Summary
Samenvatting blok 3.5: Eating, sex and other needs. Probleem 1: eetstoornissen part 1
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- Institution
Dit is een volledige samenvatting van alle artikelen van probleem 1 uit blok 5.
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Course 3.5 Eating, sex and other needsProbleem 1 - Eating Disorders part 1
Leerdoelen:
Vignet 1
- Welke eetstoornissen zijn er? DSM-V criteria en prevalentie
- Wat zijn de risicofactoren voor het ontwikkelen van een eetstoornis?
Vignet 2
- Waarom ontwikkelen eetstoornissen in mannen?
- Zijn er verschillen tussen de ontwikkeling van eetstoornissen tussen mannen en
vrouwen?
Vignet 3
- Welke eetstoornissen komen voor bij kinderen?
- Wat zijn de moeilijkheden in het diagnosticeren van eetstoornissen bij kinderen?
- Hoe voorkomend zijn eetstoornissen bij kinderen?
- Hoe/waarom ontwikkelen eetstoornissen in kinderen?
Vignet 4
- Welke rol speelt motivatie in de behandeling van eetstoornissen?
- Hoe motiveer je patiënten met eetstoornissen?
Vignet 1 - Why, Mandy?
Welke eetstoornissen zijn er? DSM-V criteria en prevalentie
BRON: DSM-V
Eetstoornissen worden gekenmerkt door een aanhoudende verstoring van eten of
eet-gerelateerd gedrag dat resulteert in aangepaste consumptie of opname van eten en dat
significante impact heeft op fysieke gezondheid of psychosociaal functioneren.
Zes soorten worden in de DSM-V behandeld: Pica, Rumination disorder, Avoidant/restrictive
food intake disorder, Anorexia nervosa, Bulimia nervosa en Binge-eating disorder.
Pica
A. Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.
B. The eating of nonnutritive, nonfood substances is inappropriate to the developmental
level of the individual.
C. The eating behavior is not part of a culturally supported or socially normative practice.
D. If the eating behavior occurs in the context of another mental disorder (e.g., intellectual
disability [intellectual developmental disorder], autism spectrum disorder, schizophrenia)
or medical condition (including pregnancy), it is sufficiently severe to warrant additional
clinical attention.
Rumination Disorder
A. Repeated regurgitation of food over a period of at least 1 month. Regurgitated food
may be re-chewed, re-swallowed, or spit out.
B. The repeated regurgitation is not attributable to an associated gastrointestinal or other
1
,medical condition (e.g., gastroesophageal reflux, pyloric stenosis).
C. The eating disturbance does not occur exclusively during the course of anorexia nervosa,
bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder.
D. If the symptoms occur in the context of another mental disorder (e.g., intellectual disability
[Intellectual developmental disorder] or another neurodevelopmental disorder), they are
sufficiently severe to warrant additional clinical attention.
Avoidant/Restrictive Food Intake Disorder
A. An eating or feeding disturbance (e.g., apparent lack of interest in eating or food;
avoidance based on the sensory characteristics of food; concern about aversive
consequences of eating) as manifested by persistent failure to meet appropriate nutritional
and/or energy needs associated with one (or more) of the following:
1. Significant weight loss (or failure to achieve expected weight gain or faltering growth
in children).
2. Significant nutritional deficiency.
3. Dependence on enteral feeding or oral nutritional supplements.
4. Marked interference with psychosocial functioning.
B. The disturbance is not better explained by lack of available food or by an associated
culturally sanctioned practice.
C. The eating disturbance does not occur exclusively during the course of anorexia nervosa
or bulimia nervosa, and there is no evidence of a disturbance in the way in which
one’s body weight or shape is experienced.
D. The eating disturbance is not attributable to a concurrent medical condition or not better
explained by another mental disorder. When the eating disturbance occurs in the
context of another condition or disorder, the severity of the eating disturbance exceeds
that routinely associated with the condition or disorder and warrants additional clinical
attention.
Anorexia Nervosa
A. Restriction of energy intake relative to requirements, leading to a significantly low body
weight in the context of age, sex, developmental trajectory, and physical health. Significantly
low weight is defined as a weight that is less than minimally normal or, for children and
adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes
with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue
influence of body weight or shape on self-evaluation, or persistent lack of recognition of
the seriousness of the current low body weight.
Deze eetstoornis heeft twee subtypes:
- Restricting type: during the last 3 months, the individual has not engaged in
recurrent episodes of binge eating or purging behavior. This subtype describes
presentations in which weight loss is accomplished primarily through dieting, fasting
and/or excessive exercise.
- Binge-eating/purging type: during the last 3 months, the individual has engaged in
recurrent episodes of binge eating or purging behaviour.
Mild: BMI>17 kg/m2
Moderate: BMI 16-16.99 kg/m2
2
, Severe: BMI 15-15.99 kg/m2
Extreme: BMI < 15 kg/m2
Er zijn drie essentiële kenmerken bij anorexia nervosa: aanhoudende calorierestrictie, angst
voor aankomen of gedrag dat dit vermijdt en een verstoring in zelf-waargenomen gewicht of
vorm.
Prevalentie anorexia nervosa: 0.4% bij jonge vrouwen, en komt meer bij vrouwen voor dan
bij mannen. Het bedraagt een 10:1 ratio. Anorexia nervosa ontwikkelt meestal tijdens de
adolescentie of jonge volwassenheid. De ontwikkeling is vaak geassocieerd met een
stressvolle levensgebeurtenis. Temperament, omgeving en genetische/fysiologische
kenmerken zijn risicofactoren. Het is geassocieerd met een verhoogd risico op zelfmoord.
Bulimia Nervosa
A. Recurrent episodes of binge eating. An episode of binge eating is characterized by
both of the following:
1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food
that is definitely larger than what most individuals would eat in a similar period of time
under similar circumstances.
2. A sense of lack of control over eating during the episode (e.g., a feeling that one
cannot stop eating or control what or how much one is eating).
B. Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such
as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting;
or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average,
at least once a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of anorexia nervosa.
Mild: An average of 1-3 episodes of inappropriate compensatory behaviors per week.
Moderate: An average of 4-7 episodes of inappropriate compensatory behaviors per
week.
Severe: An average of 8-13 episodes of inappropriate compensatory behaviors per
week.
Extreme: An average of 14 or more episodes of inappropriate compensatory behaviors
per week.
Er zijn drie essentiële kenmerken bij bulimia nervosa: herhaaldelijke episodes van binge
eating, herhaaldelijke ongepaste compenserende gedragingen ter preventie van aankomen
en zelf-evaluatie beïnvloedt door lichaamsvorm en gewicht.
Prevalentie: 1-1.5% bij jonge vrouwen, en komt meer bij vrouwen voor dan bij mannen. Het
bedraagt een 10:1 ratio. Bulimia begint meestal tijdens de adolescentie of jonge
volwassenheid. Temperament, omgeving, genetische/fysiologische kenmerken en course
modifiers (zoals comorbiditeiten of ernst) zijn risicofactoren. Het is geassocieerd met een
verhoogd risico op zelfmoord.
Binge-Eating Disorder
A. Recurrent episodes of binge eating. An episode of binge eating is characterized
by both of the following:
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