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J Adolesc Health. 2014 Dec;55(6):750-6. doi: 10.1016/j.jadohealth.2014.06.014. Epub 2014 Sep 4.

Predictors of outcome at 1 year in adolescents with DSM-5 restrictive eating disorders: report of the national eating disorders quality improvement collaborative.

Author information

1
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts. Electronic address: sara.forman@childrens.harvard.edu.
2
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
3
Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts.
4
Division of Adolescent Medicine, Stanford University School of Medicine, Stanford, California.
5
Division of Adolescent Pediatrics, Beaumont Children's Hospital, Royal Oak, Michigan.
6
Division of Adolescent Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
7
Children's Hospital of Colorado, Section of Adolescent Medicine, University of Colorado, Aurora, Colorado.
8
Department of Pediatrics, The Ohio State University, Columbus, Ohio; Nationwide Children's Hospital, Columbus, Ohio.
9
Section of Adolescent Medicine, Department of General Pediatrics, Cleveland Clinic Children's Hospital, Cleveland, Ohio.
10
Division of Adolescent Medicine, Steven and Alexandra Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York; Department of Pediatrics, Hofstra North Shore-Long Island Jewish School of Medicine, Hempstead, New York.
11
Division of Adolescent Medicine, Steven and Alexandra Cohen Children's Medical Center, North Shore-Long Island Jewish Health System, New Hyde Park, New York.
12
Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan.
13
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
14
Department of Pediatrics, University of California, San Francisco, California.
15
Division of Adolescent Medicine, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
16
Group Health Permanente, Group Health Cooperative, Seattle, Washington.
17
Indiana University School of Medicine, Indianapolis, Indiana.
18
Division of Adolescent Medicine, University of California San Francisco, San Francisco, California.

Abstract

PURPOSE:

The National Eating Disorders Quality Improvement Collaborative evaluated data of patients with restrictive eating disorders to analyze demographics of diagnostic categories and predictors of weight restoration at 1 year.

METHODS:

Fourteen Adolescent Medicine eating disorder programs participated in a retrospective review of 700 adolescents aged 9-21 years with three visits, with DSM-5 categories of restrictive eating disorders including anorexia nervosa (AN), atypical AN, and avoidant/restrictive food intake disorder (ARFID). Data including demographics, weight and height at intake and follow-up, treatment before intake, and treatment during the year of follow-up were analyzed.

RESULTS:

At intake, 53.6% met criteria for AN, 33.9% for atypical AN, and 12.4% for ARFID. Adolescents with ARFID were more likely to be male, younger, and had a longer duration of illness before presentation. All sites had a positive change in mean percentage median body mass index (%MBMI) for their population at 1-year follow-up. Controlling for age, gender, duration of illness, diagnosis, and prior higher level of care, only %MBMI at intake was a significant predictor of weight recovery. In the model, there was a 12.7% change in %MBMI (interquartile range, 6.5-19.3). Type of treatment was not predictive, and there were no significant differences between programs in terms of weight restoration.

CONCLUSIONS:

The National Eating Disorders Quality Improvement Collaborative provides a description of the patient population presenting to a national cross-section of 14 Adolescent Medicine eating disorder programs and categorized by DSM-5. Treatment modalities need to be further evaluated to assess for more global aspects of recovery.

KEYWORDS:

ARFID; Adolescents; Anorexia nervosa; Atypical anorexia nervosa; DSM-5; Quality improvement; Restrictive eating disorder; Weight recuperation

[Indexed for MEDLINE]

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