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1.
Front Psychiatry ; 15: 1377006, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38840947

RESUMO

Introduction: Cultural and contextual factors affect communication and how psychiatric symptoms are presented, therefore psychiatric assessments need to include awareness of the patients' culture and context. The Cultural Formulation Interview (CFI) in DSM-5 is a person-centred tool developed to support the exploration of cultural and contextual factors in an individualized and non-stereotypic way. Methods: The aim of this qualitative study was to find out what information the DSM-5 CFI revealed when used with native Swedish-speaking patients as part of routine clinical psychiatric assessment at an outpatient clinic. An additional aim was to enhance understanding of what kind of information the questions about background and identity yielded. The CFI was added to the psychiatric assessment of 62 native Swedish-speaking patients at an outpatient psychiatric clinic in Stockholm. Results: From the thematic analysis of the documented CFI answers, six central themes were found; Descriptions of distress and dysfunction, Managing problems and distress, Current life conditions affecting the person, Perceived failure in meeting social expectations, Making sense of the problem, and Experiences of, and wishes for, help. The CFI questions about identity yielded much information, mainly related to social position and feelings of social failure. Discussion: For further refinement of the CFI, we see a need for re-framing the questions about cultural identity and its impact on health so that they are better understood. This is needed for majority population patients as direct questions about culture may be difficult to understand when cultural norms are implicit and often unexamined. For clinical implications, our findings suggest that for cultural majority patients the DSM-5 CFI can be a useful person-centred tool for exploring cultural and, in particular, social factors and patients' perception and understanding of distress.

2.
Front Psychiatry ; 15: 1298920, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38455521

RESUMO

Introduction: Cultural variety in expressed symptom presentations of mental health problems creates difficulties in transcultural diagnostic assessments. This emphasizes the need of culturally sensitive diagnostic tools like the Cultural Formulation Interview (CFI). Although the CFI is being implemented worldwide there is a lack of studies analyzing what kind of information it provides when used with new patients in routine psychiatric assessments, and how CFI information contributes to diagnostic evaluations. This study aimed to find out what information the CFI questions revealed when used with non-native Swedish speaking patients. We also wanted to understand how the CFI may facilitate identification of psychiatric diagnoses among these patients. Materials and methods: The CFI was used as part of a routine clinical psychiatric assessment in an outpatient clinic in Sweden. Interpreters were used in the consultations when needed. A qualitative thematic analysis was used to analyze the documented CFI answers from non-native speaking patients. Results: We found that the CFI information contained contextualized descriptions of dysfunction and current life conditions, as well as expressions of emotions, often described along with somatic terms. Discussion: Our results indicate that the narrative approach of the CFI, giving contextualized information about distress and functioning, can facilitate clinicians' identification of psychiatric symptoms when language, psychiatric terms and understandings are not shared between patient and clinician.

3.
BMC Psychiatry ; 22(1): 149, 2022 02 25.
Artigo em Inglês | MEDLINE | ID: mdl-35216555

RESUMO

BACKGROUND: Culture and social context affect the expression and interpretation of symptoms of distress, raising challenges for transcultural psychiatric diagnostics. This increases the risk that mental disorders among migrants and ethnic minorities are undetected, diagnosed late or misdiagnosed. We investigated whether adding a culturally sensitive tool, the DSM-5 core Cultural Formulation Interview (CFI), to routine diagnostic procedures impacts the psychiatric diagnostic process. METHOD: We compared the outcome of a diagnostic procedure that included the CFI with routine diagnostic procedures used at Swedish psychiatric clinics. New patients (n = 256) admitted to a psychiatric outpatient clinic were randomized to a control (n = 122) or CFI-enhanced diagnostic procedure (n = 134) group. An intention-to-treat analysis was conducted and the prevalence ratio and corresponding 95% confidence intervals (CI) were calculated across arms for depressive and anxiety disorder diagnoses, multiple diagnoses, and delayed diagnosis. RESULTS: The prevalence ratio (PR) of a depressive disorder diagnosis across arms was 1.21 (95% CI = 0.83-1.75), 33.6% of intervention-arm participants vs. 27.9% of controls. The prevalence ratio was higher among patients whose native language was not Swedish (PR =1.61, 95% CI = 0.91-2.86). The prevalence ratio of receiving multiple diagnoses was higher for the CFI group among non-native speaking patients, and lower to a statistically significant degree among native Swedish speakers (PR = .39, 95% CI = 0.18-0.82). CONCLUSIONS: The results suggest that the implementation of the DSM-5 CFI in routine psychiatric diagnostic practice may facilitate identification of symptoms of certain psychiatric disorders, like depression, among non-native speaking patients in a migration context. The CFI did not result in a reduction of patients with a non-definite diagnosis. TRIAL REGISTRATION: ISRCTN51527289 , 30/07/2019. The trial was retrospectively registered.


