Anorexia

Anorexia

    * Introduction
    * Diagnosis
    * Treatment
Anorexia nervosa is an eating disorder characterized by excessive low body weight, body image and distorted over their obsessive fear of weight gain. The term anorexia was established in 1873 by Sir William Gull, one of Queen Victoria's personal physicians. It comes from Greek and means lack of desire to miinca. Anorexia is considered to present the highest mortality of any psychiatric disorder in which 6-20% of patients die. The rate of suicide in people with anorexia is also higher compared to the general population.
Anorexia is characterized by emanciere, obsessive concern for the weak, unable to maintain a normal weight, lack of menstruation. Some people with anorexia lose weight through diet and exercise excessively to lose weight, others lost through induced vomiting, use of laxatives, diuretics or enemas.
Many people with anorexia see themselves as fat even when they are hungry or malnourished clear. Nutrition, food and weight control become obsessions. A person with anorexia is repeated weighs, his carefully portioned meals, eat only small amounts of food or only certain foods. Some people recover with treatment after only one episode, while other shows relapse.
According to some studies, people with anorexia are 10 times more likely to face death as a result of the disease by the general population. The most common complication leading to death is cardiac arrest, and electrolyte imbalances. Suicide may be a cause.
Treatment for anorexia nervosa targets three areas: restoration of a normal weight of the patient, treatment of psychological disorders associated with elimination behavior or thoughts and leading to eating disorders. Drug treatment with antidepressants or serotonin reuptake inhibitors have not proved generally effective to treat or prevent anorexia relapse. Treatment in the family and its participation is effective for adolescents with anorexia in the short term. Surveillance for 4 years show a recovery rate of 60-90% with 10% of patients remain severely ill.
Pathogenesis of anorexia Anorexia nervosa is the result of a combination of social factors, psychological, biological tend to affect women more than men and teenagers more than adults. Prepubertal patients who develop anorexia have a high incidence of premorbid anxiety disorders. Disorder onset during puberty led to the theory that exercise control over food intake and body weight, teens trying to compensate for the lack of autonomy of one's life. These patients have obsessive compulsive behavior and depression.
Malnutrition secondary starvation and protein deficiency leads to disruption of normal functioning of many organs and systems. In addition to hypoglycemia and vitamin deficiency, starvation triggers the release of endogenous opioids, hipercortizolism and suppression of thyroid function. Neuroendocrine disorders cause delayed puberty, amenorrhea, anovulation, lower levels of estrogen increase growth hormone, antidiuretic hormone decreased, hipercarotenemie and hypothermia. Hypogonadism occurs in men.
Cardiovascular effects include mitral valve prolapse, ventricular dysrhythmia, long QT syndrome, bradycardia, orthostatic hypotension, congestive heart failure and shock through. Renal disorders include decreased glomerular filtrate, edema, acidosis, dehydrated, hypokalemia, and hipoaldosteronism hypochloraemia. Note Gastrointestinal constipation, delayed gastric emptying, gastric dilatation and rupture. Dental erosion by vomiting, enlargement p [arotidelor, esophagitis, Mallory-Weiss syndrome. Causes and risk factors of anorexia Genetics: Twin studies estimate a high heritability of the disease, ranging between 56-84%. Other studies show pleiomorfism associated genes involved in regulating the feeding behavior, motivation, personality and emotions associated with anorexia nervosa.
Neurobiological factors: Anorexia may be related to serotonin system disorder. Starvation has been proposed to be linked to specific anxiety, impulsivity control, the low levels of tryptophan and thyroid hormone metabolism.
Nutritional Facts: Zinc deficiency may play a role in anorexia. It is not considered initially caused the disease but is a factor that depends on the accelerating pathology of anorexia.
Psychological factors: Anorexic behavior is believed to originate from an obsessive fear of weight gain due to a distorted image of their body. There is a perception problem, but one in which perceptual information is evaluated by the person affected. People with anorexia seem to judge her own body. they may be and other psychiatric disorders such as depression, obsessive compulsive syndrome, substance abuse.
Sociocultural factors: Sociocultural studies have highlighted the role of cultural factors such as poor women to promote the ideal figure industralizate western countries.
Anorexia relationship with autism: Following an initial suggestion of a link between anorexia and autism A study in Sweden with food issues and adolescents with autism. People with autism tend to show a negative prognosis, but may benefit from using combined methods of psychological counseling and medication therapy to improve autism.
Signs and symptoms in anorexia Anorexia nervosa is a psychiatric disorder with severe psychological consequences, characterized by the inability or refusal to maintain a normal body weight of the patient. Patients have a poor opinion of their appearance. Anorexia nervosa is first a phenomenon of puberty. 85% of patients experienced onset between ages of 13-18 years. Patients with anorexia usually present with other dominant personality as desire for perfection, academic success, lack of appropriate age and sex in favor of denying hunger starvation. Features include psychiatric addiction others bodily immaturity, social isolation, obsessive-compulsive behavior and feelings of constraint. Many people have disorders of affectivity, depression. Criteria for diagnosis of anorexia are: -Refusal to maintain minimal normal weight for age and height The fear of weight gain or becoming fat, even if the patient is weak Distorted their body-image in terms of shape and weight -Amenorrhoea at least three consecutive cycles postmenarha girls.
Anorexia nervosa is specified in two types: Restrictive: during the acute episode of anorexia, the person does not have regular or excessive diet-induced vomiting, laxative or enema administration. Food too: during the current episode of anorexia nervosa, the person shows abnormal behavior induced vomiting, administration of laxatives, diuretics, enemas.
ICD-10 criteria (International Classification of Diseases Statistics), also mentions: -Inducing ways in which patients lose weight or maintain a low body weight (avoiding fatty foods, induced vomiting, excessive exercise, excessive use of diuretics and appetite suprimantelor) -Psychological characteristics: endocrine disorders in women with amenorrhea and loss of sexual interest in men; homonului high levels of growth, levels of cortisol, alterations in peripheral thyroid hormone metabolism and insulin secretion abnormalities -If onset is before puberty, development is delayed the patient's body.
Physical Exam: Patients with anorexia nervosa can present a wide spectrum of disorders associated with weight loss: Physical examination may reveal, hypothermia, peripheral edema, thin hair and obvious emancierea Patient, behavioral disorder manifested psychomotor retardation and lack of -Include abnormal vital signs such as hypothermia, hypotension and bradycardia Systolic click-examination of the heart showed mitral valve prolapse -Patients who shed parotids shows enlargement, dental erosions, electrolyte imbalances, convulsions by Dermatologic examination showed, dry skin, lanugo and decreased skin turgor.