Estudio comparativo de psicoterapia cognitivo-conductual y terapia nutricional en pacientes con diferentes tipos de trastornos de la conducta alimentaria / Comparative study of cognitive-behavioral psychotherapy and nutritional support in patients with different types of eating disorders

Fundamento y objetivo: Existen varios enfoques psicológicos para el tratamiento de la disfunción eréctil con eficacia siendo revelado por la investigación empírica; sin embargo ninguno de ellos es universalmente aceptada. El objetivo fue comparar la respuesta a la terapia cognitivo-conductual en pacientes con diferentes formas clínicas de trastornos de la alimentación. Material y método: Setenta y cuatro pacientes con diagnóstico de trastornos de la alimentación, 32 con anorexia nerviosa (AN), 19 con bulimia nerviosa (BN) y 23 con trastornos no especificados (TCANE) Comer fueron incluidos. Se trata de un estudio prospectivo y comparativo. Los pacientes fueron tratados con psicoterapia, el tratamiento nutricional y farmacológico. Resultados:Las tasas de recuperación en los grupos de pacientes con AN, BN y TCANE fueron 14 (43,7%), 8 (42,1%), 10 (43,4%), respectivamente, p> 0,05. Las tasas de mejoría fueron 14 (43,7%), 10 (52,6%), 12 (52,1%) para la AN, BN y TCANE, respectivamente, p> 0,05. Por último, la tasa de pacientes que tuvieron un mal resultado fueron 3 (9,3%), 1 (5,2%), y 1 (4,3%), p> 0,05, para AN, BN y TCANE, respectivamente. El análisis de regresión de Cox mostró que la edad de inicio de la enfermedad y no uso de drogas psicotrópicas predijeron una buena respuesta en los pacientes con disfunción eréctil. Conclusiones: La respuesta al tratamiento con terapia cognitivo-conductual, el apoyo nutricional y las drogas psicotrópicas en la mayoría de los pacientes fue favorable y similar en la mayoría de los pacientes con diferentes tipos de trastornos de la alimentación. Por otra parte, una edad temprana y no uso de drogas psicotrópicas predicen un resultado favorable en los pacientes con disfunción eréctil (AU)

Background and objective: There are several psychological approaches to treat ED with efficacy being revealed by empirical research; however none of them are universally accepted. The objective was to compare response to Cognitive Behavioral Therapy in patients with different clinical forms of Eating Disorders. Material and method: Seventy-four patients diagnosed with eating disorders, 32 with Anorexia nervosa (AN), 19 with Bulimia nervosa (BN) and 23 with Eating disorders not otherwise specified (EDNOS) were included. This is a prospective and comparative study. Patients were treated by psychotherapy, nutritional treatment and pharmacotherapy. Results: The recovery rates in the groups of patients with AN, BN and EDNOS were 14 (43.7%), 8 (42.1%), 10 (43.4%), respectively, p > 0.05. The rates of improvement were 14 (43.7%), 10 (52.6%), 12 (52.1%) for AN, BN and EDNOS, respectively, p > 0.05. Finally, the rate of patients who had poor outcome were 3 (9.3%), 1 (5.2%), and 1 (4.3%), p > 0.05, for AN, BN, and EDNOS, respectively. Cox regression analysis showed that the age of disease onset and no use of psychotropic drugs predicted a good response in patients with ED. Conclusions: The treatment response to Cognitive Behavioral Therapy, nutritional support and psychotropic drugs in the majority of patients was favorable and similar in most patients with different types of Eating Disorders. Furthermore, a young age and no use of psychotropic drugs predict a favorable outcome in patients with ED (AU)

Comparative study of cognitive-behavioral psychotherapy and nutritional support in patients with different types of eating disorders.

