A study that included all 1.3 million children born in Denmark from 1995 to 2016 provides unique data on when eating disorders typically emerge. The authors found that the peak age of onset for anorexia and bulimia was 15 years. They also found that the incidence of eating disorders for girls was more than six times the incidence for boys. Another survey, including more than 10,000 teens in a representative American sample, found slightly different results. These data showed younger ages of onset, namely, 12.3 years for anorexia, 12.4 for bulimia and 12.6 for binge-eating disorder. Despite these differing findings, both studies highlight the need for practitioners and policy-makers to ensure the availability of treatments for eating disorders among teens, including younger ones.

For more information, see Vol. 18, No. 1 of the Children’s Mental Health Research Quarterly.

A systematic review from the Children’s Health Policy Centre provides data on the proportion of young people aged 12 to 18 years who met diagnostic criteria for eating disorders — meaning that they had both symptoms and impairment. Prevalence was derived by combining findings from five rigorous original studies that assessed eating disorders in the population. All five included anorexia and bulimia while one included binge-eating disorder; however, none included avoidant/restrictive food intake disorder. The overall prevalence for eating disorders was 0.2%. This means that at any given time, approximately 700 youth in BC will meet diagnostic criteria for an eating disorder and therefore need treatment.

Still, this figure may underestimate the needs, given that it is derived from studies conducted before the COVID-19 pandemic. And evidence is emerging that eating disorder cases increased during the pandemic. For instance, a study of six Canadian pediatric hospitals found a sharp rise in cases among nine- to 18-year-olds early in the pandemic. Specifically, new diagnoses rose significantly, from 24.5 per month during the previous five years to 40.6 per month during the first wave of the COVID-19 pandemic (March through November 2020).

For more information, see Vol. 18, No. 1 of the Children’s Mental Health Research Quarterly.

A recent systematic review by the Children’s Health Policy Centre identified two programs that successfully prevented the onset of eating disorders for teen girls — one in a general population (Education Program) and one for those at risk (Body Project). These findings suggest the following recommendations for practice and policy.

• Invest in effective prevention programs. Both successful programs addressed an established risk factor for the development of eating disorders in teen girls — body dissatisfaction. As well, both taught skills for resisting social pressures to be thin. While replication studies are needed, these evaluations suggest that it is possible to prevent new cases of eating disorders and the suffering that accompanies them. Policy-makers in BC could support offering these successful examples, while evaluating the impact in local settings. Canadian studies evaluating new approaches and programs would also be helpful.
• Make use of virtual delivery’s added benefits. Virtual delivery allows programs to reach more young people in need, particularly in rural and remote communities. And the Body Project study suggests another potentially under-recognized benefit of virtual programs: recording the sessions allows young people to catch up on any missed content. This approach can not only improve program completion but also help young people integrate information on their own time.
• Sustain prevention efforts long term. Some programs included in the review showed that selected gains diminished over time. For example, Dissonance, a precursor program to Body Project, reduced dieting at one-year but not three-year follow-up, while the Body Project reduced self-reported eating disorder symptoms at six-month but not two-year follow-up. These findings suggest that some girls may benefit from booster sessions to ensure ongoing benefits.
• Address established risk and protective factors. The programs we reviewed focused on body dissatisfaction, a risk factor often first detected in adolescence. Yet, other factors can emerge earlier in childhood, including problematic eating patterns and high anxiety levels. Therefore, it may be possible to help more children by intervening in the early years. Intervening early should include offering effective anxiety prevention programs, such as those featured in our Effective Interventions report, to reduce this condition in and of itself and as a precursor to eating disorders. Practitioners can also bolster protective factors, including assisting with parent-teen relationships to improve closeness and relationship satisfaction.

Expanding efforts to prevent eating disorders is a crucial way to reduce the number of young people experiencing these conditions and the associated mental and physical stress and distress. Beyond helping young people achieve well-being and meet their potential, effective prevention efforts should also reduce later treatment costs by reducing the numbers in need. Given the benefits for individual children and families and for society, new prevention investments are therefore strongly warranted.

For more information, see Vol. 17, No. 4 of the Children’s Mental Health Research Quarterly.

On Nov. 20 each year, children around the world advocate for their rights as part of World Children’s Day. This special day amplifies kids’ voices and gives them a platform to highlight issues that matter to them.

Established by the United Nations in 1954, World Children’s Day promotes international togetherness and awareness among children worldwide. It also focuses on improving children’s welfare.

UNICEF, the United Nations Children’s Fund, marks the day with activities and events designed to help kids have their voices heard. These include a youth advocates program and kids’ takeovers of high-profile jobs in media, politics, business, sports and entertainment. Parents and caregivers can show support by wearing blue on Nov. 20 and by committing to champion children’s rights year-round.

