| Revision as of 02:42, 21 January 2010 edit71.232.239.243 (talk) →Definition← Previous edit | Revision as of 02:44, 21 January 2010 edit undo71.232.239.243 (talk) ←Replaced content with ' RayWilliamJohnson........ O.o'Tag: repeating charactersNext edit → | ||
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| {{otheruses6|Anorexia nervosa (disambiguation)|Anorexia}} | |||
| {{Infobox_Disease | |||
| | Name = Anorexia Nervosa | |||
| | Image = | |||
| | Caption = A female with anorexia | |||
| | DiseasesDB = 749 | |||
| | ICD10 = {{ICD10|F|50|0|f|50}}-{{ICD10|F|50|1|f|50}} | |||
| | ICD9 = {{ICD9|307.1}} | |||
| | ICDO = | |||
| | OMIM = 606788 | |||
| | MedlinePlus = | |||
| | eMedicineSubj = emerg | |||
| | eMedicineTopic = 34 | |||
| | eMedicine_mult = {{eMedicine2|med|144}} | |||
| | MeshID = | |||
| }} | |||
| '''Anorexia nervosa''' is an ] characterized by extremely low ], distorted ] and an obsessive fear of gaining weight. <ref>http://www.psychiatryonline.com/content.aspx?aID=3617&searchStr=anorexia+nervosa</ref> | |||
| RayWilliamJohnson........ O.o | |||
| The term anorexia nervosa was established in 1873 by ], one of ]'s personal physicians.<ref>Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica) (1873) William Withey Gull, published in the 'Clinical Society's Transactions, vol vii, 1874, p22</ref> The term is of Greek origin: ''a'' (α, prefix of negation), ''n'' (ν, link between two vowels) and ''orexis'' (ορεξις, appetite), thus meaning a lack of desire to eat.<ref>{{cite book |last=Costin |first=Carolyn |year=1999 |title=The Eating Disorder Sourcebook |location=Linconwood |publisher=Lowell House |page=6 |isbn=0585189226}}</ref> | |||
| YOur mom | |||
| ==Causes== | |||
| ====Genetics==== | |||
| Family and ] have suggested that genetic and environmental factors account for 74% and 26% of the ] in anorexia nervosa, respectively.<ref name="Klump2001">{{cite journal |author=Klump KL, Miller KB, Keel PK, McGue M, Iacono WG |title=Genetic and environmental influences on anorexia nervosa syndromes in a population-based twin sample |journal=Psychological Medicine |volume=31 |issue=4 |pages=737–40 |year=2001 |month=May |pmid=11352375 |doi=10.1017/S0033291701003725}}</ref> This evidence suggests that genes influencing both eating regulation, and personality and emotion, may be important contributing factors. In one study, variations in the ] gene ] were associated with restrictive anorexia nervosa, but not binge-purge anorexia (though the latter may have been due to small sample size).<ref>{{cite journal |author=Urwin RE, Bennetts B, Wilcken B, ''et al.'' |title=Anorexia nervosa (restrictive subtype) is associated with a polymorphism in the novel norepinephrine transporter gene promoter polymorphic region |journal=Molecular Psychiatry |volume=7 |issue=6 |pages=652–7 |year=2002 |pmid=12140790 |doi=10.1038/sj.mp.4001080}}</ref> | |||
| ====Neurobiological==== | |||
| Anorexia may be linked to a disturbed serotonin system,<ref>{{cite journal |author=Kaye WH, Frank GK, Bailer UF, ''et al.'' |title=Serotonin alterations in anorexia and bulimia nervosa: new insights from imaging studies |journal=Physiology & Behavior |volume=85 |issue=1 |pages=73–81 |year=2005 |month=May |pmid=15869768 |doi=10.1016/j.physbeh.2005.04.013}}</ref> particularly to high levels at areas in the brain with the ] - a system particularly linked to ], ] and ]. Starvation has been hypothesised to be a response to these effects, as it is known to lower ] and ] metabolism, which might reduce serotonin levels at these critical sites and ward off anxiety. Other studies of the 5HT<sub>2A</sub> serotonin receptor (linked to regulation of feeding, mood, and anxiety), suggest that serotonin activity is decreased at these sites. There is evidence that both personality characteristics and disturbances to the serotonin system are still apparent after patients have recovered from anorexia.<ref>{{cite journal |author=Kaye WH, Bailer UF, Frank GK, Wagner A, Henry SE |title=Brain imaging of serotonin after recovery from anorexia and bulimia nervosa |journal=Physiology & Behavior |volume=86 |issue=1-2 |pages=15–7 |year=2005 |month=September |pmid=16102788 |doi=10.1016/j.physbeh.2005.06.019}}</ref> | |||
