Anorexia nervosa: symptoms and features

Question 1

What is anorexia nervosa?

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Answer 1

-Eating disorder characterised by self induced weight loss

Question 2

What is restriction of energy intake (symptom)?

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Answer 2

• Extremely limits what they eat, causes significantly low body weight (taking into account age, sex)

Question 3

How does DSM-5 define ‘significantly lower body weight’ (Restriction of energy intake)?
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Answer 3

• ‘Less than minimally normal’

Question 4

How does ICD-10 define ‘significantly lower body weight’ (Restriction of energy intake)?
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Answer 4

• ‘Maintained at least 15% below expected or BMI is 17.5 or less’ (most accepted definition)

Question 5

What is fear of weight gain (DSM-5) - symptom?

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Answer 5

• Intense fear of gaining weight or becoming fat

Question 6

What are interfering behaviours (fear of weight gain)?

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Answer 6

• Behaviours that prevent them from gaining weight, DSM gives no examples

Question 7

What are some examples of interfering behaviours according to ICD-10 (fear of weight gain)?
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Answer 7

• Self induced vomiting/purging
• Excessive exercise
• Appetite suppressants

Question 8

What is meant by a disturbed experience of body weight/shape (symptom)?
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Answer 8

• Where weight/shape has disproportionate influence on persons self evaluation (perceive themselves)
• Fail to recognise how badly low their body weight is

Question 9

What would an individual be like in the restricting subtype?

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Answer 9

• Person not binged/purged (laxatives) during 3m before diagnosis (DSM-5)
• Weight loss = dieting (1 meal a day) or ^exercise

Question 10

What would an individual be like in the binge eating or purging subtype?
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Answer 10

• They binged/purged in previous 3m (DSM-5) + restrict energy intake

Question 11

What did Dahlgren et al. find?

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Answer 11

• Life prevalence Female = 1.7-3.6% Male = 0.1%

Question 12

What did Zerwas et al. find?

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Answer 12

• Occurrence of AN in 16-20 yr = 6.05 new cases per 10,000 people years

Question 13

What did Arcelus et al. find?

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Answer 13

• 6x as many deaths expected for F, highest mortality of all mental disorders

Question 14

What did Papadopoulos et al. find?

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Answer 14

• Being younger, staying longer in first hospitalisation = better outcome, survival

Question 15

Evaluate diagnosis of anorexia nervosa

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Answer 15

Sysko et al. measured test-retest reliability of AN diagnosis. Ppt assessed by telephone interview using DSM criteria. 3-7 days later diff assessor phoned each ppt. Extent of agreement (2 occasions) = excellent

> validity, severity rating dsm. Smith et al. looked at 4 severity specifiers. Found, in 109 AN adults, ^BMI (low severity) linked to ^eating disorder pathology

Question 16

What are the symptoms of anorexia nervosa?

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Answer 16

• Fear of weight gain
• Disturbed experience of body weight/shape
• Restriction of energy intake