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The Junior MARSIPAN working group was formed to develop guidelines
for young people with anorexia nervosa to complement the report
from the MARSIPAN group (CR162. MARSIPAN:
Management of Really Sick Patients with Anorexia Nervosa) which
addresses the care of adult in-patients with anorexia
nervosa.
The rationale for a separate document is that the definition of
very sick patients with anorexia nervosa differs in young people,
because serious underweight varies with age and gender; other
aspects of risk differ in young people (e.g. blood pressure norms);
consent and capacity are addressed within different legal
frameworks for young people than adults; there are differences in
service organisation for specialist child and adolescent mental
health services (CAMHS); and paediatric services have a central
role in the care of young people.
The Junior MARSIPAN report provides guidance and recommendations
on:
- Risk assessment, physical examination and
associated action.
- Location of care and transition between
services.
- Compulsory treatment.
- Paediatric admission and local
protocols.
- Management of re-feeding.
- Management of compensatory behaviours
associated with an eating disorder in a paediatric setting.
- Management in primary care and paediatric
out-patient settings.
- Discharge from paediatric settings.
- Management in specialist CAMHS in-patient
settings.
Contents
Endorsing organisations
Junior MARSIPAN Working Group
Executive summary and recommendations
Introduction
- History of the project
- Procedure followed in producing the
report
- The problem
Issues arising in all
settings
- Risk assessment: how ill is the patient?
- Location of care: where will the patient be
best managed?
- Transfer between services
- Compulsory admission and treatment
- Policies and protocols
Management of children and adolescents
with anorexia nervosa in different sectors
- Management in general practice
- Management in out-patient paediatric
settings
- Management in in-patient paediatric
settings
- Management in SEDBs
- Audit and review
Appendices
A. Calculating the degree of
underweight for females: comparison of two methods
B. Comments from general
practitioners and parents/carers group
C. Re-feeding syndrome in children
and adolescents: literature summary
D. Some cases reported to the
Junior MARSIPAN group
E. Protocols for managing very ill
young people with anorexia nervosa
F. Example of a care pathway
designed to improve speed of referral
References