Behaviour, Belief and Impairment (BBI): a diagnostic procedure for eating disorders in primary care.

BACKGROUND: Eating disorders are becoming increasingly prevalent, especially among adolescents. Recognition and assessment of their clinical presentation can be challenging for clinicians in primary care settings, where consultation time is short and experience with eating disorders is limited. The early detection and appropriate referral of adolescents with eating disorders are essential for timely management. AIM: This article reviews eating disorders and the need for a simple, time-efficient assessment which could be used in primary care settings. OUTCOME: The authors propose a unique model of assessment entitled Behaviour, Belief and Impairment or BBI, which provides a simple, time-efficient assessment that can assist in the early detection of an eating disorder. The BBI assessment model conceptualises eating disorders in three domains: the observed behaviour, the underlying belief of the patient that drives the behaviour and the subsequent physical or psychological impairment.

Case Report: A Case of Pediatric Catatonia: Role of the Lorazepam Challenge Test.

A case of a 12-year-old boy who developed catatonia is presented. He had no previous psychiatric history but has a family history of affective disorder. An extensive medical workup was negative. Despite a negative lorazepam challenge test, lorazepam was titrated up to 24 mg/day, with resolution of most catatonic symptoms. The case highlights an important point in the management of catatonia that may be a source of confusion, i.e., a positive lorazepam challenge test corroborates the diagnosis of catatonia; however, a negative lorazepam challenge test does not negate the diagnosis of catatonia, and subsequent focused benzodiazepine treatment may still be effective.