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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry
Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,532
Minerva Pediatrica 2013 April;65(2):199-206
Treatment of eating disorders during hospitalization: presentation of a hospital intensive care program in pediatric age
D’Argenio L. 1, Zaccagnino M. 1, 3, Donati C. 2, Perini A. 1, Fazzi E. 1, 3 ✉
1 Unità Operativa di Neuropsichiatria dell’Infanzia e dell’Adolescenza, Spedali Civili, Brescia, Italia;
2 ASL Brescia,Brescia, Italia;
3 Unità di Neuroriabilitazione Precoce, Spedali Civili, Brescia, Italia
Aim: The aim of this study was to present a hospital intensive care program for patients affected by a severe eating disorders, with a significant loss of weight (BMI<15 and weight less than 25° centile), severe medical complications (orthostatic hypotension, bradycardia <40 bpm or tachycardia >110 bpm or inability to sustain core body temperature), abnormal laboratory data, especially electrolyte imbalance and refusal to take food and fluids.
Methods: In our study we reported 2 year follow-up of 16 patients treated with the hospital intensive care program between 2007 and 2008 in our department.
Result: The proposed program was proved an efficient method in a critical phase of the alimentary behavior disorders. It was possible for all the patients to avoid alternative feeding techniques (enteral or parenteral) and to obtain a correct alimentation with a satisfactory improvement of clinical conditions. Eight patients (50%) fully recovered. 5 patients (31.25%) had a significant improvement reaching a BMI>18.5 and one of them had a regular menstrual cycle, too. However in this group of patients a strict modality to alimentation and concern about weight and physical appearance remain. In 3 patients (18.5%) the BMI is still low and amenorrhea persists.
Conclusions: The hospital intensive care program, inspired by the cognitive-behavioral model, through a food rehabilitation and a psychotherapeutic and psychoeducational help, lets the patients and their family understand and modify the dysfunctional patterns, experimenting a right modality to approach alimentation, with a satisfactory improvement in clinical conditions.