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58 - Treatment of eating disorders in children and adolescents

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Matthew Hodes ,
Rose Calderon ,
Cora Collette Breuner  and
Christopher K. Varley
Edited by
Peter Tyrer  and
Kenneth R. Silk
Matthew Hodes
Affiliation:
Imperial College London St Mary's Campus London UK
Rose Calderon
Affiliation:
Department of Child and Adolescent Psychiatry University of Washington Seattle, WA USA
Cora Collette Breuner
Affiliation:
Childrens' Hospital and Medical Center Seattle Washington USA
Christopher K. Varley
Affiliation:
Department of Child and Adolescent Psychiatry University of Washington School of Medicine Seattle, WA USA
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

As is the situation in many disorders of childhood and adolescence, there is very little good data to support any particular type of intervention in eating disorders that occur during this time period. While all would agree on multi-modal treatment, there are no RCTs to examine that particular type of intervention. What little evidence there is to support any type of intervention leads us to primarily family therapy interventions in this patient population. While there may be a need for psychopharmacology, cognitive-behavioral therapy and nutrition counseling, there is little evidence that can point us to better outcomes when these other interventions are employed. There is probably a role for hospitalization here, but hospitalizations keep people alive but do not necessarily alter the long-term outcome. Both the USA and the UK have practice guidelines, but these guidelines are not rooted in interventions that have withstood methodological rigor.

Introduction

There are now abundant data showing that eating disorders, including anorexia and bulimia nervosa, originate in late childhood and early adolescence (American Academy of Pediatrics, Committee on Adolescence, 2003). The vast majority of patients with eating disorders are diagnosed prior to age 25 years, with the age of onset for anorexia nervosa peaking between ages 13 and 15 years and onset of bulimia nervosa peaking between 17 and 25. Evidence for an increased incidence exists for bulimia nervosa (for example) from cohort studies (Bushnell et al., 1990; Kendler et al., 1991).

Type
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Cambridge Textbook of Effective Treatments in Psychiatry , pp. 841 - 854
Publisher: Cambridge University Press
Print publication year: 2008

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