Delirium and refeeding syndrome in anorexia nervosa

Authors

  • Mark L Norris MD,

    Corresponding author
    1. Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
    • Pediatrics and Adolescent Medicine, Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, Canada K1H 8L1

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  • Leora Pinhas MD,

    1. Department of Psychiatry, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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  • Pierre-Olivier Nadeau MD,

    1. Department of Psychiatry, St. Justine Hospital, Montreal, Quebec, Canada
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  • Debra K Katzman MD

    1. Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Abstract

Objective:

To review the literature on delirium and refeeding syndrome in patients with anorexia nervosa (AN) and present case examples in an attempt to identify common clinical features and response to therapy.

Method:

A comprehensive literature review was completed. In addition to the cases identified in the literature, we present two additional cases of our own.

Results:

We identified a total of 10 cases (all female; mean age 19 years old, range 12–29 years); 2/3 of the cases had similar clinical features predating the delirium and during refeeding.

Discussion:

Delirium, albeit rare, can be associated with the refeeding syndrome in low weight patients with AN. During the initial refeeding phase, close monitoring of medical, metabolic, and psychological parameters are important in establishing factors that may elevate risk. Early detection and treatment of delirium using nonpharmacologic and pharmacologic means are also important to help minimize the effects of this potentially deadly condition. © 2011 by Wiley Periodicals, Inc. (Int J Eat Disord 2012)

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