In the last post, we saw how:
- Pseudoneurotic Schizophrenia and Simple detorieative disorder are two forms of schizophrenia that are not added to the common forms of this condition.
- If you are in a relationship with someone with schizophrenia, you can be of use to make the person better
- Tardive Dyskinesia presents with abnormal movements.
Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for three consecutive months. This month will be dedicated to Eating Disorders. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Schizophrenia. We are done looking at research work done in Nigeria on Eating Disorders.
In this post, we are looking at a Quora. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.
The word Anorexia Nervosa is gotten from a greek word which means “loss of appetite” and in Latin, it has the implication of the fact that it has a nervous origin. There 3 characteristic features in Anorexia Nervosa, the first is that starvation is self-inflected in most of its part, and the second is that the push for being thin is against all odds or the fear of fatness as it may be. The third feature seen in this disorder is the fact that there is a clinical feature of starvation seen in this patient.
There are two types of this condition known, the restricting and the binge/purge types. In both of the conditions, the thinness of the patine is seen as the only source of good self-esteem. This becomes something that affects the person day to day thoughts and perception of themselves.
Anorexia Nervosa is sometimes but not always associated with body image problems. The parents see themselves as very large even though they are starving. Body image issues are a cause for concern when it is there but it is not needed for the diagnosis of this condition.
Close to 50% of the patients with this condition achieve weight reduction by starvation. The other half starve but in addition to that, they binge eat and purge to achieve their goal. Some patient purge after eating a minute amount of food. This condition is more common in women than in men and it starts in adolescence. The hypothesis is that the reason for it starting in adolescence is the fact that girls start their transition into womanhood at this time.
Persons with either disorder are excessively preoccupied with
weight, food, and body shape. The outcome of anorexia nervosa varies from
spontaneous recovery to a waxing and waning course to death
Eating Disorders in Nigeria (The Abstract)
This was posted in the University of Lagos Journal of Medicine, Science and Technology. The name of the study was:
SCREENING FOR EATING DISORDERS AMONG UNDERGRADUATE STUDENTS IN TWO NIGERIAN HIGHER INSTITUTIONS
This study was done by AINA, O. F1 , OLAGUNJU, A. T1 , AKINBODE, A. A1 , SULEIMAN, T. F.
The two universities used for the study were Dept. Of psychiatry, the College of Medicine at the Univerisity of Lagos and the Department of Psychiatry, Lagos University Teaching Hospital in Lagos also.
In this Abstract they explained how eating disorders are psychological problems that have implications for the physical as well as the mental health of the individual. This condition has caused deaths over the decades of the knowledge of its existence. It is still more common to find its occurrence in the western world but studies done in the Southern parts of Africa reveal that its prevalence is rare.
This study was done in two higher institutions in Lagos Nigeria which are located in western Nigeria. The method used to carry out this study was the use of a questionnaire for socioeconomic status and the other method was the use of the Eating attitude Test. The version of the eating Test used had 26 items.
The study found that 1054 students participated in the study, a majority of them were males making up 55.6%. The females made up the remaining 44.4 %. The average age of those who participated in this study was 21 (±3.66 ) years.
The subjects were weighed and their height was taken. The average weight of the participants was 63.29 (±11.14kg). The average height of the subjects was 1.69(±0.09) metres and the body mass index was 22.7.
The EAT-26 assessment had a result of 15.3% as positive for an eating disorder. More females were positive for eating disorders when compared to males.
One out of six of the subjects was noted to have been positive for an eating disorder and this is very important to note because it is believed that in African demographics they typically do not makeup such a number. Eating disorders are more prevented in females as seen in this study and the ones done in Western Countries. This study was noted to be done with limited instruments. If something like this is to be done by the @Medicvibes blog we will need to update the instruments available.
It is very important to start a treatment plan that has admission into the hospital in mind. The therapy should involve the individual and the family. The therapy method includes Behavioural, interpersonal and cognitive therapy in addition to the use of medication.
The first thing that is needed when working with this condition is to have the patient back to normal eating habits. THey patient has to be managed for dehydration, hypoglycemia and electrolyte abnormalities that come with the condition.
These key features are the first that might end up killing the patient.
Admitting the patient may be against their will if the condition is very critical and the patient is non-compliant. In the patient is less than 20% of their weight for their height, this necessitates admission into the hospital. THos e who fall below 30% weight in height may need psychiatric admission. This will be done for 2 to 6 months.
When the patient is admitted into the psychiatric ward the therapy will include behavioural, individual psychotherapy and family education and therapy. There may be a need for psychotropic medication. To see good results positive and negative reinforcement will be used throughout the therapy.
For the best result, the therapy should be flexible and the patient should be interested in getting better for the treatetn to work over time.
If a patient is not interested in the treatment they will be resistant to psychiatric treatment. They are typically brought to the hospital by friends and family who are bothered by the patient's state. They then fight the diagnosis and do not think hospital admission is necessary.
It is important to stress the need for the admission into the program like the good results for sleeping and mood disorders. These complications can be present and will help the patient make up their mind to receive therapy. It is important to develop a report with the psychiatrist and the other physicians that are involved in the treatment of this patient.
- What did you learn about Schizophrenia?
The patient with eating anorexia nervosa usually has a self inflicted starvation that is because they want to be thin and there are features of starvation.
Eating disorders was found to be seen in 1 out of 6 people in this study.
The patient suffering from anorexia nervosa usually needs to be hospitalized if they will not get better on their own.