Lecture 6 - Eating Disorders Flashcards
1
Q
What is PICA?
A
- persistent eating of non-nurtitive, non-food substances
- 1mth
- childhood onset most common
- in adults: MI and ID
- prev unclear
2
Q
What is Rumination Disorder?
A
- repeated regurgitation of food after feeding/eating
- 1mth
- childhood onset most common
- in adults: MI and ID
- prev unclear
3
Q
What is Avoidant/Restrictive Food Intake Disorder?
A
- avoidance/restriction of food intake
- failure to meet requirements for nutrition or insufficient energy intake through oral intake of food
- weight loss, nutritional deficiency, dependence on enteral feeding/oral nutritional supplements, interfered functioning
- childhood onset most common
- COMORBIDITIES: anxiety, OCD, neurodevelopmental (ASD, ADHD, ID)
4
Q
What are the DSM-5 criteria for Anorexia?
A
- restriction of energy intake leading to low body weight
- intense fear of gaining weight/becoming fat or persistent behaviour interfering with weight gain
- disturbance in way one’s shape/weight is experienced
- self-evaluation unduly influenced by shape/weight
- persistent lack of recognition of seriousness of low body weight
- subtypes: restricting, binging/purging
5
Q
What is the prev, onset, comorbidity and course of AN?
A
- prev: 0.1-1% (10F:1M)
- subthreshold more common
- onset: late teens/early 20s (later onset becoming more common)
- comorbidity: 60% dep, 33% anx
- course: highly variable
- recover
- fluctuate + relapse
- chronic deteriorating course (20%)
- cross-over to BN (50%)
- high rates of suicide
- mortality rate 5-10%
6
Q
What are the associated features of AN?
A
DISORDERED EATING
- food rituals
- food preoccupation
- food preferences
- cook for others, not self
- hungry but refuse to eat
PHYSIOLOGICAL COMPLICATIONS
- hair thin
- low HR/BP
- anaemia
- kidney failure
- bloat
- cog feature: mood, mmeory, concentration
PSYCHOLOGICAL FEATURES
- perfectionism
- feelings of ineffectiveness
- inflexible thinking
- overly restrained emotional expression (eg. anger)
- limited social spontaneity
7
Q
What are the DSM-5 criteria for Bulimia?
A
- recurrent episodes of binge eating
- recurrent inappropriate compensatory behaviours to prevent weight gain
- binging 1/wk for 3 mths
- self-evaluation unduly influences by shape/weight
8
Q
What is the prev, onset, comorbidity and course of BN?
A
- prev: 1-1.5% (10F:1M)
- subthreshold more common
- onset: late-early adulthood (later than AN)
- often occurs after an episode of dieting
- course: chronic or intermittent
- often lasts several years
- remission and recurrences of binging often alternate
- comorbidity: MDD, anxiety, substance use 33%
9
Q
What are the associated features of BN?
A
PSYCHOLOGICAL FEATURES
- low SE
- guilt
- preoccupied with food
- recognise behaviour is abnormal
PYSIOLOGICAL COMPLICATIONS
- anaemia
- swollen cheeks
- abraised knuckles
- irregular HR
- sore/irritated throat
10
Q
What is Binge Eating Disorder? Prevalence?
A
- recurrent episodes of binge eating (size, time, control)
- 1/wk for 3mths
3+ of
- eating rapidly
- eating until uncomfortably full
- eating when not physically hungry
- eating alone (embarrassed)
- disgusted with oneself (depression, guilt)
- 1.6% F, 0.8% M
- higher in obese populations
11
Q
What are OSFED and UFED?
A
Other Specified FED:
- atypical AN (not low weight)
- atypical BED (lower freq/duration)
- atypical BN (lower freq/duration)
- night eating syndrome
- purging disorder (without binging)
Unspecified FED:
- behaviours cause clinical distress/impairment but don’t meet full criteria for any other disorder
- clinician may not want to specify which criteria were met
- may be insufficient info to make specific diagnosis
12
Q
What is the deal with males and eating disorders?
A
- 10% of EDs in males
- 17% diet
- 31% want heavier, 31% want lighter
- body dissatisfaction increasing (15% in 1972, 34% in 1985 and 47% in 1997)
- extreme dieting/self-induced vomiting increasing more in M than F
13
Q
What are the treatment outcomes for EDs?
A
- worse for AN (50%) than BN (75%)
- better short-term from BED (25-80%) and at 1yr follow-up
- higher remission for EDNOS short-term (<5yrs) (68%) > but at 5yrs there is little diff b/w EDNOS and BN
14
Q
What are the prognostic factors of EDs?
A
- AN: severity, duration, body/weight concern
- BN: severity, psychiatric comorbidity
- BED: early abstinence from binge eating and to interpersonal factors
15
Q
What are the genetic risk factors for EDs?
A
- moderate heritability
- AN: 50-60%
- BN: 58-83%
- BED: 82%
- teenage obesity: 86%
