GMCCLINICS and Medical Department of the Eating Disorder Unit at The American Centre of Psychiatry and Neurology ACPN, Dubai, United Arab Emirates.
Curr Opin Pediatr. 2019 Aug;31(4):448-453. doi: 10.1097/MOP.0000000000000755.
The diagnosis of anorexia nervosa is associated with the highest mortality rate of any psychiatric disorder, mainly caused by medical complications.The purpose of this article is to review the common medical consequences of anorexia nervosa focusing on the special considerations related to children and adolescents and recent updates on the pathophysiology of these complications and their prognosis significance.
The main findings were related to the diagnostic and prognostic value of hypokalaemia, QTc prolongation, hypoglycaemia and orthostatic changes. A new modality to evaluate the heart in anorexia nervosa was explored (2DSTE) as well. Bone mineral density (BMD) loss is one of the few nonreversible consequences of anorexia nervosa. BMD loss does not seem to be significantly related to sex or to cut-off low-weight parameters in teenagers with anorexia nervosa, but rather to the amount of weight loss they have experienced. Brain volume deficits might be another irreversible complication in adolescents with anorexia nervosa.
It is crucial for any healthcare provider to be informed about the medical consequences of anorexia nervosa, not only because they can be devastating, but also because they can play an essential role in motivating patients to get treated.
神经性厌食症的诊断与任何精神障碍相关的死亡率最高有关,主要是由医疗并发症引起的。本文的目的是综述神经性厌食症的常见医学后果,重点关注与儿童和青少年相关的特殊注意事项,以及这些并发症的病理生理学的最新进展及其预后意义。
主要发现与低钾血症、QTc 延长、低血糖和直立性变化的诊断和预后价值有关。还探讨了一种评估神经性厌食症心脏的新方法(二维斑点追踪技术)。骨矿物质密度(BMD)丢失是神经性厌食症为数不多的不可逆转后果之一。BMD 丢失似乎与性别或青少年神经性厌食症的低体重参数无关,而与他们经历的体重减轻量有关。脑容量缺陷可能是青少年神经性厌食症的另一种不可逆转的并发症。
任何医疗保健提供者都必须了解神经性厌食症的医学后果,这不仅因为这些后果可能是毁灭性的,还因为它们在促使患者接受治疗方面起着至关重要的作用。