Welcome to this edition of The Bridge which focuses on eating disorders.
Research from JCPP and CAMH over the last 2 years is summarised here. Culbert et al’s research review describes some of what is known about the underlying causes of eating disorders. The aetiology of eating disorder is multifactorial and complex, but the pressure on young people from the media and the notion that there may be an idea of a ‘thin ideal’ is acknowledged.
The RCPSYCH College report CR 1681 – “Junior Marsipan: Summary of Management of really sick patients under 18 with Anorexia Nervosa” has been produced to guide clinicians in managing young people with eating disorders. It states in its key recommendations that “All health professionals should be aware that Anorexia Nervosa is a serious disorder with life-threatening physical and psychological complications and patients require the same level of care and should be subject to the same emergency protocols as a child with any other serious illness”. Over the last year there has been considerable national effort to train CAMHS and paediatric colleagues together, to promote a consistent and evidence based approach to the management of young people with eating disorders, who may have complex concurrent physical health and mental health needs.
Several members of the team I work in have attended this nationally coordinated training and have met with teams from all over the country. Young people can be categorised into Red, Amber, Green or Blue levels of risk depending on various physical and behavioural parameters e.g. their weight or degree of recent weight loss, cardiovascular health, state of hydration/degree of dietary restriction, biochemistry, compensatory behaviours etc.…. Clinicians can download the Marsipan APP for a smartphone that can help them calculate the overall score. Young people in RED zone need very close monitoring of their health and often do need to be cared for in physical health settings for periods of time, so mental health and physical health specialists working together in partnership with young people and their families is essential for young people to recover.
I hope you find this edition helpful. This pdf has some of the articles from the Eating Disorders issue of The Bridge, please feel free to share this and the direct links below with colleagues. Email publications@acamh.org with details of what you’d like to see in future.