Abstract
Knowledge of anorexia nervosa (AN) in childhood is scarce. This review gives a state-of-the-art overview on the definition, classification, epidemiology and etiology of this serious disorder. The typical features of childhood AN in comparison to adolescent AN and avoidant restrictive eating disorder (ARFID) are described. Other important issues discussed in this article are somatic and psychiatric comorbidity, differential diagnoses and medical and psychological assessment of young patients with AN. Special problems in the medical and psychological treatment of AN in children are listed, although very few studies have investigated age-specific treatment strategies. The physical and mental outcomes of childhood AN appear to be worse than those of adolescent AN, although the causes for these outcomes are unclear. There is an urgent need for ongoing intensive research to reduce the consequences of this debilitating disorder of childhood and to help patients recover.
Highlights
Anorexia nervosa (AN) is a serious and often chronic disorder with a peak incidence in adolescence. childhood AN has long been recognized and described in several case studies [1,2], knowledge of the diagnosis and treatment has become increasingly important due to the rising admission rates of childhood AN in several European countries
Childhood will be defined as aged below 14 years, as this corresponds to the age span used in many investigations of young people with AN and will include premenarchal and postmenarchal onset of the disorder
In the UK [11], the prevalence of AN in 10 to14-year-olds rose from 2.5/100,000 total children to 7.5/100,000 during the last two decades; the German health care statistics indicate an increase of patients below 15 years from seven to 13 from the year 2000 to the year 2017 (German Federal Statistics, http://www.gbe-bund.de/, assessed July 2019)
Summary
Anorexia nervosa (AN) is a serious and often chronic disorder with a peak incidence in adolescence. The same diagnostic criteria for AN should be applied to all age groups, there are differences in the presentation, epidemiology, medical and psychiatric comorbidities, as well as outcomes between younger and older patients. The aim of this article is to give a thorough overview of the diagnosis, including behavioral and physical features of childhood AN, as well as of treatment and outcomes of the disorder. We seek to underline the typical differences between onset in childhood and adolescence. Childhood will be defined as aged below 14 years, as this corresponds to the age span used in many investigations of young people with AN and will include premenarchal and postmenarchal onset of the disorder. Age below 14 years is the legal age-definition of childhood in Germany
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