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Sunday, 1 December 2013

Eating Disorders: Anorexia nervosa - The Diagnosis

Anorexia nervosa
Anorexia nervosa is a type of eating disorder usually develop in the teen years and effect over 90% of female, because of excessive food restriction and irrational fear to become fat due the wrongly influenced media as attractiveness is equated to thinness.
Diagnosis and tests
The criteria of Anorexia nervosa diagnosed if a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea(33).
After taking the complex physical exam, including detail of absence of period and the examination the symptoms of Anorexia nervosa, such as skin and nails for dryness, hair, etc. If your doctor suspect that you have develop norexia nervosa, he/she may order
1. Hematological and blood coagulation tests
In a study of Red cell and haemoglobin values in 44 women with a typical picutre of anorexia nervosa showed that 20.5% presented a picture of true anaemia. Blood iron was low, sometimes very low, with a mean value of 66 mg 0/0. Clotting parameters: PTT, TT, PT, circulating platelets and TEG were normal. This finding serves to explain the low incidence of haemorrhage and the ready haemostasis noted in this disease, in spite of the considerable food deficit(33).
Other blood tests may be required to check electrolytes and protein as well as functioning of the liver, kidney and thyroid.

2. Urinary steroids
Urinalysis is to measure the levels of dehydroepiandrosterone. The increased level of the stress marker allo-tetrahydrocorticosterone refers to the involvement of stress in these diseases(34).

3. Psychological evaluation
Psychological self-assessment questionnaires are given to test  your thoughts, feelings and eating habits.
Dr. Gordon DP, and the research team in the study of A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders indicated that Cognitive and projective psychological tests were administered to ten inpatient adolescents with anorexia nervosa and ten inpatient adolescents with conduct disorders. All subjects were selected on the basis of race, sex and overall intelligence. Results indicate that there are high numbers of neuropsychological deficits in both groups, but that neuropsychological deficits are especially numerous in the anorexia group. The two groups showed striking similarities in terms of some psychological functions, but results indicate that some aspects of personality style in the two groups are significantly different. A significant finding was that there were far more suicidal indicators on the Rorschach records of the anorectic group as compared with those found on the records of the conduct disorder group(35).


4. X-rays
X- ray may be taken to check for broken bones, pneumonia. In some cases, dual energy X-ray absorptiometry may be necessary to test for the presented osteopenia and  osteoporosis(36)

5. Electrocardiograms 
Electrocardiograms is necessary to look for heart irregularities. Anorexia nervosa caused demonstrable abnormalities of mitral valve motion and reduced left ventricular mass and filling associated with systolic dysfunction.

6. Etc.
  
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Sources
(33) http://www.ncbi.nlm.nih.gov/pubmed/869704
(34) http://www.ncbi.nlm.nih.gov/pubmed/15560936
(35) http://www.ncbi.nlm.nih.gov/pubmed/6501640
(36) http://www.ncbi.nlm.nih.gov/pubmed/22137016