Yaffa Serur, Adi Enoch-Levy, Itai Pessach, Marit Joffe-Milstein, Doron Gothelf, Daniel Stein
Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.
Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.
J Eat Disord. 2021 Feb 10;9(1):17. doi: 10.1186/s40337-021-00374-z.
Eating disorders (EDs) are among the most difficult psychiatric disorders to treat in normal conditions. They are likely even more difficult to manage in at-risk conditions such as the COVID-19 pandemic. Currently there is limited evidence about the particular needs and recommended treatment of adolescents with EDs during the COVID-19 outbreak, in particular regarding the use of telemedicine and the involvement of the family in long distance-treatment.
We sought to discuss the advantages and problems associated with the use of multi-professional long-distance telemedicine treatment in the management of adolescents with EDs and their families during the COVID-19 outbreak.
We gathered data about the treatment of adolescents with EDs in our pediatric ED-treatment center in Israel during the COVID-19 outbreak in the first 10 months of 2020, and compared it to the respective period in the past five years (2015-2019). Second, we described the management of four young females with anorexia nervosa (AN), treated in the ambulatory, daycare and inpatient facilities of our center during the COVID-19 pandemic.
Slightly less patients were treated in our center during the COVID-19 pandemic than in the respective period in the past five years. These patients received at that time considerably more treatment sessions from all treatment providers (psychiatrists, clinical nutritionists and psychotherapists). This was related, in part, to the extensive use of telemedicine during that period (more than as third of all sessions were carried out with telemedicine in comparison to no use of long-distance treatment in the previous years). The condition of the four adolescents with AN was compromised at the start of the COVID-19 quarantine. The use of multi-disciplinary long-distance telemedicine treatment resulted in an improvement in the condition in three of the four adolescents, living in well-organized families, with the motivation and ability to adjust to the new conditions, but not in one adolescent whose family experienced more problems. These families might require the use of face-to-face interventions even during pandemic conditions.
The choice of the mode of treatment for adolescents with EDs during pandemic times (telemedicine vs. face-to-face) should consider the functioning of the family.
饮食失调是正常情况下最难治疗的精神疾病之一。在诸如新冠疫情这样的高危情况下，治疗可能会更加困难。目前，关于新冠疫情期间患有饮食失调症的青少年的特殊需求和推荐治疗方法的证据有限，特别是在远程医疗的使用以及家庭在远程治疗中的参与方面。
我们试图探讨在新冠疫情期间，使用多专业远程医疗治疗患有饮食失调症的青少年及其家庭的优势和问题。
我们收集了2020年新冠疫情爆发的前10个月期间，以色列儿科饮食失调治疗中心对患有饮食失调症青少年的治疗数据，并将其与过去五年（2015 - 2019年）的相应时期进行比较。其次，我们描述了在新冠疫情期间，在我们中心的门诊、日间护理和住院设施中接受治疗的四名神经性厌食症（AN）年轻女性的治疗情况。
与过去五年的相应时期相比，新冠疫情期间我们中心治疗的患者略少。这些患者当时从所有治疗提供者（精神科医生、临床营养师和心理治疗师）那里接受的治疗疗程要多得多。这部分与该时期远程医疗的广泛使用有关（与前几年未使用远程治疗相比，超过三分之一的疗程是通过远程医疗进行的）。在新冠疫情隔离开始时，四名患有神经性厌食症的青少年的病情受到影响。多学科远程医疗治疗使四名青少年中的三名病情得到改善，这些青少年家庭组织良好，有适应新情况的动机和能力，但一名家庭问题较多的青少年病情未得到改善。即使在疫情期间，这些家庭可能也需要面对面的干预措施。
在疫情期间，为患有饮食失调症的青少年选择治疗方式（远程医疗与面对面治疗）时应考虑家庭的功能状况。
