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Medicine Notes Clinical Psychiatry Notes

Eating Disorders Notes

Updated Eating Disorders Notes

Clinical Psychiatry Notes

Clinical Psychiatry

Approximately 47 pages

This series of notes is on psychiatry. It includes psychiatry basics, treatments and complications. Each disease is separated into a different document, with it's own classification. These notes were made using a variety of textbooks, notes from tutorials with consultants and knowledge gained on the ward with doctors. These notes helped me a achieve a good grade of 78% in the end of year exams....

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The following is a more accessible plain text extract of the PDF sample above, taken from our Clinical Psychiatry Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Eating Disorders

  • Diagnostic criteria

    • ANOREXIA NERVOSA

      • General

        • BMI <17.5 (weight loss)

        • Weight loss self-induced by restricted eating especially of calorie rich foods

        • Other means of weight control too

          • Exercise

          • Vomiting

          • Purging

        • Characteristic psychopathology

          • Self-perception of being too fat when thin

          • Extreme fear of weight gain

          • Body shape and weight become all important

        • Widespread endocrine disturbance

          • Amenorrhoea

          • Libido loss

        • 2 subtypes

          • PURE RESTRICTING (eating restraint and exercise)

          • BINGE-PURGING TYPE (self induced vomiting &/or laxative misuse)

      • DSM IV criteria

        • Not maintain minimum body weight

        • Despite being underweight=extreme fears of becoming fat

        • Self perception=abnormal

          • Unduly emphasises weight/shape

          • Denies seriousness of low weight

          • Has distorted perception of own body shape/weight

        • Weight loss=missed 3 consecutive periods/only with hormones

    • BULIMIA NERVOSA

      • General

        • Recurrent binge eating (2/7 over 3 months)

        • Binge=large quantity of food in short period with loss of control

        • Extreme methods of weight control

          • Vomiting

          • Purging

          • Starvation periods

          • Excessive exercise

        • Persistent preoccupation with eating, sense of compulsion to eat

        • Characteristic psychopathology

          • Self-perception=too fat

          • Extreme fear of weight gain

          • Body shape and weight all important

        • Usually around normal weight range

          • If significantly underweight= AN-BINGE PURGING TYPE

      • DSM IV criteria

        • Binge episode

          • Consume much more food than most people would

          • Feels eating is out of control

        • Control weight gain by

          • Fasting

          • Vomiting

          • Excessive exercise

          • Laxative/diuretic abuse

        • 2/7 for 3 months

        • Symptoms not solely during AN episodes

  • Atypical eating disorders

    • Outside the diagnostic criteria for AN or BN

      • Partial syndromes of AN or BN

      • Mixed picture, both AN and BN

      • Binge eating disorder- bingeing without compensatory weight controlling behaviour (often obese)

    • Obesity not considered ED

  • Who is affected?

    • >90% female

    • AN= mid to late teens; BN= late teens to early twenties

    • Insecure, uncomfortable and dissatisfied with bodies

    • Developmental tasks of adolescence and early adulthood include

      • Physical & sexual maturation

      • Adopting adult sexual identity

      • Making one's way in the world with increasing independence

      • Developing intimate adult relationships

      • Loosening emotional ties to parents & family

    • Risk factors

      • Dieting

      • High rates in dancers, athletes, models

      • Family Hx (genetic and environmental)

      • Personality traits (rigid, obsessive, perfectionist, unable to express emotion)

      • SOCIAL CLASS IS NOT; INTELLIGENCE/ABILITY IS NOT

    • Prevalence

      • AN

        • 10-30/100,000

        • ~0.5% young females

      • BN

        • 50-150/100,000

        • ~1% young females

      • Atypical

        • ~5/1000

  • Why do people develop eating disorders?

    • Fear of fatness/desire to be slim

      • Many start with slimming

      • Dissatisfaction

      • Broader unhappiness becomes focussed on body

      • Societal belief that weight/shape very important

    • Social influences

    • Genetics

    • Family environment influences

      • Eating behaviour/attitudes learnt at home

    • Childhood traumas

      • 30% women previously sexually abusive experience

    • Low self esteem

    • Difficulty expressing emotions

    • Life stage

  • Physical complications of eating disorders

    • CARDIOVASCULAR

      • Thinning myocardium

      • Brady

      • Hypotension

      • Poor peripheral circulation

      • Arrhythmias (e.g. prolonged QT)

        • Hypokalaemia

    • GASTROINTESTINAL

      • ...

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