Magazine article Clinical Psychiatry News

Social, Physical Clues Signal Eating Disorders: Psychopathology Often Consists of Preoccupations and Rituals, Such as Excessive Mirror Checking

Magazine article Clinical Psychiatry News

Social, Physical Clues Signal Eating Disorders: Psychopathology Often Consists of Preoccupations and Rituals, Such as Excessive Mirror Checking

Article excerpt

NEW YORK -- When diagnosing adolescents with eating disorders, be aware that they may try to trick you to avoid admitting their behavior, one expert says.

"These kids go on the Internet and they know the diagnostic criteria--often better than the psychiatrist," Dr. Katherine A. Halmi, professor of psychiatry at Weill Cornell Medical College in New York, said at the annual meeting of the American Society for Adolescent Psychiatry.

"They know all the mechanisms for how to fool you."

That makes conducting a careful interview with both the adolescent and the family members critical, she said.

Be suspicious of eating disorders in adolescents with marked weight fluctuations or significant weight loss, Dr. Halmi advised. It also is important to look for excessive levels of activity such as constant jogging, biking, and aerobic exercise.

These adolescents often will pace around the house and never seem to sit down, she said.

The family and patient interviews should also include thorough questions about purging behaviors--self-induced vomiting, laxative abuse, diuretic abuse, and enemas.

But keep in mind that sometimes the parents choose to ignore this behavior or may not know about it, Dr. Halmi said.

For example, the psychiatrist often ends up seeing the family because the adolescent's friends have called the parents to alert them to the problem.

The core eating disorder psychopathology often consists of preoccupations and rituals. …

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