Monday, July 17, 2023

Youth With Eating Disorders More Likely to Use Health Care Services

Children and adolescents who have eating disorders are more likely than those without eating disorders to use most mental health and non-mental health services, a study in the International Journal of Eating Disorders has found. The study also found that children and adolescents who have avoidant restrictive intake disorder (ARFID) use mental health and non-mental health services about the same as those youth with other eating disorders, with the exception of those who have anorexia nervosa.

“It is important to examine these patterns of utilization in order to identify specific needs and areas for system improvements for specific subgroups of patients with eating disorders,” wrote Jennifer Couturier, M.D., M.Sc., of McMaster University in Hamilton, Ontario, and colleagues. “[W]e wanted to examine differences between ARFID and the other subgroups, as we are not aware of any literature on health care utilization in the ARFID population.”

The researchers examined the health records of 1,449 patients aged 5 to 17 years who had eating disorders and compared them to the health records of 7,245 patients in the same age group in the general population who did not have eating disorders. The patients in the eating disorders group had been diagnosed within two years of their inclusion in the study and included 674 with anorexia nervosa, 230 with bulimia nervosa, 59 with binge-eating disorder, 171 with avoidant restrictive intake disorder, and 315 with other eating disorders. Outcomes included hospitalizations for mental health or non-mental problems and emergency department, psychiatry, general practitioner, and pediatrician visits.

The researchers found that the use of mental health services was higher in all of the subgroups of patients with eating disorders compared with patients in the general population. Likewise, the use of non-mental health care services was higher among patients in all of the subgroups compared with the general population except for general practitioner visits and emergency department visits, which were not significantly different from that of the general population.

Couturier and colleagues then compared the use of mental health and non-mental health services by patients who had ARFID with that of all the other patients who had eating disorders. Patients with ARFID appeared to use mental health and non-mental health care services about the same as patients with other eating disorders, except for those with anorexia nervosa. Compared with patients with ARFID, patients with anorexia nervosa had 1.62 higher odds of a mental health–related hospitalization, 1.76 times the rate of pediatrician visits for mental health, and 1.69 times the rate of psychiatry visits.

The researchers noted comments by authors of other studies to suggest that health professionals working outside of eating disorder programs may not have familiarity and experience diagnosing ARFID.

“These challenges suggest that more training and specialized services [need to] be developed for those with ARFID as [mental health and non-mental health service] utilization is similar to those with other eating disorders,” Couturier and colleagues concluded.

For related information, see the Psychiatric News Special Report “Youth With Eating Disorders—Time Is of the Essence in Achieving Remission” and The American Psychiatric Association Practice Guideline For The Treatment Of Patients With Eating Disorders, Fourth Edition.

(Image: iStock/Anastasija Vujic)

Don’t Miss Out on Free Webinars Coming This Week

APA and Morehouse School of Medicine African American Behavioral Health Center of Excellence have joined forces to create a series of webinars and training modules on addressing mental health disparities among Black Americans. Two webinars that are part of this educational series will take place this week:


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