-
In schizophrenia, these symptoms reflect an excess or distortion of normal functions. These
active, abnormal symptoms may include:
--Delusions
--Hallucinations
--Thought disorders
--Disorganized behaviors
Positive Symptoms
-
These beliefs are not based in reality and usually
involve misinterpretation of perception or experience. They are the mot common
of schizophrenic symptoms.
Delusions
-
These usually involve seeing or hearing things that
don't exist, although they can be in any of the senses. Hearing
voices is the most common example among people with schizophrenia.
Hallucinations
-
Difficulty speaking and organizing thoughts may
result in stopping speech midsentence or putting together meaningless words,
sometimes known as "word salad."
Thought disorder
-
This may show in a number of ways, ranging from
childlike silliness to unpredictable agitation.
Disorganized behavior
-
refers to a diminishment
or absence of characteristics of normal function. They may appear months or
years before positive symptoms. They include:
Loss
of interest in everyday activities
Appearing
to lack emotion
Reduced
ability to plan or carry out activities
Neglect
of personal hygiene
Social
withdrawal
Loss
of motivation
-
Involves problems with thought processes. These symptoms may be the most
disabling in schizophrenia, because they interfere with the ability to perform
routine daily tasks. A person with schizophrenia may be born with these
symptoms, but they may worsen when the disorder starts. They include:
Problems
with making sense of information
Difficulty
paying attention
Memory
problems
Cognitive symptoms
-
Schizophrenia
also can affect mood, causing depression or mood swings. In addition, people
with schizophrenia often seem inappropriate and odd, causing others to avoid
them, which leads to social isolation.
-
Homelessness & Schizophrenia
Mental illness is one of the main contributors to homelessness.- Schizophrenia and homelessness are dual conditions that plague nearly every
- industrialized country in the world. The crisis is compounded by the fact that
- many schizophrenics are drug addicts and/or alcoholics. Treatment is difficult,
- if not impossible, and funding is a continuing issue. With the challenges of
- treatment, increased legal issues, schizophrenics' tendency toward violence and
- the fact that mentally ill homeless remain homeless longer than the general
- homeless
population , homeless schizophrenics have become modern- society's untouchables.
According to HealthMad.com, in 2007, approximately 200,000- people were schizophrenic and homeless.
-
Attorney General- Henry McMaster has named domestic violence as the number one crime problem
- in South Carolina.
More than 36,000 victims annually report a domestic - violence incident to law enforcement agencies around the state. Over the
- past twelve years, an average of thirty-three (33) women have been killed each
- year by their intimate partner
. Currently South Carolina ranks eighth in- the nation for the amount of homicides caused by criminal domestic violence
-
One in every four women will?
-
-
There were 35,894 victims of domestic violence in
South Carolina in 2005. 43% of reported domestic violence cases ended in an
arrest
-
In South Carolina, 36% of aggravated assaults were
domestic violence related in
2006
-
1,809 forcible rapes were reported in South Carolina
in
2005
-
28% of murders in South Carolina were domestic
violence related in
2006
-
There were 32 domestic violence related homicides
in
2005
-
The most common relationship between homicide
perpetrators and victims was boyfriend/girlfriend and the second most common
relationship was between
spouses
-
How long do you have to have the symptoms to classify as schizophrenia?
Symptoms X30 days for >6Months
-
How long for schizophrenoform DO?
Symptoms < 6 months
-
What is SAFD?
Schizoaffetive Disorder….Symptoms with & without mood episode
-
What is a delusional disorder?
Non-bizarre delusion x 1month
-
How long is a brief psychotic disorder?
> 1 day <1 month
-
What is a shared psychotic disorder?
It takes on other delusions
-
Some other psychotic disorders can be caused by what?
-
What is the diagnosis criterion for schizophrenia?
- 1. Positive or negative symptoms for 30 days for greater than 6 months
- 2. Marked social/vocational dysfunction
- 3. NOT due to:
- …….. medical
- …….. drugs
- …….. SAFD
- …….. Manic Depressive Disorder (MDD) with psychotic features
-
What are the 4 types of POSITIVE symptoms?
- 1. Delusions
- 2. Hallucinations
- 3. Disorganized Speech
- 4. Catatonia
-
Grandiosity, persecution, somatic, reference, thought insertion/withdrawal/broadcasting, ect?
Delusions
-
auditory, visual, tactile, olfactory, gustatory?
