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| Anorexia Nervosa |
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THE DIAGNOSTIC CRITERIA FOR ANOREXIA NERVOSA refuses to maintain body weight at or above the minimum `normal' weight for age and height (e.g. less than 85% of expected weight); has an intense fear of gaining weight or of becoming fat; has a disturbance in the way in which her or his body weight or body shape is experienced, or denies the seriousness of the present low body weight; has amenorrhea (in the case of post-menarchal females). Anorexia nervosa can be either: restricting type, in which there is not a history of regular binge-eating or purging behavior during the present episode of anorexia nervosa; or binge-eating/purging type, in which there is a history of regular binge-eating or purging behavior during the present episode. The ICD-10 diagnostic criteria for anorexia nervosa differ from the DSM-IV criteria in several details. ICD-10 requires that the weight loss must be self-induced by the avoidance of `fattening foods' and that men must have a loss of potency and sexual interest. Unlike DSM-IV, ICD-10 excludes a diagnosis of anorexia nervosa if there is a history of regular binge-eating. Although traditionally anorexia nervosa is not considered a psychotic disorder, in some cases it may be difficult to distinguish between the fixed false beliefs of distorted body image and a delusional state. Signs and symptoms The patient with anorexia nervosa typically comes to medical attention as a result of pressure from family members; self-referral is relatively rare. Typically, but not invariably, the disorder is seen in young females with an onset before the age of 20 years. Onset after the age of 40 years is rare. The clinical features most commonly noticed by family members are: weight loss below a healthy level; change in eating habits (e.g. types of food, frequency of eating), food preparation and cooking habits (especially when preparing food for others), and preoccupation with food. Other features include: behavioral changes - increased exercise, increased frequency of checking body weight, change in the manner of dress (people with anorexia nervosa often wear oversized clothes or multiple layers of clothing); physical changes - amenorrhea; change in the quality of hair, nails and skin; constipation or diarrhea; dizziness or fainting; decreased blood pressure, temperature or pulse rate; psychological changes - depressed mood, social withdrawal, irritability, loss of interest in usual activities, anxiety, fatigue. (from PsychiatryMatters.MD) Last update: 07-12-2005 06:18
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