Comparative study of children and adolescents referred for eating disorder treatment at a specialist tertiary setting

Walker, Tara; Watson, Hunna J.; Leach, David J.; McCormack, Julie; Tobias, Karin; Hamilton, Matthew J.; Forbes, David

doi:10.1002/eat.22201

Cited by 28 publications

(43 citation statements)

References 50 publications

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“…Researchers have pointed out that the clinical presentation of children with ED differs substantially from that of adolescent and adult patients in the following aspects: shorter disease duration, fewer symptoms of ED, lower frequency of binge/purge and physical exercises to control weight, faster loss of weight, and increased risk of growth problems 9,11 .…”

Section: Resultsmentioning

confidence: 99%

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

Alckmin-Carvalho

Cobelo

Melo

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

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Background: International studies have demonstrated an increase in the prevalence of boys and a decrease of patients' age at the beginning of outpatient treatment for eating disorders (ED). Objective: To evaluate if these changes are also present in the Brazilian population participating in the PROTAD, a Brazilian ED program, and to discuss its clinical implication for treatment. Methods: Cross-sectional study. We evaluated 150 medical records of patients under 18 years diagnosed with ED (DSM IV-TR). Patients were divided into two groups: G1 (2001-2007) (n = 77) and G2 (2008-2014) (n = 73). The girl/boy proportion and the mean age of patients were compared. Results: In G1, six boys (7.8%) were admitted (girl/boy proportion: 11.8:1), while in G2, 16 (22%) boys were admitted (girl/boy proportion: 3.5:1) (p < 0.05). The mean age in G1 was 15.6 years (SD = 1.7; 95%CI: 15.2-15.9), whereas the mean age in G2 was 14.9 years (SD = 1.9; 95%CI: 14.4-15.3) (p > 0.05). Discussion: The increase in the number of boys treated for EDs reported in international studies was also found at the PROTAD. Contrary to what has been reported in international studies, the mean age of patients at the PROTAD did not decrease significantly. Gender and sexual orientation issues, clinical presentation, prior overweight history and culture/media impact on boys should be addressed by the healthcare team to increase the therapeutic efficacy.

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Section: Resultsmentioning

confidence: 99%

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

Alckmin-Carvalho

Cobelo

Melo

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

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“…These include pressures experienced by younger patients, such as changes related to puberty and external negative in uences on body image perception and idealisation (38). It has been postulated that onset of AN prior to puberty may intensify perceived body image ideals (39), whereby the associated increase in adipose tissue and widening of the hips in adolescent females during puberty may exacerbate cognitions related to thin body ideal (13). Moreover, experience of body change in the EO-AN group may also be substantially in uenced by social media ideals, peer relationships and the emergence of gender roles (40,41) which may also contribute to the heightened stress and anxiety seen in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…Previous investigations into AOO in AN are inconclusive, with con icting evidence surrounding the impact of AOO on ED severity, prognostic implications and psychological pro le. Evidence for increased ED severity and poorer prognostic outcomes in EO-AN (as compared to LO-AN) have been demonstrated including; more rapid weight loss (12,13), poorer long-term outcomes of low body weight and psychiatric comorbidity (14), and a longer duration of illness (15). However, other studies have found no difference in severity of weight loss between EO-and LO-AN (16), fewer cases of extremely low weight in those with EO-AN compared to LO-AN (17), and a positive association between low body mass index (BMI) and increased AOO (18).…”

mentioning

confidence: 99%

A Comparison of Eating Disorder Symptomatology, Psychological Distress and Psychosocial Function Between Early and Later Onset Anorexia Nervosa

Jenkins

Chait

Cistullo

et al. 2020

Preprint

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Objective: Epidemiological studies suggest that the incidence of anorexia nervosa (AN) is increasing in younger populations, with some evidence that clinical differences occur between early onset (EO) and later onset (LO) AN, which may impact prognostic outcomes. The current study sought to compare eating disorder (ED) symptomatology, psychological distress and psychosocial function between EO- and LO-AN in a large sample of treatment-seeking patients with a diagnosis of AN.Methods: Participants included 249 individuals with a diagnosis of AN who were assessed at an outpatient ED service. The sample was divided into two groups based on age of onset (AOO) using a median split (median AOO=16); those with an AOO ≤16 years (N=128) were termed ‘EO-AN’ and those with an AOO of > 16 years (N=121) were termed ‘LO-AN’. Comparisons were made between AOO groups on assessments of ED symptomatology, psychological distress and psychosocial function. Results: EO-AN patients reporteda significantly longer illness duration (p<.001), significantly higher ED symptomatology (p=0.005), dysmorphic concern (p=0.02), stress (p=0.011), anxiety (p=0.023), and cognitive inflexibility (p=0.042), compared to the LO-AN group.Discussion: These findings suggest that clinical differences do occur according to AOO in AN wherebyEO-AN may represent a more severe form of illness. Treatment strategies which specifically address patients with EO-AN may improve long term health outcomes and recovery.

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“…All the children and adolescents need eating disorder treatment [3]. They need an negativebalance between energy intake (low-calorie, nutrient-dense foods) and energy output (physical activity and exercise).…”

Section: The Causes Of Obesitymentioning

confidence: 99%

Bariatric Surgery in Adolesencets : a multidisciplinary Approach

Yu¹

2014

Essentials and Controversies in Bariatric Surgery

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Comparative study of children and adolescents referred for eating disorder treatment at a specialist tertiary setting

Abstract: The clinical presentation of EDs differs among children and adolescents, with eating pathology and behavioral symptoms less prominent among children. Frontline health professionals require knowledge of these differences to assist with early detection, diagnosis, and prognosis.

Cited by 28 publications

References 50 publications

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

A Comparison of Eating Disorder Symptomatology, Psychological Distress and Psychosocial Function Between Early and Later Onset Anorexia Nervosa

Bariatric Surgery in Adolesencets : a multidisciplinary Approach

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