Hallucinations
-
clang, neologisms, thought block, loose assoc, perseveration?
Disorganized Speech
-
stupor, posture, excitation?
Catatonia
-
What are the NEGATIVE symptoms of schizophrenia? *Hint-Crazy 8's*
- - Affective blunting
- -Anhedonia
- -Anergia
- -Alogia
- -Apathy
- - Avolition
- - Asociality
- -Attention problems
-
What are the subtypes of schizophrenia?
- •Paranoid
- •Disorganized
- •Catatonic
- •Undifferentiated
- •Residual
-
Negative symptoms that persist inspite of resolution of positive symptoms
Residual
-
What is the scope of schizophrenia?
- •40 % attempt suicide within 10 yrs.
- •10 % actually complete suicide
- •9thleading cause of disability
- •60-70% never marry/have children
- •Occupy 25% of all hospital beds
- •70%–80% are unemployed or underemployed
- •10% of permanently disabled Americans
- • 20%–30% of the homeless population
-
Schizophrenia vs. Violence
•Evidence mixed•Media sensationalized?•Schizophrenics 14% more likely to be victimrather than comit violent crime
-
What are the demographics of Schizophrenia?
•0.5 - 1.5 % of population•Urban > Rural•Uniform rates across racial and ethnic groupsin US, except for higher rates with racial minorities in large cities •Higher rates with maternal malnutrition
-
What are the gender differences of Schizophrenia?
•Male > Female (up to 20%)•Onset: male (18-25 yr); female (25-35 yr) •Second peak in onset women after 45 yrs.•Pre-morbid function females > males•Males – More positive symptoms•Females – More negative symptoms•Women have moreemotional/affectivesymptoms – misdiagnosed MDD or SAFD
-
What are the etiological theories concerning Schizophrenia?
•Genetic – familial ; 10% greater chance•Hormonal – onset S/P puberty, thyroid, DM•Apoptosis/Excessive pruning•Virus – selectivity; dormancy; triggered bystress/hormonal; alter cellular process without destroying cells•Neurotransmitter – drugs can either mimic or eleviatesymptoms
-
What is the pathology behind Schizophrenia?
•Up To 25% loss of graymatter•Enlarged ventricles •Enlarged amygdala •Neurological abnormalities•Impaired cognitive function•Decreased prefrontal brainfunction •Impaired awareness ofillness
-
What are the 4 stages of progression when dealing with Schizophrenia?
1. Premorbid2. Prodromal3. Psychotic4. Recovery
-
Asymptomatic withgenetic/environmental vulnerability.
Premorbid (0-35 yrs.)
-
Insidious decline inwork/school/social/adaptive functioning
Prodromal (2-5 yrs.)
-
Abrupt onset of (+) &significant worsening of (-) symptoms. Often hospitalized due to unable to care for self.
Psychotic (wks.-yrs.)
-
Exacerbations & remissionswith 80% relapse rate. Degree of illness/level of functioning plateau after 10yrs.
Recovery (yrs.)
-
What are some ways to treat Schizophrenia without medications?
•Supportive psychotherapy•Family therapy•Socialization/social skills training•Cognitive Behavioral Therapy•Hospitalization
-
What are the two types of pharmacotherapeutics that treat Schizophrenia?
1. Typicals2. Atypicals
-
These Alleviate positive symptoms, have More side effects, but are Lessexpensive
typicals
-
These will alleviate positive symptoms, offer some help with negative symptoms, have fewer side effects, and MIGHT have neuroprotective effects????
Atypicals
-
What are the medication forms that treat Schizophrenia?
•Pill/capsule•Elixir•Orally disintegrating tabs (ODT)•IV/IM•Deaconate
-
What are the drug side effects for drugs that treat Schizophrenia?
•Histaminic effects – Sedation•Adrenergic effects – Orthostasis•Anticholenergic effects – Dry mouth•Hyperprolactinemia – Sexual•Metabolic effects:- Weight gain- Hyperglycemia/diabetes- Hyperlipidemia
-
What are the other med risks?
•Seizures•Stroke•Sudden death (dementia)•QTcProlongation (Geodon & Melaril)•Extrapyramidal symptoms (EPS)•Tardive dyskinesia(TD)•Neuroleptic malignant disorder (NMS)•Agranulocytosis (Clozaril)
-
What does the nurse need to monitor the patient for that is receiving treatment for Schizophrenia?