| Changes in brain structure and function are early signs often to be associated with ], and is partially reversed when normal weight is regained.<ref>{{cite journal |author=Palazidou E, Robinson P, Lishman WA |title=Neuroradiological and neuropsychological assessment in anorexia nervosa |journal=Psychological Medicine |volume=20 |issue=3 |pages=521–7 |year=1990 |month=August |pmid=2236361 |doi=10.1017/S0033291700017037}}</ref> Anorexia is also linked to reduced blood flow in the ]s. It is possible that it is a risk trait rather than an effect of starvation.<ref>{{cite journal |author=Lask B, Gordon I, Christie D, Frampton I, Chowdhury U, Watkins B |title=Functional neuroimaging in early-onset anorexia nervosa |journal=The International Journal of Eating Disorders |volume=37 Suppl |issue= |pages=S49–51; discussion S87–9 |year=2005 |pmid=15852320 |doi=10.1002/eat.20117}}</ref> | |||
| Anorexia may be linked to an autoimmune response to ] ] which influence appetite and stress responses.<ref>{{cite journal |author=Fetissov SO, Harro J, Jaanisk M, ''et al.'' |title=Autoantibodies against neuropeptides are associated with psychological traits in eating disorders |journal=Proceedings of the National Academy of Sciences of the United States of America |volume=102 |issue=41 |pages=14865–70 |year=2005 |month=October |pmid=16195379 |pmc=1253594 |doi=10.1073/pnas.0507204102}}</ref> | |||
| ====Nutrition==== | |||
| ] deficiency may play a role in Anorexia. It is not thought responsible for causation of the initial illness but there is evidence that it may be an accelerating factor that deepens the pathology of the anorexia. A 1994 randomized, double-blind, placebo-controlled trial showed that zinc (14 mg per day) doubled the rate of body mass increase compared to patients receiving the placebo.<ref name="Zincappetitereview">{{cite journal |author=Shay NF, Mangian HF |title=Neurobiology of zinc-influenced eating behavior |journal=The Journal of Nutrition |volume=130 |issue=5S Suppl |pages=1493S–9S |year=2000 |month=May |pmid=10801965 |url=http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=10801965}}</ref> | |||
| ===Psychological=== | |||
| Anorexic eating behavior is thought to originate from an obsessive fear of gaining weight due to a distorted self image<ref>{{cite journal |author=Rosen JC, Reiter J, Orosan P |title=Assessment of body image in eating disorders with the body dysmorphic disorder examination |journal=Behaviour Research and Therapy |volume=33 |issue=1 |pages=77–84 |year=1995 |month=January |pmid=7872941 |doi=10.1016/0005-7967(94)E0030-M}}</ref> and is maintained by various ]es that alter how the affected individual evaluates and thinks about their body, food and eating. This is not a ] problem, but one of how the perceptual information is evaluated by the affected person.<ref>{{cite journal |author=Skrzypek S, Wehmeier PM, Remschmidt H |title=Body image assessment using body size estimation in recent studies on anorexia nervosa. A brief review |journal=European Child & Adolescent Psychiatry |volume=10 |issue=4 |pages=215–21 |year=2001 |month=December |pmid=11794546 |doi=10.1007/s007870170010}}</ref> People with anorexia nervosa seem to more accurately judge their own body image while lacking a self-esteem boosting bias.<ref>{{cite journal |author=Jansen A, Smeets T, Martijn C, Nederkoorn C |title=I see what you see: the lack of a self-serving body-image bias in eating disorders |journal=The British Journal of Clinical Psychology / the British Psychological Society |volume=45 |issue=Pt 1 |pages=123–35 |year=2006 |month=March |pmid=16480571 |doi=10.1348/014466505X50167}}</ref> | |||
