Objective-The purpose of this study was to empirically derive eating disorder phenotypes in a clinical sample of children and adolescents using latent profile analysis (LPA) and compare these latent profile (LP) groups to the DSM-IV-TR eating disorder categories.Method-Eating disorder symptom data collected from 401 youth (ages 7-19; mean 15.14 ± 2.35y) seeking eating disorder treatment were included in LPA; general linear models were used to compare LP groups to DSM-IV-TR eating disorder categories on pre-treatment and outcome indices.Results-Three LP groups were identified: LP1 (n=144), characterized binge eating and purging ("Binge/purge"); LP2 (n=126), characterized by excessive exercise and extreme eating disorder cognitions ("Exercise-extreme cognitions"); and LP3 (n=131), characterized by minimal eating disorder behaviors and cognitions ("Minimal behaviors/cognitions"). Identified LPs imperfectly resembled DSM-IV-TR eating disorders. LP1 resembled bulimia nervosa; LP2 and LP3 broadly resembled anorexia nervosa with a relaxed weight criterion, differentiated by excessive exercise and severity of eating disorder cognitions. LP groups were more differentiated than the DSM-IV-TR categories across pre-treatment eating disorder and general psychopathology indices, as well as weight change at follow-up. Neither LP nor DSM-IV-TR categories predicted change in binge/purge behaviors. Validation analyses suggest these empirically-derived groups improve upon the current DSM-IV-TR categories.Conclusions-In children and adolescents, revisions for DSM-V should consider recognition of patients with minimal cognitive eating disorder symptoms.
Background
Healthcare workers are encouraged annually to get vaccinated against influenza. This year in view of COVID-19 pandemic, attitudes of HCWs towards vaccination are particularly important. A cross-sectional study was completed to understand how to best encourage and facilitate the vaccination of HCWs based on the previous years’ findings.
Methods
An online survey was disseminated to all hospital staff via electronic channels. The clinical audit sphinx software was used for data collection and analysis.
Results
The total number of responses was n = 728, almost double the rate from 2018 (N = 393). A total of 78% (N = 551) of participants were vaccinated last year. A total of 94% (N = 677) of participants reported their intention to be vaccinated this year. The main barriers listed were being unable to find time (32%, N = 36), side effects (30%, N = 33) and thinking that it does not work (21%, N = 23). The most popular suggestions for how to increase uptake were more mobile immunisation clinics (72%, N = 517) and more information on the vaccine (50%, N = 360). A total of 82% of participants (N = 590) agreed that healthcare workers should be vaccinated, with 56% (N = 405) agreeing that it should be mandatory. Of the participants who were not vaccinated last year (N = 159), 40% (N = 63) agreed that COVID-19 had changed their opinion on influenza immunisation with a further 11% (N = 18) strongly agreeing.
Discussion
In light of the increasing number of survey participants, more staff were interested in flu vaccination this year than ever before. The COVID-19 pandemic has had some influence on staff’s likelihood to be vaccinated. Feasibility of immunisation and education posed the largest barriers to HCW vaccination.
Eating disorders frequently have their onset in adolescence. This is problematic as Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Eating Disorder Not Otherwise Specified (EDNOS) often present with serious psychiatric and medical sequelae that can affect an adolescent's physical and emotional development. It is well documented that complications from eating disorders in adolescence can result in long-term health consequences, rendering effective psychiatric and medical treatments a necessity. To combat the medical consequences associated with eating disorders in adolescents, pediatricians must identify, treat, and monitor medical complications. Pediatricians are also responsible for assessing the need for hospitalization due to medical instability. Some advances have been made regarding psychopharmacological treatments for eating disorders. For example, antidepressant medications, such as SSRIs, have demonstrated efficacy in the treatment of adults with BN. The true effectiveness of these medications in adolescent populations remains unknown. A multidisciplinary team approach is a common treatment model in outpatient practice, but further research is required to investigate how to facilitate the collaboration of psychiatric and medical professionals. The majority of psychiatric and medical trials for eating disorder patients have involved adult participants, and most studies have investigated either psychiatric or medical treatments for eating disorders. In this review, we will add to the current literature by focusing on both psychiatric and medical treatments for eating disorders, with particular emphasis on studies conducted with adolescents.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.