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Anorexia nervosa definition and the societys perception of it

The aim of this study was to emerge the complex issues regarding the treatment, the early intervention and the prevention of the anorexia nervosa. Patients with anorexia nervosa develop a refusal in ingestion of food, maintaining a distorted self-perception of their body, considering themselves as overweighed. The diagnosis even though is made according international established criteria, varies among the patients taking into consideration additional factors like family and social environment.

As the patients refuse to admit the seriousness of their condition, they seek for medical assistance when disorders appear in vital organs, due to de-nutrition. In most cases hospitalization is necessary and includes a suitable diet program and medication treatment.

Psychological therapy is a basic part of the treatment, in long-term basis and is employed by behavior therapy and the patient's support.

Contribution of social and family factors in anorexia nervosa

Advising the public and especially parents with children in adolescence, where usually anorexia nervosa occurs, is necessary as the prevention and the early diagnosis is the best treatment. Key words Anorexia nervosa, treatment, prevention. Introduction Disorders in food injection have raised the interest of scientists the last years due to the constantly increased number, mainly of women, that report severe behavioral problems regarding the food.

Two clinical syndromes appear in adolescent and adult age: Anorexia Nervosa and Bulimia nervosa. At first the disorder was described as a hereditary abnormality of the central neurological system that appears only to young females [ 6 ].

In 1883 Huchard established the term "anorexia nervosa" and Freud 1895 suggested that anorexia is associated with melancholy and usually appears to sexual immature females. It occurs 10-20 times more in females than in males and mainly at developed countries, western countries.

The modern society enervates family bonds and reduces the time spent between parents and children, setting new priorities, altered from those of previous generations. Purpose of this study is to highlight the complex issues concerning the treatment, the early intervention and the prevention of the anorexia nervosa. Etiology of anorexia nervosa and associated factors The causes of anorexia nervosa are multi factored and there are many relative theories from the scientific community.

It is supported that the disorder is caused by a coalescence of biological, social-cultural and psychological -psychical factors. There also the view that the causes of anorexia anorexia nervosa definition and the societys perception of it are only psychical or that there is no clear evidence regarding the exact pathogenesis that induces the disorder.

But all scientists agree at the significant role of the family and particularly the mother associated with the occurrence of the disorder to children and especially to adolescent females. Adolescent crisis and new experiences, as inclinatory factors 2.

Raising a child that is only ostensibly "normal". They usually hide behaviors with lack of recognition, enhancement and confirmation of child's abilities. The preponderant psychological mechanism, which is the complete control of the body, as an effort to maintain a level the dominance over their selves. They believe that anorexia nervosa seems to be a reaction to the demands of adolescence for more independence and increased social and sexual activity. In a way, patients through the disorder replace the normal adolescent quests with the constant concern of food and control of their body weight.

They report that there are troubled relationships between parents and the anorectic children try to draw their attention. In patients' family history are mentioned cases of depression, alcoholism, and eating disorders. Biological theories are focused in the function of hypothalamus, where, based on observations and clinical results, there is a protogenic dysfunction.

Over-secretion of cortisol is detected to malnutrition and depression. There are increased corticotropin CRG levels and it is released to cerebrospinal fluid of these patients. Also amenorrhea is reported before the occurrence of weight loss. An increased level of ceretonin in brain reduces the appetite, and leptin seems to have an important roll in regulation of fat sites in the body, and as a result to the regulation of appetite.

Anorexics have lower leptin levels in blood that are increased with the temperature rise.

  1. Bryant R, Bates B. Ashwood House, Australia, 1987.
  2. MMW Fortschr Med, 2007; 149 18. But all scientists agree at the significant role of the family and particularly the mother associated with the occurrence of the disorder to children and especially to adolescent females.
  3. Psychological therapy is a basic part of the treatment, in long-term basis and is employed by behavior therapy and the patient's support.

They believe that the importance of psychological, social and biological factors varies to each individual. Biological factors may be associated with hormonal changes that occur during adolescence. Psychological mechanisms may be involved in the changes in personality and behavior during the human life and social factors may be related with the idealization of thinness, that plays a powerful role in our culture.

The prognosis of the disorder is extremely difficult to be defined, as it is influenced by the structure of personality. Persons that are hysteric, with intense obsessions, and a bad background of maternal relationship, are very likely to develop the disorder in future.

Also individuals with family history of anorexia nervosa, or with medical history of serious diseases are at the same risk. The progress of the disease varies, from immediate recovery after the treatment, to unsteady progress of weight recovery with recurrences, and to constant fatal aggravation. The extended duration of the disease, depression, frequent vomits and the excess weight loss are negative prognostic points, including hospitalized treatment, sensitivity to various diseases, and family with intense psychopathology.

Behavior of anorexic Anorexic persons have a disorder image of the normal weight and shape of the body and they consciously chose ways for weight loss that gradually lead to dying. They seem to have obsessive characteristics, high sense of duty and morality and an inclination to independence. At the beginning they are intensively busy preparing their meals, and they avoid high calorie foods, weight at least four times daily, and follow strict exhausting diets.

