| 单词 | anorexia nervosa | |||
| 释义 | anorexia nervosaanorexia ner·vo·saB0540200 (nûr-vō′sə)anorex′ia ner•vo′sa(nɜrˈvoʊ sə)n. an·o·rex·i·a ner·vo·sa(ăn′ə-rĕk′sē-ə nûr-vō′sə)anorexia nervosa
anorexia nervosaanorexia nervosa:see eating disorderseating disorders,in psychology, disorders in eating patterns that comprise four categories: anorexia nervosa, bulimia, rumination disorder, and pica. Anorexia nervosa is characterized by self-starvation to avoid obesity. ..... Click the link for more information. . anorexia nervosaa disorder of eating behaviour. This is a psychological disturbance found predominantly in young women which leads them to perceive themselves as obese and to attempt to become slim. Their disordered eating behaviour is most usually expressed as a refusal to eat sufficiently, so that weight is lost, and in conjunction there may be episodes of bulimia, or bingeing, followed by the use of purgatives and self-induced vomiting. As weight loss continues menstruation ceases, and, though at first energy appears to increase, eventually the physical condition may become life-threatening.There has been much interest in and research into this condition since the early 1970s. Among sociologists, anorexia is considered a ‘pathology of self-identity’, arising from the idealization of slimness (especially for women) in contemporary societies. Disordered family relationships have been suggested as a precipitating factor, the effort of the patient to return to being a child (immature figure, non-menstruating) suggesting an unwillingness to become an adult. It is also proposed that a genetic predisposition may underlie the problem. Current treatment is becoming more oriented to medical intervention to correct the biochemical imbalance, but social and psychiatric treatments are still widely used. When a patient is severely ill, needing hospitalization, the usual treatment has been behavioural, which can be effective in inducing weight gain. See BEHAVIOUR THERAPY. Psychotherapy is used to assist the patient achieve a realistic perception of her/his situation, and SELF-HELP GROUPS are found useful by many sufferers who may need longterm support. See also BODY. anorexia nervosa[‚an·ə′rek·sē·ə nər′vō·sə]anorexia nervosaAnorexia nervosaDefinitionAnorexia nervosa is a psychiatric disorder characterized by an unrealistic fear of weight gain, self-starvation, and conspicuous distortion of body image. The individual is obsessed with becoming increasingly thinner and limits food intake to the point where health is compromised. The disorder may be fatal. The name comes from two Latin words that mean nervous inability to eat. DescriptionAnorexia nervosa often is thought of as a modern problem, but it was first described by the English physician Richard Morton in 1689. Nevertheless, anorexia was not officially classified as a psychiatric disorder by the American Psychiatric Association until the third edition of the Diagnostic and Statistical Manual of Mental Disorders published in 1980. In the twenty-first century, anorexia nervosa is recognized as a serious problem particularly among adolescent females. Its incidence in the United States has more than doubled since 1970. The rise in the number of reported cases is thought to reflect a genuine increase in the number of persons affected by the disorder and not simply earlier or more accurate diagnosis. Anorexia nervosa is a serious public health problem not only because of its rising incidence, but also because it has one of the highest mortality rates of any psychiatric disorder. Individuals with anorexia are irrational and unrelenting in their quest to lose weight. No matter how much weight they lose and how much their health is compromised, they want to lose more weight. Anorexia may cause serious long-term health complications, including congestive heart failure, sudden death, growth retardation, dental problems, constipation, stomach rupture, swelling of the salivary glands, anemia and other abnormalities of the blood, loss of kidney function, electrolyte imbalances, and osteoporosis. There are two major subtypes of anorectics. Restrictive anorectics control their weight by rigorously limiting the amount of calories they eat or by fasting. They may exercise excessively or abuse drugs or herbal remedies claim to increase the rate at which the body burns calories. Purge-type anorectics eat and then get rid of the calories and weight by self-induced vomiting, excessive laxative use, and abuse of diuretics or enemas. About 95% of anorectics are female. It is estimated that one out of every 100-200 adolescent females meet all the Diagnostic and Statistical Manual for Mental Disorders Fourth Edition (DSM-IV-TR) criteria for anorexia. However, it has been suggested that as many as 5% of adolescent females show some characteristics of the disorder but do not meet the full diagnostic criteria. The rate among men is about 0.1%. About 85% of anorectics develop the disorder between ages 13 and 18; there is a secondary peak of individuals who become anorexic in their 40s. Originally anorexia was thought to be primarily a disorder of white, upper-middle class girls, but now it is known to be found among all races and socioeconomic groups. The disorder, however, is not evenly distributed among pastimes or occupations. Women involved in gymnastics, figure skating, dance (especially ballet), cheerleading, acting, and modeling have a much higher rate of anorexia than the general population. Men involved in wrestling, gymnastics, cross-country running, and modeling have higher than average rates. The disorder is more often diagnosed in homosexual men than in heterosexuals. Causes and symptomsAnorexia is a disorder that results from the interaction of cultural and biological factors. Research suggests that some people have a predisposition toward anorexic and that something triggers the behavior, which then becomes self-reinforcing. Hereditary, biological, psychological and social factors all appear to play a role. While the precise cause of the disorder is not known, it has been linked to the following:
