Eating Disorders in Children and Adolescents Peninsula儿童和青少年的饮食失调.pptVIP

Eating Disorders in Children and Adolescents MRCPsych Course Dr Gisa Matthies History Anorexia nervosa recognised condition in the late 19th century (1873) Early onset ED Collins 1894: 7 year old girl Marshall 1895: 11 year old girl A girl “seven and a half years old of healthy ancestry” who persistently refused food for ten weeks prior to her admission. The physical stigmata of malnutrition were reported but “more remarkable were the mental phenomena”. These included “deceitfulness, intense selfishness, self absorption and vanity.” ...was “effusively pious in conversation though she used foul language to the nurses. She concealed food in her bed and expressed herself as not wishing to improve” ( Collins, 1894) Diagnosis and Classification Both ICD 10 and DSM IV under review Planned updates: -ICD 11-2015 -DSM V-2013 DSM-IV-TR (2000) Eating disorders: -anorexia nervosa -bulimia nervosa -eating disorder not otherwise specified Feeding and eating disorders of infancy or early childhood: -pica -rumination disorder -feeding disorder of infancy and early childhood ICD-10 (1992) Eating disorders (F50):(behavioural syndromes associated with physiological disturbances and physical factors) -anorexia nervosa (F50.0) -atypical anorexia nervosa (F50.1) -bulimia nervosa (F50.2) -atypical bulimia nervosa (F50.3) -overeating associated with other psychological disturbance (F50.4) -vomiting associated with other psychological disturbance (F50.5) -other eating disorder (F50.8) -eating disorder, unspecified (50.9) ICD-10 cont. Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence (F98) -feeding disorder of infancy and childhood (F98.2) -pica of infancy and childhood (F98.3) ICD-10: diagnostic guidelines AN body weight at least 15% below expected weight, or BMI 17.5 or less weight loss is self induced body image distortion, ‘dread of fatness’ as an intrusive overvalued idea and patient imposes low wei