Psych: Management

Question 1

Anorexia nervosa, management?

Answer 1

For adults with anorexia nervosa, NICE recommend we consider one of: - individual eating-disorder-focused cognitive behavioural therapy (CBT-ED) - Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) - specialist supportive clinical management (SSCM). In children and young people, NICE recommend ‘anorexia focused family therapy’ as the first-line treatment. The second-line treatment is cognitive behavioural therapy. The prognosis of patients with anorexia nervosa remains poor. Up to 10% of patients will eventually die because of the disorder.

Question 2

Anorexia nervosa diagnosis?

Answer 2

• Diagnosis is now based on the DSM 5 criteria
• Note that BMI and amenorrhoea are no longer specifically mentioned:
  1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
  2. Intense fear of gaining weight or becoming fat, even though underweight.
  3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.