Magazine article Clinical Psychiatry News
Two Subtypes of Food Refusal in Preteens Found
SAN DIEGO -- The presence or absence of body image distortion can help clinicians identify two distinct groups of latency-age children who present with severe food refusal, Robyn S. Mehlenbeck, Ph.D., reported at the annual meeting of the Society for Developmental and Behavioral Pediatrics.
The finding is important because latency-age patients do not fit neatly into categories of anorexia or feeding disorder of early childhood, said Dr. Mehlenbeck of the department of psychiatry at Rhode Island Hospital, Brown Medical School, Providence, R.I.
"There's a lot of confusion about these kids who don't fit [a definition] and we really don't know what to call them, let alone what to do with them," she said, adding that there are no good estimates on the number of younger children with eating disorders.
She and her associates reviewed the medical charts of 44 patients, aged 6-12 years, who presented with food refusal and restrictive eating habits to a day treatment program at Rhode Island Hospital between 1999 and 2003. The treatment program takes a multidisciplinary team approach, collaborating closely with families and community providers.
At intake, families completed questionnaires about behavioral and family functioning, and quality of life. The mean age of study participants was 10 years, and more than half of the participants were female (67%). Most were white (82%), and 30% were on public insurance. The average length of stay in the program was 21 days.
The investigators divided the children into two groups. The 16 children who presented with body image distortion were called the early onset anorexia (EOA) group, while the 28 who presented with no body image distortion were called the atypical eating disorder (AED) group.
The two groups of children did not differ in terms of gender, insurance type, or program length of stay, but children in the AED group were about 2 years younger than their EOA counterparts (a mean of 9. …