| People with anorexia nervosa also have other psychological difficulties and ]. ], ], ] and one or more ] may be the most likely conditions to be ] with anorexia. High-levels of anxiety and depression are likely to be present regardless of whether they fulfill diagnostic criteria for a specific syndrome.<ref>{{cite journal |author=O'Brien KM, Vincent NK |title=Psychiatric comorbidity in anorexia and bulimia nervosa: nature, prevalence, and causal relationships |journal=Clinical Psychology Review |volume=23 |issue=1 |pages=57–74 |year=2003 |month=February |pmid=12559994 |doi=10.1016/S0272-7358(02)00201-5}}</ref> | |||
| Research into the ] of anorexia has indicated that many of the findings are inconsistent across studies and that it is hard to differentiate the effects of starvation on the brain from any long-standing characteristics. One finding is that those with anorexia have poor cognitive flexibility.<ref>{{cite journal |author=Tchanturia K, Campbell IC, Morris R, Treasure J |title=Neuropsychological studies in anorexia nervosa |journal=The International Journal of Eating Disorders |volume=37 Suppl |issue= |pages=S72–6; discussion S87–9 |year=2005 |pmid=15852325 |doi=10.1002/eat.20119}}</ref> | |||
| Other studies have suggested that there are some ] and ] biases that may maintain anorexia.<ref>{{cite journal |author=Cooper MJ |title=Cognitive theory in anorexia nervosa and bulimia nervosa: progress, development and future directions |journal=Clinical Psychology Review |volume=25 |issue=4 |pages=511–31 |year=2005 |month=June |pmid=15914267 |doi=10.1016/j.cpr.2005.01.003}}</ref> | |||
| ====Social and environmental==== | |||
| Sociocultural studies have highlighted the role of cultural factors, such as the promotion of thinness as the ] in Western industrialised nations, particularly through the media.{{Citation needed|date=December 2009}} A recent epidemiological study of 989,871 Swedish residents indicated that ], ] and ] were large influences on the chance of developing anorexia, with those with non-European parents among the least likely to be diagnosed with the condition, and those in wealthy, white families being most at risk.<ref>{{cite journal |author=Lindberg L, Hjern A |title=Risk factors for anorexia nervosa: a national cohort study |journal=The International Journal of Eating Disorders |volume=34 |issue=4 |pages=397–408 |year=2003 |month=December |pmid=14566927 |doi=10.1002/eat.10221}}</ref> People in professions where there is a particular social pressure to be thin (such as ] and ]s) were much more likely to develop anorexia during the course of their career,<ref>{{cite journal |author=Garner DM, Garfinkel PE |title=Socio-cultural factors in the development of anorexia nervosa |journal=Psychological Medicine |volume=10 |issue=4 |pages=647–56 |year=1980 |month=November |pmid=7208724 |doi=10.1017/S0033291700054945}}</ref> and further research has suggested that those with anorexia have much higher contact with cultural sources that promote weight-loss.<ref>{{cite journal |author=Toro J, Salamero M, Martinez E |title=Assessment of sociocultural influences on the aesthetic body shape model in anorexia nervosa |journal=Acta Psychiatrica Scandinavica |volume=89 |issue=3 |pages=147–51 |year=1994 |month=March |pmid=8178671 |doi=10.1111/j.1600-0447.1994.tb08084.x}}</ref> | |||
