Childhood Disorders: Feeding and Eating Disorders of Infancy or Early Childhood

2020 ◽  
Vol 8 (1) ◽  
pp. e001738
Author(s):  
Hui Wang ◽  
Hua He ◽  
Yongfu Yu ◽  
Xiujuan Su ◽  
Fei Li ◽  
...  

IntroductionPrevious studies have suggested that maternal diabetes may have programming effect on fetal brain development. However, little is known about the association between maternal diabetes and neurodevelopmental disorders in offspring that mainly manifest in infancy or early childhood. We aimed to examine the association between maternal diabetes before or during pregnancy and feeding and eating disorders (FED) in offspring.Research design and methodsThis population-based cohort study included 1 193 891 singletons born in Denmark during 1996–2015. These children were followed from birth until the onset of FED, the sixth birthday, death, emigration, or 31 December 2016, whichever came first. Relative risk of FED was estimated by HRs using Cox proportional hazards model.ResultsA total of 40 867 (3.4%) children were born to mothers with diabetes (20 887 with pregestational diabetes and 19 980 with gestational diabetes). The incidence rates of FED were 6.8, 4.6 and 2.9 per 10 000 person-years among children of mothers with pregestational diabetes, gestational diabetes and no diabetes, respectively. Offspring of mothers with diabetes had a 64% increased risk of FED (HR 1.64; 95% CI 1.36 to 1.99; p<0.001). The HR for maternal pregestational diabetes and gestational diabetes was 2.01 (95% CI 1.59 to 2.56; p<0.001) and 1.28 (95% CI 0.95 to 1.72; p=0.097), respectively. The increased risk was more pronounced among offspring of mothers with diabetic complications (HR 2.97; 95% CI 1.54 to 5.72; p=0.001).ConclusionsMaternal diabetes was associated with an increased risk of FED in offspring in infancy and early childhood. Our findings can inform clinical decisions for better management of maternal diabetes, in particular before pregnancy, which can reduce early neurodevelopmental problems in the offspring.


Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.


Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.


Psychiatry ◽  
2015 ◽  
pp. 1231-1249 ◽  
Author(s):  
Deborah R. Glasofer ◽  
Evelyn Attia ◽  
B. Timothy Walsh

2021 ◽  
Vol 7 (1) ◽  
pp. 171-182
Author(s):  
Cláudia Gomes Cano ◽  
Sandra Pires ◽  
Ana Catarina Serrano

Feeding and Eating Disorders (FED) are amongst the most frequent and severe psychiatric disorders in adolescence. These disorders can be considered an important public health issue, since they mostly affect a young population with potential significant functional impact at a young age and throughout adult life. Cognitive behavioral approach has demonstrated evidence as one of the empirically validated reference treatments for all FED. This article aims to perform a narrative review of the cognitive behavioral conceptualization and treatment approach of FED. Enhanced Cognitive Behaviour Therapy (CCT-E) is the treatment of choice for adolescents with FED when Family Therapy is contraindicated, not accepted, or not effective. Furthermore, the importance of an early intervention is emphasized, since it has been demonstrated that CCT-E has more effective results and in a shorter period of time in adolescents compared with an adult population.


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