Sociodemographic and clinical characteristics of eating disorder patients treated in the specialized residential settings in Belgium

Introduction Epidemiologic information on sociodemographic and clinical characteristics in eating disorders in Western European countries are scarce. Purpose In this study, we report demographic and clinical characteristics of eating disorder (ED) patients undergoing treatment in five specialized ED centers in Flanders (Belgium). Method Data from 642 ED patients were collected by means of a structured questionnaire. Results Data show that 93.8% of patients are female, with an average age of 22.6 years. The largest subgroup in our sample suffers from anorexia nervosa, namely 52.8%. Bulimia nervosa (BN), binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS) account for 17.7%, 10.7% and 18.8% of the sample, respectively. Mean age of onset was 17 years. Mean duration of illness was 5.6 years, but 20.2% of patients had their illness for over 8 years. Anorexia nervosa patients of the restricting type (AN-R) have the shortest duration of illness. BED patients stood out because they were older on average, more often in a relationship and more often in ambulatory treatment. 70% of patients over 20 years old completed higher education, but one-third of this group was unemployed and/or disabled. Remarkably, ED patients grow more up in intact families compared to the general population. Conclusions Epidemiology of ED patients in treatment in Flanders (Belgium) seems to resemble worldwide findings. The long duration of illness, the common evolution towards chronicity and the early work impairment underline the severe personal and societal impact of ED and call to the need for early detection and treatment of these patients

Intermittent Brugada syndrome in an anorexic adolescent girl

AbstractWe report an anorexic adolescent girl with an intermittent Brugada syndrome. A 14-year-old anorexic girl with a body mass index (BMI) of 13.15kg/m2 was admitted in the acute state of the disease with an ST elevation in V1 and V2, suggestive of Brugada syndrome. After 1 month of re-feeding, a control electrograph (ECG) was normal, but after an 8-month follow-up control with a nearly normal BMI, the ECG was again suggestive of Brugada syndrome. A genetic analysis of the gene SNC5A established a genetic change (p Leu 1582 pro), which provides the final explanation for the Brugada syndrome. Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems.<Learning objective: (i) We report the first case of a patient with anorexia nervosa with an intermittent Brugada syndrome. (ii) Moderate hypothermia can decrease the depolarization of pacemaker cells and cause ST-segment changes. (iii) Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. (iv) A genetic analysis can make the distinction and is necessary to give advice for the future lifestyle of the patient.

Can psychiatric childhood disorders be due to inborn errors of metabolism?

Many patients who visit a centre for hereditary metabolic diseases remarkably also suffer from a child psychiatric disorder. Those child psychiatric disorders may be the first sign or manifestation of an underlying metabolic disorder. Lack of knowledge of metabolic disorders in child psychiatry may lead to diagnoses being missed. Patients therefore are also at risk for not accessing efficacious treatment and proper counselling. To search the literature for the co-occurrence of child psychiatric disorders, such as ADHD, autism, psychosis, learning disorders and eating disorders and metabolic disorders. A search of the literature was conducted by performing a broad search on PubMed, using the terms “ADHD and metabolic disorders”, “autism and metabolic disorders”, “psychosis and metabolic disorders”, “learning disorders and metabolic disorders”, and “eating disorders and metabolic disorders”. Based on inclusion criteria (concerning a clear psychiatric disorder and concerning a metabolic disorder) 4441 titles and 249 abstracts were screened and resulted in 71 relevant articles. This thorough literature search provides child and adolescent psychiatrists with an overview of metabolic disorders associated with child psychiatric symptoms, their main characteristics and recommendations for further investigations