Postural Tachycardia in Psychiatric Inpatient Eating Disorders Treatment

Abstract

Objective: Postural tachycardia has been observed in eating disorders and is included in medical admission criteria. This study aimed to determine the following among a cohort of patients admitted to the Eating Disorders Unit (EDU) at Austin Hospital in Melbourne, Victoria, Australia: (i) the prevalence of postural tachycardia among eating disorder inpatients, and (ii) the associated demographic, psychiatric, and clinical features. Methods: Retrospective review of patient files was undertaken for inpatients aged 18 – 65 years with an eating disorder who resided within the Body Image & Eating Disorders Treatment & Recovery Service (BETRS) catchment area and were admitted to EDU between 01/01/21 to 30/10/23. Logistics regression was used for statistical analysis. Results: Among 177 admissions, 48 patients and 56 admissions in total had postural tachycardia. Postural tachycardia was at least partially attributed to malnutrition in 42 patients and 47 admissions. Antipsychotics were significantly positively associated and for every increase in one antipsychotic medication, there was an 89% increase in postural tachycardia diagnosis likelihood (B=0.637) (Exp(‘B’))=1.890). Higher admission BMI and weight, emergency medical reviews, ≥10 prior psychiatric admissions, and 1-3 prior medical admissions were significantly positively associated with postural tachycardia.

Conclusion: Postural tachycardia is a significant multifactorial issue which impacts patients with eating disorders. It contributes to medical instability and the need for emergency medical reviews, and is associated with antipsychotic medication use and a history of multiple medical and psychiatric admissions.