Assuntos
Transtornos Mentais , Migrantes , Transtornos de Ansiedade , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Entrevista Psicológica/métodos , Transtornos Mentais/diagnóstico , Suécia
4.
Transcult Psychiatry ; 57(4): 542-555, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32646300

RESUMO

This study is an evaluation of clinicians' and patients' experiences of the core Cultural Formulation Interview (CFI) in DSM-5. The CFI provides a framework for gathering culturally relevant information, but its final form has not been sufficiently evaluated. Aims were to assess the Clinical Utility (CU), Feasibility (F) and Acceptability (A) of the CFI for clinicians and patients, and to explore clinicians' experiences of using the CFI in a multicultural clinical setting in Sweden. A mixed-method design was applied, using the CFI Debriefing Instrument for Clinicians (N = 15) and a revised version of the Debriefing Instrument for Patients (N = 114) (DIC and DIP, scored from -2 to 2). Focus group interviews were conducted with clinicians. For patients (response rate 50%), the CU mean was 0.98 (SD = 0.93) and F mean 1.07 (SD = 0.83). Overall rating of the interview was 8.30 (SD = 1.75) on a scale from 0 and 10. For clinicians (response rate 94%), the CU mean was 1.14 (SD = 0.52), F 0.58 (SD = 0.93) and A 1.42 (SD = 0.44). From clinician focus-group interviews, the following themes were identified: approaching the patient and the problem in a new manner; co-creating rapport and understanding; and affecting clinical reasoning and assessment. Patients and clinicians found the CFI in DSM-5 to be a feasible, acceptable, and clinically useful assessment tool. The focus group interviews suggested that using the CFI at initial contact can help make psychiatric assessment patient-centred by facilitating patients' illness narratives. We argue for further refinements of the CFI.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Entrevista Psicológica/métodos , Transtornos Mentais/diagnóstico , Grupos Focais , Humanos , Transtornos Mentais/etnologia , Pacientes Ambulatoriais/psicologia , Pesquisa Qualitativa , Suécia , Escala Visual Analógica
5.
Psychother Res ; 30(8): 1011-1025, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-31709920

RESUMO

Objective: In this study, we evaluate the efficacy of outpatient individual cognitive behavioral therapy for young adults (CBT-YA) and combined family/individual therapy for young adults (FT-YA) for anorexia nervosa (AN). Method: Participants (aged 17-24 years) with AN in Sweden were recruited and assigned to 18 months of CBT-YA or FT-YA. Treatment efficacy was assessed primarily using BMI, presence of diagnosis, and degree of eating-related psychopathology at post-treatment and follow-up. Secondary outcomes included depression and general psychological psychopathology. The trial was registered at http://www.isrctn.com/, ISRCTN (25181390). Results: Seventy-eight participants were randomized, and seventy-four of them received allocated treatment and provided complete data. Clinical outcomes from within groups resulted in significant improvements for both groups. BMI increased from baseline (CBT-YA 16.49; FT-YA 16.54) to post-treatment (CBT-YA 19.61; FT-YA 19.33) with high effect sizes. The rate of weight restoration was 64.9% in the CBT-YA group and 83.8% in the FT-YA group. The rate of recovery was 76% in both groups at post-treatment, and at follow-up, 89% and 81% had recovered in the CBT-YA and FT-YA groups respectively. Conclusions: Outpatient CBT-YA and FT-YA appear to be of benefit to young adults with AN in terms of weight restoration and reduced eating disorder and general psychopathology.


