| Line 4: | Line 4: | ||
==Epidemiology== | ==Epidemiology== | ||
| + | * Prevalence among US female adolescents is 0.5% and 1-2% among adult females. | ||
| + | * F:M ratio is 10:1. | ||
| + | * '''Mortality''' in patients with AN is 5-7%; Death is most often secondary to medical complications of starvation (50%) or suicide (50%).(2) | ||
==Diagnosis== | ==Diagnosis== | ||
| Line 10: | Line 13: | ||
** This generally means BMI<17 for adults (however, those with BMI>17 may have mild AN) | ** This generally means BMI<17 for adults (however, those with BMI>17 may have mild AN) | ||
** In children, '''BMI below the 10th percentile''' is consistent with AN diagnosis (1) | ** In children, '''BMI below the 10th percentile''' is consistent with AN diagnosis (1) | ||
| − | * (B) | + | * (B) Fear of become fat or persistent behaviors that prevent weight gain |
| − | * (C) | + | * (C) Disturbance of body image |
The DSM-IV requirement for amenorrhea was removed in DSM-5 | The DSM-IV requirement for amenorrhea was removed in DSM-5 | ||
| + | |||
| + | ===Differential diagnosis=== | ||
| + | History and physical exam are essential for ruling out medical causes of anorexia (poor appetite) and weight loss. Some examples include: chronic infection, thyroid disease, Addison’s disease, IBD, connective tissue disorders, cystic fibrosis, peptic ulcer disease, disease of the esophagus, celiac disease, disease of the small intestine, diarrhea, diabetes, and occult malignancies.(1) | ||
| + | |||
==References== | ==References== | ||
1. Lock, J. et.al. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Eating Disorders. J Am Acad Child Adolesc Psychiatry 2015;54(5):412–425 | 1. Lock, J. et.al. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Eating Disorders. J Am Acad Child Adolesc Psychiatry 2015;54(5):412–425 | ||
| + | 2. Arcelus J, et. al. Mortality rates in patients with anorexia nervosa and other eating disorders. Arch Gen Psychiatry. 2011; 68:724-731 | ||
[[Category: Eating Disorders]] | [[Category: Eating Disorders]] | ||
{{stub}} | {{stub}} | ||
Revision as of 20:50, 4 September 2015
Introduction
Anorexia nervosa (AN) was first described in 1689 by Richard Morton, who called it nervous consumption. In 1870's Sir William Gull in England coined the terms anorexia nervosa while Charles Lasegue in France described anorexia hysterique
Epidemiology
- Prevalence among US female adolescents is 0.5% and 1-2% among adult females.
- F:M ratio is 10:1.
- Mortality in patients with AN is 5-7%; Death is most often secondary to medical complications of starvation (50%) or suicide (50%).(2)
Diagnosis
Essential features of DSM-5 diagnosis are:
- (A)Persistent restriction of energy intake
- This generally means BMI<17 for adults (however, those with BMI>17 may have mild AN)
- In children, BMI below the 10th percentile is consistent with AN diagnosis (1)
- (B) Fear of become fat or persistent behaviors that prevent weight gain
- (C) Disturbance of body image
The DSM-IV requirement for amenorrhea was removed in DSM-5
Differential diagnosis
History and physical exam are essential for ruling out medical causes of anorexia (poor appetite) and weight loss. Some examples include: chronic infection, thyroid disease, Addison’s disease, IBD, connective tissue disorders, cystic fibrosis, peptic ulcer disease, disease of the esophagus, celiac disease, disease of the small intestine, diarrhea, diabetes, and occult malignancies.(1)
References
1. Lock, J. et.al. Practice Parameter for the Assessment and Treatment of Children and Adolescents With Eating Disorders. J Am Acad Child Adolesc Psychiatry 2015;54(5):412–425 2. Arcelus J, et. al. Mortality rates in patients with anorexia nervosa and other eating disorders. Arch Gen Psychiatry. 2011; 68:724-731