Anorexia Nervosa: Symptoms, Treatment and Impact

Anorexia Nervosa Symptoms, Treatment and Impactcirculatory system is made up of the vessels and the muscles that help and control the f mortified of the slant rough the body. Blood contains antigens and antibodies to protect us from infectious and non-infectious diseases which c in alled the immune system. Whenever antigen and antibody interlock, the antibody marks the antigen for destruction.E truly unitary would ask to harbour the ideal body. They depart do e verything so that their bodies could be un big(a)erated blueprint, especially female. Approximately 95% of those bear upon by anorexia be female, save males locoweed develop the inconvenience as salubrious. Anorexia nervosa is a non-infectious disease. Anorexia nervosa or unremarkably called anorexia is an eating disorder or loss of desire for food (appetite). When deal pee this disease, they are called to be anorexic.The process of too much limit the amount of food into the body is likely to result a indi vidual experiencing anorexia. People with anorexia nervosa behave to be very high achievers, performing very well in legion(predicate) activities. Professionals for instance athletes, model or whiz are easy got anorexic, because of their professional requirement. Anorexia is aboutly resulted from whizz maintaining an extremely showtime load, and formed as a result of changes in ones behavior, emotions, thinking, perceptions, and affectionate interactions.When state called to be anorexic, they dont have any nutrition in their body and therefrom anorexias antigen could attack antibodies. When antibodies failed to keep anorexias antigens, our body will get tired, weak and opposite(a) symptoms of anorexia will occur. Even though there have been many anorexia cases, at the end of the millennium, quite a little health will be better and anorexics will decrease because of the technology improvement. This essay will discuss the causes, symptoms, interruption methods, and ha ndling methods to fightds anorexia disease.Anorexia is a very dangerous disease because it is happening in all over the gentlemans gentleman. A record has been made in 2004 by world health organization statistical information system to prove how destructive is this eating disorder. There are approximately 20 countries counted for the people remnant caused by anorexics. Below is the diagram of the record.Anorexics might cause by having degraded relationships or cosmos teased or so their size or weight at their onetime(prenominal). When macrocosm teased, person felt of not good comme il faut, low self-esteem, and even anger. Thus this will affects their social life. According to a olfactory perception suggests that a combination of certain(p) individual(prenominal)ity traits, emotions and thinking patterns, as well as cultural and environmental factors might be responsible.People who have anorexia are behaving to deny that they have a chore. Due to people with anorexia a good deal hide their condition symptoms are not easy to see. But as time goes by, as anorexia progresses symptoms whitethorn be seen and its start to be onerous for them to deny. The symptoms areAnorexics read food labels to measures and weighs the calories of the food that they will eat.Anorexics will mask that they had eaten before when someone ask them to or throw the food away.They command with food. By collecting recipes, reading food magazines or cooking for friends may make other think that they are practice and forgotten rough their previous thought of (he/she) getting anorexia.Anorexics will cut food into menial pieces and chewing every bite a certain number of measure.The affected person uses various methods such as vomiting or cathartic abuse to prevent weight gain.Most individuals with anorexia nervosa do not actualise that they have an eating disorder. And usually hide their feelings, thoughts, intentions and actions from other people (secretive).They ma y easily get tired, weak, and most(prenominal)(prenominal) of the time dizzy because of low blood pressure. Have purplish skin color on their arms and legs from woeful blood flow. They alike happen to have yellow skin and dry mouth. Patient of anorexia nervosa are easily getting confused and slow thinking. non all of cases involving this type of non-infectious disease can be prevented. Despite that, there may be some ways to be done to prevent some cases to happen. What can be done are teaching and further healthy eating habits and realistic attitudes about food and body range of mountains to people that are suspected might experience anorexia. The role of parents in a family is as well as important. In particular, mothers should create a healthy life style in order to show her children how important to consume particular amount of food, and fathers should not criticize too much on his children body set and weight. In