A review of the eating disorders literature with reference to dentistry

2021 ◽  
Vol 14 (3) ◽  
pp. 156-160
Author(s):  
Andrea Waylen
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Clinical Relevance ◽  
Healthcare Professionals ◽  
Signs And Symptoms ◽  
Oral Pathology ◽  
Morbidity And Mortality ◽  
Psychological Morbidity ◽  
Psychiatric Illnesses ◽  
The Uk

Eating disorders are severe psychiatric illnesses associated with physical and psychological morbidity and mortality. In the UK, around 1 in 9 people are directly affected. Oral healthcare professionals may be among the first to observe the signs and symptoms of an eating disorder because of the recognizable and consistent links with oral pathology and it is important that they are sufficiently informed about the condition, and feel confident in raising it with patients and/or their families. CPD/Clinical Relevance: Oral healthcare professionals may be among the first to suspect that a patient has an eating disorder: they can play a role in diagnosis and appropriate referral, as well as providing appropriate oral healthcare advice.

Identifying and managing eating disorders in type 1 diabetes mellitus: An all-Wales study

2021 ◽  
pp. 135910452110095
Author(s):  
Jacinta O A Tan ◽  
Imogen Spector-Hill
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Eating Disorder ◽  
Type 1 Diabetes Mellitus ◽  
Healthcare Professionals ◽  
Health And Wellbeing ◽  
Level Of Knowledge

Background: Co-morbid diabetes and eating disorders have a particularly high mortality, significant in numbers and highly dangerous in terms of impact on health and wellbeing. However, not much is known about the level of awareness, knowledge and confidence amongst healthcare professionals regarding co-morbid Type 1 Diabetes Mellitus (T1DM) and eating disorders. Aim: To understand the level of knowledge and confidence amongst healthcare professionals in Wales regarding co-morbid T1DM and eating disorder presentations, identification and treatment. Results: We conducted a survey of 102 Welsh clinicians in primary care, diabetes services and eating disorder services. 60.8% expressed low confidence in identification of co-morbid T1DM and eating disorders. Respondents reported fewer cases seen than would be expected. There was poor understanding of co-morbid T1DM and eating disorders: 44.6% identified weight loss as a main symptom, 78.4% used no screening instruments, and 80.3% consulted no relevant guidance. The respondents expressed an awareness of their lack of knowledge and the majority expressed willingness to accept training and education. Conclusion: We suggest that priority must be given to education and training of all healthcare professionals in primary care, diabetes services and mental health services who may see patients with co-morbid T1DM and eating disorders.

Does UK medical education provide doctors with sufficient skills and knowledge to manage patients with eating disorders safely?

2018 ◽  
Vol 94 (1113) ◽  
pp. 374-380 ◽  
Author(s):  
Agnes Ayton ◽  
Ali Ibrahim
Keyword(s):  
Eating Disorders ◽  
Patient Safety ◽  
Eating Disorder ◽  
Postgraduate Training ◽  
Medical Training ◽  
Improve Patient Safety ◽  
Medical Schools ◽  
Junior Doctors ◽  
The Uk ◽  
Improve Patient

BackgroundEating disorders affect 1%–4% of the population and they are associated with an increased rate of mortality and multimorbidity. Following the avoidable deaths of three people the parliamentary ombudsman called for a review of training for all junior doctors to improve patient safety.ObjectiveTo review the teaching and assessment relating to eating disorders at all levels of medical training in the UK.MethodWe surveyed all the UK medical schools about their curricula, teaching and examinations related to eating disorders in 2017. Furthermore, we reviewed curricula and requirements for annual progression (Annual Review of Competence Progression (ARCP)) for all relevant postgraduate training programmes, including foundation training, general practice and 33 specialties.Main outcome measuresInclusion of eating disorders in curricula, time dedicated to teaching, assessment methods and ARCP requirements.ResultsThe medical school response rate was 93%. The total number of hours spent on eating disorder teaching in medical schools is <2 hours. Postgraduate training adds little more, with the exception of child and adolescent psychiatry. The majority of doctors are never assessed on their knowledge of eating disorders during their entire training, and only a few medical students and trainees have the opportunity to choose a specialist placement to develop their clinical skills.ConclusionsEating disorder teaching is minimal during the 10–16 years of undergraduate and postgraduate medical training in the UK. Given the risk of mortality and multimorbidity associated with these disorders, this needs to be urgently reviewed to improve patient safety.