•Vital signs – include orthostatic BP (falls)•Weight & BMI•EKG•AIMS – Abnormal Involuntary Movement Scale (TD)•Labs – CBC, renal function,lipids, glucose, HgbA1C, LFTs, TFTs, prolactin•Suicidality
-
-
-
-
This syndrome is probably, in part, a genetic condition. People with this syndrome have motor tics and vocal tics. Motor tics are movements of the
muscles, blinking, head shaking, jerking of the arms, and shrugging. When a
person with this syndrome suddenly begins shrugging, he or she may not be
doing it on purpose. This may be a motor tic.
Tourette's Syndrome
-
These tics are sounds that a person with Tourette syndrome might make with his or her
voice. Throat clearing, grunting, and humming are all common tics. A
person with Tourette syndrome will sometimes have more than one type of tic happening
at once.
Vocal Tics
-
Tics are usually worse when a person is under?
Stress
-
Tourette syndrome is not a psychological condition, it is a ? one
neurological
-
Tourette's Statistics
Tourette's However, psychological factors are very important in this condition. Psychological distress can make the tics worse, and kids with Tourette syndrome might feel very upset because of the tics and the problems that go with them. Counselors and Tourette syndrome organizations can help kids learn how to explain tics to others. It affects at least 1 in 1,000 to 2,000 people and maybe more. It is believed that about 100,000 Americans have Tourette syndrome.
-
What drugs is ADHD treated with?
- ADHD is usually treated
- with the aid of stimulant drugs like
Ritalin. Concerta- and with non-stimulant
Straterra- as well as
amphetamines,- such as
Dexedrine- and
Adderall.
-
Stimulants are believed to
work by increasing ? levels in the brain. Stimulant medications boost
concentration and focus while reducing hyperactive and impulsive behaviors.
Dopamine
-
Stimulants for
ADD / ADHD come in both short and long-acting dosages. Short-acting stimulants
peak after several hours, and must be taken (x) times a day. Long-acting or
extended-release stimulants last 8-12 hours, and are usually taken (y)?
- (x)= 2-3 times
- (y)= 1 time per day
-
The relationship between suicide risk and
sexual orientation: results of a population-based study.
-
CONCLUSIONS:
There is evidence of a strong association between suicide risk and bisexuality or
homosexuality in ?
males
-
RESULTS: Suicide attempts
were reported by 28. 1
% of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of
heterosexual females, and 4.2% of heterosexual ?
males
-
-
Limiting access to lethal
means of self-harm is an ? strategy to prevent self-destructive
behavior, including suicide.
effective
-
Some suicidal acts are
?, resulting from a combination of psychological pain or despair
coupled with easy availability of the means to inflict self-injury: firearms,
carbon monoxide, medications, sharp objects, tall structures.
impulsive
-
By limiting the individual's ? to the
means of self-harm, a suicidal act may be prevented.
accessibility
-
The ? is to separate in
time and space the individual experiencing an acute suicidal crisis from easy
access to lethal means of self-injury and personal harm
goal
-
The hope is by making it
harder for those intent on self-harm to act on that impulse, one can buy time
for the ? to pass and for healing and recovery to occur.
crisis
-
? are the most common method
of completed suicides nationwide (54%), followed by suffocation (20%),
poisoning (17.5%), falls (2.3%), cut/pierce (1.8%), and drowning (1.2%) (CDC:
2005)
Firearms
-
This is true for men, women
and adolescents who complete suicide. In New York, ? are also the
predominant means of suicide, but by a much slimmer margin
firearms
-
Suicide by firearms seems
to be associated with their availability in the home and with victim
?
intoxication
-
Many homes contain guns and
nearly half (43%) of all homicides and suicides occur in a ?. Most victims
are shot: 67% of the homicides and 54% of the suicides in 2002 (CDC: WISQARS,
2005). In some studies, ? pose the greatest risk.
-
Asperger syndrome and interpersonal relationships
-
The lack of
demonstrated ? is possibly the most dysfunctional aspect of Asperger
syndrome.
empathy
-
Individuals
with Asperger's Syndrome experience difficulties in basic elements of (1), which
may include a failure to develop friendships or to seek shared enjoyments or
achievements with others (for example, showing others objects of interest), a
lack of social or emotional reciprocity, and impaired nonverbal behaviors in areas such as (2….4 items)?
