Bulimia

Criteria diagnoses on bulimia

As much the DSM-IV as the CIE-10 agrees in which, to be able to diagnose bulimia nervous, the stuffings and unseaworthy the compensatory conducts at least 2 times per week have to take place during three months.

Types of bulimia

Based on the type of purge that uses to compensate the stuffing, we have:

• Purgative type: when the vomit, the laxatives, the diuréticos is used like compensatory conduct, enemas, syrup of ipecacuana or even the teniasis, (infection by Tænia solium), to eliminate the more soon possible food of the institution.

• Nonpurgative type: in the 6 or 8 percent of the cases of bulimia other compensatory conducts are carried out, as intense the physical exercise or is not made anything long ago or fasting; it is a less effective method to resist and to undo of the calories. The nonpurgative type only occurs in, approximately, the 6%-8% of the cases of bulimia, since it is a less effective method to eliminate of the institution a number so lifted of calories. This type of bulimia also usually appears in those who appear the purgative type, but is a secondary form of control of the weight.

Psicopatología of bulimia

It is recommended to analyze the social environment of those people who have this problem: family, friendly, etc. In some cases, the family is the main factor problem for want of communication, and the person does the impossible thing by not being invisible before the company. The ratio of these actions is that the people with this type of problem of health feel rejected by the world, feels that its body and the image that of him the others have is negative, and usually is not conscious that they are making an irreparable damage to his health, because produces lack of dream, tires, badly humor generally and sometimes a great loss of weight (despite, the people are many that suffers bulimia that maintains a weight or a light overload perpendicular). Usually they feel very misunderstood and rejected, when the feeling that they do not fit in a company whose values are trims in the physical appearance more. This ideology makes think that only the thinness and the attractiveness will prevail in the company (as much in the nearer small groups, like the family, in greater and more distant scenes, like the work and the school). Bulimia usually appears along with a strong feeling of insecurity and with serious problems in the self-esteem, in direct link with the weight or the corporal image (they autoimagen).

He is frequent that the people with bulimia come from dysfunctional families. Many of these people even appear alexitimia, that is to say, the incapacity to undergo and to express the emotions of conscious way.

Population in risk

The population in risk is formed mainly by women of white race and middle class or discharge in countries industrialized like the Member States, Latin America generally, Spain, Canada, Australia, Japan, New Zealand, Mexico South Africa.

Bulimia nervous begins generally in the adolescence or at the beginning of the adult life; generally in the women (of each 10 people who suffer of bulimia 1 of those he is a man). The stuffings usually begin later or during a period of dietetic regime.

Mortality

The upheavals in the feeding appear one of the highest mortality rates within the group of the mental upheavals. One relatively little knows about the effects or long term consequences of bulimia. The most recent investigations suggest the prognosis is diverse. Bulimia can appear like a long term, fluctuating suffering during many years, or like a episódico problem of health, hurrying based on the events and crisis of the life of suffers that it. In the short term, some medical information suggest is an improvement of the 50 percent in the behavior (in the stuffings and the purges) in those patients who can commit themselves with a processing. Not yet consistent factors have been able to identify themselves that allow to predict the result of the processing. Nevertheless, the gravity of the sequels of the purges can be an important indicator of the prognosis; the electrolytic imbalances, the esofagitis and hiperamilasemia reflect the fact that the purges were more severe, and perhaps will generate a prognosis more discouraging. In serious cases, the person can pass away as a result of a very severe stuffing, or she even can commit suicide. In many occasions the patient appears symptoms as anxiety and usually grafts ansiolíticos excessively to revert the symptom.

Secondary direct effects and

• Aspiration (passage of the gastric content to the bronchial shaft)
• Esofágica or gastric failure
• Neumomediastino (air intake the interior of the toráxica cavity)
• Hipopotasemia (low potassium levels in the blood).
• Cardiac arrhythmia
• Anxiety or compulsión to eat
• Vomits
• Abuse in the laxative and diuréticos medecine consumption
• Tracking of diverse dietetic regimes
• Dehydration
• Menstrual alterations and amenorrhoea
• Abrupt increase and reduction of weight
• Increase in the frequency of dental decays
• Loss of the dental enamel
• Increase as large as the salivary glands
• Lost of hair
• Desestabilidad in the weight
• Depression

Processing

The processing is more effective in the initial phases of the development of this upheaval but, since bulimia are accustomed to hide-and-seek easily, the diagnosis and the processing only usually appears until this problem already has become a permanent ingredient in the life of the patient.

