Outcome of adolescents with eating disorders from an adolescent medicine service at a large children’s hospital

Hergenroeder, Albert C.; Wiemann, Constance M.; Henges, Christopher; Davé, Amanda

doi:10.1515/ijamh-2013-0341

Cited by 12 publications

(4 citation statements)

References 13 publications

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“…length and number of in-patient, day-patient and/or out-patient episodes). This resonates with findings by Hergenroeder et al 27 indicating that repeated admissions for eating disorder treatment during adolescence are associated with poor recovery. These findings highlight clinical identification in CAEDS of the likelihood for ongoing treatment into young adulthood and supports the notion that quick resolution of eating disorders in childhood/adolescence is optimal.…”

Section: Discussionsupporting

confidence: 90%

Defining and predicting service utilisation in young adulthood following childhood treatment of an eating disorder

et al. 2020

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Background Eating disorder services are often separated into child and adolescent eating disorder services (CAEDSs) and adult eating disorder services (AEDSs). Most patients in CAEDSs present with first-episode illness of short duration, which with appropriate treatment, have a good prognosis. However, some individuals receive further treatment as adults. Little is known about service utilisation in adulthood following childhood/adolescent treatment of an eating disorder. Aims This study aims (a) to estimate the proportion of patients in a CAEDS who use mental health services as young adults, (b) to delineate service utilisation following treatment in CAEDSs and (c) to identify factors in CAEDSs that predict service utilisation in young adulthood. Method A consecutive cohort of 322 patients (aged 13–17 years) seen in a CAEDS in the UK over a 5-year period were included in this audit. Data regarding their use of UK-wide adult mental health services as young adults (i.e. when aged 18–25) were extracted from local and national hospital records. Results A total of 68.3% of CAEDS patients received no mental health treatment as young adults. Although 13% of people seen in a CAEDS had brief eating disorder treatment as young adults, 10% received longer/or more intensive eating disorder treatment. Overall, 10.8% transitioned directly to an AEDS and 7.6% were re-referred following discharge from CAEDS. In our sample, older age and increased use of CAEDSs predicted increased eating disorder treatment in young adulthood. Conclusions Our results indicate that most people seen in CAEDSs do not receive further mental health treatment as young adults. Several features in CAEDSs distinguish mental health service utilisation in young adulthood, which were identified clinically and could be targeted during treatment.

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Section: Discussionsupporting

confidence: 90%

Defining and predicting service utilisation in young adulthood following childhood treatment of an eating disorder

et al. 2020

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“…The Pubmed search resulted in 192 titles for inspection and 7 abstracts for inspection of which 5 were not trials of treatment setting [28][29][30][31][32] and one was a review [33] and one new trial [34] was identified. The CCRCT Issue 6 of 12, June 2014 (n = 797723) search resulted in 20 titles for inspection of which two were duplicates and one new trial [29] was identified ( Figure 1).…”

Section: Results Of Searchmentioning

confidence: 99%

Systematic review of evidence for different treatment settings in anorexia nervosa

Madden

Hay

Touyz

2015

WJP

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AIM:To compare outcomes in anorexia nervosa (AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS:Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors (Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition. RESULTS:Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care. CONCLUSION:There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa. Core tip: Anorexia nervosa (AN) is a serious disorder incurring high costs due to hospitalization. This study compared outcomes in AN treatment studies comparing different treatment settings: inpatient, day-patient and outpatient. Five studies were identified. There was no difference in outcomes between the different settings and lengths of inpatient treatment. Both outpatient and day-patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was cheaper than prolonged inpatient care for weight normalization. There is support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting.

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“…While many patients can be managed in the outpatient setting, some require inpatient admission for medical stabilization. One study by Hergenroeder, Wiemann, Henges, and Dave () found that being hospitalized once and longer duration of follow‐up was associated with partial or full recovery in patients with eating disorders. Hospitals may benefit from having the essential disciplines available to care for admitted patients with AN and malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Recurrent hyponatremia in a young adult woman with anorexia nervosa and the effects of insufficient communication

Boyd

Durant

2018

Intl J Eating Disorders

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This is the case of an 18‐year‐old young adult woman with anorexia nervosa (AN) who presented to the emergency department with complications from AN and was found to be hyponatremic. The hyponatremia was prioritized and corrected with fluids on hospital day one. The consulting adolescent medicine team recommended the primary inpatient medical team initiate the malnutrition protocol. Nephrology recommended fluid restriction. Despite initiation of this protocol and emphasis on protocol adherence with the primary team, patient, and family, the hyponatremia recurred. Retrospectively, there were three factors that led to her recurrent hyponatremia: inconsistencies in protocol adherence across medical clinical providers, lack of knowledge regarding the importance of adherence to the malnutrition protocol, and suboptimal communication between medical clinical providers. A multidisciplinary team experienced in the care of patients with AN may enhance inpatient treatment of this condition. A multidisciplinary team experienced in AN will have a better understanding of the complexities of AN, skill in protocol implementation, understand the importance of protocol adherence, and be more likely to clearly communicate the plan of care to the patient/family. These skills can lead to improved care quality, decreased risk of adverse outcomes, and likely decreased medical costs.

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Outcome of adolescents with eating disorders from an adolescent medicine service at a large children’s hospital

Cited by 12 publications

References 13 publications

Defining and predicting service utilisation in young adulthood following childhood treatment of an eating disorder

Defining and predicting service utilisation in young adulthood following childhood treatment of an eating disorder

Systematic review of evidence for different treatment settings in anorexia nervosa

Recurrent hyponatremia in a young adult woman with anorexia nervosa and the effects of insufficient communication

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