Anorexia Nervosa

With anorexia, the patient thrives on being thin at any cost and this causes the patient's abnormal behaviors that result in a low body weight regardless of the consequences. Amenorrhea is no longer required for someone to be diagnosed with anorexia nervosa. Significantly low weight is defined as a weight that is less than minimally normal for children and adolescents and less than that is minimally expected. The patient has an intense fear of gaining weight or becoming and persistent behavior that interferes with gaining weight, even though they are significantly underweight

    The patient experiences disturbance in the way that they view their body shape and also a persistent lack of recognition of the seriousness of the current low body weight.

There are two types of Anorexia Nervosa

1. The restricting type
1. Patients restrict food intake to maintain their low weight
2. They do not like to eat in front of other people 
2.  Binge-eating/purging type
1. The restrict calories
2. They binge eat and purge

Some example of how patients suffering from anorexia suffer from distorted thinking (Hooley, et al, 2019).

• “I have a rule when I weigh myself. If I’ve gained then I starve the rest of the day. But if I’ve lost, then I starve too.”
• “Bones define who we really are, let them show.”
• “An imperfect body reflects an imperfect person.”
• “Anorexia is not a self-inflicted disease, it’s a self-controlled lifestyle.”
• “It’s not deprivation, it’s liberation.”

Here are some ways someone suffering from anorexia nervosa might try to conceal their weight loss especially if they know that they are about to be weighed.

•  wearing baggy clothes 
•  carrying hidden bulky objects so that they will weigh more when measured by others
• drinking large amounts of water to increase their weight temporarily.

DSM-5 Criteria for. . .

Anorexia Nervosa

1. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
2. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight (Hooley et al, 2019).

• Anorexia is centuries old.
• Religious literature tells of cases of extreme cases of fasting (Hooley, et al., 2019).
• 1689
• Richard Morton - wrote about the first documented cases of anorexia nervosa. An 18-year-old girl and a 16-year-old boy both suffered from what they called at the time "nervous consumption" ( Hooley, et al., 2019).
• The girl died eventually because she refused the treatment.
• 1873
• Charles Lasègue in Paris and Sir William Gull in London
• Both wrote about two different cases and described the same symptoms. 
• One case was a 14-year-old girl who was starving herself. They treated her by getting her to eat light food every few hours.
  

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.).

Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033

Antiretroviral therapy (ART)

Antiretroviral therapy (ART)

 Antiretroviral therapy (ART) is the treatment for HIV infection. It involves taking a combination of medicines every day. ART is recommended for everyone with HIV, regardless of their CD4 count or viral load.

ART does not cure HIV infection, but it can help people with HIV live long, healthy lives. It can also reduce the risk of spreading HIV to others.

HIV medicines work by reducing the amount of HIV (viral load) in the body. This helps people with HIV in two ways:

1. It gives the immune system a chance to recover. HIV attacks and destroys the body's CD4 cells, which are an important part of the immune system. When there is less HIV in the body, the immune system has a better chance to recover and produce more CD4 cells. This can help people with HIV fight off infections and certain HIV-related cancers(HIV Medicines, n.d.).
2. It reduces the risk of spreading HIV to others. When the viral load is low, it is very unlikely that HIV can be transmitted through sex or sharing needles. This is because there is less virus in the body to be passed on to others.
   
   

FDA-Approved HIV Medicines (NIH, 2021):

•  Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

• Nucleoside reverse transcriptase inhibitors (NRTIs) are a class of antiretroviral drugs that block reverse transcriptase, an enzyme HIV needs to make copies of itself.NRTIs are similar to the building blocks of DNA. When HIV reverse transcriptase incorporates an NRTI into the DNA that it is making, the NRTI stops the DNA from being completed. This prevents HIV from making copies of itself.

• Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

• Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are a class of antiretroviral drugs that work by binding to and altering the reverse transcriptase enzyme. Reverse transcriptase is an enzyme that HIV needs to make copies of itself. When NNRTIs bind to reverse transcriptase, they prevent the enzyme from working correctly. This prevents HIV from making copies of itself and helps to control the infection.

• Protease Inhibitors (PIs)
• Protease inhibitors (PIs) are a class of antiretroviral drugs that block protease, an enzyme HIV needs to make copies of itself. Protease is responsible for cutting up the HIV protein into smaller pieces that can then be assembled into new viruses. When PIs block protease, they prevent new HIV from being made(Protease Inhibitor (PI) | NIH, n.d.).

• Fusion Inhibitors
• Fusion inhibitors are a class of antiretroviral drugs that work by blocking the fusion of the HIV envelope with the host CD4 cell membrane. This prevents HIV from entering the CD4 cell. Fusion inhibitors work by binding to the HIV envelope protein gp41. GP41 is a protein that is essential for HIV to fuse with the CD4 cell membrane. When fusion inhibitors bind to gp41, they prevent the protein from changing shape, which is necessary for fusion to occur.

