Eating Disorders Among Adolescents and Young adults in Kingston, Jamaica

Abigail Harrison^1*Caryl James¹Kimberley Ferguson-Henry¹Kern Rocke²Gillian Lowe¹

• ¹The University of the West Indies, Mona, Kingston, Jamaica
• ²The University of the West Indies at Cave Hill, Bridgetown, Barbados

Introduction: Eating disorders are complex disorders characterized by a persistent disturbance of eating that impairs health and psychosocial functioning, with accompanying long-lasting effects on the individual's overall health and well-being. Presumed stereotypes may affect reporting and access to care, especially in the Caribbean, where ethnic groups are mostly non-White. This study reviewed the clinical presentation, management, and outcomes of eating disorders in adolescents and young adults in Kingston, Jamaica. It explored the factors that influence outcomes – hospital admission and recovery. Methods: This retrospective case review study included male and female adolescents and young adult participants (10-29 years old) being treated for an eating disorder in Kingston, Jamaica. Data were extracted from the medical records of patients meeting the inclusion criteria for the period January 2010 to December 2020. Sociodemographic data, medical and psychological symptoms and signs, management and outcomes were extracted. Descriptive analyses were performed - proportions and frequencies for categorical variables; means and medians for continuous variables. Inferential analyses including the independent student's t-test and analysis of variance were used to compare means and the Pearson chi-squared test used to determine the association between categorical variables. Logistic regression analyses examined predictors of outcome. Analyses were performed using SPSS version 23. Statistical significance was determined at the 5% level. Results: The study included 68 participants with a female preponderance (n=60, 88.2%). Other specified food and eating disorders (OSFED)(n=27, 39.7%) was the most common subtype seen in the sample population, and included atypical anorexia nervosa (AAN) (n=18,26.5%). Eleven (16.2%) participants were admitted to the hospital, the majority diagnosed with OSFED (n=6, 54.5%). The most common reason for admission was failure of outpatient management (n=7, 63.6%) but also 2 included admissions for active suicidal ideation (n=1) and late presentation (n=2). Multidisciplinary management by an ED-trained physician, ED-psychologist, and dietician was utilised in most participants. Discussion: Eating disorders are an emerging health concern worldwide, as well as in Jamaica. OSFED with a preponderance of atypical anorexia nervosa is the most prevalent, with overall female preponderance. These findings necessitate the implementation of measures in Jamaica in the realms of identification, prevention, and treatment.