Children and adolescents with eating disorders clinically distinct
NEW paediatric research suggests that children and adolescents with eating disorders display significant differences in clinical presentation, lending further support to research which has found eating disorders differ across age groups.
The researchers including Princess Margaret Hospital for Children Eating Disorders Program (PMH EDP) Senior Research Psychologist Dr Hunna Watson were interested in determining whether differences in physical, behavioural and clinical features existed between children and adolescents referred to the program.
They utilised data collected in the HOPE (Helping to Outline Paediatric Eating Disorders) Project, an ongoing paediatric clinical eating disorder registry comprising patients admitted to the PMH EDP from 1996.
Data from the registry on 656 young people – 104 children (<13 years) and 552 adolescents (13-17 years) – who met the DSM-V criteria for an eating disorder, was included in the study.
Diagnosis was obtained through the Eating Disorder Examination, which measures behavioural symptoms (binge-eating, purging and excessive exercise) and cognitive symptoms (restraint, weight and shape concern).
The diagnosis also involved a medical review of physical/clinical features (expected and actual BMI scores and percentage and rate of body weight lost).
Of the 104 children in the study, 41.3 per cent were diagnosed with Anorexia nervosa (AN), 1.9 per cent with Bulimia nervosa (BN) and 56.7 per cent with Eating Disorder Not Otherwise Specified (EDNOS).
For the 552 adolescents, 38 per cent were diagnosed with AN, 10.3 per cent with BN and 51.6 per cent with EDNOS.
Results indicated significant distinctions between the two groups.
Dr Watson says eating disorders in males were more common during childhood than adolescence.
"Children were less likely to binge eat, purge, or exercise for shape and weight control compared to adolescents," Dr Watson says.
"Children also lost weight at a faster rate than adolescents.
"Adolescents were more likely to present with BN and report binge eating, self-induced vomiting, and laxative misuse."
The researchers did not find any differences in mean BMI scores or percentage of body weight lost between the two groups.
However, the data revealed both children and adolescents were equally susceptible to malnutrition complications such as bradycardia and hypotension, which are common among young people with eating disorders.
"Eating disorders have severe and debilitating physical manifestations, with risk of multi-organ failure, and hospitalisation is commonly warranted," Dr Watson says.
Dr Watson says it is important that health practitioners and caregivers are aware of the differences across age groups and the need to develop age-appropriate assessments and treatments.