Eating disorders, substance abuse and behavioural disturbances in adolescence

Chapter 8 Eating disorders, substance abuse and behavioural disturbances in adolescence



Case 8.1


Ellie is one of your regular patients, who is concerned about her teenage daughter, whom she believes may be anorexic. Ellie has looked up various internet sources but is now more confused than ever, and wants some clarification from you.




Questions



1. What do you think Ellie actually means when she uses the term ‘anorexic’?

2. List some of the more important questions that you need to ask.

3.
a In which of the eating disorders is purging a feature?

b What are some of the medical consequences of purging?

4. Ellie wishes you to explain to her the differences between anorexia nervosa, bulimia nervosa and binge disorder. Create a table which clearly differentiates between these disorders.

5. What are the medical complications of anorexia nervosa?

6. What recommendations will you make to Ellie?


Case 8.2


Tom is a 17-year-old boy who has accompanied his mother to your clinic, and stays in the waiting room during her consultation. She specifically asked him to drive her to her appointment, as she wants you to ‘take a look at him’. She is primarily concerned about his lack of interest in school and social activities. He has become more withdrawn over the past 6 months, and his school results are declining. His mother reports that he has been behaving strangely, has become a ‘loner’, and often blurts out strange words with no obvious meaning. She believes that he is attention-seeking, as he claims that he hears voices which talk to him. Tom’s mother feels guilty, thinking that his problems are possibly her fault, as she is not giving him enough attention. She and her husband have recently divorced, she works full time and has three other children younger than Tom.


There is no history of trauma or accidents, and his childhood prior to his behaviour changes was unremarkable.


Observation showed a boy of average build who seems disinterested and evasive. He appears dishevelled and untidy. His mother states that this has been a problem over the last few months.




Questions



1. List the possible causes of Tom’s altered behaviour. Explain your choices.

2. What will you suggest to his mother regarding the best plan of action?

3. If Tom is truly hearing voices, what information does that give you?


Case 8.3


Jon is a 17-year-old who has presented with an acute torticollis which developed over the last 12 hours. As part of your history, you ask about the position in which he usually sleeps. He states that his sleep is frequently restless, and that he has had a problem with insomnia for the last few months.




Questions



1. What are the most important questions to ask Jon, in order to obtain a complete description of his insomnia?

2. You are aware that there are many causes of insomnia, and that a full history will require exploration of his psychosocial status in addition to Jon’s physical state. Name possible causes of insomnia in adolescence.

Related posts:

Genetic disorders, birth defects and structural deformities Default ThumbnailMiscellaneous cases in infancy and childhood Sports injuries Acute joint pain Acute back pain Upper limb pain

Stay updated, free articles. Join our Telegram channel
Tags:
Dec 26, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Eating disorders, substance abuse and behavioural disturbances in adolescence

Full access? Get Clinical Tree
Get Clinical Tree app for offline access