1. Eating Disorders:
2 major types:
 Anorexia Nervosa
 Bulimia Nervosa
Characteristics of Anorexia:
 Extremely thin
 Intense fear of gaining weight
 Refusal to maintain weight
 Psychological disturbance of body image
 Dry skin
 Brittle hair
 Amenorrhea
 Lanugo
DSM-IV subtypes:
 Restricting type
 Binge-eating-purging subtype
Characteristics of Bulimia:
 Eating excessive amounts of food
 Self induced vomiting
 Some exercise excessively
 Most within 10% of normal weight
 Erosion of dental enamel
 Severe medical problems due to purging
Features of eating disorders:
 Overly concerned with body shape
 Fear of gaining weight
 High co-morbidities; anxiety, mood, substance abuse

2. Aetiology: (no single cause)
 Genetics
 Biological
 Psychological
 Family
 Social
 Cultural
Treatment for Anorexia:
 SSRI’s (short term)
 Weight restoration
 Psycho education
 Behaviour/cognitive therapy
 Treatment often involves family
Treatment for Bulimia:
 CBT
 Interpersonal psycho therapy
 Self help technique can be effective
Nursing Interventions:
 Therapeutic relationship
 Understanding of the eating disorder
 Monitoring of vital signs, weight and emotional status
 Monitor eating and habits
 Have realistic expectations and set short term goals

3. Psychoactive Substance Use and Abuse:
3 Main Categories:
 Depressant’s (alcohol, benzo, sleeping tablets, opiates,
analgesics)
 Stimulants (amphetamines, cocaine, nicotine, MMDA)
 Hallucinogens (LSD, MMDA)
Diagnosis:
 Dependence
 Abuse
 Intoxication
 Withdrawal
Definitions:
 Intoxication: occurs when a person’s intake of substance
exceeds their tolerance
 Hazardous use: is defined as a repetitive pattern of use that
poses a risk of harmful and psychological consequences.
 Harmful use: when the pattern of substance use is actually
causing harm.
 Substance abuse: is often associated with addiction and
dependence.
 Dependence: the total psychological state of one’s addiction
to drugs or to alcohol who must receive an increasing amount
to prevent the onset of withdrawal symptoms.
Biological Treatments:
 Agonist substitution: similar safer drug
 Antagonist treatment: blocks pleasurable drug effect
 Aversive treatment: makes taking drugs unpleasant

4. Psychosocial Treatments:
 Programs
 Individual/group therapy
 Community reinforcement
 Relapse prevention
 Preventative efforts via education
Dual diagnosis:
 More than one disorder