IntroductionCurrently, there are no ideal medications for treating anorexia nervosa (AN) and bulimia nervosa (BN). This is due to the variety of symptoms from the mental and somatic spheres.ObjectivesDescribe the modern methods of psychopharmacotherapy AN and BN.MethodsData from available publications on the topic of psychopharmacotherapy AN and BN, and long-term practical experience of research staff the Department of psychiatry and medical psychology RUDN University, Moscow.ResultsTherapy includes antidepressants (AD) - serotonin reuptake inhibitors (SSRIs), antipsychotics and tranquilizers. AD groups of SSRIs reduce most of the symptoms AN and BN - depressive disorders, anxiety, obsessive and compulsive symptoms, episodes of overeating and purifying behavior, suicidal thoughts, and reduce the frequency of relapses. With severe and persistent dysmorphophobia, a high degree of impulsivity, and psychopathic behavior second-generation antipsychotics Quetiapine, Olanzapine, Risperidone and Aripiprazole are used. Benzodiazepine tranquilizers (Lorazepam) are used in small doses and as additional therapy. Data from the European national guidelines for the treatment of AN and BN very different, and the world Federation of societies for biological psychiatry (WFSBP) does not provide specific recommendations at all. There are many reasons for disagreement and lack of specificity regarding drug selection, including the lack of an equally solid evidence base, that reflects the modern state of research on the psychopharmacological treatment of eating disorders.ConclusionsIn General, therapy AN and BN should be comprehensive - psychopharmacotherapy, psychotherapy, diet therapy, social rehabilitation. Treatment should be carried out both in the hospital and on outpatient basis and should be decided individually.Conflict of interestNo significant relationships.

IntroductionAnorexia nervosa (AN) and bulimia nervosa (BN) take one of the first places in the risk of fatal outcome among eating disorders, have a tendency to chronicity and high suicidal risk. Psychopathological basis for AN and BN is a dysmorfofobia or a pathological dissatisfaction with one’s body, characterized by intrusive, overvalued or delusional ideas of physical disability. Dysmorfofobia affects the formation of affective pathology and reduces the life quality.ObjectivesThe study of the correlation between the degree of dissatisfaction with one’s bodies, affective disorders and life quality of patients with AN and BN.Methods130 female patients with AN and BN at the age of 13-44 years (the average age is 18). The disease duration from 6 months to 24 years. Validated Questionnaire image of one’s own body (QIOB) and the Scale of satisfaction with one’s body (SSOB); Hospital anxiety and depression scale (Zigmond A.); Questionnaire for the assessment of life quality (SF-36); Microsoft Excel standard correlation calculation.ResultsDissatisfaction with one’s body based on QIOB and SSOB tests has a significant positive correlation with anxiety and depression, a significant correlation with the psychological component of health, a weak correlation with the physical component of health.ConclusionsDissatisfaction with one’s body or dysmorfofobia of patients with AN and BN significantly affects their affective state and psychological component of life quality which leads to a decrease in functioning up to social maladaptation and disability to social maladjustment. The publication was prepared with the support of the “RUDN University Program 5-100”.

IntroductionAnorexia nervosa and bulimia nervosa are often accompanied by aggressive manifestations that undergo typical dynamics at different stages of the disease. The presence of aggressive phenomena in eating disorders can cause severe maladaptation of patients, cause difficulties in diagnosis, establishing compliance, and prevent the normalization of family relations.ObjectivesTo study the varieties of aggressive manifestations and their changes in the treatment of anorexia nervosa and bulimia.MethodsPsychopathological, anamnestic, psychological.ResultsThe most pronounced aggressive symptoms in typical anorexia nervosa are verbal and physical aggression against relatives and close people; feeding younger siblings, parents; threats and suppression of the opinion of relatives in relation to patients. The above aggressive statements and actions occur at the stage of correction and in the initial period of the stage of exhaustion. With deep exhaustion (pronounced cachexia) and in the process of food rehabilitation, aggressive behavior is significantly reduced. In the future, there is criticism of their own aggressive symptoms. In bulimia nervosa, only verbal aggression toward loved ones is noted, especially when they interfere with purifying behavior and massive compulsive overeating. The degree of aggression in bulimia nervosa is significantly less.ConclusionsAggressive manifestations in eating disorders depend on the stage of the disease, the degree of exhaustion and undergo reverse development in the course of therapy. Aggressive phenomena in eating disorders have a significant impact on the clinic, dynamics, outcomes of diseases and the effectiveness of treatment tactics.Conflict of interestNo significant relationships.

IntroductionIn the dynamics of bulimia nervosa, a significant proportion of patients show a pathological attraction to purifying behavior in the form of artificially induced vomiting. This variant of the pathology of the drives significantly aggravates the symptoms, causes a severe degree of maladaptation of patients and great difficulties in the treatment of the disease.ObjectivesTo identify and describe the manifestations of vomitomania in patients with bulimia nervosa, the impact on the outcome of the disease.MethodsClinico-psychopathological, psychological, catamnestic.Results120 patients with bulimia nervosa were examined: 112 women and 8 men aged 22-43 years. 86 of them (80 - women, 6 - men) were found to have vomitomania (a pathological urge to induce vomiting). Patients with pleasure, without feeling shy, awkward, described their own vomiting behavior - noted the expectation of vomiting, prepared for its implementation, observing complex rituals, imagined the vomiting act and its consequences in their minds, imagination. Describing vomiting, patients used superlative degrees of comparison, noted a sense of bliss, pleasure, “high” in the implementation of this irresistible desire. If it was impossible to induce vomiting, there was a feeling of depression, depressed mood, irritability, anger, physical distress - in fact, manifestations of withdrawal syndrome. Critical attitude to the above-described pathological behavior was absent in a significant part of cases.ConclusionsSpecial pathological attraction to vomiting – vomitomania - is a widespread symptom of bulimia nervosa and drive disorders in this disease. It presents significant challenges for therapy especially in comorbid bulimia nervosa with personality disorders and schizotypal disorder.