Identification and Management of Eating Disorders in Children and Adolescents

Rosen, David S.

doi:10.1542/peds.2010-2821

Cited by 297 publications

(194 citation statements)

References 140 publications

(166 reference statements)

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“…This aspect differs substantially from what have been observed among girls, who resort more frequently to induce vomiting and fasting periods, and therefore it should be considered when evaluating boys with ED 1,5 .…”

Section: Resultsmentioning

confidence: 73%

“…More recently, studies have found an increase in the frequency of ED among boys [3][4][5] . A study conducted in Australia with a sample of 101 children and adolescents treated in an ED program found that 25% (1:4) of the participants were boys 6 .…”

Section: Introductionmentioning

confidence: 98%

“…Studies from the 1980s and 1990s have indicated a girl/boy proportion of 10-12:1 among patients with ED admitted to outpatient treatment or inpatient unit 2 . However, international studies have shown that the epidemiology of this pathology has changed in the last decades [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

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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: 73%

Section: Introductionmentioning

confidence: 98%

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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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“…La distribución de riesgo entre mujeres y hombres que encontramos fue aproximadamente de 2/1, lo que no coincide con lo reportado en TCA en población no obesa, donde es mucho más frecuente en mujeres que hombres (10/1) 5 . Esta frecuencia por sexo es similar con lo observado en estudios de prevalencia de TCA en obesos, específicamente de trastorno por Atracón 24,33 .…”

Section: Discussionunclassified

“…Por otro lado, los adolescentes muestran un aumento de los trastornos de la conducta alimentaria (TCA) 4 . Ambas patologías constituyen problemas de salud pública complejos y prevalentes que requieren ser abordados [5][6][7][8][9] .…”

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Riesgo de trastornos alimentarios en adolescentes obesos de la Región Metropolitana

Marín¹,

Sommer

Agurto

et al. 2014

Rev. méd. Chile

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Comparison of 2 Family Therapies for Adolescent Anorexia Nervosa

et al. 2014

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IMPORTANCE Anorexia nervosa (AN) is a serious disorder with high rates of morbidity and mortality. Family-based treatment (FBT) is an evidence-based therapy for adolescent AN, but less than half of those who receive this approach recover. Hence, it is important to identify other approaches to prevent the development of the chronic form of AN for which there is no known evidence-based treatment.OBJECTIVE To compare FBT with systemic family therapy (SyFT) for the treatment of adolescent-onset AN. DESIGN, SETTING, AND PARTICIPANTSResearch in Anorexia Nervosa (RIAN) is a 2-group (FBT and SyFT) randomized trial conducted between September 2005 and April 2012. Interviewers were blinded to the treatment condition. A total of 564 adolescents receiving care at 6 outpatient clinics experienced in the treatment of AN were screened. Of these, 262 adolescents did not meet the inclusion criteria and 138 declined to participate; hence, 164 adolescents (aged 12-18 years) of both sexes meeting the criteria for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, AN (except for amenorrhea) were enrolled. Three participants were withdrawn from FBT and 7 were withdrawn from SyFT after serious adverse events occurred.INTERVENTIONS Two manualized family therapies with 16 one-hour sessions during 9 months. Family-based therapy focuses on the facilitation of weight gain, whereas SyFT addresses general family processes. MAIN OUTCOMES AND MEASURESThe primary outcomes were percentage of ideal body weight (IBW) and remission (Ն95% of IBW). The a priori hypothesis was that FBT would result in faster weight gain early in treatment and at the end of treatment (EOT).RESULTS There were no statistically significant differences between treatment groups for the primary outcome, for eating disorder symptoms or comorbid psychiatric disorders at the EOT or follow-up. Remission rates included FBT, 33.1% at the EOT and 40.7% at follow-up and SyFT, 25.3% and 39.0%, respectively. Family-based therapy led to significantly faster weight gain early in treatment, significantly fewer days in the hospital, and lower treatment costs per patient in remission at the EOT (FBT, $8963; SyFT, $18 005). An exploratory moderator analysis found that SyFT led to greater weight gain than did FBT for participants with more severe obsessive-compulsive symptoms. CONCLUSIONS AND RELEVANCEThe findings of this study suggest that FBT is the preferred treatment for adolescent AN because it is not significantly different from SyFT and leads to similar outcomes at a lower cost than SyFT. Adolescents with more severe obsessivecompulsive symptoms may receive more benefits with SyFT. TRIAL REGISTRATION clinicaltrials.gov. Identifier NCT 00610753

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Identification and Management of Eating Disorders in Children and Adolescents

Cited by 297 publications

References 140 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

Riesgo de trastornos alimentarios en adolescentes obesos de la Región Metropolitana

Comparison of 2 Family Therapies for Adolescent Anorexia Nervosa

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