• CCR5 Antagonists
• CCR5 antagonists are a class of antiretroviral drugs that work by blocking the CCR5 coreceptor on the surface of certain immune cells. HIV needs to bind to the CCR5 coreceptor in order to enter the cell, so by blocking CCR5, CCR5 antagonists can prevent HIV from infecting the cell.
  


• Integrase Strand Transfer Inhibitor (INSTIs)

• Integrase inhibitors are a class of antiretroviral drugs that work by blocking HIV integrase, an enzyme that HIV needs to make copies of itself. Integrase is responsible for inserting the HIV genetic material into the DNA of the host cell. By blocking integrase, integrase inhibitors can prevent HIV from infecting the cell and making copies of itself.


• Attachment Inhibitors

• Attachment inhibitors are a class of antiretroviral drugs that work by binding to the gp120 protein on the outer surface of HIV. The gp120 protein is essential for HIV to bind to CD4 cells, so by binding to gp120, attachment inhibitors can prevent HIV from entering CD4 cells.

• Post-Attachment Inhibitors

• The gp120 protein is essential for HIV to bind to CD4 cells. When attachment inhibitors bind to gp120, they prevent HIV from binding to CD4 cells and entering the cell. This prevents HIV from infecting the cell and replicating.
• Capsid Inhibitors
•     The capsid is essential for HIV to replicate. When capsid inhibitors bind to the capsid, they interfere with its ability to protect HIV's genetic material and enzymes. This can prevent HIV from replicating and can help to control the infection.

Pharmacokinetic Enhancers

 PKEs work by slowing down the breakdown of HIV medicine in the body. This allows more of the medicine to reach the bloodstream and be effective in fighting HIV.

Resources

 Abacavir - Patient | NIH. (n.d.). Clinicalinfo.hiv.gov. https://clinicalinfo.hiv.gov/en/drugs/abacavir/patient

 HIV Medicines. (n.d.). Medlineplus.gov. https://medlineplus.gov/hivmedicines.html

NIH. (2021, February 8). FDA-Approved HIV Medicines | HIVINFO. Hivinfo.nih.gov. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/fda-approved-hiv-medicines

Protease Inhibitor (PI) | NIH. (n.d.). Clinicalinfo.hiv.gov. https://clinicalinfo.hiv.gov/en/glossary/protease-inhibitor-pi

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Genetic and Neurochemical Factors That Lead to Mood Disorders.

Genetic and Neurochemical Factors That Lead to Mood Disorders

•  Family and twin studies suggest that there is a moderate genetic contribution to major depressive disorder (MDD).
• The serotonin-transporter gene is one candidate gene that may be involved in MDD.
• A study by Caspi and colleagues found that people with the short allele of the serotonin-transporter gene were more likely to develop MDD if they had experienced four or more stressful life events in the past 5 years.
• However, a later study by Risch and colleagues challenged these results.
• A more recent study by Culverhouse and colleagues found that the genotype-environment interaction between the serotonin-transporter gene and stressful life events does not exist.

These findings highlight the importance of replication in the scientific process, as well as the difficulties associated with mapping links between subtle variations in the human genome and the occurrence of depressive illness (Hooley et al, 2019)

•  The monoamine theory of depression states that depression is caused by a depletion of the neurotransmitters norepinephrine and serotonin.
•  Not all patients with depression have low levels of these neurotransmitters, and even when levels are low, they may not return to normal after treatment with antidepressant medication.
• More recent research suggests that dopamine dysfunction may also play a role in depression. Dopamine is involved in the experience of pleasure and reward, and its depletion may contribute to the anhedonia (inability to experience pleasure) that is a common symptom of depression.

No single theory of depression has been able to fully explain the disorder. However, research suggests that depression is caused by a complex interplay of genetic, environmental, and biological factors.

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033

 

 Hoarding

• Hoarding is a condition that has received increased research attention in recent years. It was originally thought of as a symptom of OCD but now is considered a separate disorder.
• Compulsive hoarding occurs in approximately 3 to 5 percent of adults and in  10 to 40 percent of people diagnosed with OCD.
  

• People with hoarding disorder acquire and fail to discard many possessions that are of limited value.
• Their homes are extremely cluttered and disorganized so much that it interferes with their daily activities. Some people have been buried alive in their homes by their possessions.
• Neuroimaging research has found that people with compulsive hoarding show patterns of brain activation that are different from people with OCD who do not have hoarding symptoms.
• Compulsive hoarding is associated with an increased risk of fire, falling, poor sanitation, and serious health problems.
• At-home treatments that include home visits have shown some effectiveness. These treatments work partially by changing the patient's beliefs about the importance of saving each of their possessions.

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033