Despite their importance, children’s rights and health continue to face threats from war, unrest and service cuts. Children’s mental health, in particular, remains underappreciated as a public priority, but there are ways to make a difference. See Vol. 13, No. 2 of the Children’s Mental Health Research Quarterly to read about 50 lessons learned from the Children’s Health Policy Centre’s work in this field.

To identify risk factors for eating disorders, researchers followed a large group of English children from birth to age 16. Among the nearly 4,800 young people assessed, several eating patterns were associated with increased risk. Those who were “fussy eaters” throughout childhood — defined as being choosy about foods, refusing food and having general feeding difficulties — were more likely to develop anorexia. The disorder rate for fussy eaters was 3% compared with 1% for participants overall. As well, for girls only, those who persistently under-ate throughout childhood were more likely to develop anorexia, with disorder risk being 6% higher for this group compared with other children. And for binge-eating disorder, for both boys and girls, researchers found significantly greater risk for those with low levels of overeating before age five but increasing levels after that. The binge-eating disorder rate was 2% for these children compared with 1% for participants overall.

For more information, see Vol. 17, No. 4 of the Children’s Mental Health Research Quarterly.

Beyond identifying risks, researchers have assessed factors that can protect young people from developing disordered eating. One such study examined the experiences of more than 13,000 American adolescents over a six-year period. Researchers measured positive connections with parents, including feelings of closeness and relationship satisfaction, as well as disordered eating, including fasting or skipping meals, compensatory behaviours (i.e., vomiting or taking laxatives, diuretics or weight-loss pills) and binge eating. Among teenage girls, but not boys, greater parental connectedness — with both mothers and fathers — was associated with lower odds of disordered eating in young adulthood.

For more information, see Vol. 17, No. 4 of the Children’s Mental Health Research Quarterly.

Australian researchers followed nearly 1,400 children from birth to age 20 to study the relationship between body dissatisfaction and eating disorders. To do so, they evaluated young people’s concerns about weight and shape and parents’ perceptions of their child’s weight. The researchers found that two factors together predicted bulimia and binge-eating disorder by age 20: when parents perceived their child as being overweight at age 10, and when children had high levels of concern about eating, weight and shape at age 14.

Likewise, a different study that tracked more than 1,300 Australian high-school students over one year found that dissatisfaction with shape or weight was a significant predictor for later eating disorders (including both full-criteria and subthreshold levels). As well, a study of more than 1,700 Spanish high-school students found that those with high levels of body dissatisfaction at age 13 had a three times higher risk of developing eating disorders at age 15. Another Australian study assessed nearly 2,000 high-school students over three years and found that teen girls who dieted at a severe level were 18 times more likely to develop anorexia or bulimia (both partial- or full-criteria) than those who did not diet, while teen girls who dieted at a moderate level were five times more likely to develop those disorders.

For more information, see Vol. 17, No. 4 of the Children’s Mental Health Research Quarterly.

Attention-Deficit/Hyperactivity Disorder affects approximately 1.8 million Canadians, including children and youth. And it doesn’t look the same for everyone.

This October, ADHD advocacy organizations are uniting around the theme “The Many Faces of ADHD” to highlight how ADHD affects people of all genders, ages and races. By sharing diverse experiences of ADHD, they aim to raise awareness, break down stereotypes and reduce stigma.

The ADHD Awareness Month Coalition has compiled resources to answer common questions and address myths. Visit their website to learn more.

Parents and caregivers are essential to helping children with ADHD thrive. Caregivers can help children and youth develop self-regulation skills, and substantial research supports the effectiveness of parent training interventions for childhood ADHD. To learn more, see Vol. 10, No. 4 and Vol. 11, No. 1 of the Children’s Mental Health Research Quarterly.

World Mental Health Day is held annually on Oct. 10. It raises awareness of mental health and advocates for stronger mental health supports. The day also brings global mental health organizations together to mobilize resources and strategies.

This year’s theme, “Access to services – mental health in catastrophes and emergencies,” highlights the urgent need to support people affected by humanitarian disasters. According to the World Health Organization, almost all people affected by emergencies experience psychological distress. However, this distress typically improves over time.

While children and youth often show incredible resilience in times of crisis, it is important to understand how they are impacted by traumatic events and how they can be helped. Traumatic events also occur in everyday life — such as injuries, maltreatment or witnessing the death of a loved one.

Even after children have experienced a serious adversity, it is possible to prevent mental health symptoms from developing — and adding further to their distress and burdens. To learn more about helping children cope with trauma, see Vol. 15, No. 1 of the Children’s Mental Health Research Quarterly.