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Disparities in Medical Assessment Practices for Adolescents at Risk for Eating Disorders.

Leslie Sim1, Micaela A Witte2, Jocelyn Lebow3

  • 1Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine
|December 9, 2023
PubMed
Summary

High-risk adolescents with eating disorders (EDs) are not consistently assessed, despite referrals improving diagnosis rates. Patient characteristics influence these crucial early detection practices.

Keywords:
AdolescenceEating disordersHealth-care disparitiesMedical assessmentScreening

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Area of Science:

  • Pediatric medicine
  • Adolescent health
  • Mental health screening

Background:

  • The United States Preventative Services Task Force recommends assessing high-risk adolescents for eating disorders (EDs).
  • However, evidence is insufficient for universal screening, and it remains unclear if high-risk youth receive recommended assessments.
  • Patient characteristics may influence the implementation of these practices.

Purpose of the Study:

  • To investigate assessment practices for adolescents at high risk for EDs.
  • To determine if patient characteristics influence the receipt of medical tests, referrals, and follow-up care.
  • To examine the association between assessment practices and future ED diagnoses.

Main Methods:

  • Utilized the Rochester Epidemiological Project to identify adolescents (13-18 years) at risk for EDs between 2005-2017.
  • Extracted data on patient and visit characteristics, assessment practices (tests, referrals, follow-up), and subsequent ED diagnoses.
  • Analyzed data to identify factors influencing assessment and their impact on diagnosis.

Main Results:

  • Adolescents receiving referrals were 4 times more likely to be diagnosed with an ED sooner.
  • Females were more likely than males to receive referrals.
  • Higher body mass index was associated with increased medical tests but decreased recommendations for eating/weight improvement and follow-up visits.

Conclusions:

  • Disparities exist in the assessment practices for high-risk adolescents with potential EDs.
  • Referrals significantly impact early detection and diagnosis timelines.
  • Improved tools are needed for enhanced early detection and treatment of EDs in adolescents.