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PSYCHIATRY phase 1b > Eating Disorders > Flashcards

Eating Disorders Flashcards

1
Q

What is an eating disorder?

A
  • mental disorder
  • persistent disturbance of eating behaviour or behaviour intended to control weight which significantly impairs physical health or psychosocial functioning
  • driven by fear of fatness or extreme distress about eating
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2
Q

What are the two disturbances of eating behaviour?

A
  • binge eating
  • restricted eating (quantity or range)
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3
Q

What are behaviours intended to control weight?

A
  • fasting
  • self-induced vomiting
  • excessive exercise
  • laxative, diuretic or other energy burning and appetite supressing medication
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4
Q

How do eating disorders impair physical health?

A
  • impacts growth and development
  • stops periods
  • affects brain
  • osteoporosis
  • high mortality
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5
Q

How do eating disorders impair psychosocial function?

A
  • work
  • relationships
  • daily living
  • distress
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6
Q

What are the eating disorders in the DSM-5 and ICD11?

A
  • anorexia nervosa
  • bullimia nervosa
  • binge eating disorder
  • other specified feeding and eating disorder (OSFED)
  • avoidand/restrictive food intake disorder (ARFID)
  • rumination disorder
  • pica
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7
Q

Wat are the key symptoms of anorexia?

A
  • restriction of food intake leading to significantly low body weight
  • intense fear of gaining weight or persistent behaviour that interferes with weight gain
  • disturbance in experience of weight/shape
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8
Q

What are the sub-types of anorexia?

A
  • restricting
  • binge-purge
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9
Q

What are the syptoms of bullimia?

A
  • characterised by binging rather than purging
  • overeating episodes (large amount of food and lack of self control)
  • inappropriate compensatory mechanisms
  • body image disturbance
  • occurs once a week for at least 3 weeks
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10
Q

What are the symptoms of binge eating disorder?

A
  • episodes of overeating
  • no or minimal compensation
  • frequently overweight
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11
Q

What is purging disorder?

A
  • purging without binging
  • vomiting, laxatives, diuretics or other medications including insulin
  • weight is often normal
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12
Q

Which disorders come under OSFED?

A
  • atypical anorexia
  • purging disorder
  • atypical bullimia
  • night eating disorder
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13
Q

What are the symptoms of ARFID?

A
  • eating disturbance
  • significant weight loss
  • significant nutritional deficiencies
  • dependance on enteral feeding or nutritional substances
  • interference with psychosocial functioning
  • no weight/shape concerns
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14
Q

What are the three main subtypes of ARFID?

A
  • not eating enough/little interest in eating
  • diet is limited due to sensory issues
  • refusing food because of adverse experiences
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15
Q

What is the epidemiology of eating disorders?

A
  • relativrly common in childhood and adolescence
  • around 40% of adolescent girls show ED behaviours by age 16 but only 11% diagnosable
  • incidence of anorexia and bullimia are stable
  • OSFED and BED are increasing
  • anorexia is most common in clinic
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16
Q

What is the peak onset for eating disorders in women?

A

15-19

17
Q

What is the most prevelant eating disorder?

A

Binge eating disorder

18
Q

What is the guidance used for medical emergencies caused by eating disorders?

A

MARSIPAN guidance

19
Q

What does the medical team need to do for ED patients in a medical emergency?

A
  • actively treat patient
  • safe refeeding
  • managing fluid and electrolyte imbalances
  • arranging discharge to an appropriate setting
  • managing ED behaviours
20
Q

What does the mental health team need to do for ED patients in a medical emergency?

A
  • assess and treat patients under compulsion
  • address family concerns
  • advise on appropriate onward care
  • advise on patients with complex comorbidities (e.g personality disorders or autism)
21
Q

What are key points to consider in treating patients with an eating disorder?

A
  • they are not visible
  • normal bloods do not mean things are ok
  • cardiovascular parameters are the best pointer to risk
  • intake and rate of weight loss > weight
  • red for risk means ask someone who knows
22
Q

What are the family risk factors for eating disorders?

A
  • history of dieting/eating disorders
  • history of depression, anxiety or alcohol dependence
  • history of obesity
23
Q

What are some individual risk factors for eating disorders?

A
  • female
  • genetics
  • premature birth
  • low self esteem
  • perfectionism
  • previous depression or anxiety
  • previous obesity
  • early puberty
  • diabetes
  • Crohn’s disease
  • temperment
  • neurocognition
  • life events
  • trauma
24
Q

How do eating disorders become self-perpetuating?

A
  • weight loss from diet leads to starvation-induced changes
  • increses anxiety, depression and obsessionality
  • leads to chronic illness
25
Q

What is the most common model for the onset of eating disorders?

A
  • Stice and Argas dual pathway model
  • updated Stice and Shaw dual pathway takes into acount that high BMI increases likelihood of developing an eating disorder and that there is a range of eating pathologies
26
Q

What is the triad of evidence based practise?

A
  • best scientific evidence
  • clinical experience
  • patient preference
27
Q

What is the best scientific evidence for eating disorders?

A
  • evidence of effectiveness of existing treatments is weak across the age range
  • few large scale randomized controlled treatment trials and many show no difference between treatment arms
28
Q

What are the main psychological interventions for children and young people with eating disorders?

A
  • ED focused family therapy
  • CBT
  • adolescent focused therapy for anorexia
29
Q

What are the main psychological interventions for adults with eating disorders?

A
  • MANTRA and SSCM for anorexia
  • CBT
30
Q

What does psychoeducation for eating disorders focus on?

A
  • effects of starvation on the body and mind
  • regulating body weight
  • dieting
  • adverse effects of inappropriate compensatory behaviours
31
Q

What is the goal of psychological interventions for eating disorders?

A
  • increasing confidence in making good decision when coping with stress which don’t include food or eating
32
Q

What are the most common medications used for eating disorders?

A
  • SSRIs for depression and anxiety
  • olanzapine or aripiprazole to reduce emotional dysregulation during refeeding
33
Q

What are the key things to remember about medication for eating disorders?

A
  • should never be used on its own
  • tend to manage comorbidities or support symptoms short-term
34
Q

What are the long term complications of eating disorders?

A
  • death
  • growth stunting
  • osteoporosis
  • pregnancy complications
  • dental erosison
  • mental health comorbidities
  • substance misuse
35
Q

What are the outcomes for eating disorders?

A
  • 80% of young people go into remission
  • later onset and certain personality traits increase likelihood of persistence
36
Q

What are possible triggers and maintaing factors for eating disorders?

A
  • puberty
  • socio-cultural pressures
  • family
  • pressure to achieve
  • peer behaviours
  • comments about weight

PSYCHIATRY phase 1b (7 decks)

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