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Martínez-Vega R, Maduforo AN, Renzaho A, Alaazi DA, Dordunoo D, Tunde-Byass M, Unachukwu O, Atilola V, Boatswain-Kyte A, Maina G, Hamilton-Hinch BA, Massaquoi N, Salami A, Salami O. Scoping review on mental health standards for Black youth: identifying gaps and promoting equity in community, primary care, and educational settings. Child Adolesc Psychiatry Ment Health 2024; 18:113. [PMID: 39252127 PMCID: PMC11385802 DOI: 10.1186/s13034-024-00800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 08/20/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Youth mental health is a growing concern in research, practice, and policy. Practice standards, guidelines, or strategies provide an invisible infrastructure that fosters equity, quality, and safety, potentially addressing inconsistencies and more effectively attending to the mental wellness of Black youth as a particular population of concern. This scoping review aimed to address the following question: What standards exist for the delivery of mental health services to Black youth in community, primary care, and educational settings? Due to a limited initial search yield on publications about standards for the delivery of mental health services for Black youth population, our goal was then to identify and map mental health standards, recommendations, or guidelines for the delivery of mental health services using the same settings to all youth. METHODS Searches were conducted in various databases, including PubMed/MEDLINE, PsycINFO, Embase, SocINDEX, CINAHL, Gender Studies Database, Social Services Abstracts, Sociological Abstracts, Scopus, Web of Science, and Google Scholar. Screening was independently conducted by two reviewers, with disagreements resolved by a third. Information extraction was performed by two independent reviewers. RESULTS Out of the 2,701 screened publications, 54 were included in this scoping review. Among them, 38.9% were published between 2020 and 2023, with 40.7% originating from the United States of America, 20.4% from the United Kingdom, and 13% from Canada. Concerning the settings, 25.9% of the publications focused on primary care, 24.1% on health care services, 20.4% on educational settings, and 3.7% on the community. Additionally, 25.9% were classified as general because recommendations were applicable to various settings. Attention-deficit/hyperactivity disorder (11.1%) was the most frequently considered specific condition, followed by autism spectrum disorder (9.3%) and depression (9.3%). However, 31.5% of the included references addressed mental health in general. Only three references provided specific recommendations for the Black population. CONCLUSIONS Recommendations, guidelines, or standards for Black youth mental health services in community, primary care, or educational settings are scarce and limited to North American countries. This scoping review emphasizes the need to consider ethnicity when developing guidelines or standards to improve racial equity and reduce disparities in access to mental health services.
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Affiliation(s)
- Ruth Martínez-Vega
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | - Aloysius Nwabugo Maduforo
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | - Andre Renzaho
- School of Medicine, Western Sydney University, David Pilgrim AvenueNSW2560, Campbelltown , Australia
| | - Dominic A Alaazi
- School of Health Studies, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Dzifa Dordunoo
- School of Nursing, University of Victoria, HSD Building A402A, Victoria, VIC, Canada
| | - Modupe Tunde-Byass
- Temerty Faculty of Medicine, University of Toronto, 123 Edward Street, Suite 1200, Toronto, Canada
| | - Olutoyosi Unachukwu
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | - Victoria Atilola
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada
| | | | - Geoffrey Maina
- College of Nursing, University of Saskatchewan, 173-1061 Central Avenue, PrinceAlbert, Canada
| | - Barbara-Ann Hamilton-Hinch
- Dalhousie University, Nova Scotia. School of Health and Human Performance, 5981 University Avenue, Room 4210F, Halifax, Canada
| | - Notisha Massaquoi
- Department of Health and Society, University of Toronto, Scarborough, 246 Bloor Street W, Toronto, Canada
| | - Azeez Salami
- Alberta Health Services, 604 Main Street S, T4B 3K7, Airdrie, Alberta, Canada
| | - Oluwabukola Salami
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, Calgary, Canada.