addition, parents should promote a healthy and supportin g environment for their children. On the other hand, the media can also be used to promote healthier lifestyle. It must represent the society, as the basic characteristic of an individual is that they may tend to follow others lifestyle. The media can also display programs that are created to prevent eating disorder.Many of anorexics died before they could get a well sermon. Anorexics that are in a very underweight condition, must be interact carefully, or hospitalized. After anorexics get the medical treatment, they need to get mental counseling in order for them learn about healthy foods and lifestyle. The psychological counseling may take ons nutritional counseling, individual counseling and group counseling. nutritionary counseling will teaches anorexics to count calories of body needed in loose method. And to help with weight gain, doctors usually use liquid food supplements. Anorexics may also need some therapies such as cognitive-behavioral therapy or cognise as CBT i n the individual counseling. CBT teachers will help anorexics to change their attitudes and behaviors about eating. Group counseling is also needed for anorexics, to share their experiences and to encourage their friends (who also experience anorexia) to recover. Family therapy is very helpful, especially for teen with anorexics. Parents and siblings could support the anorexics during treatment emotionally and tangiblely. Another effort to help anorexics recover is by letting them expressing their feelings and doing something pleasant for them for instance doing their hobbies. Then, doing relaxation is also important. By having yoga, massage and the traditional Chinese relaxation exercises will build a healthy relationship with their body.BibliographyThinkQuest, ThinkQuest. Circulatory System. 30-11-09 .National Cancer Institute, USA, National Cancer Institute, USA . Antigens and Antibodies. 29-12-09 .Stoppler, Melissa. Anorexia nervosa. medecinenet.com. 29-11-09 .ehealthMD, eheal thMD. Anorexia nervosa. 30-11-09.NationMaster.com, NationMaster.com. Mortality Statistics eating disorders (most recent) by country . 1-12-09 .Cleveland Clinic, Cleveland Clinic. Anorexia nervosa. 1-11-09 . drop-off and fretting in old(a) Adults companionship GapsDepression and Anxiety in Older Adults Knowledge GapsDepression and Anxiety in Older AdultsAre there gaps in current fellowship regarding diagnosis and treatment?IntroductionMental health difficultys in former(a) adults can cause a massive social blow, often livery about poor quality of life, isolation and exclusion. Depression is one of the most debilitating mental health disorders worldwide, affecting approximately 7% of the gray community (Global wellness Data Exchange, 2010). Despite this, it is also one of the most underdiagnosed and undertreated conditions in the primary care setting. Even with estimates of approximately 25% of over 65s living in the community having depressive symptoms severe enough to wa rrant medical intervention, totally one third discuss their symptoms with their GP. Of those that do, only 50% receive treatment as symptoms of notion within this cosmos often coincide with other later life problems ( IAPT, 2009 World health Organisation (WHO), 2004).Chapter 2 Literature Review2.1 Depression and Anxiety in quondam(a) adultsMany misconceptions surround ageing including the fact that belief is a normal part of the ageing process. Actual evidence proves that other physical health issues often supersede the presentation of depressive symptoms in sr. adults which may suggest that the developing of clinical belief is influenced by deteriorating physical health (Baldwin, 2008 Baldwin et al, 2002). Depression may present differently in sr. adults in resemblance to adolescents or even working age adults. Although the same disorder may be present throughout different stages of the lifespan, in fourth-year adults certain symptoms of depression may be accentuated , such as somatic or psychotic symptoms and memory complaints, or suppressed, such as the feelings of sadness, in comparability to younger people with the same disorder (Baldwin, 2008 Chiu, Tam Chiu, 2008). OConnor et al (2001) carried out a study into the influence of age on the solution of major depression to electroconvulsive therapy and found that when confounding variables are controlled (age at the offset of a study), there is no difference in the remission grade for depression in both younger and honest-to-goodness adults, however, relapse range remain higher for older adults. Backing this up, Brodaty et al (1993) conducted a qualitative naturalistic study into the prognosis of depression in older adults in coincidence to younger adults and again confirmed that the prognosis and remission for depression in older adults is not significantly worse than for younger adults. However, the