| There is a high rate of reported child sexual abuse experiences in clinical groups of who have been diagnosed with anorexia. Although prior sexual abuse is not thought to be a specific risk factor for anorexia, those who have experienced such abuse are more likely to have more serious and chronic symptoms.<ref>{{cite journal |author=Carter JC, Bewell C, Blackmore E, Woodside DB |title=The impact of childhood sexual abuse in anorexia nervosa |journal=Child Abuse & Neglect |volume=30 |issue=3 |pages=257–69 |year=2006 |month=March |pmid=16524628 |doi=10.1016/j.chiabu.2005.09.004}}</ref> | |||
| ====Relationship to autism==== | |||
| ] | |||
| Following an initial suggestion of relationship between anorexia nervosa and ],<ref name=Gillberg1985>{{cite journal |doi=10.3109/08039488509101911 |title=Autism and anorexia nervosa: Related conditions? |year=1985 |last1=Gillberg |first1=Christopher |journal=Nordic Journal of Psychiatry |volume=39 |pages=307}}</ref><ref name ="Rothery">{{cite journal |author=Rothery DJ, Garden GM |title=Anorexia nervosa and infantile autism |journal=The British Journal of Psychiatry |volume=153 |issue= |pages=714 |year=1988 |month=November |pmid=3255470 |doi=10.1192/bjp.153.5.714}}</ref><ref name=Gillberg1>{{cite journal |volume=5 |issue=1 |pages=27–32 |last1=Gillberg |first1=C. |last2=Rastam |first2=M. |title=Do some cases of anorexia nervosa reflect underlying autistic-like conditions? | |||
| |journal=Behavioural neurology |year=1992}}</ref> a ] of 102 participants into teenage onset anorexia nervosa conducted in Sweden found that 23% of people with a long-standing eating disorder are on the ].<ref name=Gillberg2>{{cite journal |author=Gillberg IC, Råstam M, Gillberg C |title=Anorexia nervosa 6 years after onset: Part I. Personality disorders |journal=Comprehensive Psychiatry |volume=36 |issue=1 |pages=61–9 |year=1995 |pmid=7705090 |doi=10.1016/0010-440X(95)90100-A}}</ref><ref name=Gillberg3>{{cite journal |author=Gillberg IC, Gillberg C, Råstam M, Johansson M |title=The cognitive profile of anorexia nervosa: a comparative study including a community-based sample |journal=Comprehensive Psychiatry |volume=37 |issue=1 |pages=23–30 |year=1996 |pmid=8770522 |doi=10.1016/S0010-440X(96)90046-2}}</ref><ref name="Råstam1">{{cite journal |doi=10.1007/BF01537541 |title=A six-year follow-up study of anorexia nervosa subjects with teenage onset |year=1996 |last1=Råstam |first1=M. |last2=Gillberg |first2=C. |last3=Gillberg |first3=I. C. |journal=Journal of Youth and Adolescence |volume=25 |pages=439}}</ref><ref name=Nilsson1>{{cite journal |author=Nilsson EW, Gillberg C, Gillberg IC, Råstam M |title=Ten-year follow-up of adolescent-onset anorexia nervosa: personality disorders |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=38 |issue=11 |pages=1389–95 |year=1999 |month=November |pmid=10560225 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0890-8567&volume=38&issue=11&spage=1389}}</ref><ref name=Wentz1>{{cite journal |author=Wentz E, Gillberg C, Gillberg IC, Råstam M |title=Ten-year follow-up of adolescent-onset anorexia nervosa: psychiatric disorders and overall functioning scales |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |volume=42 |issue=5 |pages=613–22 |year=2001 |month=July |pmid=11464966 |doi=10.1017/S0021963001007284}}</ref><ref name=Råstam2>{{cite journal |author=Råstam M, Gillberg C, Wentz E |title=Outcome of teenage-onset anorexia nervosa in a Swedish community-based sample |journal=European Child & Adolescent Psychiatry |volume=12 |issue=Suppl 1 |pages=I78–90 |year=2003 |pmid=12567219 |doi=10.1007/s00787-003-1111-y}}</ref><ref name=Wentz2>{{cite journal |author=Wentz E, Lacey JH, Waller G, Råstam M, Turk J, Gillberg C |title=Childhood onset neuropsychiatric disorders in adult eating disorder patients. A pilot study |journal=European Child & Adolescent Psychiatry |volume=14 |issue=8 |pages=431–7 |year=2005 |month=December |pmid=16341499 |doi=10.1007/s00787-005-0494-3}}</ref> Those on autism spectrum tend to have a worse outcome,<ref name="Wentz3">{{cite journal |author=Wentz E, Gillberg IC, Anckarsäter H, Gillberg C, Råstam M |title=Adolescent-onset anorexia nervosa: 18-year outcome |journal=The British Journal of Psychiatry |volume=194 |issue=2 |pages=168–74 |year=2009 |month=February |pmid=19182181 |doi=10.1192/bjp.bp.107.048686}}</ref> but may benefit from the combined use of behavioural and pharmacological therapies tailored to ameliorate autism rather than anorexia nervosa ].<ref name="Fisman">{{cite journal |author=Fisman S, Steele M, Short J, Byrne T, Lavallee C |title=Case study: anorexia nervosa and autistic disorder in an adolescent girl |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=35 |issue=7 |pages=937–40 |year=1996 |month=July |pmid=8768355 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0890-8567&volume=35&issue=7&spage=937}}</ref><ref name="Kerbeshian">{{cite journal |doi=10.1080/15622970802043117 |title=Is anorexia nervosa a neuropsychiatric developmental disorder? An illustrative case report |year=2009 |last1=Kerbeshian |first1=Jacob |last2=Burd |first2=Larry |journal=World Journal of Biological Psychiatry |volume=10 |pages=648}}</ref> Other studies may suggest that autistic traits are common in people with anorexia nervosa.<ref name=Gillberg4>{{cite journal |author=Gillberg IC, Råstam M, Wentz E, Gillberg C |title=Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder |journal=Journal of Clinical and Experimental Neuropsychology |volume=29 |issue=2 |pages=170–8 |year=2007 |month=February |pmid=17365252 |doi=10.1080/13803390600584632}}</ref><ref name=Lopez1>{{cite journal |author=Lopez C, Tchanturia K, Stahl D, Booth R, Holliday J, Treasure J |title=An examination of the concept of central coherence in women with anorexia nervosa |journal=The International Journal of Eating Disorders |volume=41 |issue=2 |pages=143–52 |year=2008 |month=March |pmid=17937420 |doi=10.1002/eat.20478}}</ref><ref name="Russell1">{{cite journal |author=Russell TA, Schmidt U, Doherty L, Young V, Tchanturia K |title=Aspects of social cognition in anorexia nervosa: affective and cognitive theory of mind |journal=Psychiatry Research |volume=168 |issue=3 |pages=181–5 |year=2009 |month=August |pmid=19467562 |doi=10.1016/j.psychres.2008.10.028}}</ref><ref name=Zastrow>{{cite journal |author=Zastrow A, Kaiser S, Stippich C, ''et al.'' |title=Neural correlates of impaired cognitive-behavioral flexibility in anorexia nervosa |journal=The American Journal of Psychiatry |volume=166 |issue=5 |pages=608–16 |year=2009 |month=May |pmid=19223435 |doi=10.1176/appi.ajp.2008.08050775}}</ref><ref name="Harrison">{{cite journal |author=Harrison A, Sullivan S, Tchanturia K, Treasure J |title=Emotion recognition and regulation in anorexia nervosa |journal=Clinical Psychology & Psychotherapy |volume=16 |issue=4 |pages=348–56 |year=2009 |pmid=19517577 |doi=10.1002/cpp.628}}</ref> However, in one report it was concluded that these findings need to be replicated using larger samples with more sensitive measures.<ref name=Hambrook1>{{cite journal |author=Hambrook D, Tchanturia K, Schmidt U, Russell T, Treasure J |title=Empathy, systemizing, and autistic traits in anorexia nervosa: a pilot study |journal=The British Journal of Clinical Psychology |volume=47 |issue=Pt 3 |pages=335–9 |year=2008 |month=September |pmid=18208640 |doi=10.1348/014466507X272475}}</ref> | |||