scholarly journals The experiential perspectives of parents caring for a loved one with a restrictive eating disorder in the UK

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Hannah Cribben ◽  
Pamela Macdonald ◽  
Janet Treasure ◽  
Erica Cini ◽  
Dasha Nicholls ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Focus Groups ◽  
Service Providers ◽  
Healthcare Providers ◽  
Transition Process ◽  
Loved One ◽  
Experience Of Care ◽  
The Uk

Background Parents of a loved one with an eating disorder report high levels of unmet needs. Research is needed to understand whether clinical guidance designed to improve the experience of parents has been effective. Aims To establish parents’ experiential perspectives of eating disorder care in the UK, compared with guidance published by Beat, a UK eating disorders charity, and Academy for Eating Disorders, the leading international eating disorders professional association. Method A total of six focus groups (one online and five face-to-face) were held throughout the UK. A total of 32 parents attended. All participants were parents of a loved one with a diagnosis of anorexia nervosa or atypical anorexia nervosa (mean age 22 years; mean duration of illness 4.4 years). Focus groups were transcribed, and the text was analysed with an inductive approach, to identify emerging themes. Results Four key themes were identified: (a) impact of eating disorder on one's life, (b) current service provisions, (c) navigating the transition process and (d) suggestions for improvement. Conclusions Current experiences of parents in the UK do not align with the guidelines published by Beat and Academy of Eating Disorders. Parents identified a number of changes that healthcare providers could make, including improved information and support for parents, enhanced training of professionals, consistent care across all UK service providers, policy changes and greater involvement of families in their loved one's care. Findings from this project informed the design of a national web-survey on loved ones’ experience of care in eating disorders.

Know the symptoms: diagnosing a brain tumour early is key

2021 ◽  
Vol 2 (1) ◽  
pp. 10-11
Author(s):  
Sarah Lindsell
Keyword(s):  
Brain Tumour ◽  
Brain Tumours ◽  
Healthcare Professionals ◽  
Signs And Symptoms ◽  
Childhood Brain Tumours ◽  
Early Signs ◽  
The Uk ◽  
The Brain

Everyone has a role to play in reducing diagnosis times for childhood brain tumours, the biggest cancer killer of children and adults under 40 years old in the UK. The Brain Tumour Charity's HeadSmart campaign aims to inform parents and healthcare professionals about the key early signs and symptoms of brain tumours.

scholarly journals Association between poor oral health and eating disorders: Systematic review and meta-analysis

2015 ◽  
Vol 207 (4) ◽  
pp. 299-305 ◽  
Author(s):  
Steve Kisely ◽  
Hooman Baghaie ◽  
Ratilal Lalloo ◽  
Newell W. Johnson
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Oral Health ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Meta Analysis ◽  
Oral Pathology ◽  
Salivary Flow ◽  
Dental Erosion ◽  
Medical Practitioners

BackgroundThere is a well-established link between oral pathology and eating disorders in the presence of self-induced vomiting. There is less information concerning this relationship in the absence of self-induced vomiting, in spite of risk factors such as psychotropic-induced dry mouth, nutritional deficiency or acidic diet.AimsTo determine the association between eating disorder and poor oral health, including any difference between patients with and without self-induced vomiting.MethodA systematic search was made of Medline, PsycINFO, EMBASE and article bibliographies. Outcomes were dental erosion, salivary gland function and the mean number of decayed, missing and filled teeth or surfaces (DMFT/S).ResultsTen studies had sufficient data for a random effects meta-analysis (psychiatric patients n = 556, controls n = 556). Patients with an eating disorder had five times the odds of dental erosion compared with controls (95% CI 3.31–7.58); odds were highest in those with self-induced vomiting (odds ratio (OR) = 7.32). Patients also had significantly higher DMFS scores (mean difference 3.07, 95% CI 0.66–5.48) and reduced salivary flow (OR = 2.24, 95% CI 1.44–3.51).ConclusionsThese findings highlight the importance of collaboration between dental and medical practitioners. Dentists may be the first clinicians to suspect an eating disorder given patients' reluctance to present for psychiatric treatment, whereas mental health clinicians should be aware of the oral consequences of inappropriate diet, psychotropic medication and self-induced vomiting.