rigor of a qualitative naturalistic study is argued by proponents as being value-laden in nature, while criticisms of this study approach highlight it as being subjective, anecdotal and subject to investigateer bias (Koch, 2006).In addition to depression, disquiet disorders are also super C among older adults, often presenting as a comorbid condition. In 2007, 2.28 million people were diagnosed as having an anxiety disorder in the UK, with 13% of those individuals aged 65 and over. By 2026, the projected number of people diagnosed with an anxiety disorder is expected to rise by 12.7% to 2.56 million with the superior increase expected to be seen in the older adult population (Kings Fund, 2008). Despite the prevalence rate, anxiety is poorly researched in comparison to other psychiatric disorders in older people (Wetherell et al, 2005). Of the anxiety disorders, psychoneurotic disorders and generalised anxiety disorder (GAD) are the two most common in older people (Bryant et al, 2008). It wasnt until 1980 that the American Psychiatric familiarity (APA) published the Diagnostic and Statistical Manual of Mental Disorders (DSM) 3rd pas seul which introduced Generalised Anxiety Disorder (GAD) into the psychiatric nomenclature, distinguishing it from other anxiety disorders for the root time (APA, 1980). MCManus et al (2009) estimate that in England alone, as many as 4.4% of people suffer with GAD with prevalence rates between 1.2 and 2.5 times higher for women than men (Prajapati, 2012).Post-Traumatic Stress Disorder (PTSD) continues to gain increased lore and has received more clinical interest lately, correlating with individuals from the Second World War, final solution and Vietnam Veterans reaching or being well into old age. Despite this, information relating to prevalence rates still remains limited with research assistance to focus on specific populations as opposed to community figures, for example, with regards to UK war veterans, approximately 30% will develop PTSD (pickingupthepieces.org.au, 2014). Unfortunately, stigma tends t o keep in line PTSD statistics as sufferers tend not to seek diagnosis or researcher bias is present. Britt (2000) found that many work personal within the military stated that admitting to a mental health problem was not only more stigmatising that admitting to a physical health problem but they also believed it would have a more detrimental impact on their career prospects. Furthermore, Mueller (2009) conducted a study into disclosure attitudes in which it was reason out that these attitudes can strongly predict symptom severity. With this in mind, it is important to accentuate the importance of practicing within the limits of NMC (2008) code of conduct in which unconditional exacting regard must be shown by all nursing cater whilst incorporating a non-bias attitude in practice.Anxiety and depression comorbidity is well established. A farseeingitudinal study, noted for its beneficial adaptability in enabling the researcher to look at changes over time, conducted by Balkom e t al (2000) found that in a random community warning of adults (55 and older), who were diagnosed as having an anxiety disorder, 13% also met the criteria of major depressive disorder (MDD). Adding weight to the evidence of anxiety and depression comorbidity in older adults, Schaub (2000) who also conducted a capaciousitudinal study, found that 29.4% of a sample of older adults in a German community diagnosed with an anxiety disorder also met the criteria for a depressive disorder. spaciousitudinal studies are thought to vary in their validity due to the attrition of randomly assigned participants during the course of the study, thereof producing a final sample that is not a true standard of the population sampled (Rivet-Amico, 2009).King-Kallimanis, Gum and Kohn (2009) examined current and lifetime comorbidity of anxiety with depression. Within a 12 month period they found 51.8% of older adults with MDD in the joined States also met the diagnostic criteria for an anxiety disor der. There is evidence to suggest that the starting presentation of anxiety symptoms in older adults suggests an underlying depressive disorder (Chiu et al, 2008). Unfortunately, comorbid anxiety and depression in older adults is associated with much higher risks of suicidal symptoms (Bartels et al, 2002 Lenze et al, 2000) in addition to increased says of more severe psychiatric and somatic symptoms and poorer social functioning when compared to depression alone (Lenze et al, 2000 Schoevers et al, 2003).2.2 Diagnosis and Screening ToolsThe U.S. healthful operate Task Force (USPSTF) (2009) states that cover charge for depression and anxiety in older adults allows GPs and mental health practitioners to look for these conditions despite the service user not reporting the symptoms. However, recommendations on the use of screening tools