The incidence of anorexia nervosa is increasing in adolescents. The pediatrician caring for teenagers is often the first professional confronted with the early signs and symptoms of this disorder. Clinical features and available literature on the psychological, nutritional, and family disorganization found in patients with anorexia nervosa are reviewed. Different therapeutic ap proaches are discussed, and current data on outcome are presented.
Get full access to this article
View all access options for this article.
References
1.
Morton R.Phthisiologica; or a treatise of consumptions. Printed for Sam Smith and Benjamin Walford at the Prince's Arms in St. Paul's Churchyard , London, 1689.
2.
Gull WWAnorexia hysteria (Apepsia hysteria). Br Med J1873;2:527.
3.
Lasegue C.On hysterical anorexia. Med Times Hosp Gaz1873;2:265.
4.
Crisp AH, Palmer RL, Kalucy RSHow common is anorexia nervosa? A prevalence study. Br J Psychiatry1976; 128:549-54.
5.
Frazier SHAnorexia nervosa. Dis Nerv Syst1965; 155-9.
6.
Theander S.Anorexia nervosa. A psychiatric investigation of 96 female patients. Acta Psychiatr Scand [Suppl] 1970;214:1-194.
7.
Feighner JP, Robins E., Guze SB, et al. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry1972;26:57-63.
8.
Beumont Pjv, Abraham SF, Argall WJ, et al. The onset of anorexia nervosa. Aust NZ J Psychiatry1978; 12:145-9.
9.
Bruch H.Eating disorders, obesity, anorexia nervosa and the person within. New York: Basic Books, 1973.
10.
Crisp AH, Hsu Lkg, Harding B., et al. Clinical features of anorexia nervosa. A study of a consecutive series of 102 female patients. J Psychosom Res1980;24:179-91.
11.
Garfinkel PE , Moldofsky H., Garner DMThe heterogeneity of anorexia nervosa: bulimia as a distinct subgroup. Arch Gen Psychiatry1980:37:1036-40.
12.
Casper RC, Eckert ED, Halmi KA, et al. Bulimia: its incidence and clinical importance in patients with anorexia nervosa. Arch Gen Psychiatry1980 ;37:1030-5.
13.
Anderson AEAnorexia nervosa and bulimia: a spectrum of eating disorders. Journal of Adolescent Health Care1983;4:15-21.
14.
Mecklenberg RS, Loriaux DL, Thompson RL, et al. Hypothalamic dysfunction in patients with anorexia nervosa. Medicine1976 ;53:147-57.
15.
Frankel RS, Jenkens JSHypothalamic-pituitary function in anorexia nervosa. Acta Endocrinol1975;78:209-21.
16.
Burman KD, Vigersky RA, Loriaux DL, et al. Investigations concerning deiodinative pathways in patients with anorexia nervosa. In: Vigersky RA, ed. Anorexia nervosa. New York: Raven Press, 1977:225-59.
17.
Vigersky RA , Loriaux DL, Anderson AE, et al. Delayed pituitary hormone response to LRF and TRF in patients with anorexia nervosa and with secondary amenorrhea associated with simple weight loss. J Clin Endocrinol Metab1976;43:893-900.
18.
Russell Gfm.Metabolic aspects of anorexia nervosa. Proc Roy Soc Med1965;58:811-4.
19.
Marshall JC , Frazer RTAmenorrhea in anorexia nervosa: assessment and treatment with clomiphene citrate. Br Med J1971;4:590-2.
20.
Wakeling A. , Marshall JC, Beardwood CJThe effects of clomiphene citrate on the hypothalamic-pituitary-gonadal axis in anorexia nervosa. Psychol Med1976 ;6:371-80.
21.
Beumont Pjv , George Gcw, Pimstone BL, et al. Body weight and the pituitary response to hypothalamic releasing hormones in patients with anorexia nervosa. J Clin Endocrinol Metab1976;43:487-96.
22.
Vigersky RA, Loriaux DLAnorexia nervosa as a model of hypothalamic dysfunction. In: Vigersky RA, ed. Anorexia nervosa. New York: Raven Press, 1977:109-21.
23.
Boyar RM, Hellman LD, Roffwarg H., et al. Cortisol secretion and metabolism in anorexia nervosa. N Engl J Med1977;296:190-3.
24.
Smith SR, Bledsoe T., Chetri MKCortisol metabolism and pituitary-adrenal axis in adults with protein-calorie malnutrition. J Clin Endocrinol Metab1975 ;40-3.
25.
Bemis KMCurrent approaches to the etiology and treatment of anorexia nervosa. Psychol Bull1978;85:593-617.
26.
Russell Gfm.The present status of anorexia nervosa. Psychol Med1977;7:363-7.
27.
Barry VC, Klawans HLOn the role of Dopamine in the pathophysiology of anorexia nervosa. J Neural Transm1976;38:107-22.
28.
Halmi KATreatment of anorexia nervosa: a discussion. Journal of Adolescent Health Care1983;4:47-50.
29.
Powers PSHeart failure during treatment of anorexia nervosa. Am J Psychiatry1982;139:1167-70.
30.
Russell Gfm.Acute dilatation of the stomach in a patient with anorexia nervosa. Br J Psychiatry1966 ; 112:203-7.
Bruch H.Perils of behavior modification in treatment of anorexia nervosa. JAMA1974;230:1419-22.
33.
Halmi KA, Powers P., Cunningham S.Treatment of anorexia nervosa with behavior modification. Arch Gen Psychiatry1975;32:93-6.
34.
Agras S., Werne J.Behavior modification in anorexia nervosa: research foundations. In: Vigersky RA, ed. Anorexia nervosa. New York: Raven Press, 1977:291-303.
35.
Minuchin S. , Baker L., Rosman BL, et al. A conceptual model of psychosomatic illness in children. Family organization and family therapy. Arch Gen Psychiatry1975;32:1031-8.
36.
Rosman BL, Minuchin S., Baker L., et al. A family approach to anorexia nervosa. Study, treatment and outcome. In: Vigersky RA, ed. Anorexia nervosa. New York: Raven Press, 1977:341-8.
37.
Liebman R., Minuchin S., Baker L.An integrated treatment program for anorexia nervosa. Am J Psychiatry1974:131:432-6.
38.
Dally PJ, Sargant W.A new treatment of anorexia nervosa. Br Med1960; 1: 1770-5.
39.
Mills I.Amitriptyline therapy in anorexia nervosa. Lancet1976;2:687.
40.
Halmi KA, Falk JRCyproheptadine, an antidepressant and weight-inducing drug for anorexia nervosa . Lancet1982; 1: 1357-8.
41.
Saleh JW, Lebwohl P.Metochlopramide induced gastric emptying in patients with anorexia nervosa . Am J Gastroenterol1980;74:127-30.
42.
Russell Gfm.General management of anorexia nervosa and difficulties in assessing the efficacy of treatment. In: Vigersky RA, ed. Anorexia nervosa. New York: Raven Press, 1977:277-89.
43.
Garner DM, Garfinkel PEThe Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychol Med1979;9:273-9.
44.
Garner DM, Olmsted MP, Bohr Y., et al. TheEating Attitudes Test: psychometric features and clinical correlates. Psychol Med1982;12:871-8.
45.
Hsu Lkg.Outcome of anorexia nervosa. Review of the literature (1954 to 1978). Arch Gen Psychiatry1980;37:1041-6.
46.
Wentz ACBody weight and amenorrhea. Obstet Gynecol1980;56:482-7.