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Arruda W, Bélanger SA, Cohen JS, Hrycko S, Kawamura A, Lane M, Patriquin MJ, Korczak DJ. Promoting optimal mental health outcomes for children and youth. Paediatr Child Health 2023; 28:417-436. [PMID: 37885601 PMCID: PMC10599492 DOI: 10.1093/pch/pxad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/04/2022] [Indexed: 10/28/2023] Open
Abstract
While paediatric care providers are often the first point of contact for children or youth experiencing mental health challenges, they may lack the resources (e.g., access to a multidisciplinary team) or training to adequately identify or manage such problems. This joint statement describes the key roles and competencies required to assess and address child and youth mental health problems, and the factors that optimize outcomes in this age group. Evidence-informed guidance on screening for and discussing mental health concerns with young people and families is provided. Preventive and therapeutic interventions with demonstrated efficacy in community care settings are discussed. This foundational statement also focuses on the changes to medical education, health systems, and health policy that are needed to improve clinical practice and advocacy efforts in Canada, including appropriate remuneration models, stepped-care approaches, targeted government funding, and professional training and education.
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Affiliation(s)
- Wilma Arruda
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Stacey A Bélanger
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Janice S Cohen
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Sophia Hrycko
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Anne Kawamura
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Margo Lane
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Maria J Patriquin
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
| | - Daphne J Korczak
- Canadian Paediatric Society, Mental Health Task Force, with the Canadian Academy of Child and Adolescent Psychiatry, Ottawa, Ontario, Canada
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Lebow J, O'Brien JRG, Mattke A, Narr C, Geske J, Billings M, Clark MM, Jacobson RM, Phelan S, Le Grange D, Sim L. A primary care modification of family-based treatment for adolescent restrictive eating disorders. Eat Disord 2021; 29:376-389. [PMID: 31675286 DOI: 10.1080/10640266.2019.1656468] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although eating disorders pose a significant threat to the health and well-being of children and adolescents, due to a profound scarcity of specialty providers, only a small percentage of patients receives evidence-based treatment. To improve access to care for restrictive eating disorders, we developed a modified version of Family-Based Treatment to be delivered by primary care providers (PCPs) and conducted a pilot study to evaluate the feasibility and preliminary outcomes of this intervention. Fifteen adolescents (mean age = 15.5 years) with restrictive eating disorders and their caregiver(s) were enrolled in Family-Based Treatment for Primary Care (FBT-PC), delivered by three trained PCPs. Retention for the intervention was high (n = 13, 86.7%). Over the course of 3 months, participants attended an average of 9.2 (SD = 2.8) sessions and experienced a significant increase in BMI percentile from 39.1 to 54.8 (t (13) = -6.71, p < .001; d = .61). FBT-PC appears to be feasible for implementation in the primary care setting and has the potential to improve access to treatment and yield positive outcomes for young patients with restrictive eating disorders.
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Affiliation(s)
- Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | | | - Angela Mattke
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Cassandra Narr
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Jennifer Geske
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Marcie Billings
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Robert M Jacobson
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA.,Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Sean Phelan
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, CA, USA.,Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA (Emeritus)
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA
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4
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Vyver E, Katzman DK. Anorexia nervosa: A paediatric health crisis during the COVID-19 pandemic. Paediatr Child Health 2021; 26:317-318. [PMID: 34336061 DOI: 10.1093/pch/pxab031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/30/2021] [Indexed: 01/04/2023] Open
Affiliation(s)
- Ellie Vyver
- Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada
| | - Debra K Katzman
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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5
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Lebow J, Mattke A, Narr C, Partain P, Breland R, Gewirtz O'Brien JR, Geske J, Billings M, Clark MM, Jacobson RM, Phelan S, Harbeck-Weber C, Le Grange D, Sim L. Can adolescents with eating disorders be treated in primary care? A retrospective clinical cohort study. J Eat Disord 2021; 9:55. [PMID: 33892810 PMCID: PMC8067301 DOI: 10.1186/s40337-021-00413-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Family-Based Treatment (FBT) is considered the first-line intervention for adolescent anorexia nervosa. However, access to this treatment is limited. Treatment programs for other pediatric mental health conditions have successfully overcome barriers to accessing evidence-based intervention by integrating mental health services into primary care. This study evaluated the proof-of-concept of a novel modification of FBT, Family-Based Treatment for Primary Care (FBT-PC) for adolescent restrictive eating disorders designed for delivery by primary care providers in their practices. METHODS This retrospective clinical cohort study evaluated 15 adolescents with restrictive eating disorders receiving FBT-PC and 15 adolescents receiving standard FBT. We examined improvement in BMI percentile, reduction in weight suppression, and clinical benchmarks of eating disorder recovery including weight restoration to > 95% of expected body weight (EBW) and resolution of DSM-5 criteria for eating disorders. RESULTS In both groups, effect sizes for increased BMI percentile exceeded Cohen's convention for a large effect (FBT-PC: d = .94; standard FBT: d = 1.15) as did effect sizes for reduction in weight suppression (FBT-PC: d = 1.83; standard FBT: d = 1.21). At the end of treatment, 80% of the FBT-PC cohort and 87% in the standard FBT group achieved > 95%EBW and 67% in the FBT-PC group and 60% in the standard FBT group no longer met DSM-5 criteria for an eating disorder. There were no cohort differences in the number of treatment drop-outs or referrals to a more intensive level of eating disorder treatment. CONCLUSIONS Findings suggest that primary care providers have potential to improve weight and clinical status in adolescents with restrictive eating disorders. Based on these results, more rigorous testing of the FBT-PC model is warranted.
