Examination of a day programme for eating disorders: impact on 3-month follow-up by psychiatric comorbidity

2019 ◽  
Vol 28 (2) ◽  
pp. 148-152 ◽  
Author(s):  
Tracey D Wade ◽  
Ertimiss Eshkevari ◽  
Corree Guerin ◽  
Jasmine Smith ◽  
Daniela Hoskin

Objective: The two aims of this preliminary investigation were to use a case series design to examine outcomes of a day programme (DP) for eating disorders and to investigate whether the presence of baseline psychiatric comorbidities moderated outcomes 3 months after discharge. Method: Linear mixed modelling was used to investigate changes over time in the 91 participants who had commenced the DP by April 2019; 87 (96%) female, 61 (67%) with a DSM-5 diagnosis of anorexia nervosa. Results: Six of our seven outcome variables (dietary restraint; concern over weight, eating and shape; clinical impairment; and psychological distress) showed moderate to large effect size improvements from baseline to follow-up. Generally, improvement declined somewhat at follow-up from discharge, with a pattern of results suggesting this decline was less where there was comorbidity at baseline. Conclusions: These results suggest that a DP effectively reduces eating disorder psychopathology regardless of the presence of psychiatric comorbidity.

2021 ◽  
Author(s):  
Stephanie Knatz Peck ◽  
Terra Towne ◽  
Christina Wierenga ◽  
Laura Hill ◽  
Ivan Eisler ◽  
...  

Abstract Background: Adult eating disorder treatments are hampered by lack of access and limited efficacy. This open-trial study evaluated the acceptability and preliminary efficacy of a novel intervention for adults with eating disorders delivered to young adults and parent-supports in an intensive, multi-family format (Young Adult Temperament-Based Treatment with Supports; YA-TBT-S). Methods: 38 YA-TBT-S participants (m age = 19.58; SD 2.13) with anorexia nervosa (AN)-spectrum disorders, bulimia nervosa (BN)-spectrum disorders, and avoidant/restrictive food intake disorder (ARFID) completed self-report assessments at admission, discharge, and 12-month follow-up. Assessments measured program satisfaction, eating disorder psychopathology and impairment, body mass index (BMI), and trait anxiety. Outcomes were analyzed using linear mixed effects models to examine changes in outcome variables across diagnoses over time. Results: Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. Participants reported reductions in ED symptomatology (AN and BN), increases in BMI (AN and ARFID), and reductions in clinical impairment (AN and ARFID) at 12-month follow-up. Conclusions: YA-TBT-S is a feasible and acceptable treatment that may improve ED outcomes in young adults with a broad range of diagnoses. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches.


2005 ◽  
Vol 33 (2) ◽  
pp. 189-200 ◽  
Author(s):  
Clare Farrell ◽  
Roz Shafran ◽  
Michelle Lee ◽  
Christopher G. Fairburn

The successful treatment of extreme shape concern in patients with eating disorders has been shown to be important for their sustained recovery. This case series reports a preliminary investigation of the effects of a new brief cognitive-behavioural intervention for extreme shape concern. The intervention, which is implemented in a single 2-hour session, addresses four mechanisms hypothesized to contribute to the maintenance of extreme shape concern and is designed to be suitable as an adjunct to existing treatments for eating disorders. Participants were five women with extreme shape concern and three female patients with eating disorders. The results indicate that the intervention was effective to various degrees in each participant, and suggest that the intervention warrants further investigation. In particular, methods of increasing the potency of the intervention should be investigated, and its efficacy tested in a larger controlled study.


Author(s):  
Simone Cheli ◽  
Veronica Cavalletti

The objective of this pilot-study is to report the preliminary results of a specifically designed therapy for gifted students enrolled in highly competitive PhD programs. We outlined a case series design (n=7), with initial, final, and 1-month follow-up assessments.Inclusion criteria were: to be a student in an international PhD program; to be defined as a gifted student (at least one WAIS-IV Index =130); to be diagnosed with a personality disorder in accordance with DSM-5 Alternative Model of Personality Disorders. Primary outcomes were general symptomatology, social disconnection, and personality disorder severity.Secondary outcomes were the presumed therapeutic targets: overcontrol, perfectionism, and self-criticism. The intervention was a 6-month third wave cognitive behavioral therapy aimed at promoting adaptive self-soothing and metacognitive strategies. At the end of the intervention all the participants showed reliable changes in both primary and secondary outcomes.


