According to Pritts and Susman "The medical history is the most powerful tool for diagnosing<unk> s". There are many medical disorders that mimic<unk> s and comorbid psychiatric disorders. Early detection and intervention can assure a better recovery and can improve a lot the quality of life of these patients. In the past 30 years<unk> s have become increasingly conspicuous and it is uncertain whether the changes in presentation reflect a true increase. Anorexia nervosa and bulimia nervosa are the most clearly defined subgroups of a wider range of<unk> s. Many patients present with subthreshold expressions of the two main diagnoses: others with different patterns and symptoms. As<unk> s, especially anorexia nervosa, are thought of as being associated with young, white females, diagnosis of<unk> s in other races happens more rarely. In one study, when clinicians were presented with identical case studies demonstrating disordered<unk>  symptoms in Black, Hispanic, and white women, 44% noted the white woman's behavior as problematic; 41% identified the Hispanic woman's behavior as problematic, and only 17% of the clinicians noted the Black woman's behavior as problematic (Gordon, Brattole, Wingate, & Joiner, 2006). Medical The diagnostic workup typically includes complete medical and psychosocial history and follows a rational and formulaic approach to the diagnosis. Neuroimaging using fMRI, MRI, PET and SPECT scans have been used to detect cases in which a lesion, tumor or other organic condition has been either the sole causative or contributory factor in an<unk> . "Right frontal intracerebral lesions with their close relationship to the limbic system could be causative for<unk> s, we therefore recommend performing a cranial MRI in all patients with suspected<unk> s" (Trummer M et al. 2002), "intracranial pathology should also be considered however certain is the diagnosis of early-onset anorexia nervosa. Second, neuroimaging plays an important part in diagnosing early-onset anorexia nervosa, both from a clinical and a research prospective".(O'Brien et al. 2001). Psychological +<unk>  Specific Psychometric Tests<unk>  Attitudes Test SCOFF questionnaire Body Attitudes Test Body Attitudes Questionnaire<unk>  Inventory<unk>  Examination Interview After ruling out organic causes and the initial diagnosis of an<unk>  being made by a medical professional, a trained mental health professional aids in the assessment and treatment of the underlying psychological components of the<unk>  and any comorbid psychological conditions. The clinician conducts a clinical interview and may employ various psychometric tests. Some are general in nature while others were devised specifically for use in the assessment of<unk> s. Some of the general tests that may be used are the Hamilton Depression<unk>  Scale and the Beck Depression Inventory. longitudinal research showed that there is an increase in chance that a young adult female would develop bulimia due to their current psychological pressure and as the person ages and matures, their emotional problems change or are resolved and then the symptoms decline. Several types of scales are currently used – (a) self-report questionnaires –EDI-3, BSQ, TFEQ, MAC, BULIT-R, QEWP-R,<unk> E-Q, EAT, NEQ – and other; (b) semi-structured interviews – SCID-I,<unk> E – and other; (c) clinical interviews unstructured or observer-based<unk>  scales- Morgan Russel scale The majority of the scales used were described and used in adult populations. From all the scales evaluated and analyzed, only three are described at the child population – it is EAT-26 (children above 16 years),<unk> I-3 (children above 13 years), and ANSOCQ (children above 13 years). It is essential to develop specific scales for people under 18 years of age, given the increasing incidence of<unk>  among children and the need for early detection and appropriate intervention. Moreover, the urgent need for accurate scales and telemedicine testing and diagnosis tools are of high importance during the COVID-19 pandemic (Leti, Garner & al., 2020). Differential diagnoses There are multiple medical conditions which may be misdiagnosed as a primary psychiatric disorder, complicating or delaying treatment. These may have a synergistic effect on conditions which mimic an<unk>  or on a properly diagnosed<unk> . * Lyme disease is known as the "great imitator", as it may present as a variety of psychiatric or neurological disorders including anorexia nervosa. * Gastrointestinal diseases, such as celiac disease, Crohn's disease, peptic ulcer, eosinophilic esophagitis or non-celiac gluten sensitivity, among others. Celiac disease is also known as the "great imitator", because it may involve several organs and cause an extensive variety of non-gastrointestinal symptoms, such as psychiatric and neurological disorders, including anorexia nervosa. * Addison's disease is a disorder of the adrenal cortex which results in decreased hormonal production. Addison's disease, even in subclinical form may mimic many of the symptoms of anorexia nervosa. * Gastric adenocarcinoma is one of the most common forms of cancer in the world. Complications due to this condition have been misdiagnosed as an<unk> . * Hypothyroidism, hyperthyroidism, hypoparathyroidism and hyperparathyroidism may mimic some of the symptoms of, can occur concurrently with, be masked by or exacerbate an<unk> . * Toxoplasma seropositivity: even in the absence of symptomatic toxoplasmosis, toxoplasma gondii exposure has been linked to changes in human behavior and psychiatric disorders including those comorbid with<unk> s such as depression. In reported case studies the response to antidepressant treatment improved only after adequate treatment for toxoplasma. * Neurosyphilis: It is estimated that there may be up to one million cases of untreated syphilis in the US alone. "The disease can present with psychiatric symptoms alone, psychiatric symptoms that can mimic any other psychiatric illness". Many of the manifestations may appear atypical. Up to 1.3% of short term psychiatric admissions may be attributable to neurosyphilis, with a much higher rate in the general psychiatric population. (Ritchie, M Perdigao J,) * Dysautonomia: a wide variety of autonomic nervous system (ANS) disorders may cause a wide variety of psychiatric symptoms including anxiety, panic attacks and depression. Dysautonomia usually involves failure of sympathetic or parasympathetic components of the ANS system but may also include excessive ANS activity. Dysautonomia can occur in conditions such as diabetes and alcoholism. Psychological disorders which may be confused with an<unk> , or be co-morbid with one: * Emetophobia is an anxiety disorder characterized by an intense fear of vomiting. A person so afflicted may develop rigorous standards of food hygiene, such as not touching food with their hands. They may become socially withdrawn to avoid situations which in their perception may make them vomit. Many who have emetophobia are diagnosed with anorexia or self-starvation. In severe cases of emetophobia they may drastically reduce their food intake. * Phagophobia is an anxiety disorder characterized by a fear of<unk> , it is usually initiated by an adverse experience while<unk>  such as choking or vomiting. Persons with this disorder may present with complaints of pain while swallowing. * Body dysmorphic disorder (BDD) is listed as a obsessive-compulsive disorder that affects up to 2% of the population. BDD is characterized by excessive rumination over an actual or perceived physical flaw. BDD has been diagnosed equally among men and women. While BDD has been misdiagnosed as anorexia nervosa, it also occurs comorbidly in 39% of<unk>  cases. BDD is a chronic and debilitating condition which may lead to social isolation, major depression and suicidal ideation and attempts. Neuroimaging studies to measure response to facial recognition have shown activity predominately in the left hemisphere in the left lateral prefrontal cortex, lateral temporal lobe and left parietal lobe showing hemispheric imbalance in information processing. There is a reported case of the development of BDD in a 21-year-old male following an inflammatory brain process. Neuroimaging showed the presence of a new atrophy in the frontotemporal region.
Eating disorder
Obsessive–compulsive disorder
Sleep disorder
Menstrual disorder
Hirsutism
Food addiction
Arrhinia
Night eating syndrome