Compulsory Treatment in the
Management of Eating Disorders
|1.||Take in and retain information material to the decision and understand the likely consequences of having, or not having, the treatment in question.|
|2.||Believe the information. (Certain disorders and states, for example, intoxication, may interfere with belief in the information.)|
|3.||Weigh the information as part of the process of arriving at a decision.|
The clinical concept of competence may be wider than this, taking into account the consistency with which a decision is held.
Much of the focus of discussions of the psychopathology of anorexia nervosa is on the abnormal beliefs of these patients (see Chapter 29). In contemporary Western cultures, these beliefs center mainly on the conviction that there is a need to lose weight. As noted in Chapter 47, comparable beliefs in non-Western cultures often center on somatic symptoms (e.g., feeling bloated or full).
The abnormal beliefs of patients with anorexia nervosa are usually classed as overvalued ideas (see Chapter 29). However, the boundary between a delusion and an overvalued idea is blurred. The level of distress, preoccupation, and action associated with the beliefs of patients with anorexia nervosa are similar to those of patients with schizophre-