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BRS PSYCHIATRY > 1b Eating Disorders > Flashcards

1b Eating Disorders Flashcards

1
Q

What are eating disorders

A

Mental disorders characterized by a persistent disturbance of eating behavior or behavior intended to control weight, which significantly impairs physical health or psychosocial functioning.

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2
Q

What drives eating disorders?

A

Fear of fatness or extreme distress about eating.

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3
Q

What is quantity-restricted eating?

A

Quantity-restricted eating is a type of eating disorder characterized by limiting the amount of food that is consumed.

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4
Q

What is range-restricted eating?

A

Range-restricted eating is a type of eating disorder characterized by limiting the types of food that are consumed.

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5
Q

What are some behaviors intended to control weight?

A

Restricted eating (fasting), self-induced vomiting, excessive exercise, and taking laxatives, diuretics, or other energy-burning or appetite-suppressing medications (such as caffeine or smoking).

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6
Q

What are the impacts of eating disorders on physical health?

A

• Impacts growth and development
• Stop periods
• Effects on the brain
• Results in osteoporosis
• High mortality

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7
Q

How do eating disorders impair psychosocial function?

A
  • Functional impairment
  • Distress
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8
Q

What are the functional impairments associated with eating disorders?

A

It impacts work, relationships (family, peers,
intimate), and daily living.

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9
Q

What are the different types of Feeding and Eating
Disorders according to DSM5 and ICD11?

A

Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Other Specified Feeding and Eating Disorders (OSFED), Avoidant/Restrictive Food Intake Disorder (ARFID), Rumination Disorder/Syndrome, and Pica.

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10
Q

What is Anorexia Nervosa?

A

An eating disorder characterized by a distorted
body image, an intense fear of gaining weight, and
a severely restricted diet.

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11
Q

What is Bulimia Nervosa?

A

An eating disorder characterized by binge eating
followed by purging, typically through self-induced
vomiting or laxative abuse.

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12
Q

What is Binge Eating Disorder?

A

An eating disorder characterized by recurrent
episodes of eating large quantities of food in a short
period of time, often to the point of discomfort,
without purging.

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13
Q

What is Other Specified Feeding and Eating
Disorders (OSFED)?

A

A category of eating disorders that do not meet the criteria for Anorexia Nervosa, Bulimia Nervosa, or Binge Eating Disorder, but still cause significant distress or impairment.

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14
Q

What is Avoidant/Restrictive Food Intake Disorder (ARFID)?

A

An eating disorder characterized by a persistent
failure to meet appropriate nutritional and/or energy needs, often due to a lack of interest in food or an avoidance of certain foods or food groups.

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15
Q

What is Rumination Disorder/Syndrome?

A

An eating disorder characterized by the repeated
regurgitation and re-chewing of food, often without
any apparent nausea or gastrointestinal distress.

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16
Q

What is Pica?

A

An eating disorder characterized by the persistent consumption of non-food substances, such as dirt, paper, or hair.

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17
Q

What are the two main features of Anorexia
nervosa?

A
  • Intense fear of gaining weight or becoming fat, or
    persistent behavior that interferes with weight gain,
  • Disturbance in experience of weight/shape,
    undue influence of weight/shape on self-evaluation,
    or persistent lack of recognition of seriousness of
    low body weight.
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18
Q

What is the difference between the two subtypes of Anorexia nervosa?

A

Restricting subtype involves restricting food intake,
while binge-eating/purging subtype involves binge
eating and/or purging behaviors.

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19
Q

What is not included in DSM-5 criteria for Anorexia
nervosa?

A

Amenorrhea.

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20
Q

What happens during overeating episodes in
Bulimia Nervosa?

A

A large amount of food is consumed in a discrete
time period.

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21
Q

What are inappropriate compensatory mechanisms
in Bulimia Nervosa?

A

Behaviors such as self-induced vomiting, misuse of
laxatives, diuretics, or other medications, fasting, or
excessive exercise.

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22
Q

What is body image disturbance in Bulimia
Nervosa?

A

A distorted perception of one’s own body shape and weight.

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23
Q

How often do overeating episodes occur in Bulimia
Nervosa?

A

At least once a week for three weeks.

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24
Q

What is the difference in weight status between
Anorexia nervosa and Bulimia nervosa?

A

Anorexia nervosa results in significantly low weight,
while Bulimia nervosa can result in normal or high
weight.

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25
Q

What is the common feature between Anorexia
nervosa, Bulimia nervosa, and Binge Eating
Disorder?

A

Guilt and shame are common features in all three
eating disorders.

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26
Q

What is the method of compensating for food intake
in Anorexia nervosa?

A

Dietary restriction is the method of compensating
for food intake in Anorexia nervosa.

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27
Q

What are the methods of compensating for food intake in Bulimia nervosa?

A

Self-induced vomiting and excessive exercise are
the methods of compensating for food intake in
Bulimia nervosa.

28
Q

Is dietary restriction a feature of Bulimia nervosa?

A

Yes, dietary restriction is a feature of Bulimia

nervosa.

29
Q

What is the abbreviation of the diagnostic manual
that includes Atypical AN?

A

DSM5.

30
Q

What is Purging Disorder?

A

An eating disorder characterized by recurrent purging behaviors to control weight or shape in the absence of binge eating episodes.

31
Q

Is Purging Disorder included in DSM5?

