Anorexia nervosa in the male child.

Abstract

Chiceta, IffinoisNOREXIA NERVOSA has presented a frequent topic for discussion A in the medical and psychiatric literature of many nations. I t is the intent of this paper: 1) to review this general literature with emphasis on clarification of some of the conflicting statements that have been made; 2) to study in some detail the dynamics of starvation; 3) to review more specifically the literature that concerns the anorectic male; 4) to present in detail the case histories and treatment of two prepubescent boys with this symptom complex, and to refer briefly to two others; and 5) to formulate in the discussion that concludes the paper the psychodynamic aspects of the subject. A comparison between our male and female cases, an explanation for this symptom choice, apparent reasons for the less frequent occurrence of this symptom complex in boys, and finally, practical suggestions for treatment will also be offered.REVIEW OF THE GENERAL LITERATURE OF ANOREXIA NERVOSA Although Morton (25), in a book published in 1694, was probably the first writer to refer to this symptom complex, as he does in the chapter entitled "Of a Nervous Consumption," Sir William Gull (10, 11), in 1874, described and named anorexia nervosa. While he had observed the condition in males, he described it as occurring typically in girls between the ages of 16 and 25 who showed extreme loss of weight with no demonstrable organic disease, slow starvation pulse, amenorrhea, and low respiration rate. A tendency to irritability, remarkable energy and ceaseless activity in these patients despite poor nutritive functions were also pointed out by him. He regarded the cause as a "perversion of the ego" and said the want of appetite was due to a morbid mental state. Although he had seen one fatal case, he regarded the prognosis for the most part as favorable. He advised feeding a t regular intervals and surrounding the patients with persons who had the greatest control over them. H e added significantly that the inclination of the patient should in no way be consulted.Since this early description of anorexia nervosa, many articles have appeared in the literature as adequately reviewed by Rahman and others (23)

Psychological correlates of weight control among anorexia nervosa patients and normal girls

“…Our findings converge on clinical descriptions of patients with anorexia nervosa, which are usually made with an implied rather than an explicit reference to 'normal' patterns of behaviour. So, for example, a 'lack of control' has been identified by Halmi (1978) and by Lawrence & Lowenstein (1978), and anorexia nervosa was described as a 'struggle for control ' by Falstein et al (1956) and by Bruch (1970). The results of our study show that this 'control' is important only in combination with measures of self-presentation, self-esteem and criticism about eating.…”

Anorexia nervosa in the male: A review of clinical, epidemiological and biological findings

“…Beumont et al (1972) In 1972, Beumont et al reviewed the literature on male AN. This essentially consisted of articles by Kay and Leigh (1954), Falstein et al (1956), Bliss and Branch (1960), Haguenau and Koupernik (1964), Thoma (1967), Ladewig (1968), and Dally (1969). The resultant 250 males were placed in four categories.…”

Bulimia: Is it an illness entity?

“…It gives a graphic account of the patient's struggles to resist overwhelmingly powerful urges to eat. In subsequent years, gorging continued to be noted in some anorexic patients (Falstein et al, 1956) and also in relation to obesity. Stunkard et al (1955) described the "night eating syndrome" in obese subjects, and Stunkard (1959) referred to other episodes of overeating in patients who were overweight.…”