🧠Psych Lecture 5- Eating Disorders, ADHD, & Autism Flashcards

Psychiatry

What is Anorexia Nervosa?

Loss of body weight and refusal to eat, despite appetite being intact. Intense fear of gaining weight. BMI < 18.5 is common.

What is Bulimia Nervosa?

Recurrent binge eating episodes with or without vomiting or other compensatory behaviors. Patients typically maintain a normal body weight.

What is Binge Eating Disorder?

A variant of bulimia nervosa characterized by binge eating without purging. Occurs >1x/week

What is Pica?

The eating of non-nutritional substances, such as dirt, paper, or chalk.

What is Rumination Disorder?

Repeated regurgitation of food, often seen in infancy or childhood.

What is Avoidant/Restrictive Food Intake Disorder?

Lack of interest in food or avoidance of eating, leading to failure to thrive.

What are the 3 core features of Anorexia Nervosa?

1. Self-induced starvation

2. Drive for thinness / fear of fatness

3. Physiologic symptoms from starvation (e.g., lanugo, heart failure, electrolyte imbalance)

How long must symptoms of Anorexia Nervosa persist for diagnosis?

At least 3 months

What are the 2 subtypes of Anorexia Nervosa?

1. Restricting type: limits intake to 300–500 calories/day

2. Binge-purging type: uses laxatives, vomiting, or excessive exercise

What is the typical onset and prognosis for Anorexia Nervosa?

• Onset: Ages 10–20s

• Comorbidity: 50% have Major Depressive Disorder

• Mortality: 5–18% (poor prognosis)

What is the First line treatment for Anorexia Nervosa?

• FIRST LINE- Psychotherapy (mainstay)

• Hospitalization if medically unstable (avoid refeeding syndrome)

• Pharmacotherapy: SSRIs for comorbid depression (fluoxetine, sertraline, fluvoxamine)

  • Avoid TCAs in emaciated patients

  • Bupropion is contraindicated- lowers seizure threshold

In short:

You avoid refeeding syndrome because restarting nutrition too quickly after starvation can cause life-threatening electrolyte shifts and heart failure.

Which medication can be used to treat anorexia and treats depression plus helps with weight gain?

Olanzapine. 

What are the key features of Bulimia Nervosa?

• Recurrent binge eating with compensatory behaviors (vomiting, laxatives, etc.)

• Occurs ≥1/week for 3 months

• Normal weight; intense fear of fatness

• Onset: Late teens to early 20s

In which eating disorder is Russell sign seen, and what is it?

• Bulimia nervosa

• Calluses/abrasions on the dorsum of the hand from repeated contact with teeth during self-induced vomiting.

What is the First Line treatment for Bulimia Nervosa?

FIRST LINE- Psychotherapy: Cognitive Behavioral Therapy (CBT)

• Outpatient: Nutritional rehabilitation

• Pharmacotherapy: SSRIs (fluoxetine, sertraline, fluvoxamine)

  • Avoid bupropion – lowers seizure threshold

What are the key features of Binge Eating Disorder?

• Binges with 4 features:

  1. Eating rapidly

  2. Eating until uncomfortably full

  3. Eating when not hungry

  4. Eating alone → guilt or distress

• Frequency: ≥1/week for 3 months

• Weight: Usually overweight or obese

What is the first line treatment for Binge Eating Disorder?

1. CBT (most effective)

2. Medications: trazodone or bupropion (can help with cravings)

3. Exercise + Self-help groups

What is the key pharmacologic distinction among eating disorders?

• Anorexia & Bulimia: ❌ Bupropion contraindicated (seizure risk)

• Binge Eating Disorder: ✅ Bupropion can be used safely

What are the 2 core symptom categories of ADHD?

• Inattention

• Hyperactivity/impulsivity

When do symptoms of ADHD typically appear?

Often observed by age 4, peak by age 7, and may lessen with age

What is the first-line treatment for ADHD in school-aged children?

• Behavioral therapy (especially in school settings)

• Add medication if therapy fails or by age 6

What are stimulant medications for ADHD?

• Methylphenidate (Ritalin)

• Dexmethylphenidate (Focalin)

• Amphetamine XR (Adderall XR)

• Lisdexamfetamine (Vyvanse)

Contraindications: anxiety, hyperthyroidism, motor tics, glaucoma, substance abuse, MAOIs

What is the main non-stimulant for ADHD?

Atomoxetine (Strattera)

• Side effects: tics, suicidal ideation, priapism, weight loss

What is the underlying pathophysiology of ADHD?

Impaired dopamine and norepinephrine signaling in frontostriatal circuits

What defines Autism Spectrum Disorder?

• Chronic neurodevelopmental condition with deficits in social, communication, and behavioral function

What are early signs of ASD?

• Poor social/language skills

• Avoiding eye contact, prefers being alone

• Trouble understanding others’ emotions

• Repetitive behaviors or obsessive interests

• Unusual sensory reactions

When are ASD symptoms usually recognized?

• Parents notice signs by age 2

• Formal diagnosis around age 4

What are treatments for ASD?

• Behavioral and educational interventions

• Pharmacologic support for specific symptoms

• Alternative therapies as adjuncts

What are the differential diagnoses for ASD? *not important

• Intellectual disability

• Social communication disorder

• Fetal alcohol spectrum disorder

• ADHD

• Anxiety disorders

What defines a Paraphilic Disorder?

Arousal to atypical objects, situations, or individuals, causing distress or harm