Anorexia nervosa na infância e na adolescência: percurso desde a identificação de sintomas até ao internamento

Abstract

Introduction – The importance of early intervention in anorexia nervosa is widely recognized. The data available in the literature shows that a prolonged duration of untreated disease is associated with a worse prognosis and that the severity of the disease at the time of diagnosis is predictive of its outcome. Objectives – To study the time of untreated disease in a sample of children/adolescents who were hospitalized with the diagnosis of anorexia nervosa. Specifically, to clarify the path from the identification of first symptoms to hospitalization regarding follow-up consultations and their management, the performance of complementary diagnostic tests, the presence of comorbidities, and the duration of hospitalization. Methods – Once the informed consent to participate in this study was signed, we gathered information from clinical files and the hospital’s clinical database regarding children and adolescents with the diagnosis of anorexia nervosa admitted to the child and adolescent psychiatry ward from January 2018 until December 2019. A descriptive statistical analysis of the sample was performed, trying to identify the course of action taken between the identification of symptoms and the search for consultation, the type of consultations to which the family resorted, the therapeutic plan implemented prior to hospitalization, and throughout the hospitalization. Finally, we tried to understand how several health professionals managed the follow-ups. Results/Discussion – In our sample (n=37), five cases had no contact with a health professional before hospitalization. Only 16 cases were referred to dietary/nutrition consultation and only 15 cases had a diet plan established prior to hospitalization. Of the 37 cases, only two were referred to a multidisciplinary team composed of pediatric, child, and adolescent psychiatrists, psychologists, and dietitians/nutritionists. Conclusion – In our sample, only a minority of cases were being followed by a multidisciplinary team prior to hospitalization. These data reinforce the need for better articulation between mental health services and other areas of intervention regarding eating disorders.