Increased emergency department use by adolescents and young adults with eating disorders

Dooley-Hash, Suzanne; Lipson, Sarah Ketchen; Walton, Maureen A.; Cunningham, Rebecca M.

doi:10.1002/eat.22070

Cited by 26 publications

(26 citation statements)

References 40 publications

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“…When screening for such high stakes disorders, having some falsely positive screens is more acceptable than missing a significant number of true cases. This high prevalence may also be at least partially related to the known increased utilization of healthcare, including emergency departments, by individuals with eating disorders (Dooley‐Hash et al, ; Ogg et al, ; Striegel‐Moore et al, ).…”

Section: Discussionmentioning

confidence: 99%

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The prevalence and correlates of eating disorders in adult emergency department patients

Dooley-Hash

Adams

Walton

et al. 2019

Intl J Eating Disorders

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Objective This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders. Method Emergency department patients aged 21–65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression. Results Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p < .001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p < .001) and to be female (OR = 2.37, CI = 1.76, 3.19, p < .001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables. Discussion Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.

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Section: Discussionmentioning

confidence: 99%

“…frequently than their peers (Dooley-Hash, Lipson, Walton, & Cunningham, 2013;Ogg, Millar, Pusztai, & Thom, 1997;Striegel-Moore et al, 2005). Additionally, one study found that the average number of emergency department visits correlates with greater severity of illness and higher mortality (Crow, Praus, & Thuras, 1999).…”

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confidence: 99%

The prevalence and correlates of eating disorders in adult emergency department patients

Dooley-Hash

Adams

Walton

et al. 2019

Intl J Eating Disorders

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“…In fact, Swanson and colleagues [ 21 ] have shown that 88% of adolescents with eating disorders have had at least one access to emergency departments, with 22% of adolescents having Binge Eating Disorder (BED). Specifically, sixteen percent of youth aged 14 to 20 years who accessed an EDpt had eating difficulties, even if not necessarily a full-blown condition [ 22 ]. Nevertheless, no specific research has been (to our best knowledge) expressly conducted to verify whether adolescent victims of road accidents are also likely to show disordered eating, one of the principal factors of vulnerability in this developmental age [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

A Theoretical and Empirical Linkage between Road Accidents and Binge Eating Behaviors in Adolescence

Cimino

Simonelli

Parolin

et al. 2018

IJERPH

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This study aimed at identifying specific clusters of maladaptive emotional–behavioral symptoms in adolescent victims of motorbike collisions considering their scores on alexithymia and impulsivity in addition to examining the prevalence of clinical binge eating behaviors (respectively through the Youth Self-Report (YSR), Toronto Alexithymia Scale-20 (TAS-20), Barratt Impulsiveness Scale-11 (BIS-11), and Binge Eating Scale (BES)). Emotional–behavioral profiles, difficulties in identifying and describing feelings, impulsivity, and binge eating behaviors have been assessed in 159 adolescents addressing emergency departments following motorbike collisions. Our results showed a cluster of adolescents with clinical binge eating behaviors, high rates of motorbike accidents, and high levels of internalizing and externalizing problems, alexithymia, and impulsivity (23.3% of the sample); a second cluster of adolescents with clinical binge eating behaviors, a moderate number of collisions, and moderate levels of emotional and behavioral problems on the above four dimensions (25.8% of the sample); and a third cluster of youth without clinical binge eating behaviors, with a moderate number of accidents, and with low scores on the four dimensions (50.9% of the sample). Adolescents of Cluster 1 showed a higher likelihood to be involved in motorbike collisions than the youth in Clusters 2 and 3 (p < 0.0001). We suggest that adolescents’ motor collisions could be associated with their difficulties in emotion regulation and with their impaired psychological profiles, which could also underpin their disordered eating. The identification of specific clusters of psychopathological symptoms among this population could be useful for the construction of prevention and intervention programs aimed at reducing motor collision recidivism and alleviating co-occurring psychopathologies.

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“…Patients may present with other complaints such as fatigue, abdominal pain and constipation, so that up to 50 % of cases can go undetected in the primary care setting [ 14 ]. In the emergency department the picture is similar, lack of training combined with atypical presentations has been demonstrated to result in the majority of eating disorders remaining undiagnosed for some years [ 15 ]. Another study of family physicians in the UK [ 16 ] found that females were more likely to receive a diagnosis than males, even when symptoms were identical, and overall there was a reluctance to diagnose AN, even in patients with very low weight status.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an online training program in eating disorders for health professionals in Australia

Brownlow

Maguire

O’Dell³

et al. 2015

J Eat Disord

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BackgroundEarly detection and treatment of eating disorders is instrumental in positive health outcomes for this serious public health concern. As such, workforce development in screening, diagnosis and early treatment of eating disorders is needed. Research has demonstrated both high rates of failure to accurately diagnose and treat cases early and low levels of perceived access to training in eating disorders by health professionals–representing an urgent need for clinician training in this area. However, significant barriers to the access of evidence-based training programs exist, including availability, cost and time, particularly when large geographic distances are involved. Online learning presents a solution to workforce challenges, as it can be delivered anywhere, at a fraction of the cost of traditional training, timing is user controlled, and a growing body of research is demonstrating it as effective as face-to-face training. The Centre for Eating and Dieting Disorders in Australia has developed an Online Training Program In Eating Disorders, to educate health professionals in the nature, identification, assessment and management of eating disorders. The aim of the current study was to evaluate the ability of this online learning course to improve clinician levels of knowledge, skill and confidence to treat eating disorders. As well as its effect on stigmatised beliefs about eating disorders known to effect treatment delivery.MethodsOne-hundred-eighty-seven health professionals participated in the program. A pre training questionnaire and a post training evaluation examined participants’ levels of knowledge, skill and confidence to treat eating disorders, as well attitudes and beliefs about people with eating disorders.ResultsSignificant improvements in knowledge, skill, and confidence to treat eating disorders was found between pre and post program assessment in health professionals who completed the course, along with a significant decrease in stigmatised beliefs about eating disorders.DiscussionThe results of this study demonstrated that the online training program was an effective tool in increasing health professionals’ level of knowledge, skill and confidence to treat people with eating disorders. The results also demonstrated that online training reduced health professionals’ personal bias towards people with eating disorders. Limitations of this study include the use of self-report measures rather than observation of the health professional in clinical practice. As a result, it is not possible to make determinations regarding the translation of these results to clinical settings.ConclusionsThe findings of this study suggest that online training programs may present an innovative solution to the considerable workforce development challenges faced by clinicians needing training in eating disorders.

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Increased emergency department use by adolescents and young adults with eating disorders

Abstract: Patients with eating disorders utilize the ED more frequently than those without and commonly present for complaints seemingly unrelated to their eating disorder.

Cited by 26 publications

References 40 publications

The prevalence and correlates of eating disorders in adult emergency department patients

The prevalence and correlates of eating disorders in adult emergency department patients

A Theoretical and Empirical Linkage between Road Accidents and Binge Eating Behaviors in Adolescence

Evaluation of an online training program in eating disorders for health professionals in Australia

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