ABSTRACT
OBJECTIVE: The current study examines the prevalence of binge eating and its association with adiposity and psychosocial functioning in a large, diverse sample of youth with type 2 diabetes. RESEARCH DESIGN AND METHODS: In the TODAY study, 678 (mean age 14.0 years; 64.9% girls) of the 704 youth randomized to the study completed a self-report measure of eating disorder symptoms and were categorized as nonovereaters, overeaters, subclinical binge eaters, or clinical binge eaters. RESULTS: Youth with clinical (6%) and subclinical (20%) levels of binge eating had significantly higher levels and rates of extreme obesity, global eating disorder and depressive symptoms, and impaired quality of life. CONCLUSIONS: These findings highlight the importance of evaluating youth with type 2 diabetes for the presence of binge eating. Future research is needed to determine the cumulative effects of disordered eating, obesity, and psychosocial distress on adherence to lifestyle change recommendations and longitudinal response to treatment.
Subject(s)
Affect/physiology , Bulimia/physiopathology , Diabetes Mellitus, Type 2/physiopathology , Quality of Life , Adolescent , Binge-Eating Disorder/physiopathology , Binge-Eating Disorder/psychology , Bulimia/psychology , Child , Diabetes Mellitus, Type 2/psychology , Feeding and Eating Disorders/physiopathology , Feeding and Eating Disorders/psychology , Female , Humans , MaleSubject(s)
Neoplasms/physiopathology , Pain Management , Child , Humans , Medical Oncology , Neoplasms/therapy , Physician-Patient RelationsABSTRACT
OBJECTIVE: To inform child and adolescent psychiatrists about the almost 500,000 children now residing in the American foster care system. This overview surveys the pediatric, developmental, and psychiatric needs of these children. METHOD: Child and adolescent psychiatrists, pediatricians, a child welfare researcher, a social worker, and a psychologist developed a consensus paper from their experience with child welfare and a review of the literature in their respective fields. RESULTS: Being in foster care is a defining experience in these children's lives. They are at risk in myriad ways: for instance, being poor, having chronic health deficits, experiencing the trauma of abuse and neglect, and suffering from a gamut of emotional challenges. Evolutionary developments in foster care such as therapeutic foster homes, kinship care, and changes in Medicaid funding will continue to alter the system. CONCLUSIONS: Foster children are a huge reservoir of unmet pediatric and psychiatric needs; research on them is spotty at best. It is hoped that child and adolescent psychiatrists will meet the challenges these youngsters present and will advocate for them.
Subject(s)
Child Health Services/organization & administration , Child Welfare/trends , Foster Home Care , Health Services Accessibility , Health Services Needs and Demand , Mental Health Services/organization & administration , Adolescent , Child , Child Psychiatry/standards , Child, Preschool , Foster Home Care/trends , Humans , United StatesABSTRACT
Every community has children placed in the out-of-home care system. Despite a high prevalence of health, mental health, and developmental morbidity in children in care, most child welfare agencies have not provided adequate diagnostic and therapeutic services for these children. A comprehensive, multidisciplinary clinic for children in out-of-home care involving pediatrics, child psychology, nursing, child development, and child welfare is described. Profiles of the health, mental health, and developmental status of the children in out-of-home care are also presented.
