Department of Child & Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH, UK.
Br J Psychiatry. 2011 Apr;198(4):295-301. doi: 10.1192/bjp.bp.110.081356.
The incidence of eating disorders appears stable overall, but may be increasing in younger age groups. Data on incidence, clinical features and outcome of early-onset eating disorders are sparse.
To identify new cases of early-onset eating disorders (<13 years) presenting to secondary care over 1 year and to describe clinical features, management and 1-year outcomes.
Surveillance over 14 months through the established British Paediatric Surveillance System, and a novel child and adolescent psychiatry surveillance system set up for this purpose.
Overall incidence was 3.01/100,000 (208 individuals). In total, 37% met criteria for anorexia nervosa; 1.4% for bulimia nervosa; and 43% for eating disorder not otherwise specified. Nineteen per cent showed determined food avoidance and underweight without weight/shape concerns. Rates of comorbidity were 41%; family history of psychiatric disorder 44%; and early feeding difficulties 21%. Time to presentation was >8 months. A total of 50% were admitted to hospital, typically soon after diagnosis. Outcome data were available for 76% of individuals. At 1 year, 73% were reported improved, 6% worse and 10% unchanged (11% unknown). Most were still in treatment, and seven were hospital in-patients for most of the year.
Childhood eating disorders represent a significant clinical burden to paediatric and mental health services. Efforts to improve early detection are needed. These data provide a baseline to monitor changing trends in incidence.
尽管总体上进食障碍的发病率似乎保持稳定，但在年龄较小的人群中可能正在增加。关于发病、临床特征和早期发病进食障碍的结局的数据很少。
确定在 1 年内到二级医疗机构就诊的 13 岁以下早期发病进食障碍（<13 岁）的新发病例，并描述其临床特征、治疗方法和 1 年结局。
通过既定的英国儿科监测系统以及为此目的建立的新的儿童和青少年精神病学监测系统，在 14 个月期间进行监测。
总体发病率为 3.01/100,000（208 人）。共有 37%符合神经性厌食症标准；1.4%符合神经性贪食症标准；43%符合其他特定的进食障碍标准。19%表现为坚决回避食物和体重减轻，但没有体重/体型方面的担忧。共病率为 41%；有 44%的家族精神病史；21%存在早期喂养困难。从出现症状到就诊的时间>8 个月。共有 50%的人住院，通常是在确诊后不久。共有 76%的人提供了结局数据。1 年后，有 73%的人报告得到改善，6%的人情况变差，10%的人情况不变（11%的人情况未知）。大多数人仍在接受治疗，7 人在一年中大部分时间住院。
儿童期进食障碍给儿科和精神卫生服务带来了重大的临床负担。需要努力提高早期发现率。这些数据为监测发病率变化趋势提供了基线。
