Eating Disorders Flashcards
Summary of Eating Disorders
Eating Disorders
The prevalence of eating disorders has increased rapidly over the last half century. As a result, they were included for the first time as a separate group of disorders in DSM-IV.
Bulimia Nervosa, Binge-Eating Disorder and Anorexia Nervosa
There are three prevalent eating disorders.
In bulimia nervosa, dieting results in out-of-control binge-eating episodes that are often follwed by purging the food through vomiting or other means. In binge-eating disorder, a pattter of binge eating is not followed by purging.
In Anorexia nervosa, in which food intake is cut dramtically, results in substantial weight loss and sometimes dangerously low body weight.
Statistics and Course for Eating Disorders
Bulimia nervosa and anorexia nervosa are largely confined to young women in developed countries who are pursuing a thin body shape that is culturally mandated and bioligical inappropriate, making it extremely difficult to achieve.
Causes of Eating Disorders
In addition to sociocultureal pressures, causal factors include possible biological and genetic vulnerabilities (the disorders tend to run in families), psychological factors (low self-esteem), social anxiety (fears of rejection) and distorted body image (relatively normal-weight individuals view themselves as fat and ugly).
Treatment of Eating Disorders
Several psychosocial treatments are effective, including cognitive-behavioural approaches combined with family therapy and interpersonal pscyhotherapy (IPT). Pharmacological treatments are less effective at the current time.
Obesity
Obestiy is not a disorder in DSM but is one of the more dangerous epidemics confronting the world today. Cultural norms that encourage eating high-fat and high-sugar foods combine with genetic and other factors to cause obesity, which is difficult to treat. Professionally directed behaviour-modification programmes emphasising diet and exercise are moderately successful, but prevention efforts in the form of changes in government policy on nutrition seem the most promising.
Sleep-Wake Disorders
Sleep-wake disorders are highly prevalent in the general population. Several types are recognised: dyssomnias (disturbances in amount and quality of sleep), parasomnias (abnormal events that occur during sleep), narcolepsy; breathing-related sleep disorders and circadian rhythm disrupurptions.
The formal assessment of sleep disorders, a polysomnias evaluation, is typically done by monitoring the heart, muscle activity, respiration and oxygen concentration as well as a surface electronecephalogram (EEG) in a suitably outfitted sleep laboratory. In addition to such monitoring, it is helpful to determine the individuals’s sleep efficiency, a percentage based on the time the individual actually sleeps as opposed to time spent in bed trying to sleep.
Hypnotic agents like benzodiazepines and non-benzodiazepines (zolipidem) are indicated and appropriate for the short-term treatment of insomnia. However, they have abuse potential, may cause rebound insomnia, impair congnition and promote falls. Any long-term treatment of sleep problems should include psychological interventions such as stimulus control and sleep hygiene.
Parasomnias such as nightmares occur during rapid eye movement (REM) (or dream) sleep, and sleep terrors and sleep walking occur during non-rapid eye movement (NREM) sleep.