Male anorecticsAlthough anorexia nervosa is still considered a disorder that largely affects women, its incidence in the male population is rising. Less is known about the causes of anorexia in males, but some risk factors are the same as for females. These include certain occupational goals (e.g., jockey) and increasing media emphasis on external appearance in men. Moreover, homosexual males are under pressure to conform to an ideal body weight that is about 20 pounds lighter than the standard "attractive" weight for heterosexual males. SymptomsRecognizing the development of anorexia can be difficult, especially in a society that values and glamorizes thinness. Dieting often is the trigger that starts a person down the road to anorexia. The future anorectic may begin by skipping meals or taking only tiny portions. She (most anorectics are female) always has an excuse for why she does not want to eat, whether it is not feeling hungry, feeling ill, having just eaten with someone else, or not liking the food served. She also begins to read food labels and knows exactly how many calories and how much fat are in everything she eats. Many anorectics practically eliminate fat and sugar from their diets and seem to live on diet soda and lettuce. Some future anorectics begin to exercise compulsively to burn extra calories. Eventually these practices have serious health consequences. At some point, the line between problem eating and an eating disorder is crossed. Anorectics spend a lot of time looking in the mirror, obsessing about clothing size, and practicing negative self-talk about their bodies. Some are secretive about eating and will avoid eating in front of other people. They may develop strange eating habits such as chewing their food and then spitting it out, or they may have rigid ideas about "good" and "bad" food. Anorectics will lie about their eating habits and their weight to friends, family, and health care providers. Many anorectics experience depression and anxiety disorders. DiagnosisDiagnosis of anorexia nervosa is complicated by a number of factors. One is that the disorder varies somewhat in severity from patient to patient. A second factor is that most anorectics deny that they are ill. Eventually they usually are brought to treatment by a family member. Most anorectics are diagnosed by pediatricians or family practitioners. Anorexia nervosa is diagnosed when most of the following conditions are present:
In addition to weight loss, anorectics develop emaciated bodies, dry or yellowish skin, and abnormally low blood pressure. There is usually a history of amenorrhea in females, and sometimes of abdominal pain, constipation, or lack of energy. The patient may feel chilly or have developed lanugo, an abnormal growth of downy body hair that is a sign of starvation. If the patient has been vomiting, she may have eroded tooth enamel or Russell's sign (scars on the back of the hand).loss The doctor will need to do tests to rule out other physical conditions that can cause weight loss or vomiting after eating, including metabolic disorders, brain tumors (especially hypothalamus and pituitary gland lesions), diseases of the digestive tract, and a condition called superior mesenteric artery syndrome. Persons with this condition sometimes vomit after meals because the blood supply to the intestine is blocked. The doctor usually will order blood tests, an electrocardiogram, urinalysis, and bone densitometry (bone density test) in order to exclude other diseases and to assess the patient's nutritional status. The doctor also will need to distinguish between anorexia and other psychiatric disorders, including depression, schizophrenia, social phobia, obsessive-compulsive disorder, and body dysmorphic disorder. Two diagnostic tests that are often used are the Eating Attitudes Test (EAT) and the Eating Disorder Inventory (EDI). TreatmentTreatment of anorexia nervosa includes both short- and long-term measures, and requires assessment by dietitians and psychiatrists as well as medical specialists. Therapy is often complicated by the patient's resistance or failure to carry out a treatment plan. Hospital treatmentHospitalization is recommended for anorexics with any of the following characteristics:
Hospital impatient care is first geared toward correcting problems that present as immediate medical crises, such as severe malnutrition, severe electrolyte imbalance, irregular heart beat, pulse below 45 beats per minute, or low body temperature. In extreme cases, hospitalized patients may be force-fed through a tube inserted in the nose (nasogastric tube) or by over-feeding (hyperalimentation techniques). There is often a high level of resistance to treatment. After the individual is physically stable, treatment includes individual and group therapy as well as re-feeding and monitoring of the patient's physical condition. Treatment usually requires two to four months in the hospital. Outpatient treatmentAnorectics who are not severely malnourished may be treated by outpatient psychotherapy and nutritional counseling. The types of treatment recommended are supportive rather than insight-oriented, and include behavioral approaches as well as individual and/or group therapy. Family therapy is often recommended when the patient's eating disorder is closely tied to family dysfunction. Self-help groups often are useful in helping anorectics find social support and encouragement. Psychotherapy with anorectics is a slow and difficult process; about 50% of patients continue to have serious psychiatric problems after their weight has stabilized. MedicationsAnorectics are treated with a variety of medications to address physical problems brought about by their eating disorder and to treat additional psychiatric problems such as depression, anxiety, and suicidal thoughts. The medications used will vary depending on the individual, however, depression is common among anorectics and is treated often treated with antidepressant drugs. PrognosisOnly about half of all anorectics will make a good, long-term physical and social recovery. The mortality rate is estimated at 6-20%. The most frequent causes of death associated with anorexia are starvation, electrolyte imbalance, heart failure, and suicide. Other long-term health complications are common. PreventionShort of major long-term changes in the larger society, the best strategy for prevention of anorexia is the cultivation of healthy attitudes toward food, weight control, and beauty (or body image) within families Some specific ways to reduce the likelihood that anorexia nervosa will develop follows:
