Criteria For Hospitalization Anorexia

Anorexia nervosa, or AN as it is also known, is an extremely severe and potentially fatal psychiatric disorder. It is often exhibited in young females, but can also appear in the somewhat older young males. Unfortunately, because the number of men who are afflicted are significantly less than females this problems often remains undiagnosed for many months.

Signs and symptoms of this disorder are: picking out just a few foods and focusing on those foods in very limited quantities, excessive exercising and weighing in sessions, altered or distorted body image, cold intolerance, brittle nails, thinning hair, a soft downy like hair on the body in places not normally seen such as the arms, fatigue, dizziness, absence of menstrual periods in a female, constipation, dry skin, abnormal heart rhythms and blood counts, dehydration, organ damage, hormonal imbalances, kidney damage or failure and low blood pressure.

In addition to these physical characteristics are behavioral changes such as skipping meals, saying they are not hungry even though they are, avoiding social situations which may include eating or wearing bathing suits, avoiding the gym (most excessive exercise is done in the privacy of their own home).

People suffering from anorexia would like to eat, but just cannot bring themselves to eat out of fear of gaining weight. A flat mood or disturbances in concentration can also be seen, attributed either to the psychiatric disorder or the nutritional deficiencies. Inside their minds they are most likely preoccupied with food and weights and measurements of themselves and the calories they have consumed throughout the day.

Anorexia nervosa is thought of as a disease of teenage women, but new findings are showing that it is surfacing in increasingly younger and younger populations.

Upon suspicion of anorexia nervosa a doctor will run a battery of tests that can include laboratory testing, a complete physical examination, an extensive psychological evaluation and other testing, if necessary, that may or may not include x-rays and/or an EKG to test for heart irregularities.

The results of extensive physical and psychological testing in accordance with the DSM, a manual published by the American Psychiatric Association, will determine if hospitalization is necessary.

Of all the mental illnesses, anorexia nervosa has one of the highest death rates. Death can occur suddenly and is often caused by heart disturbances or electrolyte imbalance brought on by the lack of nutrition or dehydration.

Criteria for hospitalization anorexia include but are not limited to: an extremely low body weight, dehydration, an abnormal cardiac arrhythmia, low body temperature, vomiting blood, anemia, electrolyte imbalance, and/or infection.

Psychological criteria for hospitalization anorexia may also be present. These criteria can include: an individual who is severely depressed, suicidal, noncompliant with their treatment, bodily self-harm such as mutilation, and/or an individual who exhibits high anxiety.

With proper treatment of this disorder the outlook is good. The condition is more prevalent in the Caucasian and Hispanic populations as opposed to their Black and Asian female counterparts.

Hospitalization treatment will include careful dietary monitoring of both dietary intake and output, close psychiatric monitoring including individual therapy and family and/or group counseling, and IV fluids as needed will be indicated for a successful outcome of this disorder.

Resources:

Cleveland Clinic: Eating Disorders

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/

Starship Children’s Health clinical Guideline: Anorexa/Eating Disorders – Inpatient Management

http://www.adhb.govt.nz/starshipclinicalguidelines/_Documents/Anorexia%20Nervosa.pdf

American College of Physicians: Anorexia and Bulimia Nervosa

http://www.acphospitalist.org/archives/2011/09/focus.htm

KartiniClinic: Eating Disorder Hopstialization Criteria

http://www.kartiniclinic.com/eating-disorder-resources/for-referring-providers/hospitalization-criteria/

Journal of Adolescent Healthcare: Anorexia Nervosa

http://www.ncbi.nlm.nih.gov/pubmed/2925472

The Royal Children’s Hospital Melbourne: Anorexia Nervosa