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Yaffa S, Adi EL, Itai P, Marit JM, Doron G, Daniel S. Treatment of eating disorders in adolescents during the COVID-19 pandemic: a case series. J Eat Disord 2021; 9:17. [PMID: 33568207 PMCID: PMC7874990 DOI: 10.1186/s40337-021-00374-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND 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. AIMS 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. METHODS 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. FINDINGS 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. CONCLUSION 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.
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Affiliation(s)
- Serur Yaffa
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Enoch-Levy Adi
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Pessach Itai
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Joffe-Milstein Marit
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel
| | - Gothelf Doron
- Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, 69978, Tel Aviv, Israel
| | - Stein Daniel
- Pediatric Psychosomatic Department, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Child and Adolescent Psychiatric Division, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 5265601, Tel Hashomer, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, 69978, Tel Aviv, Israel.
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Potterton R, Richards K, Allen K, Schmidt U. Eating Disorders During Emerging Adulthood: A Systematic Scoping Review. Front Psychol 2020; 10:3062. [PMID: 32082210 PMCID: PMC7005676 DOI: 10.3389/fpsyg.2019.03062] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/26/2019] [Indexed: 01/20/2023] Open
Abstract
Background: Eating disorders (EDs) during the transition to adulthood can derail social, psychological, and vocational development. Effective treatment is of paramount importance, yet young adults' treatment needs are typically less well met than those of adolescents. In recent years, there has been a considerable shift in how developmental psychologists understand the transition to adulthood, with this life-phase reconceptualized as "emerging adulthood" (EA) (~18-25 years). Engagement with burgeoning developmental research is likely key to providing more effective care for young people experiencing EDs. Aims: To review ED research which has utilized the concept of EA, and to assess the usefulness of this concept for ED research and practice. Methods: A systematic scoping review was conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Three databases (Psychinfo, PubMed, Embase) were searched for papers which explicitly focused on EDs during EA. No restrictions as to publication type, language, study design, or participants were applied. Included studies were assessed for developmental "informedness," and findings were qualitatively synthesized. Results: Thirty-six studies (N = 25,475) were included in the review. Most studies used quantitative methodologies, were cross-sectional in design and focused on identifying psychological and social factors which contribute to etiology of EDs. Many studies (N = 22) used well-defined samples of emerging adults (EAs); few studies (N = 8) included developmental measures relevant to EAs. Findings indicate that whilst factors implicated in EDs in adolescence and adulthood are relevant to EAs, EA-specific factors (e.g., identity exploration) may also contribute. Conventional ED services and treatments present difficulties for EAs, whilst those adapted to EAs' needs are feasible, acceptable, and more effective than treatment-as-usual. Directions for future research and clinical implications are discussed. Conclusion: Existing research indicates that the EA concept is relevant for understanding EDs during the transition to adulthood, and ED services should implement adaptations which exploit the opportunities and overcome the challenges of this developmental stage. EA is currently an underused concept in ED research, and future engagement with the developmental literature by both researchers and clinicians may be key to understanding and treating EDs during transition to adulthood.
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Affiliation(s)
- Rachel Potterton
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Katie Richards
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Karina Allen
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Ulrike Schmidt
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Banerjee SC, Greene K, Yanovitzky I, Bagdasarov Z, Choi SY, Magsamen-Conrad K. Adolescent egocentrism and indoor tanning: is the relationship direct or mediated? JOURNAL OF YOUTH STUDIES 2014; 18:357-375. [PMID: 28042281 PMCID: PMC5198897 DOI: 10.1080/13676261.2014.963536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This paper explored how imaginary audience and personal fable ideations contribute to adolescent indoor tanning intentions directly and indirectly through the way they shape pro-tanning attitude and association with peers who use tanning beds. Five hundred and ninety-five male (n = 207) and female (n = 387) adolescents, ranging in age from 11 to 19 (M = 16.87; SD = 1.34) years completed a cross-sectional survey. Measures included imaginary audience, personal fable (three dimensions: invulnerability, uniqueness, and omnipotence), pro-tanning attitude, association with peers who use tanning beds, and tanning bed use intentions. Bootstrapping analyses documented that imaginary audience ideations are indirectly associated with indoor tanning intentions through the mediation of pro-tanning attitude and association with peers who use tanning beds. Of the personal fable ideations, only invulnerability ideation is indirectly associated with indoor tanning intentions through the mediation of association with peers who use tanning beds. Design and evaluation of interventions and campaigns to reduce indoor tanning must be targeted to adolescents varying in imaginary audience ideations differently.
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Affiliation(s)
- Smita C. Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Itzhak Yanovitzky
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Zhanna Bagdasarov
- Communication and Health Issues Partnership for Education and Research, Rutgers University, New Brunswick, NJ, USA
| | - Soe Yoon Choi
- Department of Communication, Rutgers University, New Brunswick, NJ, USA
| | - Kate Magsamen-Conrad
- Department of Communication, Bowling Green State University, Bowling Green, OH, USA
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Abstract
The current study aimed to explore the personal meaning of eating difficulties. Eight women with a variety of eating issues were interviewed. These conversations were then analysed using Interpretative Phenomenological Analysis to construct a framework for understanding the personal world of the interviewees. Three overarching themes identified in participants’ accounts of their experiences are reported here: the experience of the eating difficulties as functional; negative effects of having eating difficulties; ambivalence towards the eating difficulties. These themes add to our knowledge of the potential role of personal experiences in the aetiology and maintenance of eating difficulties.
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Affiliation(s)
- Andrew P. Fox
- University of Birmingham, UK & Birmingham and Solihull Mental Health NHS Foundation Trust, UK,
| | | | - Newman Leung
- University of Birmingham, UK & Birmingham and Solihull Mental Health NHS Foundation Trust, UK
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