Psych Review Notes 6 Flashcards
In Keye’s study of healthy men who were starved,
What symptoms did they develop? What % never recovered?
Symptoms=moody, loss of humor, preoccupation with food, discussion of recipes, group solidarity, decreased decision making.
20% were permanently psychologically hurt and never recovered.
What are the subtypes of anorexia nervosa?
Restricting and Binge-Purge Types
What are some risks for AN?
Females, Genetics, Obstetrical complications, Dieting, Athletes (disordered eating, amenorrhea and osteoporosis)
What is the DSM definition of bulimia nervosa?
Binge eating (large amounts or a sense of lack of control), with recurrent compensatory behavior (purging, laxatives, over-exercising, pills, restricting), both occur 2x week for over 3 months.
Are genetics more a risk factor in AN or BN?
Anorexia has more of a link to genetics
What cathartic (drug that causes purging) can cause heart enlargement and cardiac toxicity?
Syrup of Ipecac
What are the four main causes of death in eating disorders?
Starvation, Cardiac Arrhythmia, Suicide, Gastric Dilatation/Rupture
- eating disorders have the highest death rate
- about 10% of ED pts will die from d/o directly (above)
What is the most common Axis I comorbidity in both AN and BN?
MDD or Dysthymia (50-60% of patients)
Which disorder does` better on psych meds, AN or BN?
Bulimia—SSRI’s show ability to dec binging behaviors; 50% reduction in sxs (but not elimination of sxs)
- Note: CBT is FIRST LINE tx for BN, not meds
- Note: best tx in AN is Family Therapy, best if pt is <21 y/o
What is the diagnosis if patients have recurrent binges, 2x/week
Over period of 6 months with marked distress over the binging?
Binge-Eating Disorder.
- No purging behaviors
- pts eat alone 2/2 embarrassment, eat when not hungry
- Men=Women, onset in middle adult years
Even after AN patients return to a normal weight, are they still
At risk for fertility and pregnancy complications?
Yes-reproductive rates are diminished-higher rate of pregnancy complications even if at normal weight!
What are the axes each for?
Axis I-DSM IV disorders Axis II-Personality Disorders and mental retardation Axis III-General Medical Axis IV-psychosocial and environmental Axis V-Global assessment of fxn
What sort of gain is sought in factitious disorder?
PRIMARY gain=patient wants to be in sick role and cared for, intentionally produce complaints.
- pts often will have undergone multiple medical procedures
- pts often work in medical field or family does
- note that malingering is for SECONDARY gain
What are two strong predictors of violence?
EtOH intoxication and an overt stressor (breakup, loss)
- Males ages 15-24 most likely to be violent
- Low socioeconomic status, poor social support
What sort of disorder is it when a patient expresses feelings unintentionally
And unconsciously through a metaphorical body dysfunction?
(feelings of hitting pt’s mom→paralysis of pts right arm)
Conversion disorder
- dramatic sudden development of neurologic symptoms not associated with usual signs and test results expected
- Similar to conversion d/o, somatization is also unconscious and unintentional