| It is also proposed that conditions on the autism spectrum make up the ] underlying anorexia nervosa and appealed for increased interdisciplinary collaboration (see figure to right).<ref name="Zucker1">{{cite journal |author=Zucker NL, Losh M, Bulik CM, LaBar KS, Piven J, Pelphrey KA |title=Anorexia nervosa and autism spectrum disorders: guided investigation of social cognitive endophenotypes |journal=Psychological Bulletin |volume=133 |issue=6 |pages=976–1006 |year=2007 |month=November |pmid=17967091 |doi=10.1037/0033-2909.133.6.976}}</ref> A pilot study into the effectiveness ], which based its treatment protocol on the hypothesised relationship between anorexia nervosa and an underlying autistic like condition, reduced perfectionism and rigidity in 17 out of 19 participants<ref name="Whitney">{{cite journal |author=Whitney J, Easter A, Tchanturia K |title=Service users' feedback on cognitive training in the treatment of anorexia nervosa: a qualitative study |journal=The International Journal of Eating Disorders |volume=41 |issue=6 |pages=542–50 |year=2008 |month=September |pmid=18433016 |doi=10.1002/eat.20536}}</ref> although further evaluation is needed. | |||
| ==Prognosis== | |||
| Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with anywhere from 6-20% of those who are diagnosed with the disorder eventually dying from related causes.<ref>{{cite journal |author=Herzog DB, Greenwood DN, Dorer DJ, ''et al.'' |title=Mortality in eating disorders: a descriptive study |journal=The International Journal of Eating Disorders |volume=28 |issue=1 |pages=20–6 |year=2000 |month=July |pmid=10800010 |doi=10.1002/(SICI)1098-108X(200007)28:1<20::AID-EAT3>3.0.CO;2-X}}</ref> The suicide rate of people with anorexia is also higher than that of the general population.<ref>{{cite journal |author=Pompili M, Mancinelli I, Girardi P, Ruberto A, Tatarelli R |title=Suicide in anorexia nervosa: a meta-analysis |journal=The International Journal of Eating Disorders |volume=36 |issue=1 |pages=99–103 |year=2004 |month=July |pmid=15185278 |doi=10.1002/eat.20011}}</ref> In a longitudinal study women diagnosed with either DSM-IV anorexia nervosa (n = 136) or bulimia nervosa (n = 110) respectively who were assessed every 6 – 12 months over an 8 year period are at a considerable risk of committing suicide. Clinicians were warned of the risks as 15% of subjects reported at least one suicide attempt. It was noted that significantly more anorexia (22.1%) than bulimia (10.9%) subjects made a suicide attempt.<ref>{{cite journal |author=Franko DL, Keel PK, Dorer DJ, ''et al.'' |title=What predicts suicide attempts in women with eating disorders? |journal=Psychological Medicine |volume=34 |issue=5 |pages=843–53 |year=2004 |month=July |pmid=15500305 |doi=10.1017/S0033291703001545}}</ref> | |||
| ==Treatment== | |||
| Treatment for anorexia nervosa tries to address three main areas. 1) Restoring the person to a healthy weight; 2) Treating the psychological disorders related to the illness; 3) Reducing or eliminating behaviours or thoughts that originally led to the disordered eating.<ref>{{cite journal | author = National Institute of Mental Health | url = http://www.nimh.nih.gov/health/publications/eating-disorders/anorexia-nervosa.shtml}}</ref> | |||
