RESUMEN
Anorexia nervosa and bulimia nervosa are significant mental health problems in the adolescent population; however, there are no medications approved by the FDA for the treatment of adolescents with either of these disorders. Many medications are used off label for both the symptoms of eating disorders and their co-morbid conditions, particularly SSRIs and atypical anti-psychotics. The dosing, side effect profile, and long term effects of these medications in children and adolescents is unclear. Binge eating disorder, night eating syndrome, and sleep-related eating disorder often are associated with over-weight in adolescents. There are various pharmacological approaches to the treatment of obesity in the adolescent population some of which have FDA approval. In the article the authors discuss pharmacological approaches to guide the treatment of eating disorders and obesity in the pediatric population, including risks of treatment, monitoring of potential side effects, and recent outcomes in the literature.
Asunto(s)
Anorexia Nerviosa/tratamiento farmacológico , Bulimia Nerviosa/tratamiento farmacológico , Trastornos de Alimentación y de la Ingestión de Alimentos/tratamiento farmacológico , Obesidad/tratamiento farmacológico , Psicotrópicos/uso terapéutico , Adolescente , Anticonvulsivantes/efectos adversos , Anticonvulsivantes/uso terapéutico , Antipsicóticos/efectos adversos , Antipsicóticos/uso terapéutico , Depresores del Apetito/efectos adversos , Depresores del Apetito/uso terapéutico , Terapia Conductista , Niño , Terapia Combinada , Ciclobutanos/efectos adversos , Ciclobutanos/uso terapéutico , Humanos , Lactonas/efectos adversos , Lactonas/uso terapéutico , Orlistat , Psicotrópicos/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores Selectivos de la Recaptación de Serotonina/efectos adversosRESUMEN
OBJECTIVE: The authors discuss the knowledge, attitudes, and skills needed for a resident to be competent in supporting and working with families, as mandated by the residency review committee (RRC) core competencies. METHODS: The RRC core competencies, as they relate to patients and their families, are reviewed. The Group for Advancement of Psychiatry (GAP) presents an operational version of these core competencies. RESULTS: Methods of assessment, challenges in teaching, and ways of overcoming programmatic constraints are outlined. Examples of training programs that offer ways of integrating the teaching of family skills into existing programs are described. CONCLUSIONS: The implications of the current RRC core competency requirements pertaining to families have the potential to change the training environment substantially. The GAP Family Committee proposes recommendations to facilitate the training of residents in family skills.