Child and Adolescent Psychiatry

Early onset eating disorders

This study took place from March 2005 to May 2006. At this time, early-onset eating disorders (EOED: defined here as onset before 13 years of age) were equally as likely to present to paediatricians as child psychiatrists in the UK. This study, supported by the Royal College of Psychiatrists, aimed to quantify the problem and also examine the circumstances surrounding the onset of illness as well as management regimens.  A one-year follow-up would assess short-term outcomes.

By bpsu · March 1, 2005

Lead investigator

Dr DE Nicholls

About the study

In 2005, early-onset eating disorders (EOED: defined here as onset before 13 years of age) were equally as likely to present to paediatricians as child psychiatrists in the UK.  

Management of these frequently extremely ill children was complicated by a lack of knowledge of the breadth of the problem, difficulties with recognition of eating disorders in this age group and debate over the role of paediatricians versus mental health professionals. Nevertheless, clinical experience suggested that children with EOED underwent admission to paediatric wards before referral to child mental health services.

Epidemiological studies suggested that the incidence of eating disorders, including anorexia nervosa, had been fairly static over the few decades before this study, but there was some suggestion that cases were presenting earlier in adolescence.

Work had focused on the peak ages of onset (15 years for anorexia nervosa and older for bulimia nervosa). As yet, no incidence estimates were available for this specific age group. The only incidence data for eating disorders in the UK were obtained from a GP register study of all age groups undertaken in the early 1990s. Incidence of anorexia nervosa was estimated as 17.5/100,000 in 10-19 year olds, and 0.3/100,000 in 0-9 year olds.  For bulimia nervosa, the rates were 20.5/100,000 and 0/100,000 respectively.  Retrospective studies from the US and Denmark suggested higher figures, e.g. 9-27 per 100,000 10-14 year girls and 3.7 per 100,000 for boys.

Eating disorders in prepubertal and peripubertal children frequently required paediatric admission and long-term medical monitoring as well as psychiatric management.

The study aims to:

  • Estimate the incidence of early onset eating disorders in children in the UK and Ireland.
  • Describe the demographics and family history of children presenting with eating disorders.
  • Describe the range of clinical features at presentation, including other psychiatric illnesses.
  • Delineate patterns of professional involvement (paediatric & child mental health).
  • Characterise the range of acute medical complications experienced by children with early-onset eating disorders.
  • Identify the range of therapeutic interventions used in the management of eating disorders.

Duration

March 2005 – May 2006

Published papers

Nicholls DE, Lynn R, Viner RM. Childhood eating disorders: British national surveillance study. British Journal of Psychiatry. 2011;198(4):295–301. doi:10.1192/bjp.bp.110.081356

BPSU 21st Annual report 2006 -2007

Beat
Web: https://www.beateatingdisorders.org.uk  Email: fyp@beateatingdisorders.org.uk