Term
| What are the 4 major DSM-IV criteria for Anorexia Nervosa? |
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Definition
Can be "Restricting Type" or "Binge-eating/Purging type"
1) Refusal to maintain body weight
- at or above minimally normal weight for age and height (<85% or expected)
2) Fear of gaining weight even though underweight
3) Disturbance in way in which one's body weight or shape is experienced (undue influence on self evaluation)
4) In postmenarcheal females, Amenorrhea (absence of 3 consecutive menstrual cycles) |
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Term
| What are the 2 types of Anorexics? |
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Definition
"Restricting Type" or "Binge-eating/Purging type"
- 40% of restricting type will develop binging behavior. |
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Term
| What important epidemiology features define AN? |
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Definition
1) Emerges in 2nd decade of life (peak 13-18)
2) prevalence of 0.1%-0.7% with upper/middle class white female predominance |
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Term
| Why is AN so important clinically? |
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Definition
| MOST lethal psychiatric disorder at 5-7% with tons of co-morbidities |
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Term
| What are the 2 major DSM-IV criteria for Bulimia Nervosa? |
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Definition
Can be "Purging" or "Non-purging" (i.e vomiting or not)
1) Recurrent episodes of binge eating
- eating in discrete period of time with a greater amount of food than a normal person would eat
- LACK of control during binge
2) Recurrent, inappropriate compensatory behavior
- self-induced vomiting
- misuse of laxatives, diuretics, enemas |
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Term
| How do patients with BN differ from those with AN |
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Definition
1) BN is more impulsive, with common co-morbidities of substance abuse, sexuality, spending and self-injury
- Greater diversity of Socioeconomic class (between adolescence and mid-20s)
2) AN is more introverted/obsessive with less impulsive behavior. |
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Term
| What factors should cause you to "Think" eating disorder? |
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Definition
1) Amenorrhea
2) Falling off growth curve
3) Unhealthy diets or excessive exercise
4) Syncope, dehydration, dental caries, swollen parotids
5) Parental concern (even in face of patient denial) |
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Term
| When is a diagnosis of "Eating Disorder- Not otherwise specified" appropriate? |
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Definition
When you see a few but not all, or mixed symtpoms
Example- Binge Eating Disorder (BN without compensatory weight loss)
- Recurrent, twice weekly episodes of pathological overeating with perceived "loss-of control" and dissatisfaction with body weight/shape
- No compensatory weight loss efforts
- Occurs during at least 2 days per week for at least 6 months
- Similar to BN, but less severe |
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Term
| What are some possible etiological explanations for Eating Disorders? |
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Definition
- AN is familial (>50% genetic) with 5-HT abnormalities and HPA axis abnormalities (may be consequence, rather than cause)
- Some people think 5-HT changes underly mood abnormalities and it becomes a viscous cycle. |
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Term
There is a high comorbidity with Anorexia Nervosa and:
a. Major depressive disorder
b. Substance abuse disorders
c. Psychotic disorders
d. Antisocial personality disorder |
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Definition
A
BN is common with Psychiatric Disorders |
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Term
All of the following are criteria for Bulimia Nervosa EXCEPT:
a. Body image disturbance
b. Low body weight
c. Recurrent episodes of binge eating
d. Recurrent inappropriate compensatory behaviors |
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Definition
| B- They can be overweight! |
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Term
The prevalence of Anorexia Nervosa is:
a. Greater than the prevalence of Bulimia Nervosa
b. 1:10,000
c. Less than 1%
d. 1-3% |
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Definition
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Term
A 14 y/o girl is brought in by her parents as they are concerned about her low weight. What would you expect to see if this was Anorexia Nervosa?
a. Low body weight
b. One missed menses
c. Pt says: “I’m not trying to lose weight, I’m just naturally thin.”
d. A and C |
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Definition
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Term
Bulimia Nervosa can occur even without vomiting.
a. True
b. False |
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Definition
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Term
| Distinguish between non-purging BN and Binge Eating Disorder (BED) |
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Definition
| Neither have compensatory vomiting, but Non-purging as compensatory activity of some other sort (fasting/excessive exercise) while BED does NOT. |
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