Use of Psychopharmacologic Medications in Adolescents With Restrictive Eating Disorders: Analysis of Data From the National Eating Disorder Quality Improvement Collaborative JOURNAL OF ADOLESCENT HEALTH 2015; 57 (1): 66-72
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.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).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 1year (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).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.
View details for DOI 10.1016/j.jadohealth.2015.03.021
View details for Web of Science ID 000360055900008
View details for PubMedID 26095410
The Female Athlete Triad The Female Patient 2012; 37 (6): 16-24
Obstacles in the Optimization of Bone Health Outcomes in the Female Athlete Triad SPORTS MEDICINE 2011; 41 (7): 587-607
Maintaining low body weight for the sake of performance and aesthetic purposes is a common feature among young girls and women who exercise on a regular basis, including elite, college and high-school athletes, members of fitness centres, and recreational exercisers. High energy expenditure without adequate compensation in energy intake leads to an energy deficiency, which may ultimately affect reproductive function and bone health. The combination of low energy availability, menstrual disturbances and low bone mineral density is referred to as the 'female athlete triad'. Not all athletes seek medical assistance in response to the absence of menstruation for 3 or more months as some believe that long-term amenorrhoea is not harmful. Indeed, many women may not seek medical attention until they sustain a stress fracture. This review investigates current issues, controversies and strategies in the clinical management of bone health concerns related to the female athlete triad. Current recommendations focus on either increasing energy intake or decreasing energy expenditure, as this approach remains the most efficient strategy to prevent further bone health complications. However, convincing the athlete to increase energy availability can be extremely challenging. Oral contraceptive therapy seems to be a common strategy chosen by many physicians to address bone health issues in young women with amenorrhoea, although there is little evidence that this strategy improves bone mineral density in this population. Assessment of bone health itself is difficult due to the limitations of dual-energy X-ray absorptiometry (DXA) to estimate bone strength. Understanding how bone strength is affected by low energy availability, weight gain and resumption of menses requires further investigations using 3-dimensional bone imaging techniques in order to improve the clinical management of the female athlete triad.
View details for Web of Science ID 000292941700004
View details for PubMedID 21688870
Using OCs in teen eating disorders: What are we treating? Contemporary OB/Gyn 2009; 54 (2): 39-46
The pathophysiology of amenorrhea in the adolescent. Ann N Y Acad Sci 2008; 1135: 163-178
Clinician practices for the management of amenorrhea in the adolescent and young adult athlete JOURNAL OF ADOLESCENT HEALTH 2007; 40 (4): 362-365
This study sought to describe clinician practices for the management of amenorrhea in the adolescent and young adult athlete. Clinicians adhered to certain guidelines but did not have a uniform "standard of care" for amenorrheic athletes. Almost 80% of clinicians reported insufficient guidelines for the management of this population.
View details for DOI 10.1016/j.jadohealth.2006.10.017
View details for Web of Science ID 000245567900011
View details for PubMedID 17367734
Service utilization and the life cycle of youth homelessness JOURNAL OF ADOLESCENT HEALTH 2006; 38 (5): 624-627
The study sought to describe service utilization patterns of homeless youth based on their life cycle stage. Ninety-nine percent of participants accessed services. Medical service utilization was highest among youth who were attempting to leave the street. Drug-related service utilization was lowest among youth most entrenched in street life.
View details for DOI 10.1016/j.jadohealth.2005.10.009
View details for Web of Science ID 000237215500024
View details for PubMedID 16635781
Childhood and adolescent sexuality PEDIATRIC CLINICS OF NORTH AMERICA 2003; 50 (4): 765-?
Sexuality is an important aspect of the lives of all human beings, including children and adolescents. The clinician can provide important guidance to pediatric patients and their parents regarding the healthy development of sexuality. Counseling techniques are important, including the "helping skill" model, in which the clinician can state the problem, identify options for the patient, identify consequences of each option, help the patient make a plan, and develop a plan for check back and follow-up.
View details for DOI 10.1016/S0031-3955(03)00068-3
View details for Web of Science ID 000185077000003
View details for PubMedID 12964693