The effect of multiple family therapy on weight gain in adolescents with anorexia nervosa: pilot data.

OBJECTIVE: Preliminary research suggests that multiple family therapy (MFT) may be an effective intervention for adolescent anorexia nervosa (AN). This study compared the extent of weight restoration for patients enrolled in one year of MFT compared to a matched control group receiving treatment as usual (TAU). METHOD: A retrospective chart review was performed using data from 25 MFT cases matched to 25 controls on age, diagnosis and year of entry to the eating disorder program. RESULTS: Both cases and controls experienced significant weight restoration, however patients enrolled in MFT were restored to a higher mean percent ideal body weight than the TAU group (99.6% (±7.27%) vs. 95.4 (±6.88); p<0.05). CONCLUSIONS: MFT may be more effective than TAU in restoring weight in adolescents with AN.

OBJECTIF: La recherche préliminaire suggère que la thérapie multifamiliale (TMF) peut être une intervention efficace pour les adolescents souffrant d'anorexie mentale (AM). Cette étude a comparé l'étendue de la reprise de poids pour les patients inscrits à une TMF d'un an comparativement à un groupe témoin apparié recevant le traitement usuel (TU). MÉTHODE: Un examen rétrospectif des dossiers a été mené à l'aide des données de 25 cas de TMF appariés à 25 témoins selon l'âge, le diagnostic et l'année d'entrée dans le programme des troubles alimentaires. RÉSULTATS: Les cas et les témoins ont eu des reprises de poids significatives, mais les patients inscrits à la TMF ont repris un pourcentage moyen plus élevé de leur poids corporel idéal que le groupe du TU (99,6% [±7,27 %] c. 95,4% [±6,88]; p<0,05). CONCLUSIONS: La TMF peut être plus efficace que le TU pour la reprise de poids des adolescents souffrant d'AM.

Disordered eating in Jewish adolescent girls.

OBJECTIVES: To examine the presence and nature of disordered eating attitudes and behaviours among Jewish Canadian adolescents, as compared with non-Jewish Canadian adolescents in an urban community. A secondary goal was to examine whether rates of eating-disordered behaviour differed among the adolescents based on the degree of Jewish religious observance. METHOD: High school students (n = 868) from the Toronto area completed a demographic and religious practice questionnaire together with the Eating Attitudes Test (EAT), a self-report test that discriminated adolescents with syndromal eating disorders from normal adolescents. RESULTS: Jewish females aged 13 to 20 years, but not males, reported significantly more disordered eating behaviours and attitudes, compared with their non-Jewish female counterparts. Twenty-five percent of Jewish females, as compared with 18% of non-Jewish females, scored above the clinical cut-off for the EAT. No differences in vulnerability to disordered eating were found within the group of Jewish females or males related to their degree of religious observance. CONCLUSIONS: Adolescent Jewish females, but not males, appear to be at greater risk for abnormal attitudes and behaviours related to eating, compared with their non-Jewish female peers. While the reasons for this finding are unclear, this study is a step toward improving understanding of the relations between sex, culture, religion, and the development of eating disorders. Culturally sensitive and sex-specific prevention strategies and treatment interventions are indicated.

The role of work stress as a moderating variable in the chronic pain and depression association.

OBJECTIVE: This article aims to examine the role of work stress as a moderating variable in the chronic pain-depression association, as well as sex differences in this link. METHODS: The analyses were carried out using the Canadian Community Health Survey Cycle 1.1. Key variables were chronic pain conditions (fibromyalgia, arthritis/rheumatism, back problems, and migraine headaches), work stress, and depression. The total sample comprises 78,593 working individuals. RESULTS: In this working sample, 7.6% met criteria for major depression, but the prevalence increased to 12% in those also reporting chronic pain. Both depression and comorbid chronic pain and depression were twice as prevalent in women as in men. Having a chronic pain condition and overall work stress emerged as the strongest predictors of depression. Unexpectedly, however, none of the work stress domains moderated the chronic pain and depression association. CONCLUSION: The impact of work stress should be considered in the etiology and management of major depression.

A community-based training program for eating disorders and its contribution to a provincial network of specialized services.

The Ontario Community Outreach Program for Eating Disorders is a pilot training project within the eating disorder programs at the University Health Network--Toronto General Hospital (TGH) and the Hospital for Sick Children. This system provides ongoing training, consultation, and research evaluation in areas ranging from prevention through to tertiary care, in the hopes of increasing the capacity of practitioners to respond to the healthcare pressures of those experiencing eating disorders. A total of 3,315 health care practitioners and educators in Ontario participated in community-based training workshops. A pre-post analysis of participants' self-report evaluations was conducted using chi-square analyses. The findings revealed that there was a statistically significant increase in participants' (a) knowledge of eating disorders and of body image issues and (b) level of comfort to either treat clients with eating disorders or teach a curriculum on body image. The contribution of the training program to the development of a provincial network of specialized eating disorder services, designed to promote the public's access to timely and appropriate care for the full spectrum of eating disorders, are discussed.