Viewing blog posts tagged with "Anorexia Nervosa"

Readers of this blog know that Kartini Clinic offers inpatient medical stabilization, partial hospitalization and outpatient care, all entirely family based.  We do not offer residential care.  However, we find ourselves occasionally forced to refer a patient for residential treatment despite the fact that residential care is by its very nature not family based and despite the fact that the patient will ultimately have to return to their community and family and try to stay in…

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Boys with anorexia nervosa

posted by Julie O'Toole on September 30, 2011 at 3:00pm

I sit at my desk drinking coffee; our patient census over the years is approaching two thousand children and young adults, the majority of whom have had anorexia nervosa or its variants.  And I am thinking about our boys.  

Given the approximate accepted statistic that 90% of patients with AN will be female, (even though the percentage is higher in younger patients), that still gives us around 200 boys.

Remember, with that many, if you think you recognize someone from these…

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When Other Family Members are Affected by an Eating Disorder Too

posted by Julie O'Toole on August 12, 2011 at 8:46pm

What does it mean to say a family member of a patient with anorexia nervosa is “affected” or “partially affected” with an eating disorder?

The last ten years have brought us a lot of new information about eating disorders in general and anorexia nervosa in particular.  One such bit of new information is the evidence of heritability of anorexia nervosa.  In a study published in the Archives of General Psychiatry Dr Cynthia Bulik, a well known researcher from the University of North…

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What does good treatment outcome for anorexia in children look like?

posted by Julie O'Toole on June 25, 2011 at 1:48am

Academics and researchers argue about what they refer to as "outcome" all the time.  How should treatment outcome be defined? How do you know that the patient is "there"?

These are important questions because "good outcome" will need to be defined before we can answer questions like: what percentage of children will achieve a certain outcome? How long will it take?  What factors can affect outcome? How can families influence the likelihood of a good outcome for their own child? What…

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Vertical Integration of Eating Disorder Treatment

posted by Julie O'Toole on June 18, 2011 at 1:15am

There are many by-words in contemporary medicine and ever more coming along.  “Vertical integration” is one of them, but what exactly does it mean?

It means something that we have been doing at Kartini Clinic since 2000 and something we would like to refine further as we move into the future of care for children with eating disorders.  Once, vertical integration was an innovation, now it is becoming standard.  Vertical integration is a system of care where, as the patient moves…

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The other day a young patient of mine asked me “which is more important: psychological remission or physical remission?”  Of course she was asking because she wanted to know how she could get out of the DTU most quickly, but it was a good question nonetheless.

Which is more important?  Well, let’s see…which is more important: breathing or heart beating?  Yes, it’s just like that.  There is no psychological remission without physical remission.  That’s been tried.  In fact, we spent…

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Relapse in Patients with Anorexia Nervosa

posted by Julie O'Toole on May 18, 2010 at 11:03pm

I am occasionally asked whether or not anorexia nervosa is a chronic illness.  As far as I am concerned, anorexia nervosa is a chronic illness of remission and exacerbation, which is a medical way of saying an illness that often returns after a period of stability.  Anorexia can be gotten into good remission, which may last many years, but it can flare up with a recurrence of symptoms during times of stress, life change or for no apparent reason.  We call this relapse.

As with the…

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