Maria C Monge1, Sara F Forman2, Nicole M McKenzie2, David S Rosen3, Kathleen A Mammel4, S Todd Callahan5, Rebecca Hehn6, Ellen S Rome7, Cynthia J Kapphahn8, Jennifer L Carlson8, Mary E Romano5, Joan B Malizio9, Terrill D Bravender10, Eric J Sigel11, Mary R Rouse12, Dionne A Graham13, M Susan Jay14, Albert C Hergenroeder15, Martin M Fisher16, Neville H Golden8, Elizabeth R Woods2. 1. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: mcmonge@seton.org. 2. Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. 3. Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan. 4. Division of Adolescent Pediatrics, Beaumont Children's Hospital, Royal Oak, Michigan. 5. Division of Adolescent Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee. 6. Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts. 7. Section of Adolescent Medicine, Department of General Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, Ohio. 8. Division of Adolescent Medicine, Stanford University School of Medicine, Stanford, California. 9. Division of Adolescent Medicine, Steven and Alexandra Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York. 10. Department of Pediatrics, The Ohio State University, Columbus, Ohio; Nationwide Children's Hospital, Columbus, Ohio. 11. Children's Hospital of Colorado, Section of Adolescent Medicine, University of Colorado, Aurora, Colorado. 12. Department of Pediatrics, Indiana University School of Medicine, Indiana University Health, Indianapolis, Indiana. 13. Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts. 14. Division of Adolescent Medicine, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. 15. Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. 16. Division of Adolescent Medicine, Steven and Alexandra Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York; Department of Pediatrics, Hofstra North Shore-Long Island Jewish School of Medicine, Hempstead, New York.
Abstract
PURPOSE: Psychopharmacologic medications are often prescribed to patients with restrictive eating disorders (EDs), and little is known about the frequency of use in adolescents. We examined the use of psychopharmacologic medications in adolescents referred for treatment of restrictive ED, potential factors associated with their use, and reported psychiatric comorbidities. METHODS: Retrospective data from the initial and 1-year visits were collected for patients referred for evaluation of restrictive ED at 12 adolescent-based ED programs during 2010 (Group 1), including diagnosis, demographic information, body mass index, prior treatment modalities, and psychopharmacologic medications. Additional data regarding patients' comorbid psychiatric conditions and classes of psychopharmacologic medications were obtained from six sites (Group 2). RESULTS: Overall, 635 patients met inclusion criteria and 359 had 1-year follow-up (Group 1). At intake, 20.4% of Group 1 was taking psychopharmacologic medication and 58.7% at 1 year (p ≤ .0001). White, non-Hispanic race (p = .020), and prior higher level of care (p < .0001) were positively associated with medication use at 1 year. Among Group 2 (n = 256), serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors use was most common, and 62.6% had a reported psychiatric comorbidity. Presence of any psychiatric comorbidity was highly associated with medication use; odds ratio, 10.0 (5.6, 18.0). CONCLUSIONS: Adolescents with restrictive ED treated at referral centers have high rates of reported psychopharmacologic medication use and psychiatric comorbidity. As more than half of this referral population were reported to be taking medication, continued investigation is warranted to ensure the desired outcomes of the medications are being met.
PURPOSE: Psychopharmacologic medications are often prescribed to patients with restrictive eating disorders (EDs), and little is known about the frequency of use in adolescents. We examined the use of psychopharmacologic medications in adolescents referred for treatment of restrictive ED, potential factors associated with their use, and reported psychiatric comorbidities. METHODS: Retrospective data from the initial and 1-year visits were collected for patients referred for evaluation of restrictive ED at 12 adolescent-based ED programs during 2010 (Group 1), including diagnosis, demographic information, body mass index, prior treatment modalities, and psychopharmacologic medications. Additional data regarding patients' comorbid psychiatric conditions and classes of psychopharmacologic medications were obtained from six sites (Group 2). RESULTS: Overall, 635 patients met inclusion criteria and 359 had 1-year follow-up (Group 1). At intake, 20.4% of Group 1 was taking psychopharmacologic medication and 58.7% at 1 year (p ≤ .0001). White, non-Hispanic race (p = .020), and prior higher level of care (p < .0001) were positively associated with medication use at 1 year. Among Group 2 (n = 256), serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors use was most common, and 62.6% had a reported psychiatric comorbidity. Presence of any psychiatric comorbidity was highly associated with medication use; odds ratio, 10.0 (5.6, 18.0). CONCLUSIONS: Adolescents with restrictive ED treated at referral centers have high rates of reported psychopharmacologic medication use and psychiatric comorbidity. As more than half of this referral population were reported to be taking medication, continued investigation is warranted to ensure the desired outcomes of the medications are being met.
Authors: Claire Trainor; Sasha Gorrell; Elizabeth K Hughes; Susan M Sawyer; Claire Burton; Daniel Le Grange Journal: Eur Eat Disord Rev Date: 2020-01-29
Authors: Maedeh Y Beykloo; Dasha Nicholls; Mima Simic; Ruth Brauer; Elizabeth Mills; Ian C K Wong Journal: BMJ Open Date: 2019-09-20 Impact factor: 2.692