Type of setting for the inpatient adolescent with an eating disorder: Are specialized inpatient clinics a must or will the pediatric ward do?


AKGÜL S., Pehlivanturk-Kizilkan M., Ors S., DERMAN O., Duzceker Y., KANBUR N.

TURKISH JOURNAL OF PEDIATRICS, vol.58, no.6, pp.641-649, 2016 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 58 Issue: 6
  • Publication Date: 2016
  • Doi Number: 10.24953/turkjped.2016.06.010
  • Journal Name: TURKISH JOURNAL OF PEDIATRICS
  • Journal Indexes: Science Citation Index Expanded, Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.641-649
  • Keywords: admission, adolescents, clinical setting, eating disorder, ANOREXIA-NERVOSA, REFEEDING SYNDROME, WEIGHT

Abstract

There are a range of different services for treating adolescent eating disorders (ED) but there is no clinical consensus and a paucity of research indicating which type of treatment setting is the best. Although it would be ideal to have a specialized ward for these patients what happens when this is not possible? The aim of this study was to evaluate patients with ED hospitalized on a general pediatric ward. A retrospective chart review for 37 patients hospitalized for an ED and followed by a team consisting of an adolescent medicine specialist, a child and adolescent psychiatrist and a dietician on a pediatric ward were re-evaluated. Twenty-four (64.9%) patients were diagnosed with anorexia nervosa (AN) restricting type, 8 (21.6%) with anorexia nervosa binging purging type, 3 (8.1%) with bulimia nervosa (BN) and 2 (5.4%) with eating disorder otherwise not specified. The mean age at admission was 14.79 +/- 1.75 years and 7 (20%) were males. A majority were hospitalized due to medical instability. Mean period of time from admittance to medical stabilization was 6.04 +/- 4.79 days. The mean period of admittance was 26.4 +/- 11.9 days for AN and 23.7 +/- 15.03 days for BN patients. The mean calorie intake of the AN group was 607 +/- 333 kcal and 2,358 +/- 605 kcal at hospitalization and discharge, respectively. Hypophosphatemia occurred in 2 patients during refeeding. Mean total weight gained during the whole hospitalization period was 3,950 +/- 3,524grs. This study shows that although not ideal, EDs can successfully be followed on general pediatric wards and could have implications at centers with no specialized wards.