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Their interest for any kind of activity is lost and reduced, their ability to concentrate is reduced as well as their sexual activity. The patients adopt a contrary behavior, obstinacy, laziness, emotional instability and detachedness. As organism tries to adapt with low intake of energy, appears a variety of organic disorders, such as bradycardia, arrhythmias and decrease of arterial blood pressure having as result periods of hypotension.

During laboratory testing the endocrine disorders become obvious by disorders at hormonal prices Table 1. Diagnosis of anorexia nervosa is based on diagnostic criteria established by American Psychiatric Association DSM-IV that are in valid worldwide and are referred to psychopathological symptoms and signs and to evidence of endocrinologic disorders Table 2. The first is to rehabilitate the state of nutrition.

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For anorexic patients this means to regain the body weight to normal levels. The second aim is to alter the pathological behavior of eating, so that the body weight is preserved to normal limits and to control the use of laxatives and other pathological behaviours. Evidence for hospitalization is a severe weight loss and emaciation, hypotension, hypothermia, electrolyte disorders, presence of suicidal ideation or psychosis, and the failure outpatient treatment.

  • The psychiatric history of anorexia nervosa and bulimia nervosa;
  • Advances in psychotherapy for children and adolescents with eating disorders;
  • Prax Kinderpsychol Kinderpsychiatr, 2007; 56 1;
  • In most cases hospitalization is necessary and includes a suitable diet program and medication treatment;
  • Inter J Eat Disord, 2006; 8 3;
  • Indian J Pediatr, 1998; 65 4:

The treatment approach is a combination of behavior therapy and supportive psychotherapy. This includes the learning of behavior, and then follows de learning and relearning, without seeking the causes of the previous pathologic behavior. The aim of this behavior treatment is to restore the normal way of eating. Conclusions Although there is a significant progress in treatment of anorexia nervosa, the conclusions, of the few studies during the last decade, have showed a wackiness in research, as it seems that the ways of developing prevention and treatment programs of anorexia nervosa are not connected with the risk factors and the necessity of finding a treatment approach that combines the traditional methods of therapy with new ones, and this due to limited knowledge.

The modern social models idealize women with low body weight, with result the increasing number of incidents of anorexia nervosa, especially among adolescents. Long-term aim should be the reducing effects of eating disorders and the associated risk factors.

Scientists emphasize the need of encouraging the patients to seek therapy and to treat them with understanding, while the goals and limits of treatment are attainable. Also, they suggest specific instructions regarding the level of the needed treatment to psychological and behavioral issues that characterize anorexia nervosa. All the medical professionals should realize that the recovery of the disorder is a slow procedure. The financial cost for this kind of disorders is high and onerous for the families of the patients.

Beside the long period of time, there are many variations in the force of the disease, and many times hospitalization is necessary and treatment is common to engage anorexia nervosa definition and the societys perception of it multidisciplinary team of professionals for the patients and their families.

Anorexia nervosa is a psychiatric disease with high mortality rates in young patients.

It is need the state to organize units for patients with eating disorders and to fully cover treatment and hospitalization.

The public information is essential and especially to parents with adolescent children, as we believe that prevention and early recognition of the problem are better than treatment. Indian J Pediatr, 1998; 65 4: Epidemiology and natural course of eating disorders in young women from adolescence to young adulthood. Abraham S, Llewellyn-Jones D.

Eating disorders and disordered eating. Ashwood House, Australia, 1987. Steiner H, Lock J. Anorexia nervosa and bulimia nervosa in children and adolescents: Childhood onset anorexia nervosa and related disorders. Lawrence Erlbaum and Associates Ltd, Hove. Richard Morton's second case of anorexia nervosa: Reverend Minister Steele and his son - An historical vignette. Inter J Eat Disord, 2006; 7 3: The psychiatric history of anorexia nervosa and bulimia nervosa: Weight concerns and bulimic symptoms in early case reports.

Inter J Eat Disord, 2006; 8 3: Management of eating disorders. Evid Rep Technol Assess, 2006; 135: The relationship of eating disorders and substance abuse. J Subs Abuse, 1991; 3 2: Lock J, Fitzpatrick KK. Advances in psychotherapy for children and adolescents with eating disorders. Am J Psychother, 2009; 63 4: Eating disorders in children and adolescents.

MMW Fortschr Med, 2007; 149 18: Ruhl U, Jacobi C. Cognitive-behavioral psychotherapy for adolescents with eating disorders. Prax Kinderpsychol Kinderpsychiatr, 2005; 54 4: Izydorczyk B, Czekaj B. Review of certain conceptions on eating disorders.

Suggestions on psychotherapy for women with anorexia and bulimia nervosa the authors' own experience. Psychiatr Pol, 2006; 40 1: