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Feeding, Eating and Sleep Disorders - Coggle Diagram
Feeding, Eating and Sleep Disorders
Rumination Dx
Criteria: regurgitation of food for at least 1 month that is not attributable to a gastrointestinal or other medical condition or other eating disorder
Bulimia
10:1 affecting females to males, 2% mortality rate, increased risk of suicide, very high comorbidity with BPD
Criteria
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Recurrent inappropriate compensatory behaviours in order to prevent weight gain: self-induced vomiting, misuse of laxatives, diuretics/ other medications, fasting or excessive exercise.
Binge eating and inappropriate compensatory behaviours both occur at least once a week for 3 months.
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Treatment: CBT, IPT and psychodynamic therapy, both individual and group. SSRIs (Best rate of success is fluoxetine and CBT) Bupropion not recommended- increased risk of seizure.
Anorexia Nervosa
Effects females 10:1, significantly higher rate of suicide and mortality rate is 5% due to suicide or medical complication.
Comorbid with bi-polar, depressive and anxiety disorders. OCD common with restricting type, substance use more common in binge and purging type.
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Criteria: Restriction leading to low body weight in context to age, sex, development and physical health. Intense fear of weight gain regardless of current weight. Disturbance in the way ones body weight or shape is experianced, lack of recognition for the seriousness of current low weight.
Specify: Restricting type- last 3 months individual has not engaged in recurrent episodes of binge-eating or purging behaviours. Weight loss occurs primarily through dieting, fasting or excessive exercise.
Binge-eating/ Purging type- during the last 3 months the individual has engaged in recurrent episodes of binge-eating or purging behaviours.
Treatment: Hospitalization, refeeding, CBT, IPT and psychodynamic approach both individual and in group. Family based therapy for children and adolescents.
Sleep Dx
Insomnia
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Criteria:
1 or more symptom/type:
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Late Insomnia: early waking, can't go back to sleep
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Distress or impairment, sleep difficulty occurs at least 3 nights per week for at least 3 months.
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Treatment: sleep hygiene, CBT for Insomnia (CBT-I), Benzos and sedating antidepressants
Narcolepsy
Criteria:
Recurrent periods of irrepressible need to sleep, lapsing into sleep or napping occurring within the same day. 3 times per week over the past 3 months
1 of the following:
Episodes of cataplexy, occurring at least a few times per month
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Enuresis
Criteria
Repeated voiding of urine in clothing or bed, at least 2x/week for at least 3 consecutive months.
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Subtypes- Nocturnal only (most common), diurnal only or nocturnal and diurnal.
Treatment: Urine alarm/moisture alarm, bell & pad. Desmopressin- temporarly effective, relapse upon discontinuation.
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Pica
Criteria: Persistent eating of non-native, non-food substances over the period of at least 1 month. The eating is not developmentally appropriate, not a cultural or social practice.
Binge Eating Dx
comorbidity - More common in females, especially those from an ethnic minority
Criteria:
Recurrent episodes of binge eating (eating in a discrete period of time [eg. within any 2 hr period] an amount of food that if definitely larger than what most people would eat in a similar period of time under similar circumstances. A sense of lack of control over eating during the episode)
3 of the following: eating more rapidly than normal, eating till uncomfortably full, eating large amounts when not hungry, eating alone because of feeling embarrassed by how much one is eating, feeling disgusted with oneself, depressed or very guilty afterward.
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