- 1= social interaction2= eye contact, facial expression, posture, and gesture
-
Qualitative impairment in social
interaction, as manifested by at least two of the following: (4 items)
(A) marked impairments in the use of- multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body
- posture, and gestures to regulate social interaction
(B) failure to develop peer relationships- appropriate to developmental level
(C) a lack of spontaneous seeking to- share enjoyment, interest or achievements with other people, (e.g.. by a lack
- of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional- reciprocity
-
(II) Restricted repetitive &
stereotyped patterns of behavior, interests and activities, as manifested by at
least one of the following: (4 items)
(A) encompassing preoccupation with one- or more stereotyped and restricted patterns of interest that is abnormal either
- in intensity or focus
(B) apparently inflexible adherence to- specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor- mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body
- movements)
(D) persistent- preoccupation with parts of objects
-
-
It is estimated that 8 million ? have an eating
disorder – seven million women and one million men
-
Eating disorders have the highest ? rate of any mental illness
mortality
-
A study by the National Association of Anorexia Nervosa and
Associated Disorders reported that 5 – 10% of anorexics die within 10 years
after contracting the disease; 18-20% of anorexics will be dead after 20 years
and only ? ever fully recover
30 – 40%
-
20% of people suffering from anorexia will prematurely die from
complications related to their eating disorder, including suicide and ?
heart problems
-
Common
co-morbid conditions include ? (50% to
75%), sexual abuse (20% to 50%), obsessive-compulsive disorder (25% with
anorexia nervosa), substance abuse (12% to 18% with anorexia nervosa,
especially the binge-purge subtype, and 30% to 37% with bulimia nervosa), and
bipolar disorder (4% to 13%). 1-4
major depressive disorder or dysthymia
-
Medical Complications of Anorexia?
- 1. Amenorrhea Bradycardia
- 2. Orthostatic Blood Pressure Drop
- 3. Osteoporosis
- 4. Stress fractures
-
Cold intolerance, constipation, cyanosis, edema, hypoglycemia, low albumin
Amenorrhea Bradycardia
-
What are the Structural and functional brain changes associated with anorexia?
Thyroid dysfunction
-
What can appetite suppressant abuse cause?
Anxiety, hypertension, tremors, tachycardia, Purging type reflux, parotid abnormalities, gastrointestinal - bleeding, hypokalemia, Dental caries, enamel erosion, dehydration, cardiac
- arrhythmias, and Renal failure
-
TREATING ANOREXIA involves what three components?
-
· The ? in anorexia treatment is to address and
stabilize any serious health issues. Hospitalization may be necessary to
prevent starvation, suicide, or a medical crisis. Dangerously thin anorexics
may also need to be hospitalized until they reach a less critical weight.
Outpatient treatment is an option when the patient is not in immediate medical
danger.
first priority
-
Explores the critical and
unhealthy thoughts underlying anorexia. The focus is on increasing
self-awareness, challenging distorted beliefs, and improving self-esteem and
sense of control. Also involves education about anorexia.
|
-
Promotes healthy eating behaviors
through the use of rewards, reinforcements, self-monitoring, and goal
setting. Teaches the patient to recognize anorexia triggers and deal with
them using relaxation techniques and coping strategies.
|
-
Examines the family dynamics that
may contribute to anorexia or interfere with recovery. Often includes some
therapy sessions without the anorexic patient—a particularly important
element when the person with anorexia denies having an eating disorder.
|
-
Allows people with anorexia to
talk with each other in a supervised setting. Helps to reduce the isolation
many anorexics may feel. Group members can support each other through
recovery and share their experiences and advice.
|
-
-
Genetic factors (nature) and childhood experiences (nurture) are predisposing causes for developing ?
psychiatric illness
-
?
combined with genetic predisposition begins to explain complexity of
development of child psychiatric illness
Experience
-
Related
to roles of ? and brain development
neurotransmitters
-
Perhaps epigenetic mechanism
-
Brain
mechanisms down-regulate stress reaction after ? has passed, returning
brain to prior level of functioning
ØRapid
and reversible during acute stress
threat
-
If
prolonged, severe, or repetitive stress, increased neurotransmitter activity
often ?
