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Eating Disorders (Assessment (All patients suspected for an ED also need…
Eating Disorders
Assessment
Eating and feeding disorders need a multi-disciplinary evaluation involving physical investigations, food diaries, growth charts, and psychiatric assessment
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Co-morbid with depression, anxiety, personality disorders, highest co-morbid % with social anxiety
Conclusions about the presence of a primary anxiety disorder should wait until the effects of starvation have abated.
In differentiating between anxiety disorder and ED, scope of intrusive thoughts, the scope of avoidance, and any other symptoms of fear may help clarify how these features are directly part of AN or more correctly attributed to another primary anxiety disorder
Compared to adolescents, younger children <13 years with ED were more likely to be male, less likely to be diagnosed with bulimia, but no difference in anorexia between age groups. Younger pt weight less in percentile to ideal body weight and lost weight more rapidly than older adolescents.
Assessment interviews should leave the patient with a sense of dignity and that they have been heard. The assessment interaction should be seen as an important therapeutic interaction to begin building a therapeutic alliance, balancing both an atmosphere of acceptance yet firmness without being over-confident or paternalistic.
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Treatment
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Poor prognosis – Anorexia 40% fully recover, 6-7 years
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Shortage of services often results in prolonged waiting lists for assessment, meaning that by the time of assessment, patients may be demotivated or otherwise less likely to engage in what is offered
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