2011 ◽  
Vol 19 (6) ◽  
pp. 526-530 ◽  
Author(s):  
Adam Bayes ◽  
Sloane Madden

Objective: This case series aims to describe the demographic and clinical features of male inpatients with early onset eating disorders. Method: Retrospective review was made of medical files of male patients treated for eating disorders at two children's hospitals over a 2 year period, with an onset of eating disorder before age 14 years, presenting for index admission. Demographic characteristics, DSM-IV diagnosis, clinical characteristics and treatment received were reviewed. Results: Ten male patients with a median age of 12.8 years (range 10.2 to 13.5) were identified; three met the full criteria for anorexia nervosa (AN) and four met all except the weight criterion. There was high psychiatric comorbidity: four with a major depressive episode, seven an anxiety disorder, three with obsessive-compulsive disorder (OCD) symptoms. Seven engaged in over-exercise. Seven were treated with an antidepressant, and five with an atypical antipsychotic; six required nasogastric tube (NGT) feeding. Conclusion: A minority of patients met full diagnostic criteria for AN, with many not meeting weight criteria despite medical instability. The main clinical features were food restriction, over-exercise and psychiatric comorbidity. Treatment with antidepressants, antipsychotics and NGT feeding was frequent. Future prospective studies could help identify gender-specific features as well as benefits and potential side effects of pharmacotherapy in this age group.


2020 ◽  
Vol 9 ◽  
Author(s):  
Jane Ogden ◽  
Elina Pavlova ◽  
Hollie Fouracre ◽  
Frances Lammyman

Abstract Two promising strategies to manage eating behaviour are intuitive eating (IE; following hunger) and pinned eating (PE; ignoring hunger/eating at specific times of the day). This study compared IE and PE on behavioural markers. Participants (n 56) were randomly assigned to IE (n 28) or PE (n 28) and given instructions to follow for 1 week. Drive to eat, behaviour, behavioural intentions and self-efficacy were measured at baseline and follow-up. Participants also evaluated their specific intervention. Comparable changes over time were found for both conditions for many measures. Significant conditions by time interactions were found for healthy snacking, total self-efficacy and self-efficacy for weight loss: those following IE showed an increase in each of these outcomes compared to those following PE who showed no change. The IE group found their intervention more useful than those following PE. Further research is needed to build on these preliminary findings.


2011 ◽  
Vol 5 (8) ◽  
pp. 1949
Author(s):  
Paula Carolina Valença Silva ◽  
Eliane Germano Mendes

ABSTRACTObjective: to describe the nursing assistance in the postoperative of lower limb varicose veins surgery and propose an assistance protocol. Method: this is a descriptive transversal study, with a case series design, in which 201 patients who undertook a lower limb varicose veins surgery in the vascular surgery ambulatory of a university hospital in Recife, Pernambuco, Brazil, were interviewed, within the period from August 2006 to April 2007, in the 30th postoperative day. The following inclusion criteria were adopted: pain complaint, fatigue, burning, heavy weight feeling, swelling, lower limb cramps, and/or claudication in the postoperative. For the data collection an interview form with sociodemographic and clinic information was used. The research was approved by the Committee of Ethics and Research of Instituto Materno-Infantil Professor Fernando Figueira, under the Protocol 827. The data underwent a descriptive statistical analysis through the software Epiinfo 6.04. Results: one observes the patients did not receive advice from the nursing staff on bath (62.2%), walk (63.2%), postoperative wound dressings after hospital discharge (61.2%), and follow-up appointments (60.7%). In 93% of the cases patients did not use wound dressings. Conclusions: the data show drawbacks of nursing procedures during hospitalization. At the end of this data analysis, a proposal of nursing assistance protocol was designed for this group of patients, aiming to improve the care of surgical patients operated on at the institution. Descriptors: nursing, varicose veins, assistance.RESUMOObjetivo: descrever a assistência de enfermagem no pós-operatório de cirurgia de varizes de membros inferiores e propor um protocolo de assistência. Método: trata-se de um estudo transversal descritivo, tipo série de casos, no qual foram entrevistados 201 pacientes submetidos à cirurgia de varizes de membros inferiores no ambulatório de cirurgia vascular de um hospital universitário de Recife-PE, no período de agosto de 2006 a abril de 2007, no 30º dia de pós-operatório. Foram adotados os seguintes critérios de inclusão: queixa de dor, cansaço, queimação, sensação de peso, inchaço, cãibras em membros inferiores e/ou claudicação no pré-operatório. Para coleta de dados foi utilizado um formulário de entrevista contendo informações sociodemográficas e clínicas. A pesquisa foi aprovada pela Comissão de Ética e Pesquisa do Instituto Materno-Infantil Professor Fernando Figueira, sob o Protocolo n. 827. Os dados foram submetidos à análise estatística descritiva pelo programa Epiinfo 6.04. Resultados: observou-se que os pacientes não receberam no período pós-operatório orientação por parte da enfermagem quanto a banho (62,2%), deambulação (63,2%), curativos após a alta hospitalar (61,2%) e consultas de retorno (60,7%). Em 93% dos casos não houve realização de curativos. Conclusões: os dados demonstram fragilidades nas condutas de enfermagem durante o internamento. Ao término da análise desses dados foi elaborada uma proposta de protocolo de assistência de enfermagem para esse grupo de pacientes visando à melhoria dos cuidados ao paciente cirúrgico operado na instituição. Descritores: enfermagem, varizes, assistência.RESUMENObjetivo: describir la atención de enfermería en el postoperatorio de cirugía de varices de miembros inferiores y proponer un protocolo de atención. Métodos: se trata de un estudio transversal descriptivo de tipo serie de casos en el que se entrevistó a 201 pacientes sometidos a cirugía de varices de los miembros inferiores en el ambulatorio de cirugía vascular de un Hospital Universitario de Recife – PE, durante el periodo de agosto de 2006 a abril de 2007 en el trigésimo día de postoperatorio. Se adoptaron los siguientes criterios de inclusión: quejas de dolores, cansancio, ardores, sensación de peso, hinchazón, calambres en miembros inferiores o claudicación en el pre operatorio. Para la recogida de datos se utilizó un impreso de entrevista que contiene informaciones socio-demográficas y clínicas. La investigación fue aprobada por la Comisión de Ética e Investigación del Instituto Materno Infantil Profesor Fernando Siqueira bajo protocolo nº 827. Los datos se sometieron a análisis estadístico descriptivo del programa Epiinfo 6.04. Resultados: se observó que durante el posoperatorio los pacientes no recibieron orientación por parte de la enfermería respecto al baño (62,2%), respecto a sus desplazamientos (63,2%), curativos tras el alta hospitalaria (61,2%) ni sobre consultas de vuelta (60,7%). En el 93% de los casos no se efectuaron curativos. Conclusiones: los datos demuestran fragilidades en las conductas de enfermería durante la internación. Al término del análisis de estos datos, se elaboró una propuesta de protocolo de asistencia de enfermería para este grupo de pacientes en pos de una mejoría de cuidados al paciente quirúrgico operado en la Institución. Descriptores: Enfermería, varices, asistencia.