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Anorexia nervosa anorexia[an″o-rek´se-ah]The syndrome was first described more than 300 years ago and was once thought to be exceedingly rare. However, in recent years its incidence has been rapidly increasing throughout the world in developed countries as diverse as Russia, Japan, Australia, and the United States. The condition occurs mainly in girls after the age of puberty, and the prevalence may be as high as one in a hundred. Nutritional counseling, social services and support, health education, and health care are all components in the physical and psychological recovery from an eating disorder. The physical sequelae, as well as the social and cultural aspects, require a multidisciplinary approach individualized to the unique needs of the victim and family. Inpatient treatment, either partial or complete, is required when the individual's problems warrant intensive services or if outpatient treatment is not successful. Some hospitals have special units for patients with eating disorders, providing an environment for treatment that emphasizes the simultaneous treatment of physiologic and psychological problems by professionals trained in the management of these patients. The American Psychological Association has identified numerous areas for research related to eating disorders. Information and support for professionals as well as persons affected by the disorder can be obtained from the National Association of Anorexia Nervosa and Associated Disorders by writing to them at P.O. Box 7, Highland Park IL 60035 or calling their hotline at 1-847-831-3438. an·o·rex·i·a ner·vo·saAnorexia nervosa (AN) has been defined as a compulsive pursuit of thinness at the expense of health. It is characterized by steady weight loss, to and below 85% of normal weight for height, achieved by rigorous dieting, often supplemented by strenuous exercise and sometimes by self-induced vomiting or the use of diuretics or laxatives. Onset is typically during adolescence; 90% of patients are women. Estimates of prevalence range from 0.3-3% of girls and women between the ages of 10 and 25. Risk factors include white race, upper-class background, and a compulsive, perfectionistic personality. Body image is grossly distorted, with perception of a normal habitus, and even an emaciated one, as obese. Despite limited insight, patients are often highly manipulative, denying their dietary practices, shunning encounters with health care professionals, and choosing clothing that conceals their thinness. Physical consequences of AN, in addition to wasting of muscle and loss of subcutaneous fat, include anemia, electrolyte imbalance, bradycardia, hypotension, asthenia, exaggerated sensitivity to cold, constipation, and dryness and scaliness of skin with increased pigmentation and growth of lanugo. Women become amenorrheic and are at risk of osteoporosis and stress fractures or irreversible bone deformation, The female athletic triad (disordered eating, amenorrhea, and osteoporosis) is associated particularly with sports that emphasize low body weight, such as running, swimming, gymnastics, and figure skating. Cognitive-behavioral therapy and treatment with antidepressants, lithium, or other agents lead to remission in many patients, but the relapse rate is high. Severe cachexia or extreme dietary deviance may require hospitalization and intravenous correction of acute nutritional and electrolyte deficiencies. At least 50% of patients have persistent psychiatric problems throughout life, particularly with eating and sexuality. The mortality rate of AN is about 5%. anorexia nervosa(nûr-vō′sə)anorexia nervosaPsychology An eating disorder primarily–>95% of young ♀, characterized by an extreme aversion to food, and attributed to a misperception of body image–anorectics believe they are overweight even when significantly underweight Clinical Average 25% below normal weight:height ratio, absence of ≥ 3 menstrual periods, cold intolerance, hypothermia, constipation, hypotension, bradycardia Clinical Anemia, leukopenia, electrolyte abnormalities, ↑ BUN and creatinine, ↑ cholesterol, ↓ LH, FSH DiffDx Panhypopituitarism, Addison's disease, hyperthyroidism, DM, Crohn's disease, CA, TB, CNS tumors Management Psychotherapy, hospitalization. See Bulimia, Eating disorders.an·o·rex·ia ner·vo·sa(an'ŏ-rek'sē-ă nĕr-vō'să)anorexia nervosaA serious disorder of perception causing the sufferer, almost always a young woman, to believe that she is too fat, when, in fact, she may be very thin. Food intake is drastically reduced and emaciation results. Treatment is difficult and the best efforts of those trying to help are often frustrated by the determination of the sufferer to avoid eating. Hospital treatment is usually necessary as there is a real risk of a fatal outcome, often from suicide.an·o·rex·ia ner·vo·sa(an'ŏ-rek'sē-ă nĕr-vō'să)Compare: bulimia nervosa anorexia nervosa
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anorexia nervosa - (psychiatry) a psychological disorder characterized by somatic delusions that you are too fat despite being emaciated