scholarly journals Problems across care pathways in specialist adult eating disorder services

2009 ◽  
Vol 33 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Glenn Waller ◽  
Ulrike Schmidt ◽  
Janet Treasure ◽  
Katie Murray ◽  
Joana Aleyna ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Resource Utilisation ◽  
Clinical Implications ◽  
Evidence Based ◽  
Care Pathways ◽  
Patient Journey ◽  
End Of Treatment ◽  
Complete Treatment ◽  
Evidence Based Care

Aims and MethodDespite considerable knowledge of outcomes for patients who complete treatment for eating disorders, less is known about earlier stages in the treatment journey. This study aimed to map the efficiency of the anticipated patient journey along care pathways. Referrals to specialist eating disorder services (n=1887) were tracked through the process of referral, assessment, treatment and discharge.ResultsThe patient mortality rate was low. However, there were serious problems of attrition throughout the care pathways. of the original referrals where a meaningful conclusion could be reached, in approximately 35% the person was never seen, only half entered treatment and only a quarter reached the end of treatment.Clinical ImplicationsThis study demonstrates considerable inefficiency of resource utilisation. Suggestions are made for reducing this inefficiency, to allow more patients the opportunity of evidence-based care.

scholarly journals Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

2021 ◽  
Author(s):  
Andreas Birgegård ◽  
Afrouz Abbaspour ◽  
Stina Borg ◽  
David Clinton ◽  
Emma Forsén Mantilla ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Data Availability ◽  
Evidence Based ◽  
List Type ◽  
Convenience Sample ◽  
Eating Disorder Symptom ◽  
Disorder Symptom ◽  
Evidence Based Care ◽  
The Impact

AbstractObjectiveTo document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.MethodWe re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).ResultsThree important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.ConclusionsThe COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.Significant Outcomes and LimitationsIndividuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental healthEven individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptomsA large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across SwedenLimitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.Data Availability StatementFully anonymized data are available from the corresponding author upon request.

Adapting a Technology-Based Eating Disorder Model for Athletes

2018 ◽  
Vol 12 (4) ◽  
pp. 699-717 ◽  
Author(s):  
Rachael E. Flatt ◽  
Craig Barr Taylor
Keyword(s):  
Eating Disorders ◽  
Health Programs ◽  
Evidence Based ◽  
Face To Face ◽  
Self Help ◽  
High Prevalence ◽  
Integrate Technology ◽  
Receive Treatment ◽  
Mental Health Programs ◽  
Evidence Based Care

Eating disorders (EDs) are common amongst athletes, yet few receive treatment. Given that athletes have a unique set of risk factors for eating disorders and are faced with additional barriers to treatment, new models outside of face-to-face treatment are necessary to reach the population and provide more affordable, tailored, evidence-based care. One solution is to use digital mental health programs to provide primary or supplemental therapy. Digital programs can provide accessibility and privacy, and recent advancements allow for more personalized online experiences. However, there have been no studies to date that integrate technology-based tools to address the especially high prevalence rates of EDs in athletes. This paper describes how an integrated model that includes online screening linked to guided self-help programs, all adapted specifically for athletes, can be used to provide prevention and intervention of EDs in athletes.

scholarly journals The Renfrew Unified Treatment for Eating Disorders and Comorbidity: Long-Term Effects of an Evidence-Based Practice Implementation in Residential Treatment

2021 ◽  
Vol 12 ◽  
Author(s):  
Heather Thompson-Brenner ◽  
Simar Singh ◽  
Taylor Gardner ◽  
Gayle E. Brooks ◽  
Melanie T. Smith ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Anxiety Sensitivity ◽  
Experiential Avoidance ◽  
Multilevel Models ◽  
Sensitivity Index ◽  
Evidence Based ◽  
Long Term Study ◽  
Significant Difference

Background: The Renfrew Unified Treatment for Eating Disorders and Comorbidity (UT) is a transdiagnostic, emotion-focused treatment adapted for use in residential group treatment. This study examined the effect of UT implementation across five years of treatment delivery.Methods: Data were collected by questionnaire at admission, discharge (DC), and 6-month follow-up (6MFU). Patient outcomes were measured by the Eating Disorder Examination-Questionnaire, Center for Epidemiologic Studies-Depression Scale, Brief Experiential Avoidance Questionnaire (BEAQ), Anxiety Sensitivity Index, and Southampton Mindfulness Scale. Data were analyzed for N = 345 patients treated with treatment-as-usual (TAU), and N = 2,763 treated with the UT in subsequent years.Results: Results from multilevel models demonstrated a significant interaction between implementation status (TAU vs. UT) and time, both linear and quadratic, for the depression, experiential avoidance, anxiety sensitivity, and mindfulness variables. Patients treated with the UT showed more improvement in these variables on average, as well as more rebound between DC and 6MFU. Results from multilevel models examining eating disorder outcome showed no significant difference between the TAU and UT for the full sample, but a significant three-way interaction indicated that the UT produced more improvement in the EDE-Q relative to the TAU particularly for patients who entered treatment with high levels of experiential avoidance (BEAQ score).Conclusion: This long-term study of a transdiagnostic, evidence-based treatment in residential care for eating disorders and comorbidity suggests implementation was associated with beneficial effects on depression and emotion function outcomes, as well as eating disorder severity for patients with high levels of baseline emotion regulation problems. These effects did not appear to diminish in the 5 years following initial implementation.