2006 ◽  
Vol 189 (4) ◽  
pp. 324-329 ◽  
Author(s):  
Alan Stein ◽  
Helen Woolley ◽  
Sandra Cooper ◽  
Jonathan Winterbottom ◽  
Christopher G. Fairburn ◽  
...  

BackgroundChildren of mothers with eating disorders are at increased risk of developmental disturbance, but there has been little research in middle childhood, when disturbed eating habits tend to emerge.AimsTo examine whether maternal eating disorders identified in the postnatal year are associated with the development of disturbed eating habits and attitudes in children at 10 years of age.MethodFollow-up comparative study of 56 families (33 mothers with eating disorders and 23 controls). Psychopathology of children, mothers and fathers was assessed by interview, and mother-child interaction observed.ResultsThe index group of children scored higher than controls on three of four domains of eating disorder psychopathology and on a global score. Children's eating disturbance was associated with length of exposure to mothers' eating disorder and mother-child mealtime conflict at 5 years. There was some evidence of increased emotional problems in index children.ConclusionsThe children of mothers with eating disorders manifested disturbed eating habits and attitudes compared with controls, and may be at heightened risk of developing frank eating disorder psychopathology.


Author(s):  
Jae Ik Lee ◽  
Mohd Shahrul Azuan Jaffar ◽  
Han Gyeol Choi ◽  
Tae Woo Kim ◽  
Yong Seuk Lee

AbstractThe purpose of this study was to evaluate the outcomes of isolated medial patellofemoral ligament (MPFL) reconstruction, regardless of the presence of predisposing factors. A total of 21 knees that underwent isolated MPFL reconstruction from March 2014 to August 2017 were included in this retrospective series. Radiographs of the series of the knee at flexion angles of 20, 40, and 60 degrees were acquired. The patellar position was evaluated using the patellar tilt angle, sulcus angle, congruence angle (CA), and Caton-Deschamps and Blackburne-Peel ratios. To evaluate the clinical outcome, the preoperative and postoperative International Knee Documentation Committee (IKDC) and Lysholm knee scoring scales were analyzed. To evaluate the postoperative outcomes based on the predisposing factors, the results were separately analyzed for each group. Regarding radiologic outcomes, 20-degree CA was significantly reduced from 10.37 ± 5.96° preoperatively to −0.94 ± 4.11° postoperatively (p = 0.001). In addition, regardless of the predisposing factors, delta values of pre- and postoperation of 20-degree CA were not significantly different in both groups. The IKDC score improved from 53.71 (range: 18–74) preoperatively to 94.71 (range: 86–100) at the last follow-up (p = 0.004), and the Lysholm score improved from 54.28 (range: 10–81) preoperatively to 94.14 (range: 86–100) at the last follow-up (p = 0.010). Isolated MPFL reconstruction provides a safe and effective treatment for patellofemoral instability, even in the presence of mild predisposing factors, such as trochlear dysplasia, increased patella height, increased TT–TG distance, or valgus alignment. This is a Level 4, case series study.


2019 ◽  
Author(s):  
Anna Angelousi ◽  
Eva Kassi ◽  
Melpomeni Peppa ◽  
Alexandra Chrysoulidou ◽  
George Zografos ◽  
...  

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