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6 Eating Disorders > Clinical features > Flashcards

Clinical features Flashcards

0
Q

What are the two types of AN

A

Restricting

Binge-eating / purging

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1
Q

What are the features of AN

A

Restriction of energy intake relative to requirements
Leads to low weight for age, sex, dev trajectory
Intense fear of gaining weight
Disturbance in way weight is experienced, lack of seriousness

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2
Q

Why was refusal to eat removed from DSM5?

A

Derogatory
Judgemental
Some bmi levels not applicable to adolescents so now termed weight less than minimally normal

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3
Q

What are features of bulimia

A 
Normal weight 
Repeated episodes of binge eating
Large amount in short time
Feel out of control during binge
Compensatory behaviour
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4
Q

What are features of binge eating

A 
Recurrent episodes of bingeing
No compensatory behaviour
Eat more rapidly
Eat until overfull or when not hungry
Distress during binge
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5
Q

What are the causes of eating disorders

A

Multiple pathways
Interaction of biological (genetics,physiology)
Psych(personality, family,cog)
Social (society modelling, pressure regarding weight and appearance)

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6
Q

Is anorexia an internal or external disorder

A

Internal

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7
Q

What is the best predictor of bulimia in adolescence

A

Dieting

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8
Q

What are the genetic factors involved in eating disorders

A

Increase risk of relative with eating disorder
AN high concordance in mono twins
Social anxiety, perfectionism, negative affect
BN lower concordance in mono twins
Tolerance to vomiting, impulsivity

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9
Q

What parts of physiology play role in aetiology

A

Hypothalamus - role in hunger and eating regulation
Serotonin and dopamine and norepinephrine
Low sero assoc w impulsivity and binge eating

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10
Q

What family environment factors contribute to eating disorders

A

Modelling of eating disorder behaviour
High expressed emotion
Critical conflicted family
Don’t allow individuation

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11
Q

What psych factors contribute to ED

A

High level of perfectionism

Low self esteem

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12
Q

What psych treatment for bulimia is treatment of choice

A

CBT

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13
Q

What is the new version of CBT used to treat bulimia

A 
CBT E
Can also target the key difficulty areas of 
Perfectionism
Low self esteem
Interpersonal difficulties
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14
Q

What factors can lead to bingeing

A

Emotional trigger eg anger, sorrow,
Eating ‘bad’ food
Fasting for long period

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15
Q

What is ipt and how can it be used for ED

A

Interpersonal psychotherapy
Assumes reciprocal link between mood interpersonal factors and eating
Improve interpersonal functioning
Effective in long term but treatment takes longer than CBT

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16
Q

What is the preferred treatment for AN

A

Outpatient and family based therapy

Parents are responsible for helping child gain weight

17
Q

What are the 3 phases of family based treatment for AN

A
  1. Parents restore child’s weight
  2. Transfer control back to adolescent
  3. Adolescent developmental issues
18
Q

What is the mean peak age for AN

A

17 years but two peaks at 14 and 18

19
Q

What are the two peak ages of AN associated with

A

Developmental crises and increasing independence eg. Puberty, transition from school/university/ work and leaving home

20
Q

What is the mean age of onset for bulimia

A

18 years

21
Q

What are the features of males with eating disorders

A

Same patterns of disturbed body image and eating
More bingeing
Rely more on fasting and exercise to compensate
More likely to have suffered premorbid obesity,alcohol problems
Less likely to have mood disorders than females

22
Q

What are features of binge eating disorder

A

Recurrent binges with lack of control
No use of inappropriate compensatory behaviours
Binges causes distress, embarrassment, disgust and guilt
Eat more rapidly,eat when not hungry,or when full

23
Q

Which disorder has highest mortality rate of any psychological disorder

A

AN

24
Q

What damage is done by AN

A 
Electrolyte depletion
Dysfunctional nerve and muscle cells
Cardiac arrhythmias, cardiac arrest
Hypotension, feel faint on standing 
Body temp drops,abdominal pain,bloating,constipation
25
Q

What effect on oestrogen

A

Lowered leading to amenorrhea,arrested sexual development, regression of ovaries
Lower bone density, osteoporosis, stunted growth

26
Q

What types of food do bulimic so tend to binge more on

A

Junk food

27
Q

What are important features of bingeing

A

That person is out of control

Amount of food eaten

28
Q

What physiological changes seen in bulimia

A

Enlarged salivary glands
Erosion of dental enamel
Tearing of oesophagus
Electrolyte imbalance

29
Q

What additional psych disorders seen in bulimia

A

Anxiety and mood disorders

Substance a users

30
Q

What features do AN and bulimia share

A

A morbid fear of putting on weight

Losing control of eating

31
Q

What is the difference between AN and bulimi

A

AN are proud of their weight loss and control of their diet

Bulimia are ashamed of their eating issues and lack of control

32
Q

How does bulimia differ from binge eating purging type AN

A

AN binge on small amounts of food and purge more consistently, perhaps each time they eat

33
Q

Why does su typing of AN only refer to the last 3 months

A

Bec there are few differences between the two on severity of symptoms or personality
Subtyping may not be useful in predicting future course but merely reflect a phase

34
Q

What psych disorders are associated with AN

A

Anxiety and mood
Obsessive compulsive disorder. Unpleasant thoughts assoc w gainig weight and so they engage in ritualistic behaviours to rid themselves of these thoughts

35
Q

How does BEDdiffer from other eating disorders

A

Different patterns of heritability
More likely in males
Later age of onset
Greater chance of remission and response to treatment

36
Q

What are similarities between BED and AN and bulimia

A

Concerns about shape or weight

37
Q

Why do people have BED

A

Alleviate bad mood or negative affect

38
Q

What is the strongest predictor of bulimia

A

Childhood obesity

Continuing overemphasis on being thin

39
Q

Which disorder is more chronic

A

Bulimia

40
Q

Which disorder is more resistant to treatment

A

AN

6 Eating Disorders (4 decks)

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