Assuntos
Anorexia Nervosa/terapia , Terapia Cognitivo-Comportamental , Terapia Familiar , Adolescente , Anorexia Nervosa/psicologia , Feminino , Humanos , Resultado do Tratamento , Adulto Jovem
6.
Eur Eat Disord Rev ; 27(1): 76-85, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30094893

RESUMO

OBJECTIVE: The prognosis in cases of anorexia nervosa (AN) is unsatisfactory, and it is therefore important to examine pretreatment predictors of outcome. METHODS: Female AN patients (N = 74) included in a randomised controlled trial receiving individual cognitive behavioural therapy (CBT) or family-based treatment (FBT) were included. Predictors of the outcome were explored using pretreatment eating disorder psychopathology. RESULTS: In the CBT group, lower levels of emotional dysregulation and greater deficits in identifying and coping with inner states were predictors of weight increase, explaining 37.7% of the variance. In the FBT group, lower interoceptive deficits predicted an increase in weight (explaining 17.7% of the variance), whereas bulimic behaviour (32.4%) and problems with emotional regulation (23.3%) were predictors of increased diagnostic symptoms. CONCLUSIONS: Bulimic symptoms and the ability to identify and cope with emotional states appear to be important aspects that should be addressed in the treatment of young adult patients with AN.


Assuntos
Anorexia Nervosa/terapia , Terapia Cognitivo-Comportamental , Terapia Familiar , Adaptação Psicológica , Adolescente , Adulto , Anorexia Nervosa/psicologia , Feminino , Humanos , Resultado do Tratamento , Adulto Jovem
7.
Nord J Psychiatry ; 72(5): 347-353, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29703121

RESUMO

AIM: The aim of the study was to explore the psychometric properties of the Inventory of Interpersonal Problems (IIP-64) and to compare levels of interpersonal distress in Swedish female outpatients with anorexia nervosa or bulimia nervosa with age- and gender-matched controls. METHODS: Totally, 401 participants were included; anorexia nervosa (n = 74), bulimia nervosa (n = 85) and controls (n = 242). All participants completed the IIP-64. The eating disorder (ED) patients also filled out the Eating Disorder Inventory-2/3 (EDI). RESULTS: Internal consistency of IIP-64 was acceptable to high. Principal component analyses with varimax rotation of the IIP-64 subscales confirmed the circumplex structure with two underlying orthogonal dimensions; affiliation and dominance. Significant correlations between EDI-3 composite scales ineffectiveness and interpersonal problems and IIP-64 were found. ED patients reported higher levels of interpersonal distress than controls on all but one subscale (intrusive/needy). CONCLUSIONS: IIP-64 can be considered to have acceptable to good reliability and validity in a Swedish ED sample. IIP-64 can be a useful complement in assessment of interpersonal problems in ED.


Assuntos
Anorexia Nervosa/psicologia , Bulimia Nervosa/psicologia , Relações Interpessoais , Pacientes Ambulatoriais/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/epidemiologia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Feminino , Humanos , Psicometria , Distribuição Aleatória , Reprodutibilidade dos Testes , Suécia/epidemiologia , Adulto Jovem
8.
J Child Health Care ; 21(4): 415-423, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29110521

RESUMO

Lifestyle factors and behaviours are adopted very early in life and tend to persist throughout life. Considering that the parents are the primary gatekeepers for their child's health, there is a need to gain more knowledge and deeper understanding about what causes parents to act and react in order for early preventive efforts to have any effect. The aim was to explore the parental views and considerations concerning 'child health' among parents with infants 8-10 months old. The sample was strategic and 16 parents (aged 23-41) were recruited from three child health centres in Sweden. Open-ended interviews were conducted and a qualitative, manifest content analysis approach was utilized. The parents described the subject 'child health' as a large, multifaceted concept. Three categories emerged during data analysis: developing a sixth sense, being affected by perceptions and believing health and ill health as a continuum. The parents perceived food and feeding issues as one of the most worrying aspects and a significant indicator of 'child health'. In order to meet the parents on their turf, the 'healthy health message' conveyed needs to take the parental perspective into consideration rather than attempting to educate the parents from predetermined assumption, belief and values.


