Eating Disorders Slides PDF

Y S C P H I A T Eating Y R Disorders DR. PAREDES LIMÓN OBJECTIVES By the end of this lesson, the student will be able to: Apply diagnostic criteria for Anorexia Nervosa & Bulimia. Explore etiological factor...

Y S C P H I A T Eating Y R Disorders DR. PAREDES LIMÓN OBJECTIVES By the end of this lesson, the student will be able to: Apply diagnostic criteria for Anorexia Nervosa & Bulimia. Explore etiological factors and risk elements. Discuss multidisciplinary treatment approaches. Block 8: Psychiatry  EATING DISORDERS Two well defined eating disorders, anorexia nervosa (AN) and bulimia nervosa (BN) share some overlapping features: sdfasdsasd - 90% of people affected are female. -“Binge eating disorder” ANOREXIA NERVOSA Patients with anorexia nervosa have an intense fear of weight gain, overvaluation of thinness, and body image distortion leading to calorie restriction and severe weight loss resulting in appropriately low body weight. Peak age of onset: 15-19 years. sdfasdsasd Precipitated by weight loss due to: Non pathological dieting/ increased exercise Often associated with obsessive-compulsive personality traits. Block 8: Psychiatry ANOREXIA NERVOSA 2 types: Binge-eating/ Restricting type purging type Weight loss is achieved Eating binges followed through diet, fasting by purges including self- and/or excessive induced vomiting, use of exercise. laxatives, enemas or diuretics. Block 8: Psychiatry ANOREXIA NERVOSA Restricting type During the past three months, the individual has not engaged in recurrent episodes of binge eating or purging (i.e., self- induced vomiting or incorrect use of laxatives, diuretics, or enemas). This subtype describes presentations in which weight loss is primarily due to diet, fasting and/or excessive exercise. Binge-eating/purging type During the past three months, the individual has engaged in recurrent episodes of binge eating or purging (i.e., self- induced vomiting or improper use of laxatives, diuretics, or enemas). Block 8: Psychiatry ETIOLOGY Temperamental Environmental Genetic and physiological Individuals who develop The historical and There is an increased anxiety disorders or intercultural variability risk among first-degree display obsessive traits of the prevalence of biological relatives of in childhood are at anorexia nervosa people who have the increased risk of supports its relationship disorder. developing anorexia with the culture and Increased risk of nervosa. environments in which depressive and bipolar thinness is valued. disorders has also been Professions and hobbies found among first- that encourage degree relatives of thinness, such as being a people with AN. model or elite athlete, are also related to higher risk. Block 8: Psychiatry CLINICAL FEATURES Weight loss Hypothyroidism Extreme starvation Amenorrhea Constipation Osteopenia/osteoporosis Cold intolerance Lethargy Hypotension Bradycardia Lanugo Arrythmias Block 8: Psychiatry  ENDOCRINE CARDIAC Pubertal delay or arrest, ECG abnormalities: T-wave growth retardation and short inversion, ST depression and stature, amenorrhea, sick MEDICAL prolonged QT interval. euthyroid state. CONSEQUENCES OF EATING DISORDERS METABOLIC HEMATOLOGICAL Uremia, renal calculi, Anemia, thrombocytopenia, osteoporosis leucopenia GASTROINTESTINAL Constipation and abnormal liver function tests Block 8: Psychiatry DIAGNOSTIC MAKERS F0R AN LABORATORY/IMAGING ABNORMALITIES Hyponatremia Hypochloremic Increased growth hormone (GH) Hypokalemix alkalosis (if vomiting) Increased Cortisol Arrythmia (especially QT Reduced gonadotropins (LH, FSH) prolongation) Reduced sex steroid hormones Hypercholesterolemia (estrogen, testosterone) Transaminitis Hypothyroidism Leukopenia Hypoglycemia Anemia (normocytic, normochromic) Osteopenia Elevated BUN Block 8: Psychiatry DIAGNOSTIC CRITERIA: DMS-5 CRITERIA Anorexia Nervosa A. Restriction of B. Intense fear of C. Disturbed body energy intake in gaining weight or image, undue influence relation to needs, becoming fat, or of weight or shape on leading to significantly persistent behavior self-evaluation, or denial low body weight in that interferes with of the seriousness of the relation to age, sex, weight gain, even at current low body course of development significantly low weight. and physical health. weight. Block 8: Psychiatry  Specify the current severity: Minimum severity is based, in adults, on current body mass index (BMI) or in children and adolescents, on body mass index percentile (BMI). A low body weight for adults will be a BMI 17 kg/m2 Moderate: BMI 16-16.99 kg/m2 Severe: BMI 15-15.99 kg/m2 Extreme: BMI