scholarly journals Prenatal and perinatal factors and risk of eating disorders

2020 ◽  
pp. 1-11
Author(s):  
Janne Tidselbak Larsen ◽  
Cynthia M. Bulik ◽  
Laura M. Thornton ◽  
Susanne Vinkel Koch ◽  
Liselotte Petersen
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Cox Regression ◽  
Obsessive Compulsive ◽  
Eating Disorder Risk ◽  
Psychiatric Illnesses ◽  
Not Otherwise Specified ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders ◽  
Disorder Risk

Abstract Background Among the most disabling and fatal psychiatric illnesses, eating disorders (EDs) often manifest early in life, which encourages investigations into in utero and perinatal environmental risk factors. The objective of this study was to determine whether complications during pregnancy and birth and perinatal conditions are associated with later eating disorder risk in offspring and whether these associations are unique to EDs. Methods All individuals born in Denmark to Danish-born parents 1989–2010 were included in the study and followed from their 6th birthday until the end of 2016. Exposure to factors related to pregnancy, birth, and perinatal conditions was determined using national registers, as were hospital-based diagnoses of anorexia nervosa (AN), bulimia nervosa, and eating disorder not otherwise specified during follow-up. For comparison, diagnoses of depressive, anxiety, and obsessive-compulsive disorders were also included. Cox regression was used to compare hazards of psychiatric disorders in exposed and unexposed individuals. Results 1 167 043 individuals were included in the analysis. We found that similar to the comparison disorders, prematurity was associated with increased eating disorder risk. Conversely, patterns of increasing risks of EDs, especially in AN, with increasing parental ages differed from the more U-shaped patterns observed for depressive and anxiety disorders. Conclusions Our results suggest that pregnancy and early life are vulnerable developmental periods when exposures may influence offspring mental health, including eating disorder risk, later in life. The results suggest that some events pose more global transdiagnostic risk whereas other patterns, such as increasing parental ages, appear more specific to EDs.

scholarly journals The Role of the Gut Microbiome, Immunity, and Neuroinflammation in the Pathophysiology of Eating Disorders

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 500
Author(s):  
Michael J. Butler ◽  
Alexis A. Perrini ◽  
Lisa A. Eckel
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Immune System ◽  
Binge Eating ◽  
Gut Microbiome ◽  
Diet Composition ◽  
Caloric Intake ◽  
Psychiatric Illnesses ◽  
Increased Risk

There is a growing recognition that both the gut microbiome and the immune system are involved in a number of psychiatric illnesses, including eating disorders. This should come as no surprise, given the important roles of diet composition, eating patterns, and daily caloric intake in modulating both biological systems. Here, we review the evidence that alterations in the gut microbiome and immune system may serve not only to maintain and exacerbate dysregulated eating behavior, characterized by caloric restriction in anorexia nervosa and binge eating in bulimia nervosa and binge eating disorder, but may also serve as biomarkers of increased risk for developing an eating disorder. We focus on studies examining gut dysbiosis, peripheral inflammation, and neuroinflammation in each of these eating disorders, and explore the available data from preclinical rodent models of anorexia and binge-like eating that may be useful in providing a better understanding of the biological mechanisms underlying eating disorders. Such knowledge is critical to developing novel, highly effective treatments for these often intractable and unremitting eating disorders.

scholarly journals Patient and public priorities for breast cancer research: a qualitative study in the UK

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e036072
Author(s):  
George Boundouki ◽  
Rebecca Wilson ◽  
Paula Duxbury ◽  
Julia Henderson ◽  
Laura Ballance ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Research ◽  
Qualitative Study ◽  
Support Groups ◽  
Healthcare Professionals ◽  
Research Priorities ◽  
Signs And Symptoms ◽  
Breast Cancer Research ◽  
Research Themes ◽  
The Uk

