Anorexia nervosa natural history, complications and prognosis: Difference between revisions
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Created page with "__NOTOC__ {{Anorexia nervosa}} {{CMG}} ==Overview== ==Possible complications== *Complications can be severe. A hospital stay may be needed. *Complications may include: :*Bloat..." |
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== ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref> == | |||
=== Recommendations for Obesity, Dieting, and Anorexia === | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Life-threatening ventricular arrhythmias in patients with obesity, anorexia, or when dieting should be treated in the same manner that such arrhythmias are treated in patients with other diseases, including ICD and pacemaker implantation as required. Patients receiving ICD implantation should be receiving chronic optimal medical therapy and have reasonable expectation of survival with a good functional status for more than 1 y. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class III]] | |||
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|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Prolonged, unbalanced, very low calorie, semistarvation diets are not recommended; they may be harmful and provoke life-threatening ventricular arrhythmias. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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{|class="wikitable" | |||
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Programmed weight reduction in obesity and carefully controlled re-feeding in anorexia can effectively reduce the risk of ventricular arrhythmias and SCD. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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==Prognosis== | ==Prognosis== | ||
*Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with approximately 6% of those who are diagnosed with the disorder eventually dying due to related causes.<ref>{{citation|first1 = David B|last1 = Herzog|first2 = Dara N|last2 = Greenwood|first3 = David J|last3 = Dorer|first4 = Andrea T|last4 = Flores|first5 = Elizabeth R|last5 = Ekeblad|first6 = Ana|last6 = Richards|first7 = Mark A|last7 = Blais|first8 = Martin B|last8 = Keller|title = Mortality in eating disorders: A descriptive study|journal = International Journal of Eating Disorders|volume = 28|number = 1|pages = 20-26|year = 2000}}</ref> The suicide rate of people with anorexia is also higher than that of the general population and is thought to be the major cause of death for those with the condition.<ref>Pompili M, Mancinelli I, Girardi P, Ruberto A, Tatarelli R. (2004) Suicide in anorexia nervosa: a meta-analysis. ''Int J Eat Disord'', 36 (1), 99-103. PMID 15185278</ref> A recent review suggested that less than one-half recover fully, one-third improve, and 20% remain chronically ill.<ref>Steinhausen HC. (2002) The outcome of anorexia nervosa in the 20th century. ''Am J Psychiatry'', 159 (8), 1284-93. PMID 12153817.</ref> | *Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with approximately 6% of those who are diagnosed with the disorder eventually dying due to related causes.<ref>{{citation|first1 = David B|last1 = Herzog|first2 = Dara N|last2 = Greenwood|first3 = David J|last3 = Dorer|first4 = Andrea T|last4 = Flores|first5 = Elizabeth R|last5 = Ekeblad|first6 = Ana|last6 = Richards|first7 = Mark A|last7 = Blais|first8 = Martin B|last8 = Keller|title = Mortality in eating disorders: A descriptive study|journal = International Journal of Eating Disorders|volume = 28|number = 1|pages = 20-26|year = 2000}}</ref> The suicide rate of people with anorexia is also higher than that of the general population and is thought to be the major cause of death for those with the condition.<ref>Pompili M, Mancinelli I, Girardi P, Ruberto A, Tatarelli R. (2004) Suicide in anorexia nervosa: a meta-analysis. ''Int J Eat Disord'', 36 (1), 99-103. PMID 15185278</ref> A recent review suggested that less than one-half recover fully, one-third improve, and 20% remain chronically ill.<ref>Steinhausen HC. (2002) The outcome of anorexia nervosa in the 20th century. ''Am J Psychiatry'', 159 (8), 1284-93. PMID 12153817.</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Possible complications
- Complications can be severe. A hospital stay may be needed.
- Complications may include:
- Bloating or swelling
- Bone weakening
- Electrolyte imbalance (such as low potassium)
- Dangerous heart rhythms
- Decrease in white blood cells, which leads to increased risk of infection
- Severe dehydration
- Severe malnutrition
- Seizures due to fluid loss from repeated diarrhea or vomiting
- Thyroid gland problems, which can lead to cold intolerance and constipation
- Tooth decay
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) [1]
Recommendations for Obesity, Dieting, and Anorexia
| Class I |
| "1. Life-threatening ventricular arrhythmias in patients with obesity, anorexia, or when dieting should be treated in the same manner that such arrhythmias are treated in patients with other diseases, including ICD and pacemaker implantation as required. Patients receiving ICD implantation should be receiving chronic optimal medical therapy and have reasonable expectation of survival with a good functional status for more than 1 y. (Level of Evidence: C)" |
| Class III |
| "1. Prolonged, unbalanced, very low calorie, semistarvation diets are not recommended; they may be harmful and provoke life-threatening ventricular arrhythmias. (Level of Evidence: C)" |
| Class IIa |
| "1. Programmed weight reduction in obesity and carefully controlled re-feeding in anorexia can effectively reduce the risk of ventricular arrhythmias and SCD. (Level of Evidence: C)" |
Prognosis
- Anorexia is thought to have the highest mortality rate of any psychiatric disorder, with approximately 6% of those who are diagnosed with the disorder eventually dying due to related causes.[2] The suicide rate of people with anorexia is also higher than that of the general population and is thought to be the major cause of death for those with the condition.[3] A recent review suggested that less than one-half recover fully, one-third improve, and 20% remain chronically ill.[4]
- Women who develop this eating disorder at an early age have a better chance of recovering completely. However, most people with anorexia will continue to prefer a lower body weight and be very focused on food and calories.
- Weight management may be hard. Long-term treatment may be needed to stay at a healthy weight.
References
- ↑ Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M; et al. (2006). "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (10): e385–484. doi:10.1161/CIRCULATIONAHA.106.178233. PMID 16935995.
- ↑ Herzog, David B; Greenwood, Dara N; Dorer, David J; Flores, Andrea T; Ekeblad, Elizabeth R; Richards, Ana; Blais, Mark A; Keller, Martin B (2000), "Mortality in eating disorders: A descriptive study", International Journal of Eating Disorders, 28 (1): 20–26
- ↑ Pompili M, Mancinelli I, Girardi P, Ruberto A, Tatarelli R. (2004) Suicide in anorexia nervosa: a meta-analysis. Int J Eat Disord, 36 (1), 99-103. PMID 15185278
- ↑ Steinhausen HC. (2002) The outcome of anorexia nervosa in the 20th century. Am J Psychiatry, 159 (8), 1284-93. PMID 12153817.