Anorexia Nervosa: Features, Treatment and Prognosis

In this article we will discuss about the Anorexia Nervosa:- 1. Meaning of Anorexia Nervosa 2. Clinical Features of Anorexia Nervosa 3. Treatment 4. Prognosis.

Meaning of Anorexia Nervosa:

This is a psychiatric disease arising from a refusal to eat which often leads to severe emaciation. Pa­tients are usually middle class and often above average intelligence. The disease affects mainly the adolescent girls and young women, but cases are seen in older women and also in men. The patients come from homes where plenty of food is available and often some of the family are obese.

Clinical Features of Anorexia Nervosa:

1. The weight may be reduced to 35 kg or less. Patients often deny all normal sense of fatigue.

2. The pulse is slow; the blood pressure, pe­ripheral blood flow, and skin temperatures are all low.

3. There is usually no anemia, there may be fine downy hair. Amenorrhoea is a characteristic feature but secondary sexual characteristics are present.

4. Urinary excretion of gonadotrophins and oestrogens is diminished.

5. Menstruation starts at puberty when weight rises above 47 kg and stops when it falls below 47 kg. The plasma potas­sium may be abnormally low.

6. Anorexia is common in patients with an anxiety state, a depressive illness.

Treatment of Anorexia Nervosa:

1. The primary aim is to get the patient to eat. Severe cases should be treated by a psychiatrist and under close supervision in hospital until a satisfactory weight has been achieved.

2. Chlorpromazine in doses up to 150 to 200 mg three times daily makes the patient more amenable, counteracts vomiting and is claimed to increase appetite.

3. Disturbed relationships within the family need attention. Regular interview with rela­tives conducted by a psychiatric social worker over many months should reduce guilt, misunderstanding and intolerance.

Prognosis of Anorexia Nervosa:

1. Restoration of weight and menstruation may occur within several months in fa­vourable cases.

2. 50 per cent may make a partial recovery continuing to restrict their diet and remain­ing abnormally thin. There is a mortality of about 5 per cent from suicide.