Bulimia and vomiting syndrome.
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Biomedical subjects
Publications and source records attributed to A R Lucas.
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Five major areas in the study of anorexia nervosa have been defined: the descriptive area (1868-1914), the pituitary era (1914-1940), the era of rediscovery of the illness (1930-1961), the psychoanalytic era (1940-1967), and the modern era (1961- ). The illness as a biopsychosocial entity has been delineated. An integrated view of the disorder, recognizing multiple factor interaction in a vulnerable person, and an individualized approach to treatment, are proposed.
Records of 34 hyperventilating children aged 18 years or younger seen at the Mayo Clinic over a 25-year period were reviewed. Five different clinical subtypes were identified. Evaluation and treatment varied considerably. At follow-up, 40% were still hyperventilating as adults, and many had signs and symptoms of chronic anxiety. Hyperventilation in childhood can be a signal that the child is experiencing severe anxiety, which may persist into adulthood.
Eighteen patients ranging in age from 4 to 20 years who were seen at the Mayo Clinic from 1970 through 1976 for suspected epilepsy were studied. Seventeen of these patients had previously been treated with anticonvulsant medication, and the majority had been subjected to multiple diagnostic procedures. After careful analysis of their histories, clinical examinations, and appropriate laboratory studies, their seizures appeared to be nonepileptic in nature. Various psychogenic and other nonorganic causes were identified. These cases are presented to alert the physician to the not infrequent occurrence of pseudoepileptic seizures in children and adolescents who do not have epilepsy.
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The authors report on their treatment of 32 young patients with severe anorexia nervosa who had lost an average of 37% of their original body weight. The therapeutic approach, conceived to meet both the physiological and the psychological needs of the patients, was carried out in a psychiatric unit for adolescents in a general hospital and involved separation of the patient from his or her family, treatment of the malnutrition, individually planned psychotherapy, and concurrent work with the family. The importance of accepting the patient's uniqueness, maintaining long-term contact, and encouraging the patient's striving toward constructive growth and autonomy is emphasized.
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