I was a patient at Kartini some time ago and am now in the position to have a family of my own. I have drawn on much of the wisdom...
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Genetics of Brain Disorders

posted by Morgan O'Toole-Smith on September 17, 2014 at 9:31am

Medicine is moving at the speed of light.  And that’s a good thing.  We have a long road ahead of us to move out of the pre-scientific eras, where no one required an evidence base to do most anything.  And we face an even longer road to shed the paternalistic roots of “doctor knows best” (not to mention parent blaming for brain disorders!).  But perhaps the longest road of all is the road that is now leading us to real “individualized” or “personalized” medicine.

Actually, I prefer…

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The Promise of Personalized Medicine

posted by Julie O'Toole on September 3, 2014 at 10:15am

Advances in medicine come in all shapes and sizes: vaccines, antibiotics, anti-virals, immune system boosters and reducers, technological changes and recently, the hope that faster, cheaper and more accurate genetic analysis can bring us the new approach to medicine and medications: personalized medicine.

As I have mentioned in a previous blog, a leading proponent of personalized medicine has been Dr Eric Topol, editor-in-chief of Medscape and director the Scripps Translational…

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Save Yourself First

posted by Julie O'Toole on August 27, 2014 at 3:18pm

It has become almost trite to advise parents struggling with the “severe pushback” of doing battle with their child’s eating disorder to remember that flight attendants caution parents travelling with small children to “first place the oxygen mask on yourself (really counter-intuitive for parents) and then place it on your child.” When I first heard this advice on a plane (astonishingly not what would have come naturally to me) I thought “of course! If I am unconscious then my…

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Making ‘em Mad

posted by Julie O'Toole on August 13, 2014 at 12:43pm

I’m sometimes not sure whom I make madder: some kids, some parents, or some insurance companies!

Making kids mad:

Me:  “Jill, help me understand why your weight would be way down this week?”

Jill (shrugging):  “I don’t know.  I actually exercised less and ate exactly what I was supposed to.”

Me:  “OK. I guess your body is just telling us you need more food.”

Jill:  “What!!?? No way!  I refuse to have more food.”

Me:  “Well…. unless you can think of something that didn’t go quite the…

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Parental Supervision

posted by Julie O'Toole on August 6, 2014 at 3:45pm

Eating disorders strike children at virtually all stages of development. Sometimes we think it’s most difficult when they strike a very young child, sometimes it seems the most difficult when a “child” is about to go off to college, or a student exchange program, or start a new school. Personally I think mid adolescence is one of the most difficult times for an eating disorder to strike a child.

Childhood and early adolescence are characterized by learning new skills, but also by…

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Can I Tell You About Eating Disorders?

posted by Julie O'Toole on July 24, 2014 at 3:27pm

Have you ever wondered what to tell your other children and family members about your child’s eating disorder?  Have you ever wished you had a child friendly, succinct and upbeat resource to share?

Along comes a small book to be published shortly from from Jessica Kingsley Publishers, written by Bryan Lask and Lucy Watson called Can I tell You About Eating Disorders?   This little book is apparently one of a series of books written about what the authors refer to as “limiting…

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The Stigma of Mental Illness

posted by Julie O'Toole on July 16, 2014 at 4:28pm

Lots of ink is been spilled on the subject of the stigma associated with having an eating disorder.  And in order to discuss the subject sensibly we need to get a few terms straight. It was considered a giant step forward in our field when Dr. Thomas Insel, head of NIMH, began blogging, writing and speaking about the fact that all mental illnesses are brain disorders, and that anorexia nervosa in particular was a severe mental illness.  Prior to that it had been possible to…

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Intranasal Treatment for Anxiety

posted by Julie O'Toole on July 2, 2014 at 3:36pm

Providers are finally beginning to dip our toes in the waters which have flowed from the realization that psychiatric and psychological disorders are brain disorders.  Case in point: social anxiety.

I don’t know whether we see quite a few eating disordered patients with social anxiety because these diagnoses frequently run together or because social anxiety is so prevalent in the general population, but we do.

And now comes an article by Michael Liebowitz and colleagues from Columbia…

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Eating Junk

posted by Julie O'Toole on June 25, 2014 at 3:12pm

Recently a patient of ours returned from a treatment setting where she had been presented with “challenge foods”.  In her case she had been given cheetos and soda pop.  Now I ask you, why on earth would someone encourage a child to eat such a thing?

A lot of ink has been spilled on teaching Americans in general and children in particular to make good food choices.  Just because you have anorexia nervosa as a child, and desperately need to gain and maintain adequate weight, does not…

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Do Parents Cause Eating Disorders?

posted by Julie O'Toole on June 18, 2014 at 2:59pm

Sometimes things happen to me that cause me to wonder what planet I have landed on.  Five years ago -- to say nothing of ten or fifteen -- whenever I insisted that parents didn’t cause eating disorders, any more than they cause schizophrenia or bipolar disorder or autism, I was treated like I hadn’t done my homework.  Thankfully, that has changed. Virtually no responsible eating disorder professional of any stature believes that parents cause severe mental illnesses, of which…

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