A scoping review of the role of primary care providers and primary care-based interventions in the treatment of pediatric eating disorders

Lenton-Brym, Talia; Rodrigues, Anthony; Johnson, Natasha; Couturier, Jennifer; Toulany, Alène

doi:10.1080/10640266.2018.1560853

Cited by 7 publications

(3 citation statements)

References 36 publications

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“…Furthermore, even at a young age, eating disorders are associated with severe comorbidity, which may complicate treatment efforts. Clinicians should consider referrals for specialty mental health care especially as research on the efficacy of primary care-based interventions for pediatric eating disorders is in its infancy(Lenton- Brym, Rodrigues, Johnson, Couturier, & Toulany, 2020).Data used in the preparation of this article were obtained from the ABCD SM Study (https://abcdstudy. org), held in the NIMH Data Archive (NDA).…”

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confidence: 99%

Psychiatric comorbidity of eating disorders in children between the ages of 9 and 10

Convertino

Blashill

2021

Child Psychology Psychiatry

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Background Eating disorders exhibit high comorbidity with other psychiatric disorders, most notably mood, substance use, and anxiety disorders. However, most studies examining psychiatric comorbidity are conducted in adolescents and adults. Therefore, the comorbidity among children living with eating disorders is unknown. The aim of this study was to characterize co‐occurring psychiatric disorders with eating disorders in a US sample of children aged 9–10 years old utilizing the Adolescent Brain Cognitive Development study. Methods The analytic sample included 11,718 children aged 9–10 years. Anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorder subtype diagnoses were examined. Statistical analyses were conducted using complex sampling. Odds ratios and 95% confidence intervals were calculated comparing the likelihood of being diagnosed for a psychiatric disorder when having an eating disorder, as compared to children without an eating disorder, children diagnosed with major depressive disorder, and children diagnosed with posttraumatic stress disorder using binary logistic regression. Results Co‐occurring psychiatric disorders were substantially higher in children with eating disorders as compared to children without eating disorders, but not as compared to children diagnosed with major depressive disorder or posttraumatic stress disorder. The most common comorbidities for the eating disorder group were anxiety disorders (71.4%), attention deficit/hyperactivity disorder (47.9%), disruptive/impulse control disorders (45.0%), mood disorders (29.6%), and obsessive‐compulsive disorder (28.8%), largely in line with previous research. Conclusions This study extends prior research finding high rates of comorbidity in eating disorders, specifically with anxiety, mood, and disruptive/impulse control disorders. Clinicians assessing for psychiatric disorders should be aware that eating disorders can occur in children 9 and 10 years old and are associated with severe comorbidity. Referrals for specialty mental health care should be considered.

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confidence: 99%

Psychiatric comorbidity of eating disorders in children between the ages of 9 and 10

Convertino

Blashill

2021

Child Psychology Psychiatry

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“…Because eating disorders are complex conditions with both medical and psychological features that require clinical attention, they lend themselves well to an integrated care model. Moreover, since the majority of adolescents with eating disorders present first to primary care [19], embedding treatment at this point of care may improve rates of early detection and effective intervention [20]. In addition, patients often delay or avoid presenting for specialty eating disorder care due to the high degree of stigma and pervasive misunderstandings surrounding these disorders [21].…”

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confidence: 99%

Can adolescents with eating disorders be treated in primary care? A retrospective clinical cohort study

et al. 2021

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Background Family-Based Treatment (FBT) is considered the first-line intervention for adolescent anorexia nervosa. However, access to this treatment is limited. Treatment programs for other pediatric mental health conditions have successfully overcome barriers to accessing evidence-based intervention by integrating mental health services into primary care. This study evaluated the proof-of-concept of a novel modification of FBT, Family-Based Treatment for Primary Care (FBT-PC) for adolescent restrictive eating disorders designed for delivery by primary care providers in their practices. Methods This retrospective clinical cohort study evaluated 15 adolescents with restrictive eating disorders receiving FBT-PC and 15 adolescents receiving standard FBT. We examined improvement in BMI percentile, reduction in weight suppression, and clinical benchmarks of eating disorder recovery including weight restoration to > 95% of expected body weight (EBW) and resolution of DSM-5 criteria for eating disorders. Results In both groups, effect sizes for increased BMI percentile exceeded Cohen’s convention for a large effect (FBT-PC: d = .94; standard FBT: d = 1.15) as did effect sizes for reduction in weight suppression (FBT-PC: d = 1.83; standard FBT: d = 1.21). At the end of treatment, 80% of the FBT-PC cohort and 87% in the standard FBT group achieved > 95%EBW and 67% in the FBT-PC group and 60% in the standard FBT group no longer met DSM-5 criteria for an eating disorder. There were no cohort differences in the number of treatment drop-outs or referrals to a more intensive level of eating disorder treatment. Conclusions Findings suggest that primary care providers have potential to improve weight and clinical status in adolescents with restrictive eating disorders. Based on these results, more rigorous testing of the FBT-PC model is warranted.

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“…Various theories have been proposed to explain the causes of pica (Johns et al, 2019), which include poverty, inadequate parental supervision, poor mother-child relationship, separation from mother, child neglect, or child abuse (Lenton-Brym et al, 2020). It is also more common in children with autism, hyperactivity and attention deficit disorder, schizophrenia, obsessive-compulsive disorder, and depression (Chakraborty et al, 2011).…”

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Pica: Treatment with Punica Granatum extract

Shekarriz

Jokar

Yousefi

2021

Phytotherapy Research

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Pica is an eating disorder characterized by craving for nonfood items, such as dirt, clay, detergents, soap, stone, and paper. It occurs in children who start feeling the world with the oral cavity. The exact etiology of this disorder is still unknown; nonetheless, its treatment and prevalence vary according to patients' behavior and characteristics. We aim to present a case report of a patient with pica who was treated with Persian Traditional Medicine. This treatment was performed using four doses of 15 ml Punica granatum extract after every meal for 3 weeks while fasting before breakfast. The patient's appetite improve within 3 weeks, with remarkable improvement in pica symptoms. Punica granatum extract seems to be effective in controlling pica.

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A scoping review of the role of primary care providers and primary care-based interventions in the treatment of pediatric eating disorders

Cited by 7 publications

References 36 publications

Psychiatric comorbidity of eating disorders in children between the ages of 9 and 10

Psychiatric comorbidity of eating disorders in children between the ages of 9 and 10

Can adolescents with eating disorders be treated in primary care? A retrospective clinical cohort study

Pica: Treatment with Punica Granatum extract

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