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anxiety betegség

Although medications such as anticancer, antimicrobial, immunomodulatory, neurological or hormonal therapies may have a negative impact on mood, adequate attention was not paid until the withdrawal of rimonabant in 2008. In the present study the authors review full spectrum of currently available medications discussing anxiety and depression as possible adverse effects of treatment. A relatively high risk of depression should always be considered when pharmacotherapy applied, especially if current depressive episodes, positive family history, or neurotic personality traits increasing susceptibility to depressogenic effects. Prior to start of medical treatment, the potential effectiveness of the given drug should be precisely evaluated, and alternative medical and non-medical treatment options should also be carefully considered. In addition, monitoring patients during treatment for signs of depressive or anxious symptoms is necessary.

Annak ellenére, hogy számos szomatikus betegség kezelésére alkalmazott – például daganatellenes, antimikrobás, immunmoduláns, neurológiai, illetve hormonháztartásra ható – gyógyszer hathat negatív irányban a hangulatra, ezt egészen a rimonabant 2008-ban emiatt történt visszavonásáig nem kezelték jelentőségének megfelelően. A szerzők a teljes gyógyszerpalettát áttekintve tárgyalják a szorongást és a depressziót, mint gyógyszer-mellékhatásokat. A gyógyszerválasztásnál minden esetben figyelembe kell venni, ha a betegeknél magas a depresszió kialakulásának a kockázata, például, ha már korábban előfordult vagy jelenleg is fennáll a depressziós epizód vagy betegség, ha a családi anamnézisben előfordul depresszió, illetve ha a betegnél olyan neurotikus személyiségvonások állnak fenn, amelyek következtében sérülékenyebb a depressziót kiváltó hatásokkal szemben. A veszélyt jelentő gyógyszerek felírása előtt emellett célszerű figyelembe venni az alkalmazni kívánt szer hatékonyságát, a rendelkezésre álló alternatív gyógyszeres és nem gyógyszeres terápiás lehetőségeket, és minden esetben biztosítani kell a beteg monitorozását a kezelés során az esetleges depressziós vagy szorongásos tünetek mihamarabbi észlelése érdekében. Orv. Hetil., 2013, 154, 1327–1336.

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Trichotillomania falls under the DSM-5 category of “Obsessive-Compulsive Related Disorders” and refers to an individual experiencing a compulsive need to pull out one’s hair. Individuals with eating disorders and trichotillomania share many clinical features such as emotion dysregulation, an inability to effectively cope, and/or obsessive-compulsive tendencies.

Approximately 14 to 53% of those with BPD also experience an eating disorder diagnosis [2]. BPD differs from any other disorder listed as it falls under the Diagnostic and Statistical Manual of Mental Illness (DSM-5) criteria for personality disorders. These refer to long-term patterns of thoughts and behaviors that are more chronic versions of mental illness than an anxiety or mood disorder, for example. Those with both BPD and eating disorders struggle with emotional regulation, distress tolerance, interpersonal effectiveness skills, and grounding themselves. Individuals with BPD also engage in severe behaviors to avoid real or perceived rejection and these behaviors, with some of these being eating disorder behaviors.

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Substance use disorders are incredibly common in those with eating disorder diagnoses, with 27% of those with Anorexia Nervosa, 36.8% of those with Bulimia Nervosa, and 23.3% of those with BED experiencing both [1]. These disorders often feed off of one another, with one study determining that women with either an eating disorder or substance were more than 4 times as likely to develop the other disorder as those women that experienced neither disorder [6]. People often use substances and/or eating disorder behaviors to help them cope and, therefore, those struggling are likely to engage in one or both disorders.

It is not uncommon for those with an eating disorder to struggle with other mental health diagnoses as well. The direction of this relationship is unclear and depends on each individual. Eating disorders may develop as maladaptive coping skills for mental health diagnoses, however, mental health issues may also develop as a result of eating disorder behaviors. Regardless, understanding the relationship between eating disorders and co-occurring mental health issues is key to effective diagnosis and treatment of the individual.

Co-occurring disorders refer to individuals that struggle with two or more mental health diagnoses at once. For those with eating disorders, this means that they engage in and struggle to overcome eating disorder behaviors in addition to other existing mental health disorder(s).

Like anxiety disorders, depression and other mood disorders (such as Bipolar Disorder) often co-occur with eating disorders. These disorders often lead to the development of eating disorders as an ineffective method of coping, occur due to malnourishment and the impact of eating disorders, and/or both. 42.1% of those with Anorexia Nervosa, 70.7% of those with Bulimia Nervosa, and 46.4% of those with BED also have a diagnosis of a depressive disorder.