Anxiety Disorders Flashcards
% of EDs that are men / boys
15 to 20
BMI of bulaemia
normal / above normal
BMI of binge eating disorder
above normal
BMI of anorexia
low
what common belief do eating disorders have
individuals judge their self worth in terms of their shape / weight / eating / ability to control these features
EDs have highest rate of mortality of any mental illness. true or false?
TRUE - pre pandemic for sure but likely now
ED with the highest mortality rate
anorexia
why does anorexia have the highest mortality rate
physical decline & suicide
sex ratio of AN
1:10 F:M
age on onset for AN usually
16 to 17
diagnostic for AN
15% below expected or BMI under 17.5
behaviours of AN
self induced weight loss
avoidance ofcertain foods / resitriction
vomitting / purging / xs exercise / appetite suppresants / laxatives
thoughts of AN
body image distortion
dread of fatness
overvalued ideas
imposed low weight threshold
endocrine disorders of AN
HPA axis
amonorhoea
reduced libido / impotence
raised GH levels
altered TFTs
abnormal insulin secretion
delayed / arrested puberty
causes of EDs
genetics, personality, cultural enviroment, reaction to traumatic life event
physiological risk factors
lack of adaptive coping strategies
easily anxious / shy
personality traits: perfectionist / rigidity / impulsive
low self esteem
feelings of inadequacy / lack of control in life
depression, anxiety, anger, lonely
overlap of AN with other mental health disorders
depression - Sx of depression are Sx of starvation too
anxiety / OCD / social phobia - obsessions / compulsions related to food / exercise / weight
maintaining factors of AN
starvation –> difficulty concentrating / infelxible thinking / low mood / bloating makes ppl feel they lose control / guilt and denial
affected loved ones –> unhelpful, conflict, anger, carers can be lulled in false sense of security, intelligence masks it, splitting of family
how can you think of ED
like a food phobia
dental and renal consequences of ED
dental caries
renal calculi
blood issues of AN
anaemia, leucopaenia, thrombocytopaenia
neuro signs of AN
peripheral neuropathy, loss of brain volume
reproductive issues of AN
infertility, low birth weight infant
endocrine issues of AN
low K/Na/sugar/Ca/body temp
amenorrhoea, osteoporosis, high cortisol
russels sign?
callused skin over interpharangeal joints due to xs vomitting
hypercaratonaemia?
orange tint to skin like jaundice but spares sclera
heart and tummy issues of AN
low BP, porlonged QT, arrhytmias, cardiomyopathy
delayed gastric emptyingd
derm issues of AN
dry scal skin, brittle hair, lanugo hair
screening questionaire of AN
SCOFF
what is included in SCOFF Qs
do you make yourself sick when you feel full
*****
other features to look for in AN
overvalued ideas about shape / weight
body image disturbance
hormonal disturbance - no periods etc
emotionally labile
hide behaviours
Ix of AN
full psych history
SCOFF questionnaire to screen
current ED Sx - vomiting, laxatives, exercise, periods
bio/ psycho / social factors
collateral history from family - also to see fmaily dynamics
blood tests for AN
FBC - high HB in dehydration
ESR - organic cause
U&Es - urea/creaitnine/K/Pi/Mg - low
CK - raised in exercising
Amylase - raised = vomitting
glucose
LFTs - elevated
TFT
albumin
cholesterol - elevated
hypercortisolaemia, raised GH, low LH/FSH, low E/P
why would Na be low in AN
ppl drink lots and lots of water to gain weight for weigh ins