Management and treatment of eating disorders with severe medical complications on a psychiatric ward: a study of 9 inpatients in Japan

Abstract

Objective: To describe eating disorders inpatients with severe medical complications and elucidate the problems in managing them on a psychiatric ward.

Method: Of the 111 eating disorders patients hospitalized on our psychiatric ward from January 2005 to December 2012, 9 had eating disorders with severe medical complications. Through chart review and computerized data collection, we retrospectively evaluated patient clinical data.

Result: All 9 patients were women, with a mean age of 22.4±5.7 years, mean body weight of 26.2±3.0 kg, and mean body mass index of 10.5±1.5 on admission. Severe medical complications commonly seen were severe hypoglycemia, refeeding syndrome, coagulation abnormality, and severe liver dysfunction. Three patients died during hospitalization. All patients were managed mainly on the psychiatric ward despite their abnormally low body weight and severe medical complications.

Conclusions: Patients with eating disorders, although physically serious, often need to be managed on a psychiatric ward, even at the risk of providing less than ideal care for their physical complications. It is important to assess patient status both physically and psychologically and to select an appropriate therapeutic environment for safe and effective treatment.

Keywords: A psychiatric ward; Anorexia nervosa; Medical complications.