CONCEPT:The nervous anorexy is a disorder characterized by the abnormal and limitless concern in him referred to the corporal weight and to the ingestion of food.
This disorder originates a conduct directed toward the lost of weight like main objective, intense fear to win weight, distortion of the corporal image.
The patients that have disorders of the alimentary conduct present a wide range of symptoms that they oscillate between two opposed poles, represented by the nervous anorexy, regarding loss of weight, and the nervous bulimia , as for the excessive gain of the same. Until the 50% of the patients with anorexy nervous develop symptoms of bulimia and some patients that they initially arebulimics develop symptoms anorexics.
APPROACHES FOR THE DIAGNOSIS OF NERVOUS ANOREXY
-A. Rejection to maintain the corporal weight equal or above the minimum value considering the age and the size.
-B. Intense fear to win weight or be converted in obese, even being below the normal weight according to age and size.
-C. Alteration of the perception of the weight or thecorporal silhouette, exaggeration of their importance in the self-assissment or negation of the danger that it behave the under corporal weight.
-D. In the postpuberty women, presence of amenorrhoea.
APPROACHES FOR THE DIAGNOSIS OF NERVOUS BULIMIA
- A. Presence of recurrent gorging. A gorging is characterized for ingestion of food in a short space of time in superior amountto which most of the people would ingest in period of similar time and in the same circumstances, and this accompanied by a sensation of loss of control on the ingestion of the food.
-B. Conducts compensatory not suitables, of repeated way, with the purpose of not winning weight, like provocation of the vomit, excessive use of laxatives, diuretics, enemas or other medicaments, fast and excessiveexercise.
-C. The gorging and the conducts not suitables takes place, like average, at least twice to the week during a period of three months.
- D. The self-assessment is excessively influenced by the weight and the corporal silhouette.
We could distinguish two types of nervous anorexy and bulimia ;
- restrictive type: during the episode of nervous anorexy, theindividual doesn't appeal regularly to gorging or to purges.
- compulsive/purgative type: during the episode of nervous anorexy, the individual appeals regularly to gorging or purges.
EPIDEMIOLOGY: COURSE AND PROGNOSIS OF THE ILLNESS.
FREQUENCY: A more frequent illness in women is that in males.
COURSE: The course of the nervous anorexy varies from an only episode withpsychological recovery and of the corporal weight, going by a rehabilitation nutritional with relapses, up to one chronic course, not remittent, that it even could conclude with the death of the patient.
EVOLUTION: The percentage of people that they recover completely is moderated, approximately 2/3 of the patients continue suffering a constant and morbid concern for the weight and food, and up toone 40% it present bulimics symptoms. Even between whom they have positive evolutions, defined for the recovery of the weight and the reappearance of the menstruation, many patients present any another symptom psychiatric constant, included the dysthymia, the social phobia, the obsessive compulsive symptoms and the consumption of addictive substances.
In general the adolescents get evolutionsbetter than the adults and more frequent how much minor age they have.
ETIOLOGY AND PATHOGENY
It is ignored the existence of a etiology and a specific pathogeny in the development of the nervous anorexy. The last hypothesis that they try to look for a physiologic base that explains this disorders they go guided to the study of the neurotransmitter and neuropeptides....