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Affiliation(s)
- Jocelyn Lebow
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. .,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.
| | - Angela Mattke
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Cassandra Narr
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Paige Partain
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Renee Breland
- Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA
| | | | - Jennifer Geske
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Marcie Billings
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Robert M Jacobson
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA.,Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Sean Phelan
- Department of Health Science Research, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Cynthia Harbeck-Weber
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Daniel Le Grange
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.,Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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6
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Hornberger LL, Lane MA. Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics 2021; 147:peds.2020-040279. [PMID: 33386343 DOI: 10.1542/peds.2020-040279] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Eating disorders are serious, potentially life-threatening illnesses afflicting individuals through the life span, with a particular impact on both the physical and psychological development of children and adolescents. Because care for children and adolescents with eating disorders can be complex and resources for the treatment of eating disorders are often limited, pediatricians may be called on to not only provide medical supervision for their patients with diagnosed eating disorders but also coordinate care and advocate for appropriate services. This clinical report includes a review of common eating disorders diagnosed in children and adolescents, outlines the medical evaluation of patients suspected of having an eating disorder, presents an overview of treatment strategies, and highlights opportunities for advocacy.
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Affiliation(s)
- Laurie L Hornberger
- Division of Adolescent Medicine, Children's Mercy Kansas City and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri; and
| | - Margo A Lane
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba
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7
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Lenton-Brym T, Rodrigues A, Johnson N, Couturier J, Toulany A. A scoping review of the role of primary care providers and primary care-based interventions in the treatment of pediatric eating disorders. Eat Disord 2020; 28:47-66. [PMID: 30664402 DOI: 10.1080/10640266.2018.1560853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Youth with eating disorders are often cared for by specialized interdisciplinary teams in pediatric tertiary care centers. Enhanced involvement of primary care providers may provide added benefits to patients because it offers improved access, better continuity of care, and possibly less financial burden. This paper aims to synthesize and assess the literature on the role of the primary care provider in treating pediatric eating disorders in order to identify an optimal model of shared care. Sources were identified by entering search terms in 10 databases. Eligible sources were English publications focusing on primary care-based interventions for eating disorders in youth (=<24 years). The search yielded 5,516 unique citations. Of these, 61 were ultimately included. Sources fell into two categories: (1) primary research (n = 3) and (2) reviews with recommendations for primary care providers (n = 58). The primary studies considered the primary care provider conducting behavioral therapy and guided self-help. Review articles suggested providing education, assessing for hospitalization, aiding in weight restoration, managing complications, referring, and coordinating care. Limited evidence exists that can guide effective primary care-based interventions for the treatment of pediatric eating disorders. Further research is needed to develop and evaluate interventions for the treatment of pediatric eating disorders in primary care settings so that best practices can be identified.