| Drug treatments, such as ] or other ] medication, have not been found to be generally effective for either treating anorexia,<ref>{{cite journal |author=Claudino AM, Hay P, Lima MS, Bacaltchuk J, Schmidt U, Treasure J |title=Antidepressants for anorexia nervosa |journal=Cochrane Database of Systematic Reviews |volume= |issue=1 |pages=CD004365 |year=2006 |pmid=16437485 |doi=10.1002/14651858.CD004365.pub2}}</ref> or preventing relapse<ref>{{cite journal |author=Walsh BT, Kaplan AS, Attia E, ''et al.'' |title=Fluoxetine after weight restoration in anorexia nervosa: a randomized controlled trial |journal=JAMA |volume=295 |issue=22 |pages=2605–12 |year=2006 |month=June |pmid=16772623 |doi=10.1001/jama.295.22.2605}}</ref> although it has also been noted that there is a lack of adequate research in this area. | |||
| ] has also been found to be an effective treatment for adolescents with short term anorexia.<ref>{{cite journal |author=Lock J, le Grange D |title=Family-based treatment of eating disorders |journal=The International Journal of Eating Disorders |volume=37 Suppl |issue= |pages=S64–7; discussion S87–9 |year=2005 |pmid=15852323 |doi=10.1002/eat.20122}}</ref> At 4 to 5 year follow up one study shows full recovery rate of 60 - 90% with 10-15% remaining seriously ill. This compares favourable to other treatments such as inpatient care where full recovery rates vary between 33-55%.<ref>{{cite journal |author=le Grange D, Eisler I |title=Family interventions in adolescent anorexia nervosa |journal=Child and Adolescent Psychiatric Clinics of North America |volume=18 |issue=1 |pages=159–73 |year=2009 |month=January |pmid=19014864 |doi=10.1016/j.chc.2008.07.004}}</ref> | |||
| ==Epidemiology== | |||
| Anorexia has an incidence of between 8 and 13 cases per 100,000 persons per year and an average prevalence of 0.3% using strict criteria for diagnosis.<ref>{{cite journal |author=Bulik CM, Reba L, Siega-Riz AM, Reichborn-Kjennerud T |title=Anorexia nervosa: definition, epidemiology, and cycle of risk |journal=The International Journal of Eating Disorders |volume=37 |issue=S1 |pages=S2–9; discussion S20–1 |year=2005 |pmid=15852310 |doi=10.1002/eat.20107}}</ref><ref>{{cite journal |author=Hoek HW |title=Incidence, prevalence and mortality of anorexia nervosa and other eating disorders |journal=Current Opinion in Psychiatry |volume=19 |issue=4 |pages=389–94 |year=2006 |month=July |pmid=16721169 |doi=10.1097/01.yco.0000228759.95237.78}}</ref> The condition largely affects young adolescent women, with between 15 and 19 years old making up 40% of all cases. Furthermore, the majority of cases are unlikely to be in contact with mental health services.{{Citation needed|date=December 2009}} Approximately 90% of people with anorexia are female.<ref name="GowersBryant-Waugh2004">{{cite journal |author=Gowers S, Bryant-Waugh R |title=Management of child and adolescent eating disorders: the current evidence base and future directions |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |volume=45 |issue=1 |pages=63–83 |year=2004 |month=January |pmid=14959803 |doi=10.1046/j.0021-9630.2003.00309.x}}</ref> | |||
| ==See also== | |||
| <div class="references-small" style="-moz-column-count:3; column-count:3;"> | |||
| * ] | |||
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| * ] for a historical perspective on anorexia nervosa | |||
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| * '']'' (book) | |||
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| ==References== | |||
| {{Reflist|2}} | |||
| ==External links== | |||
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| * NHS Direct | |||
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| ===Media stories and reports=== | |||
| * - ] on ] websites. | |||
| * - ] on the increasing prevalence of anorexia in young people. | |||
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Revision as of 02:44, 21 January 2010
RayWilliamJohnson........ O.o