Eating disorders and liaison psychiatry Flashcards
List the different types of eating disorders, by most common to least common
- OSFED (Other Specified Feeding or Eating Disorder) 47%
- Binge eating disorder 22%
- Bulimia nervosa 19%
- Anorexia nervosa 8%
- ARFID (avoidant restrictive food intake disorder) 5%
What is the peak age for development of an eating disorder
Between 13 and 17 years
Outline the ICD-10 characteristics for Anorexia nervosa
- Deliberate weight loss (induced and sustained by the patient)
- “Dread of fatness and flabbiness of body contour” as an intrusive overvalued idea
- Usually undernutrition, with secondary endocrine and metabolic changes
List some ‘symptoms’ of anorexia nervosa (how it presents)
- Restricted dietary choice
- Excessive exercise
- Induced vomiting and purgation
- Use of appetite suppressants, laxatives or diuretics
Outline the ICD-10 characteristics for Bulimia nervosa
- Repeated bouts of overeating followed by vomiting or use of purgatives
- Excessive preoccupation with the control of body weight
Shares many psychological features with anorexia nervosa, including an over-concern with body shape and weight
Outline how bulimia nervosa and binge eating disorder are different
Both conditions involve recurrent binge eating with loss of control over their eating behaviour
Bulimia nervosa involves compensatory behaviour to prevent gaining weight, whereas in binge eating disorder there is no compensatory behaviour
List some predisposing factors for eating disorders
- Genetics
- Biological / hormonal changes e.g. during puberty
- Psychological traits e.g. perfectionism or low self-esteem
- Stressful life events e.g. bullying, trauma
- Family environment (although not the cause)
Outline the findings for the following blood test electrolyte abnormalities (low or high) in anorexia nervosa
- Calcium
- Magnesium
- Phosphate
- Potassium
Calcium = low
Magnesium = low
Phosphate = low
Potassium = low
Outline the findings for the following blood test parameters (low or high) in anorexia nervosa
- LH and FSH
- Oestrogen
- Testosterone
- WCC
- Growth hormone and cortisol
- Cholesterol
- Acidosis or alkalosis
LH and FSH = low
Oestrogen = low
Testosterone = low
WCC = low
Growth hormone and cortisol = high
Cholesterol = high
Acidosis or alkalosis = metabolic alkalosis (vomiting or use of diuretics)
List some potential concurrent mental health disorders which may occur alongside eating disorders
- Mood disorders
- Anxiety
- OCD
- ADHD
- Substance misuse
- EUPD
- Autism
List some physical symptoms which may occur as a result of eating disorders
- Fractures (reduced bone density)
- GORD
- Amenorrhoea
- Syncope
- Constipation
- Reduced libido / impotence
- Difficulty maintaining temperature
Outline the NICE guidelines for management of anorexia nervosa in adults
- Psychoeducation
- Monitoring of weight, mental and physical health
- Individual CBT focused on eating disorders (CBT-ED)
- Maudsley anorexia nervosa treatment for Adults (MANTRA)
- Specialist supportive clinical management (SSCM)
Outline the NICE guidelines for management of anorexia nervosa in children
- Psychoeducation
- Monitoring of weight, mental and physical health
- Family therapy focused on anorexia nervosa (FT-AN)
Second line: individual eating-disorder-focused cognitive behavioural therapy (CBT-ED) or adolescent focused psychotherapy for anorexia nervosa (AFP-AN)
Outline the NICE guidelines for management of bulimia nervosa for adults
- Guided self-help focused on bulimia nervosa
Second line: group cognitive behavioural therapy focused on eating disorders (CBT-ED)
Outline the NICE guidelines for management of bulimia nervosa for children
- Family therapy focused on bulimia nervosa (FT-BN)
Second line: individual cognitive behavioural therapy focused on eating disorders (CBT-ED)
