Disturbances of behaviour and body physiology Flashcards
Anorexia Nervosa ICD10
- low bodyweight of 15% or more below the expected norm and BMI of 17.5 or less (only if aged over 16)
- self-induced weight loss, avoidance of foods, vomiting, purging, excessive exercise, use of appetite suppressants
- body image distortion, a dread of fatness
- endocrine disturbances- due to HPA axis dysfunction, amennorrhoea, reduced sexual interest, raised GH levels, increased cortisol, altered TFTs, abnormal insulin secretion
- delayed/arrested puberty if onset is pre-pubertal
Anorexia Nervosa DSM4
-amenorrhoea is defined as 3 consecutive cycles absent
2 types:
1. Binge-eating/purging type
2. Restricting type
Atypical anorexia nervosa
- disorder that fulfills some of the features of AN but in which the overall clinical picture does not justify the diagnosis
- older in age
- recurring bouts of depression
- numerous somatic complaints
- unmet dependency needs
- little evidence of distortion of body image is seen
ICD10 Bulimia Nervosa
- persistent preoccupation with eating
- irresistible craving for food
- binges
- attempts to counter the fattening effects of food
- morbid dread of fatness with imposed low weight threshold
- in atypical bulimia one or more of these features are absent
DSM Bulimia
2 types
- Purging
- Non-purging
Eating disorder not otherwise specified (EDNOS)
-most common DSM diagnosis of eating disorder
Binge eating disorder (BED)
- falls under atypical bulimia in ICD10 and EDNOS in DSM4
- recurrent binge eating with no purges
- associated with obesity
- mid 40s
- high degree of spontaneous remission and stressed associated overeating is a common phenomenon
Sleep walking
- ICD-10 Chaper 5 F51
- mostly childhood
- if persistence in adulthood then significant psychological disturbance is suspected
- can be seen in early dementia
Sleep terror
- ICD-10 Chapter V F51
- very little recall, autonomic disturbance
- disorientation on waking
Kleine-Levin syndrome
-ICD-10 chapter VI
-periods of hypersomnolence and hyperphagia
-non-specific EEG
-most often seen in adolescent males with complete recovery by 3rd and 4th decade of life
also lack of concentration, mood changes, hypersexuality and anxiety
Narcolepsy
- ICD-10 chapter VI
- excessive daytime drowsiness accompanied by a sudden onset of REM sleep (sleep seizure or narcolepsy)
- sleep paralysis and hypnagogic hallcuinations may also occur but are less common
- virtually always famililal
- 99.5% patients have the HLA antigen DR2
International Classification of Sleep DIsorders
- commonly used
- Dyssomnias- primary insomnia, primary hypersomnia, circadian sleep disorder, narcolepsy, breathing related sleep disorders, sleep state misperception
- Parasomnias: arousal disorders, sleep wake transition disorders, REM sleep parasomnias, other parasomnias
Dyssomnias
- ICSD
- primary insomnia
- primary hypersomnia
- circadian sleep disorders
- narcolepsy
- breathing related sleep disorders
- sleep state misperception
Arousal disorders
- parasomnias
- arise from NREM sleep
- confusional arousals
- sleep walking
- sleep terrors
Sleep-wake transition disorders
- sleep starts
- sleep talking
REM sleep parasomnias
- REM behavioural disorder
- nightmares
- sleep paralysis
Other parasomnias
sleep bruxism
sleep enuresis
Sexual disorders
-in ICD 10 coded in F52 group
-in DSM can be classified into
1. sexual desire disorders (sexual aversion, hypoactive sexual desire)
2. sexual arousal disorder (female sexual arousal disorder, male erectile disorder)
3. orgasmic disorders (female and male orgasmic disorder, premature ejaculation)
4. sexual pain disorder (dyspareunia, vaginismus)
5 other (related to substance missuse or general medical disorders)
Puerperal disorders
-F53
depression and psychosis
Non-dependence abuse
F55
-codes for abuse of a wide variety of medications, proprietary drugs and folk remedies, and psychotropic
drugs that do not produce dependence
-e.g antidepressants, laxatives and analgesics
