Sravanti Lakshmi, Velusamy Arul, Karki Utkarsh, Kommu John Vijay Sagar, Girimaji Satish Chandra
Dept. of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Oxfordshire CAMHS NDC Pathway Team, Oxford, United Kingdom.
Indian J Psychol Med. 2024 Jul;46(4):323-329. doi: 10.1177/02537176231222574. Epub 2024 Feb 4.
Anorexia nervosa is one of the least studied mental health conditions in the Indian setting. The objective of this study was to assess the course and outcome of anorexia nervosa in adolescents who had presented to a tertiary care child and adolescent psychiatry center over a period of 10 years.
The present study is a retrospective chart review of adolescents (up to the age of 18 years) with a diagnosis of anorexia nervosa, coded as F50.0 or F50.1 according to ICD 10, from 1 April 2009 to 31 March 2019. Data were extracted from the case records using standardized abstraction forms and evaluated using descriptive and nonparametric statistics.
The average age at presentation and the average age at onset were 14.1 years and 13.1 years, respectively. The male-to-female ratio of the sample who got admitted was 1:9. The average duration of hospital stay was about 30 days. The duration of in-patient care and weight gain were positively correlated, with severe to extremely ill adolescents improving even in less than one month of in-patient care. Seventy per cent of the admitted adolescents followed up. The functional outcome as measured by a 'return to school' improved in 57.1% of the sample.
The present study highlights the collaborative multidisciplinary and individualized treatment approach employed for adolescents diagnosed with anorexia nervosa within an inpatient mental health facility in India. Adolescents who presented with more severe illness at the initial assessment, such as an early onset of symptoms and a low BMI, experienced substantial weight gain that exhibited a positive correlation with the length of their stay in the inpatient facility.
神经性厌食症是印度研究最少的心理健康状况之一。本研究的目的是评估在10年期间到三级儿童和青少年精神病学中心就诊的青少年神经性厌食症的病程和结局。
本研究是一项回顾性病历审查，对象为2009年4月1日至2019年3月31日期间诊断为神经性厌食症（根据国际疾病分类第10版编码为F50.0或F50.1）的青少年（年龄在18岁及以下）。使用标准化提取表格从病例记录中提取数据，并使用描述性和非参数统计进行评估。
就诊时的平均年龄和发病时的平均年龄分别为14.1岁和13.1岁。入院样本的男女比例为1:9。平均住院时间约为30天。住院护理时间和体重增加呈正相关，病情严重至极重的青少年即使在住院护理不到一个月的时间里也有改善。70%的入院青少年进行了随访。以“返校”衡量的功能结局在57.1%的样本中有所改善。
本研究强调了印度一家住院心理健康机构对诊断为神经性厌食症的青少年采用的协作多学科和个体化治疗方法。在初始评估时病情更严重的青少年，如症状早发和体重指数较低者，体重有显著增加，且与他们在住院机构的停留时间呈正相关。
