Impulse Control Disorders

Question 1

Describe intermittent explosive disorder and its treatment.

Answer 1

• it is recurrent outburst of aggression that result in assault against people or property which are out of proportion to the triggering event
• patients are often remorseful after
• treatment involves SSRIs, anticonvulsants, lithium, or propanolol

Question 2

What is the treatment for kleptomania?

Answer 2

psychotherapy, behavior therapy, and SSRIs

Question 3

What is the treatment for gambling disorder?

Answer 3

participation in Gamblers Anonymous and psychotherapy

Question 4

What is the treatment for trichotilomania?

Answer 4

SSRIs, antipsychotics, or lithium along with behavioral interventions like substituting another behavior, relaxation techniques, or positive reinforcement

Question 5

What is the treatment for pyromania?

Answer 5

behavior therapy, supervision, and SSRIs

Question 6

What are the criteria for anorexia nervosa?

Answer 6

• a BMI less than 17.5 or body weight less than 85% ideal
• an intense fear of gaining weight and distorted body image
• may be with or without burning and bingeing

Question 7

What is the treatment for anorexia nervosa?

Answer 7

• behavioral and family therapy

- supervised weight-gain program which may be supplemented with olanzepine for it’s metabolic side effects

Question 8

What are the criteria for bulimia nervosa?

Answer 8

• episodes of binge eating with inappropriate attempts to compensate occurring twice weekly for at least 3 months
• a preoccupation with body weight and body image

Question 9

What are the two key differences between anorexia nervosa and bulimia nervosa?

Answer 9

• bulimia nervosa is more egodystonic

- anorexia nervosa is defined by a low weight whereas those with bulimia often have a normal weight or are overweight

Question 10

What is the treatment for bulimia nervosa?

Answer 10

fluoxetine or another SSRI and CBT

Question 11

What are the criteria for binge-eating disorder?

Answer 11

• binge eating habits that lead to emotional distress occurring at least twice weekly for six months
• but do not engage in purging behaviors and are not preoccupied with body weight or image

Question 12

What is the treatment for binge-eating disorder?

Answer 12

• psychotherapy and behavioral therapy

- supplemented with stimulants for appetite reduction

Question 13

What are the key differences between anorexia nervosa, bulimia nervosa, and binge-eating disorder?

Answer 13

• anorexia is the only one defined by a low body weight
• bulimia nervosa is defined by a binge-purge cycle and preoccupation with body image and weight
• binge-eating disorder is also defined by a binge-purge cycle but is not associated with a disturbance in body image

Question 14

What pharmacotherapy is used for the treatment of anorexia nervosa, bulimia nervosa, and binge-eating disorder?

Answer 14

• anorexia: second generation antipsychotics for metabolic side effects
• bulimia: SSRIs, particularly fluoxetine
• binge-eating: stimulants for appetite reduction