irreversible
-
Resilience: ability to withstand stressØAffected- by individual characteristics, early life experiences
Protective- factors in their environment
Are- competent, realistic, flexible, assured of their own inner resources and
- support
ØHave- strong sense of personal control
ØTake- age-appropriate responsibility
ØRecover- quickly when faced with stressors
-
-
Derive- realistic, well-defined goals
Respond- to complex social needs
Understand- and advocate for child
Develop- comprehensive treatment plan that identifies and integrates child’s needs and
- family resources
Realize- that behavior is cultural, must be viewed from
sociocultural- perspective
-
First- goal: to establish therapeutic alliance with child and parents
If- child’s verbal communications vague or unclear, ask for more explanations
Child- may not respond to problem-centered lines of communication
ØFirst- discuss more general aspects of child’s life (family members, school, friends)
-
-
Strategies for
Communicating with Children
Understand- age-related development
Convey- respect and authenticity
Use- familiar vocabulary at child’s level of understanding
Assess- child’s needs in immediate situation
Assess- child’s capacity to cope with change
-
-
Strategies for
Communicating with Children
Increase- coping skills by creative, unstructured play
Use- indirect age-appropriate communication techniques (storytelling, picture
- drawing, creative writing)
Use- alternative communication devices for children with special needs (sign
- language, computer aids)
-
Ego Competency Skills
Important to learn
Focus- nursing assessment on specific skills all children need to become competent
- adults
Regardless- of medical diagnosis, assess child for mastery of these skills:
ØEstablishing- closeness and trusting relationships
ØHandling- separation/independent decision making
ØNegotiating- joint decisions and interpersonal conflict
ØDealing- with frustration/unfavorable events
ØCelebrating- good feelings and experiencing pleasure
ØWorking- for delayed gratification
ØRelaxing- and playing
ØCognitive- processing through words, symbols, images
ØEstablishing- adaptive sense of direction or purpose
-
•More common childhood
psychiatric illnesses
ADHDDepressionAnxiety-
-
Effective Coping
Behaviors for Children
Withdrawing- from stressful situations
Postponing- immediate response
Finding- more manageable situation
Restructuring- (manipulating or shaping) environment
Accepting- good and bad as part of life
Working- toward maintaining optimal conditions of adjustment, security, comfort
-
-
Medication:- improve brain functioning
Social- skills training: improve socialization
Behavior- management: learn impulse control
Cognitive- therapy: practice problem solving and communication
Parent- education: integrate new behaviors and skills into child’s life
-
-
Eating Regulation Responses and Eating Disorders
-
Adaptive Eating Responses
- •Balanced
- eating patterns
- •Appropriate
- caloric intake
- •Body
- weight appropriate for height
- •Able
- to regulate eating habits
- •Resists
- overuse or underuse of food
- •Maintains
- biological, psychological, sociocultural integrity
-
Maladaptive Eating Responses
•Illnesses- associated with maladaptive eating regulation responses
–Anorexia nervosa–Bulimia nervosa–Binge eating disorder–Night eating syndrome -
-
Continuum of
Adaptive Eating Responses
-
Implications
•Eating- disorders more common among females; males more reluctant to seek treatment
•Sociocultural norms result in- distorted body image
-
-
•Eating- disorders can cause biological changes: altered metabolic rates, profound
- malnutrition, possibly death
•Eating- obsessions can cause psychological problems, e.g., depression, isolation,
- emotional
lability -
-
Eating Disorders: Anorexia
- •Anorexia nervosa in approximately 0.5%-1% of females
- •About 5%-10% of people with anorexia are male
- •Usual onset between 13-20 years but can occur in any age
-
Eating Disorders: Anorexia
- •Although hungry, person with anorexia refuses to eat
- because of distorted self-perception of fatness
- •Starvation ensues
- •Can become chronic illness
- •Estimated mortality from anorexia nervosa: 5% of those
- with the disorder
-
Eating Disorders: Bulimia
- •Bulimia nervosa more common
- –Estimated in 1%-4% of
- population, mostly females
- –4%-15% of female high
- school and college students
- •Onset usually at 15-18 years old
-
Eating Disorders: Bulimia
- •Uncontrolled binge eating alternating with vomiting or
- dieting
- •Same patient may have bulimia and anorexia
- •Bulimia usually occurs in people of normal weight but
- people may be obese or thin
-
Eating Disorders: Binge Eating
- •Binge
- eating disorder: consuming large amounts of calories in contained amount of
- time
- •Differs
- from bulimia because person does not attempt to prevent weight gain
- •Purging
- behaviors not used
- •Prevalence:
- approximately 2%-4% of population
-
Eating Disorders: Night Eating
•Night- eating syndrome: pattern of awakening during night associated with food intake
–Not yet listed as separate eating disorder in DSM-IV-TR–Estimated 1.5% in general population –Make up 27% of severely obese population seeking surgical treatment -
-
Overlapping Relationships Among Eating Disorders
-
Assessment
•Complete- biological, psychological,
sociocultural evaluations•Full- physical examination: vital signs; weight; skin; cardiovascular system;
- evidence of laxatives, diet pills, diuretic abuse, and/or vomiting; dental
- examination
•Psychiatric- history: dieting and substance use, family assessment, medication
-
-
Screening for Eating Disorders
•Focus specific attention on assessment of eating- regulation responses
•Several questionnaires and rating scales screen for- eating disorders
•Adding these two questions may be as effective as more- extensive questionnaires to identify people with eating disorders:
–Are you satisfied with your eating patterns?
