Anorexia nervosa in boys

Anorexia nervosa: change over time in age of onset, presentation and duration of illness

The question as to whether anorexia nervosa as an illness has transformed itself was partially addressed in an investigation into the possible change over time in age of onset, age of presentation and the derived variable, delay between onset and presentation. These three variables were examined in 827 patients diagnosed as suffering with anorexia nervosa, who had attended the Eating Disorders Unit at the Middlesex and St George's Hospitals from 1960 to 1990. This analysis revealed a stable age of onset but a lengthening in duration of illness and associated increase of age at presentation. However, investigation of data obtained from two other tertiary referral centres revealed stability of all three variables over time. The overall conclusion was that there has been no change in the age of onset of anorexia nervosa during the past 30 years. The increasing delay in presentation to the eating disorders clinic is most likely attributable to a change in the practice of patient referrals to a national tertiary referral centre.

Clinical presentation of anorexia nervosa in males: 24 new cases

As part of a larger prognostic study of anorexia nervosa, clinical features at presentation of 24 males with anorexia are described, and compared with a female group matched for date of admission. Data were extracted from the original case records and follow-up interview. The study confirms the view that males display the classical syndrome of anorexia nervosa, but differs from previous studies in several respects. Age at onset (mean 18.6 years) and at presentation (mean 20.2 years) is later, with a mean duration of illness at presentation of only 1.6 years. A premorbid tendency to obesity is confirmed; maximum weight loss during the illness amounted to 42% matched population mean weight (MPMW), and weight at presentation was 78.5% MPMW, somewhat higher than the female group. In keeping with earlier studies, binging and vomiting were noted commonly, in around half of sufferers, but laxative abuse was less frequent and excessive exercising more frequent in males. Depressive and obsessional symptoms are common in both groups, and a strong family history of affective disorders and alcohol abuse was noted in over one third.

Anorexia nervosa in adolescent males: a review and case study

The clinical presentation of anorexia nervosa among males is quite rare. This paper examines the personality and developmental issues of anorexia nervosa in adolescent males through a comprehensive review of the literature and a case presentation. In addition, this paper will demonstrate the application of the empirical literature in the development of a conceptual model to identify critical diagnostic and psychotherapeutic issues within the assessment of a clinically rare case, a male adolescent with anorexia nervosa.

Anorexia nervosa and bulimia in males: lessons from a low-risk population

The literature on anorexia nervosa and bulimia in male patients was reviewed with the intention of (a) identifying differences that may exist between male and female sufferers, and (b) isolating, through a study of etiological factors in the low-risk (male) group, those factors that may be specific in the etiology of these disorders in both sexes. Current knowledge suggests that fundamental male-female differences do not exist as far as the etiology or symptomatology of these disorders is concerned. Given such similarities, the lower incidence among males suggests biological, social and intrapsychic determinants, that can be conceived to be more active in female versus male populations.

Anorexia nervosa in males. A comparison with female patients

The demographic features, clinical picture, antecedent events and family background in 13 male patients with anorexia nervosa are compared with those in a control group of 39 adolescent female anorectics; the general picture of the illness in males is similar to that in females. Focusing on a group of males, usually less vulnerable to anorexia nervosa, can highlight possible predisposing factors.

Outpatient treatment of primary anorexia nervosa in adult males

The majority of studies of primary anorexia nervosa have focused on adolescent females. Relatively little has been written on anorectic males, and there has been scarcely any documentation of the occurrence of this disorder in adult males. The present paper describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. Suggestions are made for future research.

Selectivity of treatment modalities

Consensus as to diagnostic definitions and criteria in Child Psychiatry is recent. Traditional "treatment" has been direct psychotherapy of child patient and mother. Despite growing precision of etiologic concepts and expansion of therapeutic approaches, many centres continue to define therapy in terms of their available techniques rather than the actual needs of the child. A brief review and definition of the major clinical syndromes is given. A glossary of the therapeutic modalities and their description is provided. Selection of treatment interventions is discussed in terms of diagnosis, severity, strengths of child patient, and the environmental modifications possible. Case illustrations are given. Periodic reassessment is essential to reselect therapeutic goals and determine choice as well as simultaneity versus sequentiality of therapeutic interventions.

Anorexia nervosa: a retrospective view

Philosophical and theological notions regarding food and eating are briefly reviewed, as is the history of anorexia nervosa. Modern studies of social, psychological, and biological aspects of anorexia nervosa have failed, as yet, to provide an organized coherent understanding of the etiology of this disorder.