BACKGROUND AND OBJECTIVE: There are several psychological approaches to treat ED with efficacy being revealed by empirical research; however none of them are universally accepted. The objective was to compare response to Cognitive Behavioral Therapy in patients with different clinical forms of Eating Disorders. MATERIAL AND METHOD: Seventy-four patients diagnosed with eating disorders, 32 with Anorexia nervosa (AN), 19 with Bulimia nervosa (BN) and 23 with Eating disorders not otherwise specified (EDNOS) were included. This is a prospective and comparative study. Patients were treated by psychotherapy, nutritional treatment and pharmacotherapy. RESULTS: The recovery rates in the groups of patients with AN, BN and EDNOS were 14 (43.7%), 8 (42.1%), 10 (43.4%), respectively, p>0.05. The rates of improvement were 14 (43.7%), 10 (52.6%), 12 (52.1%) for AN, BN and EDNOS, respectively, p>0.05. Finally, the rate of patients who had poor outcome were 3 (9.3%), 1 (5.2%), and 1 (4.3%), p>0.05, for AN, BN, and EDNOS, respectively. Cox regression analysis showed that the age of disease onset and no use of psychotropic drugs predicted a good response in patients with ED. CONCLUSIONS: The treatment response to Cognitive Behavioral Therapy, nutritional support and psychotropic drugs in the majority of patients was favorable and similar in most patients with different types of Eating Disorders. Furthermore, a young age and no use of psychotropic drugs predict a favorable outcome in patients with ED.

High prevalence of eating disorders not otherwise specified in northwestern Spain: population-based study.

PURPOSE: To determine the incidence and prevalence of eating disorder and its clinical forms. METHODS: All new ED cases of both genders, ≥15 years old, diagnosed from January 2005 to December 2009 were included. All patients who suffered from ED in December 2009 were included in the prevalence study. This is a prospective, population-based study. Cumulative incidence rates and 20-year prevalence were calculated. RESULTS: The ED incidence was 14.1 (95% CI 11.4-16.1) cases per 100,000 inhabitants per year, for AN, BN and EDNOS 3.1 (95% CI 2.00-4.1), 4.4 (95% CI 3.0-8.00) and 6.5 (95% CI 4.8-7.9), respectively. The incidence of ED at the four age-intervals, 15-24, 25-34, 35-45 and >45 years, revealed that the 25-34-year interval had the highest incidence; moreover, new cases were observed even in the >45-year interval. The prevalence of ED was 82.8 (95% CI 69.4-94.5) per 100,000 inhabitants, being for AN, BN and EDNOS 18.6 (95% CI 12.5-24.4), 25.7 (95% CI 18.5-32.5) and 38.3 (95% CI 29.4-46.5), respectively. CONCLUSIONS: The incidence and prevalence of EDNOS are the highest in the ED cases; furthermore, new cases of ED are observed above the age of 45, which are remarkable data.

Disordered eating behaviors in type 1 diabetic patients.

Patients with type 1 diabetes mellitus are at high risk for disordered eating behaviors (DEB). Due to the fact that type 1 diabetes mellitus is one of the most common chronic illnesses of childhood and adolescence, the coexistence of eating disorders (ED) and diabetes often affects adolescents and young adults. Since weight management during this state of development can be especially difficult for those with type 1 diabetes, some diabetics may restrict or omit insulin, a condition known as diabulimia, as a form of weight control. It has been clearly shown that ED in type 1 diabetics are associated with impaired metabolic control, more frequent episodes of ketoacidosis and an earlier than expected onset of diabetes-related microvascular complications, particularly retinopathy. The management of these conditions requires a multidisciplinary team formed by an endocrinologist/diabetologist, a nurse educator, a nutritionist, a psychologist and, frequently, a psychiatrist. The treatment of type 1 diabetes patients with DEB and ED should have the following components: diabetes treatment, nutritional management and psychological therapy. A high index of suspicion of the presence of an eating disturbance, particularly among those patients with persistent poor metabolic control, repeated episodes of ketoacidosis and/or weight and shape concerns are recommended in the initial stage of diabetes treatment, especially in young women. Given the extent of the problem and the severe medical risk associated with it, more clinical and technological research aimed to improve its treatment is critical to the future health of this at-risk population.