Redigerer Anoreksi (avsnitt)

====Differensialdiagnoser====
Det finnes flere ulike medisinske og psykologiske tilstander som er blitt feildiagnostisert som anorexia nervosa; i noen tilfeller er det gått over 10 år før riktig diagnose er blitt gitt. I et rapportert tilfelle av [[achalasi]] (innsnevring av spiserøret) som ble feildiagnostisert som AN,  tilbragte pasienten to måneder innlagt på et psykiatrisk sykehus.<ref>{{cite journal |author=Marshall JB, Russell JL |title=Achalasia mistakenly diagnosed as eating disorder and prompting prolonged psychiatric hospitalization |url=https://archive.org/details/sim_southern-medical-journal_1993-12_86_12/page/1405 |journal=Southern Medical Journal |volume=86 |issue=12 |pages=1405–7 |year=1993 |month=desember |pmid=8272922 |doi=10.1097/00007611-199312000-00019}}</ref>

Det finnes flere andre psykiske lidelser som kan utgjøre en faktor ved anorexia nervosa. Noen av disse oppfyller kriteriene for en egen Akse I-diagnose, eller det kan dreie seg om en personlighetsforstyrrelse som tilhører Akse II. Årsaksforholdet mellom personlighetsforstyrrelser og spiseforstyrrelser er ennå ikke konstatert fullt ut.<ref>{{cite journal |author=Rosenvinge JH, Martinussen M, Ostensen E |title=The comorbidity of eating disorders and personality disorders: a meta-analytic review of studies published between 1983 and 1998 |journal=Eating and Weight Disorders |volume=5 |issue=2 |pages=52–61 |year=2000 |month=juni |pmid=10941603}}</ref> Noen mennesker har en tidligere lidelse som kan øke sårbarheten for å utvikle en spiseforstyrrelse,<ref>{{cite journal |author=Kaye WH, Bulik CM, Thornton L, Barbarich N, Masters K |title=Comorbidity of anxiety disorders with anorexia and bulimia nervosa |url=https://archive.org/details/sim_american-journal-of-psychiatry_2004-12_161_12/page/2215 |journal=The American Journal of Psychiatry |volume=161 |issue=12 |pages=2215–21 |year=2004 |month=desember |pmid=15569892 |doi=10.1176/appi.ajp.161.12.2215}}</ref><ref>{{cite journal |author=Thornton C, Russell J |title=Obsessive compulsive comorbidity in the dieting disorders |url=https://archive.org/details/sim_international-journal-of-eating-disorders_1997-01_21_1/page/83 |journal=The International Journal of Eating Disorders |volume=21 |issue=1 |pages=83–7 |year=1997 |month=januar |pmid=8986521 |doi=10.1002/(SICI)1098-108X(199701)21:1<83::AID-EAT10>3.0.CO;2-P}}</ref><ref>{{cite journal |author=Vitousek K, Manke F |title=Personality variables and disorders in anorexia nervosa and bulimia nervosa |url=https://archive.org/details/sim_journal-of-abnormal-psychology_1994-02_103_1/page/137 |journal=Journal of Abnormal Psychology |volume=103 |issue=1 |pages=137–47 |year=1994 |month=februar |pmid=8040475 |doi=10.1037/0021-843X.103.1.137}}</ref> noen utvikler en etterpå.<ref>{{cite journal |author=Braun DL, Sunday SR, Halmi KA |title=Psychiatric comorbidity in patients with eating disorders |url=https://archive.org/details/sim_psychological-medicine_1994-11_24_4/page/859 |journal=Psychological Medicine |volume=24 |issue=4 |pages=859–67 |year=1994 |month=november |pmid=7892354 |doi=10.1017/S0033291700028956}}</ref> Alvorlighetsgrad og type spiseforstyrrelse har vist seg å påvirke hvilke tilleggslidelser en person kan ha.<ref>{{cite journal |author=Spindler A, Milos G |title=Links between eating disorder symptom severity and psychiatric comorbidity |journal=Eating Behaviors |volume=8 |issue=3 |pages=364–73 |year=2007 |month=august |pmid=17606234 |doi=10.1016/j.eatbeh.2006.11.012}}</ref> Disse samtidige tilleggslidelsene kan også ha flere differensialdiagnoser, så som depresjon som kan være forårsaket av så ulike faktorer som [[Lymes sykdom]] (flåttsykdom) eller [[hypotyreose]] (lavt stoffskifte).  