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Affiliation(s)
- T Lenton-Brym
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - A Rodrigues
- Division of Adolescent Medicine, McMaster University, Hamilton, ON, Canada
| | - N Johnson
- Division of Adolescent Medicine, McMaster University, Hamilton, ON, Canada
| | - J Couturier
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - A Toulany
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada.,Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada
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8
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Stay the course: practitioner reflections on implementing family-based treatment with adolescents with atypical anorexia. J Eat Disord 2019; 7:10. [PMID: 31049201 PMCID: PMC6482523 DOI: 10.1186/s40337-019-0240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 04/02/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Atypical anorexia nervosa (AN) has received minimal empirical attention regarding effective diagnosis and treatment. Family-based treatment (FBT) might be a promising treatment for atypical AN, yet it is unclear as to what adaptations are needed to the current manualized FBT for AN model. The objective of the current study was to identify how FBT practitioners applied FBT for atypical AN for adolescents in their clinical practice, and if there were any implementation challenges and adaptations to the model for this population. METHODS The current study employed fundamental qualitative description, with the aim of capturing practitioners' reflections on working with adolescents with atypical AN in clinical practice. A purposeful sample of practitioners with training in FBT were recruited and each participant completed an individual, semi-structured interview. Data was analyzed using conventional content analysis. RESULTS A total of 23 practitioners participated in this study. The results indicate that practitioners maintained some fidelity to manualized FBT in treating atypical AN, but they differed in their discussions around target weights, what constitutes weight restoration, and the dosage for FBT phases. Salient practice challenges included operationalizing the Diagnostic and Statistical Manual of Mental Disorders - 5th Edition (DSM-5) definition of atypical AN, identifying a 'goal weight' for adolescents and activating parents to take charge of the re-nourishment process. CONCLUSIONS The results of this qualitative study demonstrate practitioner reflections on the delivery and adaptations of FBT for adolescents with atypical AN. These reflections highlight the need to establish the delivery of coherent and consistent treatment and messaging with patients and families. Further, practitioners' reflections highlight common strategies to increase the sense of urgency in parents to support their child with atypical AN.
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10
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Gusella JL, Campbell AG, Lalji K. A shift to placing parents in charge: Does it improve weight gain in youth with anorexia? Paediatr Child Health 2017; 22:269-272. [PMID: 29479232 DOI: 10.1093/pch/pxx063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Family-based treatment (FBT) has emerged as a promising approach for medically stable youth with anorexia nervosa (AN). While there is evidence that therapists embrace the core principles of FBT, most face barriers in implementing the model with fidelity. Little research has been conducted to determine whether adhering to the core methods of placing parents in charge are sufficient in restoring weight in youth with AN. This study involved a chart review of youth under 16 years of age, treated by a Canadian tertiary care health centre-based eating disorders team (EDT). The purpose was to compare the weight gain of youth treated before and after the team was trained in FBT and shifted to empowering parents to be in charge of weight gain. As predicted, youth who participated in family sessions adhering to the 'parents in charge' approach (PIC, N=32) made greater gains in percentage of ideal body weight (%IBW) and were more likely to reach body weights within a healthy range as compared with youth (N=14) who participated in a 'non-specific therapy' (NST) involving expert driven psycho-educational family sessions. Youth whose parents were placed in charge of weight gain were also significantly less likely to be hospitalized on the psychiatry unit for weight restoration, had significantly shorter mean duration of stays on this unit, and required tube-feeding less frequently than youth who participated in NST. Collectively, the results suggest that placing parents in charge of refeeding promotes efficient weight gain, while decreasing the need for more intensive intervention.
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Affiliation(s)
- Joanne L Gusella
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Anna G Campbell
- Community Mental Health, IWK Health Centre, Halifax, Nova Scotia
| | - Kristin Lalji
- Child and Adolescent Mental Health Specialized Services, Alberta Health Services, Calgary, Alberta
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Abstract
Abnormal menstruation in adolescent girls can cause psychological and physical strain from excess, unpredictable, painful, or even absent bleeding. Care providers who understand what is normal and what is concerning can educate and often reassure the young woman and her family. When there is an abnormal or concerning scenario, they can initiate investigations and/or treatment in an expedient fashion to limit psychosocial and/or physical morbidity. This article provides pediatricians, family doctors, nurse practitioners, and adult gynecologists with the knowledge and understanding of the common complaints, differential diagnoses, and treatment strategies.
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Affiliation(s)
- Mary Anne Jamieson
- Department of Obstetrics & Gynecology, Queen's University, 99 University Ave, Kingston, Ontario K7L 3N6, Canada.