Eating Disorders

2020 ◽  
pp. 511-530
Author(s):  
Anoop Narahari ◽  
Raman Baweja ◽  
Piyush Das ◽  
Amit Chopra
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Sleep Disturbances ◽  
The Body ◽  
Current Evidence ◽  
Evidence Based ◽  
Short Sleep Duration ◽  
Nocturnal Eating ◽  
Abnormal Eating ◽  
Nutritional Balance

Sleep and eating behavior are complimentary homeostatic functions and adequate sleep is fundamental for the nutritional balance of the body. Short sleep duration has been linked to development of obesity and abnormal eating patterns in children and adults. Individuals with eating disorders report significantly higher sleep disturbances of sleep apnea, insomnia, circadian rhythm disorders, and impairment of daytime functioning, as compared to controls. Sleep disturbances have been implicated in suicidal behaviors in patients with eating disorders. This chapters outline the current evidence examining the pathophysiology and comorbidity of sleep disturbance in daytime eating disorders and focus on clinical assessment and management of nocturnal eating disorders including night eating syndrome and particularly sleep-related eating disorder, which is a combination of parasomnia and eating disorder. There is an imminent need to develop evidence-based pharmacological and psychological treatments for management of nocturnal eating disorders and the sleep disturbances associated with daytime eating disorders.

Twelve-year course and outcome of bulimia nervosa

2004 ◽  
Vol 34 (8) ◽  
pp. 1395-1406 ◽  
Author(s):  
MANFRED M. FICHTER ◽  
NORBERT QUADFLIEG
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
General Pattern ◽  
Prospective Longitudinal Study ◽  
End Of Treatment ◽  
Co Morbidity ◽  
Prospective Longitudinal

Background. Since little is known about the long-term course and outcome of bulimia nervosa, the authors designed a 12-year prospective longitudinal study with five cross-sectional assessments based on a large sample of consecutively treated females with bulimia nervosa (purging type) (BN-P).Method. One hundred and ninety-six females with BN-P were assessed (1) at the beginning of treatment, (2) at the end of treatment, (3) at 2-year follow-up, (4) at 6-year follow-up, and (5) at 12-year follow-up. In self-ratings as well as expert ratings based on interviews we assessed specific eating-disorder and general psychopathology.Results. The general pattern of results over time showed substantial improvement during treatment, slight (in most cases non-significant) decline during the first two years after the end of treatment, and further improvement and stabilization until 12-year follow-up. At that point the majority of patients (70·1%) showed no major DSM-IV eating disorder, 13·2% had eating disorders not otherwise specified, 10·1% had BN-P and 2% had died. Very few had undergone transition to anorexia nervosa or binge-eating disorders. Logistic regression analyses showed that psychiatric co-morbidity was the best and most stable predictor for eating-disorder outcome at 2, 6 and 12 years.Conclusions. Course and outcome of BN-P was generally more favourable than for anorexia nervosa.

scholarly journals Mapping services to support a patient's journey through evidence-based care pathways after a cardiac event

2009 ◽  
Vol 18 ◽  
pp. S266
Author(s):  
R.A. Clark ◽  
D. Wilkinson ◽  
N. Coffee ◽  
K. Eckert ◽  
P. Astles ◽  
...  
Keyword(s):  
Cardiac Event ◽  
Evidence Based ◽  
Care Pathways ◽  
Evidence Based Care

Clinical Registries and Evidence-Based Care Pathways

Spine ◽  
2014 ◽  
Vol 39 ◽  
pp. S136-S138 ◽  
Author(s):  
Anthony L. Asher ◽  
Clinton J. Devin ◽  
Thomas Mroz ◽  
Michael Fehlings ◽  
Scott L. Parker ◽  
...  
Keyword(s):  
Evidence Based ◽  
Care Pathways ◽  
Clinical Registries ◽  
Evidence Based Care

Cognitive Behavioral Therapy for Eating Disorders

2010 ◽  
pp. 330-347 ◽  
Author(s):  
Gregory D. Wilson
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Behavioral Therapy ◽  
Evidence Based ◽  
Cognitive Behavior ◽  
Evidence Based Treatment ◽  
Not Otherwise Specified ◽  
Self Help ◽  
Clinical Strategies

Cognitive behavior therapy (CBT) is the most effective treatment of bulimia nervosa (BN) and binge eating disorder (BED). Initial findings with eating disorder not otherwise specified (EDNOS) other than BED promise similar outcomes. Options for improving upon the efficacy and efficiency of CBT are discussed, primarily by incorporating an expanded range of principles and clinical strategies from CBT in general. Fairburn’s (2008) enhanced CBT provides an illustration. Dissemination of CBT is poor. Guided self-help based on CBT principles is effective for a subset of patients with BN and BED and provides the means for making evidence-based treatment available to a wider range of patients. There is scant research on CBT for anorexia nervosa, and evidence of efficacy is lacking.

Sign in / Sign up

Export Citation Format

Share Document