Eating Disorder Patients at a NSW Teaching Hospital: A Comparison with State-Wide Data

Abstract

The aim of the study was to present data which may be useful in deciding the type of services needed for eating disorder (ED) patients in New South Wales (NSW). The demographic and clinical characteristics of 155 patients consecutively admitted to a special ED unit at a major Sydney teaching hospital during the triennium 1989-1991 were documented and compared with relevant data from the State as a whole (709 admissions for ED to public facilities and 938 admissions for ED to private facilities during the same period). The findings are discussed in the light of information from overseas studies. Although a relatively large number of ED patients are admitted to hospitals in NSW, their short duration of stay suggests that many may receive inadequate treatment. The unit in the Department of Psychiatry at the Royal Prince Alfred Hospital (RPA), the largest public ED service in NSW, provides a special service for these patients. It is effective in bringing about nutritional restoration, with a duration of stay similar to those reported from centres overseas. Most referrals are tertiary, and there is a high prevalence of physical morbidity indicating a need for access to general medical facilities. Most serious physical complications occur in patients who can be identified by their chronicity and by the pattern of their behavioural disturbance. These various factors are considered in the formulation of recommendations for rationalizing the service.

Assessing quality of life in eating disorder patients

“…A total of 40 individuals who did not meet full criteria for anorexia nervosa or bulimia nervosa were excluded. Inspection of the EDE-Q, age and BMI data indicated that individuals in this subgroup were primarily cases of partial-syndrome anorexia, as in other clinical samples [5]. Data from eight individuals who did not meet full criteria for binge eating disorder were also excluded.…”

“…The World Health Organization Quality of Life Assessment Group was formed in response to the perceived need for development of a purely subjective measure [33], while others have argued for a greater reliance on more 'contextual' factors, such as standard of living, levels of autonomy and access to social support, particularly in the assessment of patients suffering from schizophrenia and related disorders [32]. Such factors may be less relevant in eating disorder patients, who are typically not economically disadvantaged [5]. Measures of HRQoL, which combine both subjective and objective elements, might be considered to lie somewhere in between these poles.…”

“…Cases of eating disorders presenting to treatment place a considerable strain on health services due to high levels of clinical load (patient days), high levels of comorbidity with anxiety and affective disorders, and high rates of relapse [5,6]. Medical complications of anorexia nervosa, resulting from severe weight loss, may be life threatening.…”

More males seek treatment for eating disorders

“…The proportion of males identified in clinic-based case series has generally been substantially smaller than the proportion identified in community-based samples (Lucas et al, 1991;Carlat & Camargo, 1991;Beumont, Schrader, & Lennerts, 1995). This discrepancy has caused speculation that males may be less likely to seek treatment for eating disorders than their female counterparts (Carlat & Camargo, 1991).…”

Disability associated with community cases of commonly occurring eatinq disorders

“…Cases of eating disorders presenting for treatment place a considerable strain on health services because of high levels of clinical load (patient days), high levels of comorbidity with anxiety and affective disorders, and high rates of relapse. 5,6 Medical complications of anorexia nervosa (AN), including loss of menstruation, are a consequence of severe weight loss and may be life-threatening. However, AN is uncommon and affects primarily adolescent girls.…”