Understanding Anorexia Nervosa: Diagnosis, Origins, Evaluation, and Treatment - Prof. Nava, Apuntes de Psicología de la salud

¡Descarga Understanding Anorexia Nervosa: Diagnosis, Origins, Evaluation, and Treatment - Prof. Nava y más Apuntes en PDF de Psicología de la salud solo en Docsity! Apellido: Timiliotis Asignatura: Psicología de la Salud Nombre: Joanna Profesor: José Navarro Góngora Curso: B (3) Fecha: 30/03/2014 Comentario de texto 2 Anorexia Nervosa Abstract: The article to be commented on, written by E. Attia and B.T Walsh is about Anorexia nervosa which is a serious mental illness characterized by maintaining a low and inappropriate body weight. The DSM -IV lists four criteria for the diagnosis. The prevalence of anorexia is usually estimated 0.5-1 % for women and a tenth of it for men. The course of anorexia nervosa is very variable. The evaluation should include specific questions about eating behavior. The physical and behavioral characteristics have led to the development of a variety of neurobiological hypothesis. For younger patients the family-based treatment appears promising. Development of the main ideas: The main idea of this article is to inform about anorexia nervosa, as well as the diagnoses, the origin, the evaluation and treatment. Diagnostic Anorexia is a mental illness that drives people to lose more weight than is considered healthy and to suffer from distorted cognitions about shape and weight. Usually weight loss is achieved by a decrease in total food intake or binge eating and /or purging. The identification of anorexia nervosa can be very complicated, as sufferers carry it in secret, they are embarrassed and deny it and as a result the disease can stay undetected. In the current diagnosis, there are four criteria outlined by the DSM –IV: (1) the refusal to maintain body weight at or above a minimally normal weight for age and height, (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 and (4) in postmenarchal females, amenorrhea Furthermore, DSM-IV describes two subtypes of anorexia nervosa—the restricting subtype and the binge- purge subtype. The DSM-IV criteria are most easily applied when patients are both sufficiently ill to fulfill all four diagnostic criteria and able to describe their ideation and behavior accurately. However, because ambivalence and denial frequently lead those with anorexia nervosa to minimize their symptoms, the clinician must make inferences about mental state and behavior. An additional problem in diagnosis is that many individuals meet some but not all of the formal diagnostic criteria. Proper diagnosis of any condition that includes low weight and restrictive eating must include consideration of other psychiatric and medical conditions that include these problems. Medical conditions, including endocrine disturbances, gastrointestinal disturbances, infections, and neoplastic processes may present with weight loss and should be considered when evaluating a patient for a possible eating disorder. Background and Epidemiology Anorexia nervosa has been recognized for centuries, medieval stories are characterized by a large weight loss from a self-imposed starvation diet that transforms the sufferer. However, their first clinical descriptions were given by Morton in 1689 and the term Anorexia nervosa were coined by Gull in 1873. A 2002 review in the American Journal of Psychiatry concluded that little progress was made during the second half of the 20th century in understanding the etiology, prognosis, or treatment of the disorder. Despite its long-standing recognition, remarkably little is known about the etiology of, and effective treatment for, anorexia nervosa This disease is highly prevalent in more developed countries. Prevalence rates for anorexia nervosa are generally described as ranging from 0.5% to 1.0% among females with males being affected about one-tenth as frequently. Risk Factors and the course of the illness The identification of risk factors for anorexia nervosa is challenging because the low incidence of the disorder makes the conduct of prospective studies of sufficient size very difficult. A variety of possible risk factors have been identified, including early feeding difficulties, symptoms of anxiety, perfectionistic traits, and parenting style, but none can be considered to have been conclusively demonstrated. Similarly, cultural factors undoubtedly play some role in the development of anorexia nervosa, although the disorder’s long history and its presence in regions around the globe. Genetic factors are increasingly accepted as important contributors to the risk of anorexia nervosa. The course of anorexia nervosa is highly variable, with individual outcomes ranging from full recovery to a chronic and severe psychosocial disability accompanied by physical complications and death. Intervention early in the course of illness and full weight restoration appear to be associated with the best outcomes and adolescent patients have a better prognosis than do adults Several studies have found that there are alterations in the function of serotonin in various clinical conditions, which are eating disorders, depression, aggressive behavior, anxiety. The neuroanatomical evidences indicate that serotonergic neurons have an inhibitory effect on the activity of various brain areas involved in mediating anxiety. If Anorexia is not threatened it can lead to physiological problems such as damaged organs (especially the heart, brain and kidneys), fall in blood pressure, pulse and respiratory rate, brittle nails and hair, low body temperature, bone thinning… Physiological disturbances and neurobiological hypotheses A multitude of biological disturbances may occur in underweight patients, but most appear to be normal physiological responses to starvation. Clinically significant abnormalities may develop in the cardiovascular, gastrointestinal, reproductive, and fluid and electrolyte systems. These abnormalities usually do not require specific treatment beyond refeeding, and they return to normal on weight restoration. A worrisome possible exception is reduced bone density; since peak bone density is normally achieved during young adulthood, a