[Self-injury behavior in eating disorders].
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Biomedical subjects
Publications and source records attributed to E Mitrany.
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PURPOSE: The current study examines the nationwide incidence of eating disorders (ED) among Jewish adolescents over a 5-year period (1989-93). METHODS: Data were obtained from 80% of all community and hospital adolescent and mental health institutions in Israel. Case identification was based on screening records according to DSM-III-R criteria for ED. RESULTS: Six hundred and thirty two new cases were identified with the following diagnostic distribution: anorexia 60%, bulimia 17%, anorexia and bulimia 4%, and ED not otherwise specified 20%. The present analysis is limited to females only (N = 602 or 95%). Median age for anorexia is 15 years and for bulimia 16 years. CONCLUSION: On the basis of this initial survey, the mean annual incidence of all eating disorders in Jewish Israeli females 12-18 years of age is 48.8 per 100,000. For anorexia the mean incidence is 29.0 and for bulimia 8.6. These figures represent an underestimation of the actual incidence due to incomplete data accrual.
One hundred and forty cases of claimed psychic trauma of a minor following an accident were reviewed. In two-thirds of the cases the injury followed a road accident. Other causes of injury were burns, animal bites, falls, etc. Injury 'by proxy' warranted compensation if psychic trauma was proven. Some of the more complex ethical, philosophical and psychiatric issues which confront the expert are reviewed such as credibility of the complaints, overexposure of a child to medical scrutiny, temporary versus permanent psychic damage, etc.
Some patients with eating disorders have neither anorexia nervosa (A.N.) nor bulimia. Cases which do not rigorously meet the DSM-III-R criteria for anorexia nervosa or for bulimia are usually defined as "eating disorders N.O.S." Among them are patients with pathological characteristics very closely related to the above-mentioned categories. Others, however, although affected by an eating disorder, present a quite different clinical picture from either A.N. or bulimia. In a study of 80 eating disorder cases, only 45 met the strict definition of A.N. or bulimia. The other 35 were diagnosed as atypical eating disorders and are the focus of this presentation. 29 were classified as Eating Disorders N.O.S. and 6 as obesity. Co-morbidity, gender and age data, and clinical vignettes are presented.
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