title: Medically Hospitalized Patients With Eating Disorders and Somatoform Disorders in Pediatrics: What Are Their Similarities and Differences and How Can We Improve Their Care?
abstract: The purpose of the current study is to describe the demographic and clinical characteristics and health care use of medically hospitalized patients with eating disorders (ED) and somatoform disorders (SFD) in a pediatric setting and to use the findings to explore opportunities for improved care.
  
  
  
  Retrospective chart reviews of 125 patients with SFD and 125 patients with ED (N = 250) seen at a tertiary pediatric facility over a 12- and 19-month period, respectively.
  
  
  
  Patients in both groups were predominantly girls, white, came from households with above average incomes, and had academic pressures, internalizing coping styles, and high rates of anxiety disorders. Compared with SFD patients, ED patients had longer medical admissions (P < .001), more depressive disorders (P < .01), higher lifetime rates of suicidal ideation and self-injurious behaviors (P < .05), and were more frequently discharged to intensive psychiatric treatment programs (P < .001). SFD patients were referred later to psychiatry (P < .001), had more emergency department visits (P < .001) and more visits to other hospitals (P < .05) and also had higher rates of learning difficulties (P < .001), bullying (P < .05), and trauma (P < .01) compared with ED patients.
  
  
  
  Identifying overlapping features and key differences in the clinical characteristics and health care use of patients with primary psychiatric disorders like ED and SFD, who are frequent users of medical services, is the first step toward developing innovative, integrated hospital-based care approaches and clinical pathways that can reduce service utilization and improve patient outcomes.
authors.affiliation: Departments of Psychiatry, and patricia.ibeziako@childrens.harvard.edu.|Harvard Medical School, Boston, Massachusetts; and.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ibeziako
authors.affiliation: Departments of Psychiatry, and.|Harvard Medical School, Boston, Massachusetts; and.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Rohan
authors.affiliation: Departments of Psychiatry, and.|Harvard Medical School, Boston, Massachusetts; and.
authors.forename: Simona
authors.initials: S
authors.lastname: Bujoreanu
authors.affiliation: Departments of Psychiatry, and.|Boston College, Chestnut Hill, Massachusetts.
authors.forename: Christine
authors.initials: C
authors.lastname: Choi
authors.affiliation: Departments of Psychiatry, and.
authors.forename: Meghan
authors.initials: M
authors.lastname: Hanrahan
authors.affiliation: Departments of Psychiatry, and.|Harvard Medical School, Boston, Massachusetts; and.|Adolescent Medicine, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Melissa
authors.initials: M
authors.lastname: Freizinger
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010346:Patient Care Management / Q000592:standards; D058996:Quality Improvement; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000175:diagnosis*; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D014481:United States / Q000453:epidemiology