{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:02:39Z","timestamp":1760234559427,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T00:00:00Z","timestamp":1621900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Type 1 diabetes mellitus (T1DM) is a chronic disease that can affect the physical and mental health of children and adolescents, often leading to anxiety disorders with chronic activation of the hypothalamic axis (HPA). Moreover, a great proportion of adolescents with T1DM also demonstrate anorexia nervosa (AN), due to the increased preoccupation with food and the need to have an acceptable body image. Herein is described the first case study of an adolescent patient diagnosed with T1DM, anxiety disorder (AD), and AN. A 14-year-old girl with T1DM since the age of 12 years presented weight loss at age 13 years and 3 months and low body mass index (BMI), which did not improve despite dietary recommendations and adequate disease control. Additionally, she presented menstrual disorders at the age of 12 years and 11 months (menstrual age 12 years and 1 month). A psychological evaluation of the teenager was conducted using a semi-structured interview that assessed perceived stress, health status, quality of life, and depression. AD and AN were diagnosed and the patient initiated an intervention focusing on psychological health and nutrition and which incorporated physiotherapeutic relaxation sessions and breathing exercises. After 3 months of treatment, the patient\u2019s BMI was increased, and a normal menstrual cycle was apparent. These results have since remained consistent. Stress leads to the appearance of AN and menstrual disorders. Therefore, physiotherapeutic programs could reduce stress and effectively ameliorate AN and AD.<\/jats:p>","DOI":"10.3390\/children8060443","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T02:53:36Z","timestamp":1621911216000},"page":"443","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Synergistic Effects of a Complementary Physiotherapeutic Scheme in the Psychological and Nutritional Treatment in a Teenage Girl with Type 1 Diabetes Mellitus, Anxiety Disorder and Anorexia Nervosa"],"prefix":"10.3390","volume":"8","author":[{"given":"Pelagia","family":"Tsakona","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 570 01 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaios","family":"Dafoulis","sequence":"additional","affiliation":[{"name":"Child-Adolescents\u2019 Psychiatric Clinic, Hippokration General Hospital of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-0857","authenticated-orcid":false,"given":"Anastasios","family":"Vamvakis","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit, 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantina","family":"Kosta","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit, 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Styliani","family":"Mina","sequence":"additional","affiliation":[{"name":"Child-Adolescents\u2019 Psychiatric Clinic, Hippokration General Hospital of Thessaloniki, 546 42 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis","family":"Kitsatis","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit, 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Hristara-Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Health Sciences, International Hellenic University, Alexander Campus, 570 01 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0202-364X","authenticated-orcid":false,"given":"Emmanuel","family":"Roilides","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit, 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyriaki","family":"Tsiroukidou","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit, 3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1093\/jpepsy\/jsw002","article-title":"Understanding the Areas and Correlates of Diabetes-Related Distress in Parents of Teens With Type 1 Diabetes","volume":"41","author":"Hessler","year":"2016","journal-title":"J. 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