Assuntos
Saúde da Criança/normas , Conhecimentos, Atitudes e Prática em Saúde , Pais/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Estilo de Vida , Masculino , Pesquisa Qualitativa , Suécia
9.
Eur J Psychol ; 11(2): 233-43, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-27247654

RESUMO

The aim of this exploratory study was to investigate the correlation between cultural and psychological factors in relation to predicting eating disorders in two different non-clinical Italian (n = 61) and Swedish (n = 31) female populations, thought to have different cultures and lifestyles. The Swedish sample would reflect an emancipated model of women pursuing autonomy and freedom but also an ideal of thinness, while the Italian sample would reflect a difficult transition from traditional submissiveness to modern autonomy. Both groups completed self-report instruments assessing cultural values (e.g., collectivism and individualism) and features of eating disorders (e.g., drive for thinness, bulimia, body dissatisfaction, self-esteem, parental criticism and perfectionism). Swedish women were found to display higher levels of bulimia, perfectionism, and individualism than Italian women, while regression analysis showed that in the Italian sample high levels of collectivism were correlated with measures of EDs. The results support the hypothesis that EDs are linked with both modern values of autonomy, independence and emancipation, and situations of cultural transition in which women are simultaneously exposed to traditional models of submission and opportunities for emancipation and autonomy.

10.
Nord J Psychiatry ; 69(2): 142-51, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25434459

RESUMO

BACKGROUND: The Eating Disorder Inventory-3 (EDI-3) is designed to assess eating disorder psychopathology and the associated psychological symptoms. The instrument has been revised and has not yet been validated for Swedish conditions in its current form. AIMS: The aim of this study was to investigate the validity and reliability of this inventory and present national norms for Swedish females. METHODS: Data from patients with eating disorders (n = 292), psychiatric outpatients (n = 140) and normal controls (n = 648), all females, were used to study the internal consistency, the discriminative ability, and the sensitivity and specificity of the inventory using preliminary cut-offs for each subscale and diagnosis separately. Swedish norms were compared with those from Denmark, USA, Canada, Europe and Australian samples. RESULTS: The reliability was acceptable for all subscales except Asceticism among normal controls. Analysis of variance showed that the EDI-3 discriminates significantly between eating disorders and normal controls. Anorexia nervosa was significantly discriminated from bulimia nervosa and eating disorder not otherwise specified on the Eating Disorder Risk Scales. Swedish patients scored significantly lower than patients from other countries on the majority of the subscales. Drive for Thinness is the second best predictor for an eating disorder. The best predictor for anorexia nervosa was Interoceptive Deficits and Bulimia for the other diagnoses. Conclusions/clinical implications: The EDI-3 is valid for use with Swedish patients as a clinical assessment tool for the treatment planning and evaluation of patients with eating-related problems. However, it still exist some uncertainty regarding its use as a screening tool.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Escalas de Graduação Psiquiátrica , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Bulimia Nervosa/diagnóstico , Estudos de Casos e Controles , Diagnóstico Diferencial , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Pacientes Ambulatoriais/psicologia , Inventário de Personalidade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Suécia , Adulto Jovem
11.
Nord J Psychiatry ; 67(6): 424-32, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23301630

RESUMO

BACKGROUND: Anorexia nervosa (AN) is a serious psychiatric disorder with high mortality rates a poor outcome and no empirically supported treatment of choice for adults. Weight increase is essential for recovery from AN why research exploring important contributors is crucial. AIMS: The current study examined the importance of motivation to change eating behaviour, treatment expectations and experiences, eating disorder symptomatology, self-image and treatment alliance for predicting weight increase. METHODS: Female patients (n = 89) between 18 and 46 years of age with AN were assessed pre-treatment and at 6- and 36-month follow-ups with interviews and self-report questionnaires. At the 6-month follow-up the response rates differed from n = 58 (65%) to 66 (74%), and at the 36-month follow-up the response rates differed from n = 71 (80%) to 82 (92%). RESULTS: At treatment start, expressed motivation to change eating habits, social insecurity and self-neglect were predictors of weight increase from 0 to 6 months, while duration, the time from onset to entering treatment, body dissatisfaction and interoceptive awareness were predictors of weight increase from 0 to 36 months. CONCLUSIONS: In designing treatment for adult patients with AN, it is essential to include multifaceted interventions addressed to patients' motivation to change, social relations, negative self-image and body dissatisfaction in order to achieve weight increase. Early detection and thereby short duration is an additional important factor that contributes to weight increase.