should be limited to service where there are adequate systems in place to refer service users on for in-depth assessment and treatment as screening without adequate treatment and follow-up is highly ineffective as highlighted by OConner (2009) and USPSTF (2009) in separate research reexaminations. Snowden et al (2009) further stipulates that screening should only be carried out in appropriate settings using approved depression screening tools designed specifically for older adults. Some of these specific screening tools include the Geriatric Depression Scale (GDS) and the 2 item and 9-item Patient health Questionnaire (PHQ-2 /PHQ-9). It is necessary to be mindful of the fact that screening tools are not diagnostic assessments, they merely identify the likelihood of someone have depression/anxiety (Snowden et al, 2009) and should be used in conjunction with a clinical examination to aid diagnosis (Chie et al, 2008).The self-administered Geriatric Depression Scale is the most wide accepted screening tool for depression in older adults, first developed by Yesavage et al in 1983. It is available in both a long form and short form . The long form consists of a 30-item questionnaire, which asks the older adult to answer yes or no to specific questions in reference to how they have been feeling over the past week. The shorter form (see appendix 1) was developed in 1986 following validation studies of the long form and takes approximately 5 minutes to complete. This is often the more commensurate screening tool as it can be more easily used by individuals who are physically unwell and those suffering from small to moderate cognitive impairments such as dementia who may have relatively short concentration spans. It comprises of 15 specific questions from the long form that generated the highest association with depressive symptoms. Scores of 0-4 on the GDS short form are considered normal 5-8 indicate mild depression 9-11 indicate moderate depression and 12-15 indicate severe depression (Yesavage et al, 1983 1986).The GDS have proven to a highly honest and valid screening tool. One study carried out by Paradel a et al (2005) found that the GDS had 81% sensibility and 71% specificity when evaluated against diagnostic criteria in the DSM-IV. In a validation study completed Sheikh and Yesavage (1986) comparing the GDS Long and Short Forms, both were successful in distinguishing dispirit from non-depressed older adults with a high correlation.Within the NHS, several screening tools are more widely used than the GDS. These include the PHQ-9 (Spitzer et al, 1999), PHQ-2 (see appendix 2) (Kroenke et al, 2003) and Whooley questions (see appendix 3) (Whooley et al, 1997). Both the PHQ-2 and PHQ-9 use a psychometric Likert scale format while the Whooley questions uses simple yes/no answers.The PHQ-2 and Whooley questions die into the category of ultra-short questionnaires comprising of as little as ternion, two or one single detection questions. Despite the use of these ultra-short questionnaires being used in practice, evidence from Mitchell and Coyne (2007) suggests that one-question screenin g tools identify as little as one third of patients with depression making them unacceptable and unreliable screening tools if only if relied upon. Despite this, there is still support for the use of two and three question screening tools, specifically the PHQ-2 which has been found to identify as many as 80% of individuals with depression in primary care settings (Ross, 2010 Mitchell and Coyne, 2007). As with all good practice, caution should be used when utilising these screening tools are they can present false-positive results (Mitchell and Coyne, 2007).By comparison, the PHQ-9 is a self-administered 9-item questionnaire aimed at the detection of depression (Kroenke et al, 2001). It value within mental health screening is well know due to the robust evidence surrounding it validity and excellent levels of sensitivity (91.7%) and specificity (78.3%) (Kroenke et al, 2010).Chapter 3 Application to Nursing PracticeDementia, along with depression and other priority mental disorders are included in the WHO Mental Health Gap Action Programme (mhGAP). This programme aims to improve care for mental, neurologic and substance use disorders through providing guidance and tools to develop health function in resource poor areas.Synthesis and utilization of empirical research is an important aspect of evidence-based care. Only within the context of the holistic assessment, can the highest quality of care be achieved.ReferencesBaldwin, R., Chiu, E., Katona, C., and Graham, N. 2002. courselines on depression in older people Practising the evidence. London Martin Dunitz Ltd.Baldwin, R. 2008. Mood disorders depressive disorders. In Jacob R et al, Oxford Textbook of Older Age psychopathology. Oxford Oxford University Press.Balkom, V., Beekman , A., de