Anovulatory Uterine Bleeding
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A comprehensive treatment plan includes a combination of good nutritional rehabilitation, psychotherapy, and medications. Weight, cardiac, and metabolic status of the individual with AN determine the acuity of the illness and the need for hospitalization. Aims of treatment are to restore the patient’s nutritional status by establishing healthy eating patterns, treat medical complications, correct core dysfunctional ideations related to eating disorders, enlisting family support, and providing for family counseling. Medications for treatment of AN can be initiated before or after weight gain. Medications can maintain normal eating behaviors as well as treat associated depressive or obsessivecompulsive symptoms. Antidepressants like the serotoninspecific reuptake inhibitors, for example, fluoxetine (Prozac), are commonly considered. Low doses of antipsychotics for marked agitation with psychotic thinking and benzodiazepene anxiolytics for extreme anticipatory anxiety are helpful. Long-term follow-up shows recovery rates ranging from 44% to 76% with mortality of up to 20% primarily from cardiac arrest or suicide. Treatment guidelines are readily available with an abridged, up-to-date version at www.guidelines.gov/ index.asp. SEE ALSO: Body image, Bulimia nervosa, Depression, Eating disorders, Weight control
Suggested Reading American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association. (2000). Eating disorders measures. In Handbook of psychiatric measures (pp. 647–673). Washington, DC: Author. American Psychiatric Association Work Group on Eating Disorders. (2000). Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157, 1–39. Fairburn, C., & Brownell, K. (2002). Eating disorders and obesity (2nd ed., pp. 233–237). New York: Guilford Press. Kaplan, H. I., & Sadock, B. J. Eating disorders. In Synopsis of psychiatry (8th ed., pp. 720–736). Philadelphia: Lippincott, Williams and Wilkins.
KATHLEEN N. FRANCO RASHMI DESHMUKH
Anovulatory Uterine Bleeding see Vaginal Bleeding
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