A decade of data from a specialist statewide child and adolescent eating disorder service: does local service access correspond with the severity of medical and eating disorder symptoms at presentation?

Journal of Eating Disorders

Chloe Shu³  David A Forbes²  Julie Potts¹  Julie McCormack¹  Matthew Hamilton³  Sarah J Egan³  Hunna J Watson⁴  Kimberley J Hoiles³  Jeremy Alman³ 

[1]Eating Disorders Program, Child and Adolescent Mental Health Service, Child and Adolescent Health Service, Roberts Road, Subiaco, Western Australia, Australia

[2]School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, Australia

[3]School of Psychology and Speech Pathology, Division of Health Sciences, Curtin University, Kent St, Bentley, Western Australia, Australia

[4]Princess Margaret Hospital for Children Eating Disorders Program, Perth 6840, Western Australia, Australia

关键词: Rural;    Medical complications;    HOPE Project;    Eating disorders;    Child;    Adolescent;   

Others  :  1133349
DOI  :  10.1186/s40337-014-0032-0

 received in 2014-06-25, accepted in 2014-10-15,  发布年份 2014

【 摘 要 】

Background

Eating disorders affect up to 3% of children and adolescents, with recovery often requiring specialist treatment. A substantial literature has accrued suggesting that lower access to health care services, experienced by rural populations, has a staggering effect on health-related morbidity and mortality. The aim of this study was to evaluate whether lower service access foreshadowed a more severe medical and symptom presentation among children and adolescents presenting to a specialist eating disorders program.

Method

The data source was the Helping to Outline Paediatric Eating Disorders (HOPE) Project registry (N ~1000), a prospective ongoing registry study comprising consecutive paediatric tertiary eating disorder referrals. The sample consisted of 399 children and adolescents aged 8 to 16 years (M =14.49, 92% female) meeting criteria for a DSM-5 eating disorder.

Results

Consistent with the hypotheses, lower service access was associated with a lower body mass index z-score and a higher likelihood of medical complications at intake assessment. Contrary to our hypothesis, eating pathology assessed at intake was associated with higher service access. No relationship was observed between service access and duration of illness or percentage of body weight lost.

Conclusions

Lower service access is associated with more severe malnutrition and medical complications at referral to a specialist eating disorder program. These findings have implications for service planning and provision for rural communities to equalize health outcomes.

【 授权许可】

   
2014 Alman et al.; licensee BioMed Central Ltd.

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