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In Adults With Anorexia Nervosa, Is Participating In Olanzapine (Low Dose) Or Olanzapine Plus Cognitive Behavioural Treatment For Eating Disorder (Cbt

1738 words - 7 pages

Background
Anorexia nervosa is a serious life-threatening, chronic and complex psychiatric disease that has prevalence about 0.5%. The common onset of anorexia nervosa is 1% of adolescents, high predominance of young female, the age between 13-24 years old, and associated with multifactorials. The neurobiological, genetic factors, psychological and environmental may contribute to pathophysiological action. Many teenage girls of anorexia nervosa have a trend of an idealized thinness by her careers, such as competition athletes and dancers.
Concurrently, anorexia nervosa is linked with debilitating cognitive, emotional and physical processes and destructive weight loss behaviours. And it can be co-morbid with some mental illnesses, such as depression, obsessive compulsive, anxiety, substance abuse, borderline and histrionic personality disorders. Anorexia nervosa is characterized by weight loss and refusing to maintain body weight at about a minimally normal range for age and height. It has a body image distortion, fears of weight gain and losses menses. There are two subtypes: restricting one is that the person has not engaged to binge eating or purging behaviours but manifested as food restriction, a relentless pursuit of thinness by obsessive fear of overweight or obese, distortion of body image with delusion proportion; binge eating or purging subtype is that individual has regularly engaged in binge-eating or purging behaviours (i.e. self-induced misuse of laxative, diuretics or enemas). Anorexia nervosa has impacted developmental and psychosocial functions, and also has the highest premature mortality for psychiatric disorders. When a person’s body mass index is 15 to 17.5 (below 65% to 85% of normal weight), she or he may have the complications of bradycardia, dehydration, hypothermia, hypotension, heart arrhythmias, cardiac and renal failure, amenorrhea and hormonal imbalances, osteopenia and neurological impairment. The treatment is difficult and expensive, and typically involves a multimodal and multidisciplinary approach, such as the nutrition, psychopharmacological and psychological therapies. Furthermore, the relapse is common, even in remission the symptoms occur. There are no medications, which are approved by Food and Drugs Administration (FDA) for the treatment of anorexia nervosa2. However, during the last few years, even though the dearth of studies demonstrating efficacy, like “atypical neuroleptics medications,” olanzapine and risperidone were well tolerated by patients and improved symptoms, increased rate of weight gain and reduced in obsession scores. And also, the studies found that effective with cognitive behavioural therapy (CBT) plus olanzapine that improve the compulsivity, depression and aggressiveness. To evaluate the efficacy and safety of olanzapine and cognitive behavioural therapy in treating anorexia nervosa, it is hypothesized that who diagnosed anorexia nervosa with olanzapine or olanzapine plus CBT-E...

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