related to toxic-metabolic diseases.
Rare pathologies, those genetically determined, but in constant increase those related to toxic factors such as alcohol and drugs, with important impact on the survival of the patient, his autonomy, his lifestyle and that of his whole family.
Because cellular metabolism affects the nervous system conspicuously and dramatically, and often the physician helplessly witnesses a set of symptoms he never wanted to see.
Therefore, in genetically determined metabolic disorders, the main elements involved are alterations in the metabolism of the digestive and respiratory organelles. The pathology consists of accumulation of substances (mainly lipids) or demyelination.
In contrast, in toxic pathologies, the damage is’ often direct toxic, in many cases (as in opiates) also mediated by an ischemic process, is conditioned by systemic pathologies (renal or hepatic failure), and very often the toxic substance “replaces” the metabolic support elements (Oxygen, glucose, water), inducing damage.
In Italy in 2023, about 3,000,000 people suffer from Eating Disorders.
We are talking about 5% of the Italian population, and unfortunately 30% of adolescents after COVID, of which 6% are under 12 years old (1).
Such an incidence is comparable to that of Diabetes (5.9%, 3,500,000 people) (1) and is higher than that of cancer in Italy (about 4% of the entire population) (2).
This figure is also alarming because it is growing and growing especially in the adolescent population, which is our future.
In DCA, pain makes its way into the body image, which is the first aspect evident on the outside of each of us, because one’s body becomes an impenetrable peel (in obesity), or transparent (in anorexia), and food becomes a cure (in bulimia) to the pain itself, and suffering , frustration vent in compensatory behaviors (the purging mechanisms), and obsession with the body,with food catalyze attention on a daily basis. Sunsets, the sea, the rays of the sun, the laughter of friends, the caresses of loved ones become pale and faint glimmers in daily life characterized only by a profound distortion of one’s body.
Early diagnosis allows the establishment of a course of treatment and care not only for the patient but also for the familiar surroundings. Therapy should focus on identifying vital risk factors, nutritional framing with cognitive-behavioral techniques, and individual psychotherapy (sometimes combined with group psychotherapy) and helping the family environment. Therapists all need to work together and for the patient by supporting the family and educating them, and must be able to have emergency referral points available to stabilize the patient where necessary (3).
1) Istat data 2023
2) Epicenter.iss.it; cancer registry in Italy
3) clinical Practice Guideline for Eating disorders. Ministry of Healthcare and Consumer affairs.
www.sisdca.it
