Clinical Characteristics of Adolescents with Eating Disorders

Öz

Eating disorders (EDs) are psychiatric conditions often beginning in adolescence, with increasing prevalence and significant comorbidities. This study aimed to present data from adolescents diagnosed with EDs to raise awareness. Patients presenting to our Adolescent Health Outpatient Clinic between June 2019 and June 2023 were included. Age, sex, presenting complaints, clinical and follow-up characteristics (symptom duration, weight loss, menstrual history, comorbidities, hospitalization, follow-up) were retrospectively collected from hospital records. A total of 76 patients (two males, 2.6%) were included: 21 (27.6%) with anorexia nervosa (AN), 46 (60.5%) with atypical AN (AAN), seven (9.2%) with bulimia nervosa (BN), and two (2.6%) with avoidant/restrictive food intake disorder (ARFID). The mean age at presentation was 15.4 ± 1.4 years (range 12.3–17.8), and median follow-up was seven months (range 2–14). The most common presenting complaint in AN and AAN groups was food restriction. Weight loss and hospitalization rates were similar between AN and AAN patients (p = 0.215 and 0.329, respectively). Secondary amenorrhea occurred in half of AN patients (n = 10) and in 45.5% of AAN patients (n = 20) (p = 0.736). Refeeding syndrome was not observed. Two patients in each of the AN, AAN, and BN groups had comorbid depression, and one patient in the AAN group had comorbid anxiety disorder. EDs in adolescence may require hospitalization and structured follow-up. As diagnosis largely depends on clinical interview and history, routine assessment of nutritional and psychosocial history is essential for accurate diagnosis, follow-up, and evaluation of comorbidities.

Anahtar Kelimeler

• Adolescence
• eating disorder
• anorexia nervosa
• bulimia nervosa
• avoidant/restrictive food intake disorder

Yeme Bozukluğu Tanılı Ergenlerin Klinik Özellikleri

Öz

Yeme bozuklukları sıklıkla ergenlik döneminde başlayan, sıklığı giderek artan, önemli komorbiditeleri olan psikiyatrik hastalıklardır. Bu çalışmada yeme bozukluğu nedeniyle izlenen hastaların verileri sunularak, bu konudaki farkındalığın artırılması amaçlandı. Haziran 2019-Haziran 2023 tarihleri arasında hastanemiz Ergen Sağlığı polikliniğine başvuran ve yeme bozukluğu tanısı alan olgular çalışmaya dahil edildi. Olguların yaş, cinsiyet, başvuru şikayetleri, klinik ve izlem özellikleri (şikayetlerin süresi, kilo kaybı düzeyi, menstrual öyküleri, komorbiditeler, hastaneye yatış, izlem süresi) hastane kayıtlarından geriye dönük olarak değerlendirildi. Çalışmaya ikisi (%2,6) erkek, 76 yeme bozukluğu tanısı alan olgu dahil edildi. Olguların 21’i (%27.6) anoreksiya nervoza (AN), 46’sı (%60,5) atipik AN (AAN), yedisi (%9,2) bulimiya nervoza (BN) ve ikisi (%2,6) kaçıngan/kısıtlı yiyecek alımı bozukluğu (‘Avoidant/restrictive food intake disorder’, ARFID) idi.  Olguların başvuru yaşları ortalama 15.4 ± 1.4 15,41,4 yıl (yaş aralığı 12,3-17,8), ortalama izlem süreleri 7 (2-14) ay idi. AN ve AAN grubunda en sık başvuru şikayeti gıda alımının kısıtlanması idi. AN ve AAN gruplarında kilo kaybı yüzdeleri ve hastaneye yatış yüzdeleri benzer bulundu (p sırasıyla 0,215 ve 0,329). AN grubunun yarısında (n:10) ve AAN grubunun %45,5’inde (n:20) sekonder amenore mevcuttu (p=0,736). Olguların hiçbirinde yeniden beslenme sendromu görülmedi. AN, AAN ve BN gruplarında ikişer olguda depresyon, AAN grubunda bir olguda anksiyete bozukluğu eşlik ettiği gözlendi. Yeme bozuklukları ergenlik döneminde hastane yatışı gerekebilen, izlemin önemli ve özellikli olduğu hastalıklardır. Tanı büyük ölçüde klinik görüşme ve öyküye dayandığından, tüm ergenlerin rutin değerlendirmelerinin bir parçası olarak beslenme öyküsü ve psikososyal öykü alınması; tanı, izlem ve komorbiditelerin değerlendirilmesi açısından gereklidir

Anahtar Kelimeler

• Ergenlik
• yeme bozukluğu
• anoreksiya nervoza
• bulimiya nervoza
• kaçıngan/kısıtlı yiyecek alımı bozukluğu

Kaynakça

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