ABSTRACT
Fear of vomiting can be a symptom associated with several disorders, including Eating Disorders (ED), Specific Phobia (Emetophobia), Avoidant Restrictive Food Intake Disorder (ARFID) and Obsessive Compulsive Disorder (OCD), making proper diagnosis challenging. At this time the literature exploring this symptom is limited, and to our knowledge very few cases have been described in the child and adolescent population. We report here the cases of one child and one adolescent presenting with significant weight loss, food restriction and fear of vomiting. The child's fear of vomiting masked a concurrent desire to achieve fitness and weight loss, which was uncovered following weight restoration. The adolescent patient, although significantly underweight and food avoidant, also expressed no concerns with body image, until weight restored. The history, course in hospital and management of these patients is discussed, along with several challenges that complicated the diagnosis.
La peur de vomir peut être un symptôme associé à plusieurs troubles, notamment les troubles alimentaires (TA), une phobie spécifique (émétophobie), le trouble de l'alimentation sélective et évitante (TASE) et le trouble obsessionnel compulsif (TOC), ce qui complique la tâche de poser un diagnostic approprié. À l'heure actuelle, la littérature explorant ce symptôme est limitée, et à notre connaissance, très peu de cas ont été décrits dans la population des enfants et des adolescents. Nous rendons compte ici des cas d'un enfant et d'un adolescent qui présentaient des pertes de poids significatives, une restriction alimentaire et la peur de vomir. La peur de vomir de l'enfant masquait un désir co-occurrent d'atteindre la forme physique et une perte de poids, ce qui a été découvert après avoir repris du poids. Le patient adolescent, bien que d'un poids significativement insuffisant et évitant la nourriture, n'exprimait pas non plus de préoccupations d'image corporelle, jusqu'à ce qu'il ait repris du poids. Les antécédents, l'évolution à l'hôpital et la prise en charge de ces patients sont discutés, ainsi que plusieurs difficultés qui compliquaient le diagnostic.
ABSTRACT
The objective of this study was to examine the acceptability and tolerability of omega-3 fatty acids as an adjunctive treatment for children and adolescents with eating disorders (EDs). Children and adolescents with EDs received omega-3 supplements (300 mg eicosapentaenoic acid [EPA] and 200 mg docosahexaenoic acid [DHA]/day) in addition to standard treatment for 8 weeks. Primary outcomes were dropout rate, compliance, and side effects. Secondary outcomes included percent ideal body weight, Eating Disorders Inventory-3 (EDI-3), Children's Depression Inventory-2 (CDI-2), and Multidimensional Anxiety Scale for Children (MASC). There were 21 participants with mean age of 15.29 ± 2.0 years. There were no dropouts. Omega-3 was well tolerated by all participants. Compared to baseline, at week 8 there was a significant increase in mean percent ideal body weight but no significant difference in scores on the EDI-3, CDI-2, and MASC. We conclude that omega-3 supplements are acceptable and well tolerated in the pediatric ED population.
