EATING DISORDER PATIENTS EVOLUTION THREE YEARS AFTER INTAKE IN DAY HOSPITAL

2017 ◽  
Keyword(s):  
Eating Disorder ◽  
Day Hospital

scholarly journals Rapid Response to Day Hospital Treatment in Bulimia Nervosa and Purging Disorder: a Randomized Controlled Trial of an Intervention to Facilitate Early Behaviour Change

2021 ◽  
Author(s):  
Danielle Elziabeth MacDonald
Keyword(s):  
Randomized Controlled Trial ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Controlled Trial ◽  
Rapid Response ◽  
Hospital Treatment ◽  
Day Hospital ◽  
Purging Disorder ◽  
Randomized Controlled ◽  
End Of Treatment

Even the most effective treatments for bulimia nervosa and purging disorder have high rates of nonremission and relapse. As such, improving treatment efficacy is an important research priority in this area. Research has consistently demonstrated that rapid response – defined as substantial improvements in key eating disorder behaviours (e.g., binge eating, vomiting, dietary restriction) during the initial weeks of cognitive behavioural therapy (CBT) – is the strongest and most robust predictor of good outcomes at end-of-treatment and in follow-up (Vall & Wade, 2015). Further, research has failed to identify pre-treatment demographic or clinical variables that account for this relationship, suggesting that rapid response is due to elements of CBT itself. This study aimed to demonstrate that rapid response can be clinically facilitated. A four-session CBT intervention focused on encouraging rapid response was compared to a matched-intensity motivational interviewing intervention, both adjunctive to intensive treatment in a randomized controlled trial. The CBT intervention included psychoeducation about rapid response, a focus on goal-setting, and use of behavioural skills for making concrete changes. Forty-four women with bulimia nervosa or purging disorder participated in the study. There were no baseline differences between groups on any demographic or clinical variables. Intent-to-treat results showed that compared to those who received motivational interviewing, participants who received CBT were significantly more likely to make a rapid response to day hospital treatment, and had fewer total eating disorder behaviours and more normalized eating during the first 4 weeks of day hospital treatment. Additionally, between baseline and day hospital end-of-treatment, participants who received CBT made significantly greater improvements on overvaluation of weight and shape and difficulties with emotion regulation. These findings indicate that rapid response to intensive treatment can be clinically facilitated using an adjunctive intervention focused on encouraging rapid and substantial change. These findings also suggest that rapid response may be related to improved outcome via improvements in overvaluation of weight and shape or emotion regulation. This study provides support for theoretical contentions that rapid response is due to CBT-related factors, and provides the framework for future research investigating rapid response as a causal mechanism of good outcome for eating disorders.

Full Of Nothing

2016 ◽  
Vol 33 (S1) ◽  
pp. S425-S425
Author(s):  
E. Cortazar Alonso ◽  
H. Guillen Rodrigo ◽  
S. Fuentes Marquez
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Infant Mental Health ◽  
Western Civilization ◽  
Day Hospital ◽  
Competing Interest ◽  
The Biggest Loser ◽  
First Time

The eating disorders like anorexia, bulimia nervosa, and obesity are known and described from the principles of Western civilization. Eating disorders affect a large number of people, which about the 90–95% of them are women. Not to forget is their multicausality. Though their etiology is not exactly known yet, being on a diet is the most important predictor of having an eating disorders.We summarize here a case of R. a 30-year-old woman, who visited the Infant Mental Health Institut for the first time at the age of 13 referred by her pediatrician and suspected to have an eating disorder. R. lived with her parents and an older sister. The patient suffered an underweight below the healthy and a distorted perception of her body among other symptoms. She has gone through several specialists and treatments including day hospital since her first entrance at the hospital.The flexibility and cooperation between the different therapists involved in the treatment is essential for a good outcome of the patient. There are many factors that can have an influence in the treatment, like the reluctance to the treatment, the counter transference feelings that the therapy can cause and the way of relationship. These factors can often cause situations of confusion and misunderstandings between the different professionals who attend the patient, who have to be well coordinated. Not to forget is that the biggest loser of all is the patient itself.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Psychological meanings of eating disorders and their association with symptoms, motivation toward treatment, and clinical evolution among outpatients

2019 ◽  
Vol 15 (2) ◽  
pp. 367-379
Author(s):  
Marie-Pierre Gagnon-Girouard ◽  
Marie-Pier Chenel-Beaulieu ◽  
Annie Aimé ◽  
Carole Ratté ◽  
Catherine Bégin
Keyword(s):  
Eating Disorders ◽  
Factor Analysis ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Treatment Acceptability ◽  
Day Hospital ◽  
Clinical Tool ◽  
Clinical Evolution ◽  
Attribution Process

Unlike patients suffering from egodystonic disorders, people with eating disorders sometimes attribute positive meanings to their symptoms, and this attribution process contributes to the maintenance of the disorder. This study aims at exploring psychological meanings of eating disorders and their associations with symptoms, motivation toward treatment, and clinical evolution. Eighty-one adults with an eating disorder (anorexia nervosa, n = 46 and bulimia nervosa, n = 35) treated in a day-hospital program were asked, each week over an 8-week period, to identify the psychological meanings they ascribed to their eating disorder. Avoidance was the most frequently identified meaning, followed by mental strength, security, death, confidence, identity, care, and communication. Avoidance was more frequently mentioned by participants with bulimia than in cases of anorexia. Security and mental strength were associated with less motivation toward treatment. Death was associated with more depressive and anxious symptoms. An exploratory factor analysis showed that these meanings formed three main dimensions: Avoidance, Intrapsychic, and Relational. Findings suggest that psychological meanings associated with eating disorders can be assessed and used as a clinical tool to increase treatment acceptability and effectiveness.