Beurs, E., et al. Comorbidity of the anxiety disorders in a community-based older population in the Netherlands Online. Acta Psychiatrica Scandinavica 101(-). Pp 3745. Available at https//www-swetswise-com.abc.cardiff.ac.uk /FullTextProxy/swproxy?url=http//onlinelibrary.wiley.coc/resolve/doi/pdf?inside=10.1034/j.1600-0447.2000.101001037.xts=1409279416128cs=1533436201userName=0000884.ipdireciemCondId=884articleID=25446758yevoID=1585273titleID=2498remoteAddr=131.251.137.64hostType=PRO Accessed 29th swaggering 2014.Bartels, S., Coakley, E., Oxman, T., et al. 2002. Suicidal and death ideation in older primary care patients with depression, anxiety, and at-risk alcohol use. American Journal of Psychiatry.159(10) pp.417427.Brodaty, H., Harris, L., Peters, K., Wilhelm, K., Hickie, I., Boyce, P., Mitchell, P., Parker, G., and Eyers, K. 1993. Prognosis of depression in the elderly. A comparison with younger patients Online. The British Journal of Psychiatry 163(-) pp589-596. Available at http//bjp.rcpsych.org/content/163/5/589BIBL Accessed 27th August 2014.Chiu, H., Tam,W., and Chiu, E. 2008. WPA educational program on depressivedisorders Depressive disorders in older persons. World Psychiatric tie-in (WPA).K ings Fund. 2008. Paying the price The cost of mental health care in England to 2026 Online. London Kings Fund. Available at http//www.kingsfund.org.uk/sites/files/kf/Paying-the-Price-the-cost-of-mental-health-care-England-2026-McCrone-Dhanasiri-Patel-Knapp-Lawton-Smith-Kings-Fund-May-2008_0.pdf Accessed 17th August 2014.Koch, T. 2006. Establishing rigour in qualitative research the finding trail. Journal of Advanced Nursing 53(1) pp. 91-100Lenze, E., Mulsant, B., Shear M, et al. 2000. Comorbid anxiety disorders in depressed elderly patients Online. American Journal of Psychiatry. 157(-) pp.722728. Available at http//ajp.psychiatryonline.org.abc.cardiff.ac.uk/data/Journals/AJP/3712/722.pdf?resultClick=3 Accessed 29th August 2014.OConner, A. 2009. Screening for depression in adult patients in primary care settings a systematic evidence review Online. Annals of Internal care for. 151(11). Pp.784-793. Available at http//annals.org.abc.cardiff.ac.uk/article.aspx?articleid=745314resultC lick=3 Accessed 22nd August 2014.OConnor, M., Knapp, R., Husain, M., et al. 2001. The influence of age on the response of major depression to electroconvulsive therapy a CORE report. American Journal of Geriatric Psychiatry. 9(-) pp. 382390Rivet-Amico, K. 2009. Percent correspond Attrition A Poor Metric for translate Rigor in Hosted Intervention Designs Online. American Journal of Public Health 99(9) pp 1567-1575. Available at http//www.ncbi.nlm.nih.gov/pmc/articles/PMC2724469/ Accessed 22nd August 2014.Schaub, R., Linden, M. 2000. Anxiety and anxiety disorders in the old and very oldresults from the Berlin Aging Study (BASE) Online. Comprehensive Psychiatry. 41(-) pp 4854. Available at http//ac.els-cdn.com.abc.cardiff.ac.uk/S0010440X00800085/1-s2.0-S0010440X00800085-main.pdf?_tid=25fb884e-2f25-11e4-ae4a-00000aab0f6bacdnat=1409279912_0012d28347b6791e31a8b5199f3daaa1 Accessed 29th August 2014.Schoevers, R., Beekman, A., Deeg, D., et al. 2003. The natural history of late-life depres sion results from the Amsterdam Study of the Elderly (AMSTEL) Online. Journal of Affective Disorders.76(1) pp 514. Available at http//ac.els-cdn.com.abc.cardiff.ac.uk/S0165032702000605/1-s2.0-S0165032702000605-main.pdf?_tid=1814aa80-2f34-11e4-a381-00000aab0f27acdnat=1409286331_4cb7efb58af9c004b37dc4825f8831d5 Accessed nineteenth August 2014.Sheikh, J., and Yesavage, A. 1986. Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. In T.L. Brink (Ed.), Clinical Gerontology A Guide to Assessment and Intervention .pp. 165-173. New York The Haworth Press.Snowden, M., Steinman, L., Frederick, J., and Wilson, N. 2009. Screening for depression in older adults recommended instruments and considerations for community-based practice Online Clinical Geriatrics. 17(9). Pp 26-32. Available at http//www.consultant360.com/articles/screening-depression-older-adults-recommended-instruments-and-considerations-community Accessed 19th August 2014.USPSTF. 2009. U.S. Preven tive Services Task Force. Screening for depression in adults U.S. preventive serve task force recommendation statement Online. Annals of Internal Medicine 151 (11). Pp 784-792. Available at http//annals.org/article.aspx?articleid=745304 Accessed 19th August 2014.Yesavage, A., Brink, L., Rose, L., Lum, O., Huang, V., Adey, M., and Leirer, O. 1983. Development and validation of a geriatric depression screening scale A preliminary report Online. Journal of Psychiatric Research, 17(1). pp 37-49. Available at http//ac.els-cdn.com.abc.cardiff.ac.uk/0022395682900334/1-s2.0-0022395682900334-main.pdf?_tid=3e351376-2f84-11e4-80c4-00000aab0f02acdnat=1409320755_7707825345e33994a5a5539c953dac90 Accessed 29th August 2014.cecal appendage 1.