In the past, the people with bulimia were hospitalized in order to put aim to the landlord of stuffings and purges, and she registered to him as soon as the symptoms had disappeared. But this procedure no longer is frequent present time, since of that way superficial attention at the most of the problem were only put and, shortly after, when the symptoms returned did, it with a much greater intensity.

Several centers of processing in institutions (internamiento) offer long term support, council and interruption of the symptoms. The most common form of processing at the moment includes therapy, that usually is group therapy psycotherapy or mental-behavioral therapy. The people with anorexy or bulimia the same type of processing and usually are member of the same groups of processing. This must to that in many cases the patients suffer of both sufferings, of simultaneous way. Some denominate to this phenomenon “interchange of symptoms” (symptom swapping). These forms of therapy concentrate so much in the symptoms that take to the individual to appear these behaviors like in the symptoms related to the feeding. Along with the therapy, many psychiatrists prescribe antidepressing or antipsicóticos. The antidepressants appear in different forms, and the one that has shown more promising results is the fluoxetina or Prozac. In a study that was realized with a group of 382 people with bulimia, those whom they received between 20 and 60 mg of Prozac appeared a reduction in their symptoms among the 45 and 67 percent, respectively. It is possible that other many medecines work, but until now the Prozac has shown the most positive results.

The antipsicóticos are used, here, in doses smaller than those than they are applied to the cases with schizophrenia. With an upheaval of the feeding, the patient perceives the reality of another way and has great difficulties to include/understand what means to eat in conditions “perpendicular”. Unfortunately, since this upheaval appeared including in the Manual of diagnosis and statistic of mental upheavals (DSM), not yet he knows himself which will be the long term results of the processings that have come being applied to many patients with this problem. So far, the most recent investigations indicate that a 30 percent of the patients falls quickly, whereas the 40 percent appears chronic symptoms.

The speed of the processing is one of the factors most important to give a prognosis. Those people receive who it in the initial phases of the higher upheaval will have one more a more permanent recovery and.

Doctor Sabine Naessén, who works in the Karolinska Institute, discovered that some women with this suffering also have a hormonal imbalance that consists of the overproduction of testosterone (hormone that, although also is present in the female body, it predominates in the institution of all man), and that, to treat them, the use of a contraceptive pill who contains estrogens gives like result the reduction of the symptoms of bulimia. Of course, more studies make lack to determine the effectiveness of this type of processing. It is only possible to recover of this disease if the person in question makes the decision to fight and to change (she is a mental illness).

Bibliography

1. 'nervosa Bulimia - Definition, Description, You cause and symptoms, Demographics, Diagnosis, Treatments, Prognosis, Prevention'
2. ↑ bulimia - Definitions from Dictionary.com
3. ↑ http://www.psych.org/public_info/eatingdisorders52201.cfm
4. ↑ Abnormal Psychology An Integrative Approach - First Canadian edition. By D.H. Barlow, V.M.Durand, and S.H. Stewart
5. ↑ http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders
6. ↑ Durand, Mark, Barlow, David. “Essentials of Abnormal Psychology Fourth Ed” Thomson Wadsworth, CA 2006, ISBN 0-534-60575-3
7. ↑ Durand, Mark, Barlow, David. “Essentials of Abnormal Psychology Fourth Ed” Thomson Wadsworth, CA 2006, ISBN 0-534-60575-3
8. 'Assessment and Treatment of Bulimia Nervosa - June 1998 - American Academy of Family Physicians'
9. ↑ http://www.edauk.com/sub_what_is_bulimia.htm
10. 'BBC - Health - Conditions - Eating disorders'
11. ↑ Durand, Mark, Barlow, David (2006). Essentials of Abnormal Psychology, Fourth Edition, Wadsworth, CA: Thomson.
12. ↑ Kriz, Kerri-Lynn Murphy (May 2002). The Efficacy of Overeaters Anonymous in Fostering Abstinence in Binge-Easting Disorder and Bulimia Nervosa. Virginia Polytechnic Institute and State University.
13. ↑ Bulimia Nervosa
14. ↑ Bulimia May Result from Hormonal Imbalance - Startpage - ki.se
15. 'Bulimia'
16. 'Eating Disorders for Coaltion Research, Policy & Action - Statistics'
17. ↑ Bulimia May Result from Hormonal Imbalance - Startpage - ki.se