scholarly journals Rapid Response to Day Hospital Treatment in Bulimia Nervosa and Purging Disorder: a Randomized Controlled Trial of an Intervention to Facilitate Early Behaviour Change

2021 ◽  
Author(s):  
Danielle Elziabeth MacDonald
Keyword(s):  
Randomized Controlled Trial ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Controlled Trial ◽  
Rapid Response ◽  
Hospital Treatment ◽  
Day Hospital ◽  
Purging Disorder ◽  
Randomized Controlled ◽  
End Of Treatment

Even the most effective treatments for bulimia nervosa and purging disorder have high rates of nonremission and relapse. As such, improving treatment efficacy is an important research priority in this area. Research has consistently demonstrated that rapid response – defined as substantial improvements in key eating disorder behaviours (e.g., binge eating, vomiting, dietary restriction) during the initial weeks of cognitive behavioural therapy (CBT) – is the strongest and most robust predictor of good outcomes at end-of-treatment and in follow-up (Vall & Wade, 2015). Further, research has failed to identify pre-treatment demographic or clinical variables that account for this relationship, suggesting that rapid response is due to elements of CBT itself. This study aimed to demonstrate that rapid response can be clinically facilitated. A four-session CBT intervention focused on encouraging rapid response was compared to a matched-intensity motivational interviewing intervention, both adjunctive to intensive treatment in a randomized controlled trial. The CBT intervention included psychoeducation about rapid response, a focus on goal-setting, and use of behavioural skills for making concrete changes. Forty-four women with bulimia nervosa or purging disorder participated in the study. There were no baseline differences between groups on any demographic or clinical variables. Intent-to-treat results showed that compared to those who received motivational interviewing, participants who received CBT were significantly more likely to make a rapid response to day hospital treatment, and had fewer total eating disorder behaviours and more normalized eating during the first 4 weeks of day hospital treatment. Additionally, between baseline and day hospital end-of-treatment, participants who received CBT made significantly greater improvements on overvaluation of weight and shape and difficulties with emotion regulation. These findings indicate that rapid response to intensive treatment can be clinically facilitated using an adjunctive intervention focused on encouraging rapid and substantial change. These findings also suggest that rapid response may be related to improved outcome via improvements in overvaluation of weight and shape or emotion regulation. This study provides support for theoretical contentions that rapid response is due to CBT-related factors, and provides the framework for future research investigating rapid response as a causal mechanism of good outcome for eating disorders.

310 Multidisciplinary management of elderly patients with heart failure in a day hospital

2007 ◽  
Vol 6 (1) ◽  
pp. 68-68
Author(s):  
N MUNOZRIVAS ◽  
M MENDEZ ◽  
P MONTEJODEGARCINI ◽  
A YERA ◽  
M CANO ◽  
...  
Keyword(s):  
Heart Failure ◽  
Elderly Patients ◽  
Multidisciplinary Management ◽  
Day Hospital ◽  
Patients With Heart Failure

Klassifikation von Essstörungen im Zuge von DSM-V mit besonderem ­Fokus auf der Diagnostik von Ess­anfällen bei der Binge-Eating-Störung

2011 ◽  
Vol 59 (4) ◽  
pp. 267-274 ◽  
Author(s):  
Anja Hilbert
Keyword(s):  
Eating Disorder ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Klinische Relevanz ◽  
Dsm V

Zusammenfassung.Die Klassifikation von Essstörungen steht im Zentrum aktuellen Forschungsinteresses. Gerade relativ rezente diagnostische Kategorien wie die Binge-Eating- oder Essanfallsstörung (Binge Eating Disorder, BED) und diagnostische Hauptmerkmale wie Essanfälle bedürfen im Zuge der Überarbeitungen des DSM einer Überprüfung. In dem vorliegenden Artikel werden zunächst die für das DSM-V vorgeschlagenen Veränderungen der diagnostischen Kriterien der BED und anderer Essstörungen beschrieben. An­schließend wird das Essanfallsmerkmal der Größe der verzehrten Nahrungsmenge in einer Forschungsübersicht hinsichtlich seiner klinischen Relevanz für die BED betrachtet. Dabei zeigt sich, dass sowohl objektive als auch subjektive Essanfälle psychopathologisch relevant sind. Jedoch sind objektive Essanfälle aufgrund ihrer Assoziation mit einem geringeren Behandlungserfolg, einer größeren residualen Symptomatik und vermehrten Rückfalltendenzen das vergleichsweise stringentere Erfolgskriterium in der Therapieerfolgsforschung der BED. Vor diesem Hintergrund erscheint es für die BED zentral, neben objektiven Essanfällen zusätzlich auch subjektive Essanfälle zu erfassen. Für das DSM-V wird empfohlen, ein Schema zu entwerfen, um das Auftreten und die Häufigkeit dieser Formen von Essanfällen für die BED sowie für andere klinische und subklinische Formen von Essanfällen systematisch zu erheben. Eine sorgfältige Erfassung der Essanfallsgröße in Studien zur Psychopathologie, zum Verlauf und zur Behandlung, wird es erlauben, die klinische Relevanz dieses Merkmals über das Essstörungsspektrum hinweg weiter zu klären.

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