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Fernández-del-Valle M, Larumbe-Zabala E, Morande-Lavin G, Perez Ruiz M. Muscle function and body composition profile in adolescents with restrictive anorexia nervosa: does resistance training help? Disabil Rehabil 2015; 38:346-53. [DOI: 10.3109/09638288.2015.1041612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Eneko Larumbe-Zabala
- Clinical Research Institute, Texas Tech University Health Sciences Center, TX, USA,
| | - Gonzalo Morande-Lavin
- Department of Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesus, Spain, and
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13
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Fernandez-del-Valle M, Larumbe-Zabala E, Villaseñor-Montarroso A, Cardona Gonzalez C, Diez-Vega I, Lopez Mojares LM, Perez Ruiz M. Resistance training enhances muscular performance in patients with anorexia nervosa: a randomized controlled trial. Int J Eat Disord 2014; 47:601-9. [PMID: 24810684 DOI: 10.1002/eat.22251] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 10/12/2013] [Accepted: 12/30/2013] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Low-intensity exercise applied in anorexia nervosa patients has been shown to have a harmless effect on body composition and to effect short-term improvements in muscular strength and agility. The aim of this study was to determine the effects of a high-intensity resistance training program designed for adolescents to improve strength and agility in anorexia nervosa restricting-type patients (AN-R). METHODS From a total of 36 female patients with AN-R, one group (intervention, n = 18) underwent a supervised high-intensity resistance training program lasting 8 weeks, and the other group with no exercise (control, n = 18). Body weight, body mass index, whole-body muscular strength, and agility were assessed before, after, and 4 weeks after training (detraining). RESULTS Leg-press, bench-press, and lateral row tests improved significantly (p < 0.001) after 8 weeks of training compared with controls. Improvements were maintained after the detraining period. The training program also showed beneficial effects on agility. DISCUSSION A high-intensity resistance training program adapted to the recommendations for adolescents in AN-R patients was effective and safe, improving muscular strength in the whole body and the ability to perform daily tasks. However, long-term maintenance of gains seems to be linked to the continuance of training or the use of a maintenance program.
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Rousseau C, Nadeau L, Pontbriand A, Johnson-Lafleur J, Measham T, Broadhurst J. La santé mentale jeunesse : un domaine à la croisée des chemins. SANTE MENTALE AU QUEBEC 2014. [DOI: 10.7202/1025909ar] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Si l’importance grandissante de la santé mentale des jeunes fait consensus, de multiples questionnements émergent cependant quant aux spécificités de ce domaine, qui ne peut être conçu comme une extension des services adultes pour des groupes plus jeunes. Cet article aborde ces questionnements en croisant les savoirs provenant de la documentation et ceux qui émergent à la suite de l’implantation du Plan d’action en santé mentale au Québec.
Le Plan d’action en santé mentale a mis de l’avant la collaboration et le partenariat entre institutions et disciplines. Malgré des avancées significatives, des discontinuités peu favorables à une prise en charge écosystémique persistent. Un ensemble de recherches récentes suggère que les contextes organisationnels qui encadrent les services influencent à la fois la façon dont les interventions sont mises en place et leurs résultats cliniques. Une structure de gestion flexible qui engage les intervenants en favorisant une appropriation du pouvoir, tout en minimisant les sources de stress au travail et en facilitant la création de partenariats, semble nécessaire pour favoriser la concertation interdisciplinaire et intersectorielle. Celle-ci est essentielle à la mise en place de services en santé mentale jeunesse.
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Affiliation(s)
- Cécile Rousseau
- Professeur titulaire, Université McGill
- CSSS de la Montagne (CLSC de Parc-Extension)
| | | | | | | | | | - Joanna Broadhurst
- Chef de programme DI/TED DP et santé mentale jeunesse CSSS de la Montagne
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16
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Abstract
The incidence and prevalence of eating disorders in children and adolescents has increased significantly in recent decades, making it essential for pediatricians to consider these disorders in appropriate clinical settings, to evaluate patients suspected of having these disorders, and to manage (or refer) patients in whom eating disorders are diagnosed. This clinical report includes a discussion of diagnostic criteria and outlines the initial evaluation of the patient with disordered eating. Medical complications of eating disorders may affect any organ system, and careful monitoring for these complications is required. The range of treatment options, including pharmacotherapy, is described in this report. Pediatricians are encouraged to advocate for legislation and policies that ensure appropriate services for patients with eating disorders, including medical care, nutritional intervention, mental health treatment, and care coordination.
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