Assuntos
Anorexia Nervosa/psicologia , Aumento de Peso , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/fisiopatologia , Anorexia Nervosa/terapia , Atitude Frente a Saúde , Índice de Massa Corporal , Emoções , Comportamento Alimentar , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Motivação , Cooperação do Paciente/psicologia , Prognóstico , Autoimagem , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
12.
J Multidiscip Healthc ; 5: 169-77, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22888259

RESUMO

BACKGROUND: Anorexia nervosa is a serious illness with a high mortality rate, a poor outcome, and no empirically supported treatment of choice for adults. Patients with anorexia nervosa strive for thinness in order to obtain self-control and are ambivalent toward change and toward treatment. In order to achieve a greater understanding of patients' own understanding of their situation, the aim of this study was to examine the expectations of potential anorexic patients seeking treatment at a specialized eating-disorder unit. METHODS: A qualitative study design was used. It comprised 15 women between 18 and 25 years of age waiting to be assessed before treatment. The initial question was, "What do you expect, now that you are on the waiting list for a specialized eating-disorder unit?" A content analysis was used, and the text was coded, categorized according to its content, and further interpreted into a theme. RESULTS: FROM THE RESULTS EMERGED THREE MAIN CATEGORIES OF WHAT PARTICIPANTS EXPECTED: "treatment content," "treatment professionals," and "treatment focus." The overall theme, "receiving adequate therapy in a collaborative therapeutic relationship and recovering," described how the participants perceived that their expectations could be fulfilled. DISCUSSION: Patients' expectations concerning distorted thoughts, eating behaviors, a normal, healthy life, and meeting with a professional with knowledge and experience of eating disorders should be discussed before treatment starts. In the process of the therapeutic relationship, it is essential to continually address patients' motivations, in order to understand their personal motives behind what drives their expectations and their desire to recover.

13.
Int J Ment Health Nurs ; 18(5): 318-25, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19740141

RESUMO

Anorexia nervosa (AN) mainly affects girls or women between 13 and 45 years of age. According to previous studies, one of the reasons for the desire to be thin is low self-esteem. The purpose of the study was to examine the self-esteem of 38 female patients with AN between 16 and 25 years of age, before and after 3 months of treatment at a specialist ward for eating disorders in Göteborg, Sweden. A quantitative pre- and post-assessment based on two self-rating questionnaires, the Rosenberg Self-Esteem Scale (RSE-S) and three subscales (weight phobia, body dissatisfaction, and ineffectiveness) of Eating Disorder Inventory-2 (EDI-2), together with body mass index (BMI), were used in the study, which was conducted between June 2005 and March 2008. The results reveal that self-esteem, BMI, weight phobia, and body dissatisfaction improved significantly between pre- and post-treatment. The RSE-S and EDI-2 ineffectiveness correlate highly with one another, which lends support to convergent validity, and the internal consistency was high for both the RSE-S and EDI-2 ineffectiveness. The results indicate that the treatment was effective, as both patients' self-esteem and BMI increased after completed treatment, which was the primary goal of the treatment at this ward. Future studies should focus on follow up and the way self-esteem manifests itself at different points in time within an individual.