-
Assessment: Eating Disorders
•Actual- and desired weight, weight history, menstruation
•Food- avoidances, restrictions, dieting, fasting patterns/unusual nutrition beliefs
•Frequency,- extent, timing of binge eating, and/or purging/compulsive exercise patterns
-
-
Assessment: Eating Disorders
•Use- of laxatives, diuretics, diet pills, other methods of purging/chewing and
- spitting food
•Weight- or shape preoccupation/body image disturbances
•Food- preferences, peculiarities
•Impact- of illness on school, work, social life
-
-
•Rapid- consumption of much food in discrete period
•Emphasis- on patient’s perception of loss of control, perceived excessive caloric intake
- more important than total number of calories consumed, but must assess both
•Usually- binge secretively, often feel shame
-
-
•Person- with bulimia typically average weight or slightly overweight with unsuccessful
- dieting history
•Several- times weekly to more than 10 times/day, or occasional binges related to
- stressful situations
-
-
Behaviors: Fasting or Restricting
•People- with anorexia eat 500-700 calories (as few as 200) daily
•Eliminate- all meat, poultry, fish, dairy; do not substitute
nonanimal protein, nutrients•May- be obsessive-compulsive: eat same foods repeatedly, foods in predetermined
- order, bizarre food preferences, avoid fattening food, fast for days
-
-
•Excessive- exercise
•Forced- vomiting
•Over-the-counter- or prescription diuretics, diet pills, laxatives, steroids
•Laxative- abuse common, inefficient way to
- lose; abuse can increase to 60 doses/week
-
Medical Complications of
Eating Disorders
•Central nervous system•Renal•Hematological•GastrointestinaI•Metabolic•Endocrine•Cardiovascular -
-
Medical Problems
Related to Anorexia
•Patients- 30% below ideal body weight often have life-threatening clinical, laboratory
- findings
•People- who vomit and use laxatives or diuretics, regardless of weight, usually have
- health problems
•Metabolic- and endocrine abnormalities result from malnutrition/starvation
-
-
Medical Problems
Related to Anorexia
•Often- see amenorrhea, osteoporosis,
hypometabolic symptoms (cold intolerance, bradycardia)•Starvation- may cause hypotension, constipation, acid-base, fluid-electrolyte disturbances,
- e.g., pedal edema
-
-
Medical Problems
Related to Bulimia
•Potassium depletion and hypokalemia from vomiting,- laxative or diuretic abuse
•Symptoms of potassium depletion: muscle weakness,- cardiac arrhythmias, conduction abnormalities, hypotension
•Gastric, esophageal, bowel abnormalities common in- patients with bulimia
•May erode dental enamel, cause enlarged parotid glands -
-
Medical Problems
Related to Binge Eating
•Excess- weight: serious health problems
•Increased- weight: exacerbate health problems
•Medical- problems common
•Excess- weight: hypertension, cardiac problems, sleep apnea, difficulties with
- mobility, diabetes mellitus
-
-
Co-morbid Mental Illnesses
•Depression- or
dysthymia in 50%-75% of people- with anorexia and bulimia
•Obsessive-compulsive- disorder in up to 25% of patients with anorexia nervosa
•Patients- with bulimia have increased rates of anxiety disorders, posttraumatic stress
- disorder, substance abuse, mood disorders
-
-
•Psychological: rigidity, perfectionism•Environmental: illnesses, sexual abuse, drug abuse,- media influences
•Familial: increased risk in female relatives
|