{| class="wikitable" align="center" style="margin:1em;margin-top:0"
! style="background:#D2DDF3" colspan="2"|<span style="color:#000000;">Komorbide lidelser</span>
|- bgcolor="#fbf4ce"
|  Akse I 
|  Akse II
|- bgcolor="#fbf4ce"
|  [[depresjon]]<ref>{{cite journal |author=Casper RC |title=Depression and eating disorders |journal=Depression and Anxiety |volume=8 |issue=Suppl 1 |pages=96–104 |year=1998 |pmid=9809221 |doi=10.1002/(SICI)1520-6394(1998)8:1+<96::AID-DA15>3.0.CO;2-4}}</ref> 
|  [[tvangspreget personlighetsforstyrrelse]]<ref>{{cite journal |author=Serpell L, Livingstone A, Neiderman M, Lask B |title=Anorexia nervosa: obsessive-compulsive disorder, obsessive-compulsive personality disorder, or neither? |url=https://archive.org/details/sim_clinical-psychology-review_2002-06_22_5/page/647 |journal=Clinical Psychology Review |volume=22 |issue=5 |pages=647–69 |year=2002 |month=juni |pmid=12113200 |doi=10.1016/S0272-7358(01)00112-X}}</ref>
|- bgcolor="#fbf4ce"
|  [[skadelig bruk av rusmidler]], [[alkoholisme]]<ref>{{cite journal |author=Bulik CM, Klump KL, Thornton L, ''et al.'' |title=Alcohol use disorder comorbidity in eating disorders: a multicenter study |url=https://archive.org/details/sim_journal-of-clinical-psychiatry_2004-07_65_7/page/1000 |journal=The Journal of Clinical Psychiatry |volume=65 |issue=7 |pages=1000–6 |year=2004 |month=juli |pmid=15291691 |doi=10.4088/JCP.v65n0718}}</ref> 
| 
|  [[borderline personlighetsforstyrrelse]]<ref>{{cite journal |author=Larsson JO, Hellzén M |title=Patterns of personality disorders in women with chronic eating disorders |journal=Eating and Weight Disorders |volume=9 |issue=3 |pages=200–5 |year=2004 |month=september |pmid=15656014}}</ref>
|- bgcolor="#fbf4ce"
|  [[angstlidelser]]<ref>{{cite journal |author=Swinbourne JM, Touyz SW |title=The co-morbidity of eating disorders and anxiety disorders: a review |journal=European Eating Disorders Review : the Journal of the Eating Disorders Association |volume=15 |issue=4 |pages=253–74 |year=2007 |month=juli |pmid=17676696 |doi=10.1002/erv.784}}</ref> 
| 
|  [[narsissistisk personlighetsforstyrrelse]]<ref>{{cite journal |author=Ronningstam E |title=Pathological narcissism and narcissistic personality disorder in Axis I disorders |journal=Harvard Review of Psychiatry |volume=3 |issue=6 |pages=326–40 |year=1996 |pmid=9384963 |doi=10.3109/10673229609017201}}</ref>
|- bgcolor="#fbf4ce"
|  [[tvangslidelser]]<ref>{{cite journal |author=Anderluh MB, Tchanturia K, Rabe-Hesketh S, Treasure J |title=Childhood obsessive-compulsive personality traits in adult women with eating disorders: defining a broader eating disorder phenotype |url=https://archive.org/details/sim_american-journal-of-psychiatry_2003-02_160_2/page/242 |journal=The American Journal of Psychiatry |volume=160 |issue=2 |pages=242–7 |year=2003 |month=februar |pmid=12562569 |doi=10.1176/appi.ajp.160.2.242}}</ref><ref>{{cite journal |author=Pinto A, Mancebo MC, Eisen JL, Pagano ME, Rasmussen SA |title=The Brown Longitudinal Obsessive Compulsive Study: clinical features and symptoms of the sample at intake |journal=The Journal of Clinical Psychiatry |volume=67 |issue=5 |pages=703–11 |year=2006 |month=mai |pmid=16841619 |doi=10.4088/JCP.v67n0503}}</ref> 
|  [[histrionisk personlighetsforstyrrelse]]<ref>{{cite journal |author=Lucka I, Cebella A |title=[Characteristics of the forming personality in children suffering from anorexia nervosa] |language=polsk |journal=Psychiatria Polska |volume=38 |issue=6 |pages=1011–8 |year=2004 |pmid=15779665}}</ref>
|- bgcolor="#fbf4ce"
