Comparative study of children and adolescents referred for eating disorder treatment at a specialist tertiary setting

Authors

  • Tara Walker MAppPsych,

    1. School of Psychology and Exercise Science, Division of Social Sciences, Humanities and Education, Murdoch University, Perth, Australia
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  • Hunna J. Watson PhD, MPsych(Clin),

    Corresponding author
    1. Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
    2. School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Australia
    3. School of Psychology and Speech Pathology, Division of Health Sciences, Curtin University, Perth, Australia
    • Correspondence to: Hunna Watson, PhD, MPsych(Clin), Eating Disorders Program, Princess Margaret Hospital for Children, GPO Box D184, Perth, Western Australia 6840, Australia. E-mail: hunna.watson@health.wa.gov.au

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  • David J. Leach MEPsych,

    1. School of Psychology and Exercise Science, Division of Social Sciences, Humanities and Education, Murdoch University, Perth, Australia
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  • Julie McCormack MSc(Psych),

    1. Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
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  • Karin Tobias MSc(Psych),

    1. Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
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  • Matthew J. Hamilton BSc(Psych),

    1. School of Psychology and Speech Pathology, Division of Health Sciences, Curtin University, Perth, Australia
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  • David A. Forbes MBBS, FRACP

    1. Eating Disorders Program, Princess Margaret Hospital for Children, Perth, Australia
    2. School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Australia
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ABSTRACT

Objective

To examine child and adolescent differences in the clinical presentation of eating disorders (EDs) at referral to a specialist pediatric program.

Method

This study compared cognitive, behavioral, and physical and medical features of children (≤12 years) and adolescents (13–18 years) with EDs presenting to a state-wide specialist pediatric ED service over two decades (N = 656; 8–18 years; 94% female).

Results

Significant differences were found between the groups. Children were more commonly male (p < .001), had lower eating pathology scores (p < .001), were less likely to binge eat (p = .02), purge (p < .001) or exercise for shape and weight control (p < .001), and lost weight at a faster rate than adolescents (p = .009), whereas adolescents were more likely to present with bulimia nervosa spectrum disorders (p = .004). Children and adolescents did not differ significantly on mean body mass index z-score, percentage of body weight lost, or indicators of medical compromise (p > .05).

Discussion

The clinical presentation of EDs differs among children and adolescents, with eating pathology and behavioral symptoms less prominent among children. Frontline health professionals require knowledge of these differences to assist with early detection, diagnosis, and prognosis. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:47–53)

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