A

Yes, it is considered as an Atypical AN subtype in

DSM5.

32
Q

Is Purging Disorder included in ICD11?

A

Yes, it is included as a separate diagnosis in ICD11.

33
Q

Is binge eating present in purging disorder?

A

No, it is absent.

34
Q

What is the weight range of individuals with purging
disorder?

A

Normal weight range.

35
Q

What is OSFED?

A

OSFED stands for ‘Other Specified Feeding or

Eating Disorders’.

36
Q

What are the types of OSFED?

A

Atypical AN, purging disorder, atypical BN, and

night eating syndrome.

37
Q

What is ARFID?

A

ARFID stands for Avoidant/Restrictive Food Intake
Disorder. It replaces and extends Feeding
Disorders of Infancy and Early Childhood (FdoIEC).

38
Q

What are the symptoms of ARFID?

A

The symptoms of ARFID include feeding/eating disturbance, significant weight loss, significant nutritional deficiency, dependance on enteral feeding/nutritional supplements, and marked interference with psychosocial functioning.

39
Q

What is the difference between ARFID and other
eating disorders?

A

Unlike other eating disorders, ARFID does not
involve weight/shape concerns.

40
Q

What are the three subtypes of ARFID?

A

The three subtypes of ARFID are: individuals who
do not eat enough/show little interest in feeding,
individuals who only accept a limited diet in relation
to sensory features, and individuals whose food
refusal is related to aversive experience.

41
Q

What percentage of adolescent girls show ED behaviors by age 16?

A

Around 40%.

42
Q

What percentage of adolescent girls are
diagnosable with ED by age 16?

A

11%.

43
Q

Are the incidence rates of AN and BN stable?

A

Yes.

44
Q

Are the incidence rates of OSFED and BED
increasing?

A

Yes, they may be increasing.

45
Q

Which is the most common disorder in ED clinics?

A

AN (Anorexia Nervosa).

46
Q

Is there much research on ARFID?

A

No, not much research has been done on ARFID.

47
Q

What is the definition of prevalence?

A

Existing cases at a time point or over a time period.

48
Q

What is the prevalence of AN in adolescents?

A

0.3-2%, but higher using DSM5 criteria (no

amenorrhea).

49
Q

What is the prevalence of BN in adolescents and adults?

A

Adolescent: 1-2%, Adult: 2-3%.

50
Q

What is the female to male ratio for BN?

A

9:1

51
Q

What is the lifetime prevalence of BED in females
and males?

A

Females: 2.3%, Males: 0.8%.

52
Q

What are eating disorders classified as?

A

Serious mental illnesses, like psychoses but more common

53
Q

What is the likelihood of first-degree relatives
developing AN?

A

11 times more likely

54
Q

What is the percentage of first-degree relatives likely to develop AN?

A

Between 58% -74%

55
Q

What is the percentage of first-degree relatives likely to develop BN?

A

Between 54%-83%

56
Q

What is the percentage of first-degree relatives likely to develop BED?

A

Between 41%-57%

57
Q

What are some risk factors for eating disorders?

A
  • Psychological
  • Trauma/ Life events
  • Family
  • Socio-cultural factors
58
Q

What are the psychological risk factors for eating disorders?

A
  • perfectionism (especially fasting and purging)
  • High self esteem - protective for AN; low self esteem - risk factor for bulimic and compulsive eating
  • anxiety disorders (i.e. OCD) - risk of AN
  • externalising disorders (i.e. ADHD), hx of depression risk of BN,
59
Q

What trauma/life events can be risk factors for eating disorders?

A
  • Sexual abuse (binge-purge type disorders)
  • Life events (non-specific)
60
Q

What family influences can be risk factors for eating disorders?

A
  • Maternal emotional wellbeing and protective parenting style
  • Maternal dieting and paternal comments about weight influence girls but not boys
61
Q

What socio-cultural factors can be risk factors for eating disorders?

A
  • Some evidence of increase in developing countries of incidence/prevalence (mass media exposure)
  • Bullying, teasing by peers, social pressure to be thin
  • Exposure to social network media
62
Q

What are the current psychological interventions for childhood eating disorders?

A

Children and Young People:
- ED focussed Family Therapy
- CBT
- Adolescent focussed therapy (AN only)

63
Q

What are the current psychological interventions for adult eating disorders?

A

Adults
- MANTRA (Maudsley Model of Anorexia Nervosa Treatment for Adults) (AN only)
- SSCM (Specialist Supportive Clinical Management) (AN only)
- CBT

64
Q

What are the key points for medication for eating disorders?

A
  • Never use on its own
  • Tends to be used to manage comorbidities or support symptoms control in short term
65
Q

What medications are most commonly used for eating disorders?

A
  • SSRIs for anxiety or depression
  • Olanzapine or aripiprazole to reduce emotional dysregulation during refeeding
66
Q

What are the long term complications of eating disorders?

A
  • Death
  • Growth stunting (if pre-pubertal onset)
  • Osteoporosis
  • Pregnancy complications
  • Dental erosion
  • Mental health comorbidities including substance misuse
67
Q

What are the common outcomes of eating disorders?

A
  • Most young people go into remission (80%)
  • Some relapse in adulthood
  • Later onset and certain personality traits increase likelihood of persistence

BRS PSYCHIATRY (12 decks)

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