| [[ADHD]]<ref>{{cite journal |author=Dukarm CP |title=Bulimia nervosa and attention deficit hyperactivity disorder: a possible role for stimulant medication |journal=Journal of Women's Health |volume=14 |issue=4 |pages=345–50 |year=2005 |month=mai |pmid=15916509 |doi=10.1089/jwh.2005.14.345}}</ref><ref>{{cite journal |author=Mikami AY, Hinshaw SP, Arnold LE, ''et al.'' |title=Bulimia nervosa symptoms in the multimodal treatment study of children with ADHD |url=https://archive.org/details/sim_international-journal-of-eating-disorders_2010-04_43_3/page/248 |journal=The International Journal of Eating Disorders |volume=43 |issue=3 |pages=248–59 |year=2010 |month=april |pmid=19378318 |doi=10.1002/eat.20692}}</ref><ref>{{cite journal |author=Biederman J, Ball SW, Monuteaux MC, Surman CB, Johnson JL, Zeitlin S |title=Are girls with ADHD at risk for eating disorders? Results from a controlled, five-year prospective study |journal=Journal of Developmental and Behavioral Pediatrics |volume=28 |issue=4 |pages=302–7 |year=2007 |month=august |pmid=17700082 |doi=10.1097/DBP.0b013e3180327917}}</ref><ref>{{cite journal |author=Cortese S, Bernardina BD, Mouren MC |title=Attention-deficit/hyperactivity disorder (ADHD) and binge eating |url=https://archive.org/details/sim_nutrition-reviews_2007-09_65_9/page/404 |journal=Nutrition Reviews |volume=65 |issue=9 |pages=404–11 |year=2007 |month=september |pmid=17958207 |doi=10.1111/j.1753-4887.2007.tb00318.x}}</ref>
| 
|  [[unnvikende personlighetsforstyrrelse]]<ref>{{cite journal |author=Bruce KR, Steiger H, Koerner NM, Israel M, Young SN |title=Bulimia nervosa with co-morbid avoidant personality disorder: behavioural characteristics and serotonergic function |url=https://archive.org/details/sim_psychological-medicine_2004-01_34_1/page/113 |journal=Psychological Medicine |volume=34 |issue=1 |pages=113–24 |year=2004 |month=januar |pmid=14971632 |doi=10.1017/S003329170300864X}}</ref>
|-
|}
*[[Dysmorfofobi]] (på engelsk Body Dysmorphic Disorder, forkortet BDD) er en somatoform lidelse (lidelser kjennetegnet ved at legemlige symptomer dominerer pasientens plager uten at legemlig sykdom kan påvises), som rammer opptil 2 % av befolkningen. BDD karakteriseres av overdreven opptatthet av en reell eller innbilt fysisk skavank. Diagnosen forekommer like mye hos menn som hos kvinner. Selv om BDD har blitt feildiagnostisert som anorexia nervosa, finner man dog samsykelighet i 25% til 39% av tilfeller av AN.<ref name="Grant">[300] ^ Grant JE, Kim SW, Eckert ED. Body dysmorphic disorder in patients with anorexia nervosa: prevalence, clinical features, and delusionality of body image. 
Int J Eat Disord. 2002 november, 32 (3) :291-300.PMID 12210643</ref> BDD er en kronisk og ødeleggende lidelse som kan føre til sosial isolasjon, depresjon, selvmordstanker og selvmordsforsøk.<ref name="Grant" />


Det er ofte vanskelig å skille mellom diagnosene anorexia nervosa, [[bulimia nervosa]] og andre, uspesifiserte spiseforstyrrelser (EDNOS) da det finnes betydelig overlapping mellom pasienter som er diagnostisert med disse lidelsene. Tilsynelatende små endringer i en pasients atferd eller holdning kan endre en diagnose fra anorexia nervosa/overspisende type til bulimia nervosa. Det er ikke uvanlig for en person med en spiseforstyrrelse å gå gjennom ulike diagnoser ettersom atferden og holdningene hos vedkommende endres over tid.<ref name="Zucker1">{{cite journal |author=Zucker NL, Losh M, Bulik CM, LaBar KS, Piven J, Pelphrey KA |title=Anorexia nervosa and autism spectrum disorders: guided investigation of social cognitive endophenotypes |journal=Psychological Bulletin |volume=133 |issue=6 |pages=976–1006 |year=2007 |month=november |pmid=17967091 |doi=10.1037/0033-2909.133.6.976 |url=http://www.duke.edu/web/mind/level2/faculty/labar/pdfs/Zucker_et_al_2007.pdf}}</ref>