Anorexia nervosa is one of the diseases that border with mental pathology. Currently, anorexia occurs in both adolescents and adults, among whom more than half of the cases are the consequence of neurotic reactions. The core of the disease is a deliberate restriction in food intake or complete refusal to eat in order to correct an imaginary or drastically overestimated overweight. Notably, the illness is formed under the pretext of social, psychological, and biological preconditions. When establishing the treatment plan for a patient, consultations of psychiatrists, psychotherapists, endocrinologists, and nutritionists are essential to ensure that a comprehensive approach is applied. The basic principle that should drive the delivery of care is multidisciplinarity aimed at the restoration of the physical and psychological health of individual.
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It should be noted that many disorders border with mental pathology. For instance, neurosis, psychopathy, and mental dysfunctions in somatic diseases are the vivid examples of such cases. On the one hand, these disorders are between normality and psychopathology, but, on the other hand, the border with the psychic and somatic pathology, thus, it is rather often difficult to distinct between these two categories. Anorexia nervosa is one of such diseases. Currently, anorexia occurs in both adolescents and adults, among whom more than half of the cases is the outcome of neurotic reactions (Moskovich, Timko, Honeycutt, Zucker, & Merwin, 2016). Anorexia nervosa is a deliberate restriction in food intake or complete refusal to eat in order to correct an imaginary or drastically overestimated overweight. At the present level of medicine development, the disease is considered a typical psychosomatic pathology (illness, which is based on a disorder of the vital instincts such as eating instinct, the instinct of self-preservation with the development of cachexia). The purpose of this paper is to review the causes of this disease and to propose a treatment plan for patients experiencing this health problem.
Three Perspectives of Disorder
Anorexia nervosa is formed under the pretext of a number of social, psychological, and biological preconditions. A significant role is also played by heredity. Recent studies in this area have revealed that exogenous hazards in the first years of life, personality traits, as well as factors of micro-social nature, can act as triggers. Moreover, depression, exhaustion, aversion to food, and stress play a major role in the emergence of the eating disorder (Moskovich et al., 2016).
Biological causes of the disorder are linked to several different issues. The scientists, who conducted analysis of the genealogy of patients suffering from anorexia, hypothesized that there is a gene reflecting the susceptibility to anorexia nervosa. This gene can be activated in adverse conditions such as mental stress, poor diet, and so on. Moreover, a possible biological cause can be the dysfunction of neurotransmitters (serotonin, dopamine, and norepinephrine) that are responsible for eating behavior (Myland Kaufman & Milstein, 2012). According to the reviewed studies, some people with eating disorders may have certain unbalanced chemicals that control digestion, appetite, and the feeling of hunger.
Psychological causes of the disease are connected to the personality type of the patient. In terms of direct psychological triggers, many mental disorders cause the emergence of anorexia. For example, people with obsessive-compulsive disorder and hysterical neurosis are most susceptible to this illness. Importantly, schizophrenia together with anorexia nervosa is characterized by visual and verbal hallucinations about food (Myland Kaufman & Milstein, 2012). In general, anorexia can develop in people that have the desire for perfection or have low self-esteem. In addition, special features of personality predisposing to the development of anorexia nervosa include hysterical, anxious – suspicious, and schizoid traits. Often patients with this disease are also susceptible to the appearance of obsessive-compulsive disorder.
Regarding sociological factors, potentially all the population groups are under the jeopardy of the disease emergence. Severe changes in the social status might cause the disorder in mentally unstable people (Sue, Sue, Sue, & Sue, 2013). Apart from that, patients from strongly caring families might also experience the symptoms. However, patients with low social status and those having a low self-esteem tend to develop the disorder due to their desire to attain more attention to themselves.
Plan of Treatment
When planning the treatment of patient with a similar disorder, consultations of psychiatrist, psychotherapist, endocrinologist, and nutritionist are essential to ensure that a comprehensive approach is applied (Lock & Le Grange, 2012). The basic principle of treatment is a multidisciplinary plan of care aimed at restoration of the physical and psychological health of patient. Health restoration measures would include the normalization of body weight, eliminating the effects of starvation, the formation of proper eating and correct perceptions of body weight and physique. Moreover, the joint work together with the psychiatrist or psychotherapist is needed to eliminate the psychiatric comorbidity (depression, anxiety, and obsessive-compulsive disorder). To improve the quality of life and social adaptation of the patient, family counseling should be carried out (Lock & Le Grange, 2012). Modern psychodynamic therapy for anorexia nervosa involves an emphasis on objective relations, conflict analysis and formation of adequate ideas about the patient’s personality. It is aimed at correcting the beliefs of patients, skills training, and increasing the individual’s resistance to stress.
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Thus, anorexia nervosa is a complex disease that requires immediate medical attention. Various biological, psychological, and sociological factors can serve as triggers of the illness. It is essential to work jointly with patients, their families, and specialists in different medical fields to ensure that each of these factors is addressed in the plan of care. Therefore, it can be stated that a holistic approach towards treatment solely can address the patients’ needs effectively.
Lock, J., & Le Grange, D. (2012). Treatment manual for anorexia nervosa. New York, NY: Guilford Press.
Moskovich, A., Timko, C., Honeycutt, L., Zucker, N., & Merwin, R. (2016). Change in expressed emotion and treatment outcome in adolescent anorexia nervosa. The Journal of Treatment & Prevention, 1-12.
Myland Kaufman, D., & Milstein, M. (2012). Kaufman’s clinical neurology for psychiatrists. New York, NY: Elsevier.
Sue, D., Sue, D. W., Sue, D., & Sue, S. (2013). Understanding abnormal behavior (10th ed.). Belmont, CA: Wadsworth Cengage Learning.