Citation

Saito S, Kobayashi T, Kato S. Gen. Hosp. Psychiatry 2014; 36(3): 291-295.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.genhosppsych.2014.02.001

PMID

unavailable

Abstract

OBJECTIVE: To describe eating disorders inpatients with severe medical complications and elucidate the problems in managing them on a psychiatric ward.

METHOD: Of the 111 eating disorders patients hospitalized on our psychiatric ward from January 2005 to December 2012, 9 had eating disorders with severe medical complications. Through chart review and computerized data collection, we retrospectively evaluated patient clinical data.

RESULT: All 9 patients were women, with a mean age of 22.4±5.7 years, mean body weight of 26.2±3.0 kg, and mean body mass index of 10.5±1.5 on admission. Severe medical complications commonly seen were severe hypoglycemia, refeeding syndrome, coagulation abnormality, and severe liver dysfunction. Three patients died during hospitalization. All patients were managed mainly on the psychiatric ward despite their abnormally low body weight and severe medical complications.

CONCLUSIONS: Patients with eating disorders, although physically serious, often need to be managed on a psychiatric ward, even at the risk of providing less than ideal care for their physical complications. It is important to assess patient status both physically and psychologically and to select an appropriate therapeutic environment for safe and effective treatment. © 2014 Elsevier Inc.

Language: en

Keywords

Humans; adolescent; Adult; Female; adult; human; Adolescent; Japan; female; Fatal Outcome; Young Adult; resuscitation; autopsy; case report; cause of death; suicide attempt; complication; hospitalization; Inpatients; anorexia nervosa; binge eating disorder; Psychiatric Department, Hospital; Anorexia nervosa; death; article; anorexia; eating disorder; mental disease; symptomatology; disease association; retrospective study; clinical article; hospital admission; human cell; human tissue; psychiatric department; headache; paralysis; nuclear magnetic resonance imaging; brain edema; haloperidol; dehydration; hospital patient; fatality; intensive care; psychomotor disorder; leukopenia; fever; cardiovascular disease; respiratory tract disease; lung edema; neurologic disease; alanine aminotransferase; aspartate aminotransferase; brain disease; glucose; hypoglycemia; low birth weight; creatinine; leukocyte count; urea; body weight; DSM-IV; disease control; blood clotting disorder; nose feeding; hepatic encephalopathy; nitrogen; disseminated intravascular clotting; malaise; body mass; hypophosphatemia; acute pancreatitis; liver disease; fluid intake; Anorexia Nervosa; consciousness disorder; leg edema; systolic blood pressure; ceftriaxone; cerebrospinal fluid; treatment duration; cachexia; Bacillus; young adult; brain abscess; bacterial pneumonia; brain embolism; temporal lobectomy; heart ventricle septum defect; hyperammonemia; neutrophil count; blood clotting; bacterial meningitis; A psychiatric ward; anisocoria; brain decompression; branched chain amino acid; emaciation; Emaciation; hyperammonemic encephalopathy; Medical complications; physical inactivity; refeeding syndrome; sudden cardiac death