title: Comparative study of children and adolescents referred for eating disorder treatment at a specialist tertiary setting.
abstract: OBJECTIVE
  To examine child and adolescent differences in the clinical presentation of eating disorders (EDs) at referral to a specialist pediatric program.
  
  
  METHODS
  This study compared cognitive, behavioral, and physical and medical features of children (≤ 12 years) and adolescents (13-18 years) with EDs presenting to a state-wide specialist pediatric ED service over two decades (N = 656; 8-18 years; 94% female).
  
  
  RESULTS
  Significant differences were found between the groups. Children were more commonly male (p < .001), had lower eating pathology scores (p < .001), were less likely to binge eat (p = .02), purge (p < .001) or exercise for shape and weight control (p < .001), and lost weight at a faster rate than adolescents (p = .009), whereas adolescents were more likely to present with bulimia nervosa spectrum disorders (p = .004). Children and adolescents did not differ significantly on mean body mass index z-score, percentage of body weight lost, or indicators of medical compromise (p > .05).
  
  
  CONCLUSIONS
  The clinical presentation of EDs differs among children and adolescents, with eating pathology and behavioral symptoms less prominent among children. Frontline health professionals require knowledge of these differences to assist with early detection, diagnosis, and prognosis.
authors.affiliation: School of Psychology and Exercise Science, Division of Social Sciences, Humanities and Education, Murdoch University, Perth, Australia.
authors.forename: Tara
authors.initials: T
authors.lastname: Walker
authors.forename: Hunna J
authors.initials: HJ
authors.lastname: Watson
authors.forename: David J
authors.initials: DJ
authors.lastname: Leach
authors.forename: Julie
authors.initials: J
authors.lastname: McCormack
authors.forename: Karin
authors.initials: K
authors.lastname: Tobias
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hamilton
authors.forename: David A
authors.initials: DA
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D001919:Bradycardia / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002653:Child Behavior Disorders / Q000503:physiopathology / Q000523:psychology*; D015331:Cohort Studies; D015444:Exercise / Q000523:psychology*; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology; D007035:Hypothermia / Q000453:epidemiology / Q000209:etiology; D054368:Laxatives / Q000008:administration & dosage; D016014:Linear Models; D008297:Male; D015596:Nutrition Assessment; D012737:Sex Factors; D062606:Tertiary Care Centers; D014839:Vomiting / Q000453:epidemiology; D015431:Weight Loss
chemical_list: D054368:Laxatives
keywords: adolescent; anorexia nervosa; bulimia nervosa; child; developmental psychopathology; eating disorders; medical complications