Original article
Use of Psychopharmacologic Medications in Adolescents With Restrictive Eating Disorders: Analysis of Data From the National Eating Disorder Quality Improvement Collaborative

https://doi.org/10.1016/j.jadohealth.2015.03.021Get rights and content

Abstract

Purpose

Psychopharmacologic medications are often prescribed to patients with restrictive eating disorders (EDs), and little is known about the frequency of use in adolescents. We examined the use of psychopharmacologic medications in adolescents referred for treatment of restrictive ED, potential factors associated with their use, and reported psychiatric comorbidities.

Methods

Retrospective data from the initial and 1-year visits were collected for patients referred for evaluation of restrictive ED at 12 adolescent-based ED programs during 2010 (Group 1), including diagnosis, demographic information, body mass index, prior treatment modalities, and psychopharmacologic medications. Additional data regarding patients' comorbid psychiatric conditions and classes of psychopharmacologic medications were obtained from six sites (Group 2).

Results

Overall, 635 patients met inclusion criteria and 359 had 1-year follow-up (Group 1). At intake, 20.4% of Group 1 was taking psychopharmacologic medication and 58.7% at 1 year (p ≤ .0001). White, non-Hispanic race (p = .020), and prior higher level of care (p < .0001) were positively associated with medication use at 1 year. Among Group 2 (n = 256), serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors use was most common, and 62.6% had a reported psychiatric comorbidity. Presence of any psychiatric comorbidity was highly associated with medication use; odds ratio, 10.0 (5.6, 18.0).

Conclusions

Adolescents with restrictive ED treated at referral centers have high rates of reported psychopharmacologic medication use and psychiatric comorbidity. As more than half of this referral population were reported to be taking medication, continued investigation is warranted to ensure the desired outcomes of the medications are being met.

Section snippets

Data source and collection procedures

The National Eating Disorder Quality Improvement Collaborative (NEDQIC), initially a group of 11 Adolescent Medicine-based ED programs, was formed in 2006 to address knowledge gaps in treatment outcomes in adolescents with restrictive ED [21]. The first phase of the NEDQIC reviewed data from 2006, and the second phase of the collaborative commenced in 2011 with the review of data from 2010.

For Phase 2 of the collaborative, 12 adolescent medicine sites throughout the United States provided data

Results

Across the 12 sites, 635 patients met inclusion criteria for a restrictive ED, and 359 had a 1-year follow-up visit for evaluation, comprising Group 1. Significant differences in sex and diagnosis were noted between those patients in the overall population and those included in Group 1, as males and patients diagnosed with ARFID were less likely to have 1-year follow-up (Table 1). Reasons noted for lack of follow-up data included as follows: recovered/discharged from care (n = 28, 10.1%),

Discussion

Our study found that the rate of reported psychopharmacologic medication use in this adolescent and young adult referral population with restrictive ED was 20% at intake and increased to more than 50% at 1-year follow-up. This latter rate exceeds that in a nationally derived sample of adolescents, in which approximately 20% of patients with any type of ED were taking medication [17]. However, our study population had a high rate of psychiatric comorbidity; both the type and number of

Acknowledgments

Portions of this work were previously presented in the following contexts: (1) Poster Presentation. Society for Adolescent Health and Medicine 2013 Annual Meeting; 2013 March 13–16; Atlanta, GA and (2) Special Interest Group. Society for Adolescent Health and Medicine 2014 Annual Meeting; 2014 March 23–26; Austin, TX.

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