ObjectiveInternationally recognised specialist breast cancer scientists, clinicians and healthcare professionals have published breast cancer research gaps that are informing research funding priorities in the UK and worldwide. We aimed to determine the breast cancer research priorities of the public to compare with those identified by clinicians and scientists.DesignWe conducted a qualitative study and thematic analysis using ‘listening events’ where patients with breast cancer and public representatives used a patient’s breast cancer journey to identify research themes.Participants and settingFemale participants were recruited from attendees at participating hospitals and support groups in the northwest of England, including patients, their family and friends as well as staff at a local retail centre.InterventionA framework approach was used to analyse transcribed discussions until thematic saturation was reached.Main outcome measuresBreast cancer research priorities were identified from participant discussions and compared with the published gaps identified by scientists and healthcare professionals.ResultsThematic saturation was reached after 27 female participants participated in listening events. Our participants consistently focused on improved methods of dissemination of information and improving education on the signs and symptoms of breast cancer. This was not highlighted by scientists or healthcare professionals. There was strong emphasis on quality of life-related issues such as side effects of treatment. There was some agreement between the priorities deduced by our study and those of the professionals in the areas of screening, prevention and breast reconstruction.ConclusionOur study identified some research themes that were not identified by scientists and healthcare professionals in two earlier landmark studies. This highlights the importance of including patients and public representatives when setting research priorities. The results should be used to guide investigators when planning future studies and for funding bodies in allocating resources for future projects.

scholarly journals Confidence in eating disorder knowledge does not predict actual knowledge in collegiate female athletes

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5868 ◽  
Author(s):  
Megan E. Rosa-Caldwell ◽  
Christopher Todden ◽  
Aaron R. Caldwell ◽  
Lauren E. Breithaupt
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Intercollegiate Athletics ◽  
Female Athletes ◽  
Athletic Trainers ◽  
Signs And Symptoms ◽  
Average Score ◽  
Average Confidence ◽  
Simple Regression Analysis ◽  
Collegiate Female Athletes

Background Eating disorders are serious psychological disorders with long term health impacts. Athletic populations, tend to have higher incidences of eating disorders compared to the general population. Yet there is little known about athletes’ eating disorder knowledge and how it relates to their confidence in their knowledge. Therefore, the purpose of our study was to evaluate collegiate female athletes’ eating disorder (ED) knowledge and confidence in their knowledge. 51 participants were recruited from a National Association of Intercollegiate Athletics (NAIA) university in the mid-west and asked to complete a 30-question exam assessing one’s knowledge of five different categories related to eating disorders. Confidence in the correctness of answers was assessed with a 5-point Likert-scale (1 = very unconfident, 5 = very confident). A one-way ANOVA was used to determine differences between scores on different categories and overall scores. A simple regression analysis was used to determine if confidence or age was predictive in knowledge scores. Results The average score of participants was 69.1%, SD = 10.8% with an average confidence of 3.69/5, SD = 0.33. Athletes scored lowest with regards to Identifying Signs and Symptoms of EDs compared to other sub-scores (p < 0.05). There was no relationship between knowledge and confidence scores. Discussion There is limited ED knowledge among collegiate female athletes. This may be problematic as many athletes appear confident in the correctness of their answers despite these low scores. Coaches should be aware of this lack of knowledge and work with clinical practitioners, such as dieticians, team physicians and athletic trainers to educate and monitor their athletes on eating disorders, specifically signs and symptoms.

scholarly journals Comparative analysis of COVID-19 guidelines from six countries: A qualitative study on the US, China, South Korea, the UK, Brazil and Haiti

2020 ◽  
Author(s):  
JI YOUN YOO ◽  
Samia Valeria Ozorio Dutra ◽  
Dany Fanfan ◽  
Sarah Sniffen ◽  
Hao Wang ◽  
...  
Keyword(s):  
Qualitative Study ◽  
South Korea ◽  
Healthcare Professionals ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Healthcare Systems ◽  
Contact Tracing ◽  
Clinical Signs And Symptoms ◽  
The Government ◽  
The Uk

Abstract Background: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases.Methods: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N=55) and analyzed using content analysis.Results: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country’s healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction.Conclusion: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus’s spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries’ response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country’s communities and healthcare systems.

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