Recognition and duration of illness in adolescent eating disorders: Parental perceptions of symptom onset
Recognition and duration of illness in adolescent eating disorders: Parental perceptions of symptom onset
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DOI：
10.1111/eip.13224
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发表时间：
2021-08-26
影响因子：
2
通讯作者：
Nicholls, Dasha
中科院分区：
文献类型：
--
作者：
Rosello, Rocio;Gledhill, Julia;Nicholls, Dasha
目的了解父母最早报告的提示其子女可能患有进食障碍（艾德）的体征，并量化从症状发作到专家评估的时间。方法这是一个二次分析的数据来自父母的78个年轻人提出的英国社区艾德服务谁完成了一份问卷调查，询问他们第一次注意到他们的孩子显示（a）饮食模式的变化，（B）体重的问题，（c）形状的问题。父母也被要求描述他们注意到的第一件事，可能的艾德症状。结果平均年龄14.9岁（SD：1.58），女性94%，其中神经性厌食症50例，神经性贪食症10例，非典型神经性厌食症18例。在评估前一年内最常注意到体重和体型问题（平均分别为12.7个月[SD：12.8]和13.3个月[SD：13.2]），在转诊至专科护理前平均观察到饮食模式改变9.7个月（SD：7.6）。根据父母对孩子症状的描述，提出了七个主题：（1）饮食模式改变，（2）形状问题，（3）体重问题，（4）观察到的体重减轻，（5）暴食/补偿行为，（6）其他心理健康问题和（7）身体症状。结论最常见的父母担心的是饮食模式的改变，特别是他们的孩子变得更加严格/规则约束方面的饮食和饮食限制。这些外部变化可能在体重减轻等身体变化之前观察到，这为父母、初级保健和其他专业人员提供了早期识别的可能性，并对改善预后产生影响。
Aim To understand the earliest parent reported signs suggesting their child may have an eating disorder (ED), and to quantify time from symptom onset to specialist assessment. Methods This is a secondary analysis of data derived from parents of 78 young people presenting to a British community ED service who completed a questionnaire asking when they first noticed their child displaying (a) a change in eating pattern, (b) weight concerns, (c) shape concerns. Parents were also asked to describe the first thing they noticed in terms of possible ED symptoms. Results Mean age was 14.9 (SD: 1.58), 94% were female with diagnoses of anorexia nervosa (n = 50), bulimia nervosa (n = 10) and atypical anorexia nervosa (n = 18). Weight and shape concerns were most often noticed over a year prior to assessment (mean 12.7 months [SD: 12.8] and 13.3 months [SD: 13.2], respectively), with eating pattern change observed a mean of 9.7 months (SD: 7.6) before referral to specialist care. Seven main themes were developed from parents' descriptions of their child's symptoms: (1) eating pattern change, (2) shape concern, (3) weight concern, (4) observed weight loss, (5) binge eating/compensatory behaviours, (6) other mental health concerns and (7) physical symptoms. Conclusions The most common parental concerns were eating pattern change, specifically their child becoming more rigid/rule-bound with regard to eating and dietary restraint. Such external changes are likely observed before physical changes such as weight loss, offering potential for early identification by parents, primary care and other professionals, with implications for improved prognosis.