Early-onset eating disorders affect about 3 in every 100,000 children
under the age of 13, according to a new study published in the British
Journal of Psychiatry.
Experts from the UCL (University College
London) Institute of Child Health, who carried out the research, are
calling for “urgent action” to improve both the detection of eating
disorders in young children and availability of services.
The
research team used the well-established British Paediatric Surveillance
Unit of the Royal College of Paediatrics and Child Health and a new
child and adolescent psychiatry surveillance system, to identify new
cases of eating disorders in children aged between 5 and 13 years, and
living in the UK and Republic of Ireland.
Over a 14 month period,
208 cases of early-onset eating disorders were confirmed. The
researchers estimate that this gives an overall incidence rate of 3.01
cases in every 100,000 children. As expected, most of the 208 children
with eating disorders were girls (82%), with boys accounting for 18%.
In
total, 37% of the children were diagnosed with anorexia nervosa. 43%
were classified as having an eating disorder not otherwise specified,
because although they showed symptoms of anorexia they were not
underweight.
Only 1% of the children were diagnosed with bulimia
nervosa or binge eating – which the researchers believe is likely to be
an underestimate. The remaining 19% had symptoms of disordered eating,
such as food avoidance and being underweight, but did not have a
preoccupation with their weight or shape.
104 (50%) of the
children were admitted to hospital for treatment – mainly to paediatric
wards. All the children were followed up after a year. At this time, 130
(73%) had improved, 11 (6%) were worse and 18 (10%) unchanged. Almost
two-thirds (96) of the children were still receiving treatment, with a
small number (7) in hospital for most of the year.
44% of the
children had a close family member with a history of mental illness,
most commonly anxiety or depression. In addition, 20% of the children
had a history of early feeding problems, particularly fussy or picky
eating. According to the researchers, this supports the idea that family
history of mental illness and early feeding problems may be risk
factors in the development of early-onset eating disorders.
Lead
researcher Dr Dasha Nicholls, a consultant child and adolescent
psychiatrist, said: “Our study gives the first estimate of the incidence
of early-onset eating disorders in UK and Irish children. It is too
early to say if there has been a rise in the numbers of children with
eating disorders in recent years, but we hope our research can be used
as a baseline from which to monitor future trends.”
Dr Nicholls
continued: “Unfortunately, many eating disorder services are aimed
specifically at adolescents. Childhood eating disorders are not quick or
easy to treat. For a minority of children it may be the start of a
severe and enduring illness, with death rates comparable to some forms
of leukaemia. Our study shows there is an urgent need to consider the
needs of children with eating disorders separately – and not simply
lower the age range of existing adolescent services.”
Reference
Nicholls
DE, Lynn R and Viner RM. Childhood eating disorders: British national
surveillance study. British Journal of Psychiatry 2011; 198: 295-301
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