Assuntos
Anorexia Nervosa/psicologia , Anorexia Nervosa/terapia , Atitude Frente a Saúde , Equipe de Assistência ao Paciente/organização & administração , Autoimagem , Adolescente , Adulto , Anorexia Nervosa/diagnóstico , Imagem Corporal , Índice de Massa Corporal , Terapia Cognitivo-Comportamental/organização & administração , Feminino , Seguimentos , Unidades Hospitalares/organização & administração , Humanos , Pesquisa em Avaliação de Enfermagem , Avaliação de Programas e Projetos de Saúde , Assistência Progressiva ao Paciente/organização & administração , Enfermagem Psiquiátrica/organização & administração , Psicoterapia de Grupo/organização & administração , Fatores Socioeconômicos , Inquéritos e Questionários/normas , Suécia , Resultado do Tratamento
14.
Eat Disord ; 17(1): 72-88, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19105062

RESUMO

The current study evaluated the outcome of family-based treatment for female adolescents with anorexia nervosa (N = 32), at the Anorexia-Bulimia Outpatient Unit in Göteborg, Sweden. Patients/parents were assessed pre-treatment, at 18- and 36-month follow-ups concerning eating disorder symptoms, general psychopathology, family climate and BMI. At the 36-month follow-up, 75% of the patients were in full remission with reduction in eating disorder symptoms and internalizing problems and they experienced a less distant and chaotic atmosphere in their families. These results show that family-based treatment appears to be effective in adolescent anorexia nervosa patients regarding areas examined in this study.


Assuntos
Anorexia Nervosa/terapia , Terapia Familiar/métodos , Psicoterapia/métodos , Adolescente , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/psicologia , Feminino , Seguimentos , Humanos , Inventário de Personalidade , Projetos Piloto , Escalas de Graduação Psiquiátrica , Estatísticas não Paramétricas , Inquéritos e Questionários , Suécia , Resultado do Tratamento
15.
Nord J Psychiatry ; 60(6): 463-8, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17162454

RESUMO

The current study evaluated a new Internet-based self-help guide based on cognitive-behavioural therapy for patients with bulimic symptoms. Thirty-eight participants from a waiting list at an eating-disorder outpatient unit were assessed pre-treatment, post-treatment and at a 2-month follow-up using the Rating of Anorexia and Bulimia interview-revised version, an anamnesis questionnaire, the Eating Disorder Inventory-2 (EDI-2) and Symptom Check List-90-Revised (SCL-90R). The SCL-90R Global Severity Index and most EDI-2 subscales showed significant differences from pre-to post-treatment and the 2-month follow-up, apart from ineffectiveness, impulse regulation and social insecurity. Expert ratings revealed a significant reduction in vomiting, dietary restraints and weight phobia, with the exception of binge eating from pre-treatment to the 2-month follow-up. Exercise increased significantly, indicating that participants changed their method of compensation. An Internet-based self-help guide for bulimic symptoms is a promising new tool and can be used effectively as the first step in a stepped-care model. Further evaluations with randomized controlled trials are necessary.


Assuntos
Bulimia/diagnóstico , Bulimia/terapia , Terapia Cognitivo-Comportamental/instrumentação , Internet/instrumentação , Grupos de Autoajuda , Adolescente , Adulto , Bulimia/epidemiologia , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Programas de Rastreamento/métodos , Índice de Gravidade de Doença , Inquéritos e Questionários , Suécia , Fatores de Tempo
16.
Eat Behav ; 7(2): 161-75, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16600844

RESUMO

OBJECTIVES: To assess weight problems and correlates in respect of body image, depression, anxiety and demographic background factors. METHOD: 405 Swedish adolescents were assessed in respect of Body Mass Index (BMI), biographical data, the Body Esteem Scale for Adolescents and Adults (BESAA), the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI). RESULTS: Boys were in the positive and girls in the negative direction from ideal BMI for age and gender. Girls and boys differed in respect of CDI, MASC and of BESAA where girls generally were shifted in the "pathological" direction. DISCUSSION: The adolescents' own positive attitude to slimness, negative mood (girls), and anxiety symptoms that reflect social fears (boys) and physical aspects of anxiety (girls and boys) were important correlates of lower BMI than ideal. Adolescent cultural norms need to be addressed in preventive work. However, in girls' separation anxiety might be a protective factor against underweight. In girls, overweight seems to be associated with negative self-esteem.


Assuntos
Ansiedade/epidemiologia , Ansiedade/psicologia , Imagem Corporal , Peso Corporal , Depressão/epidemiologia , Depressão/psicologia , Adolescente , Ansiedade/diagnóstico , Índice de Massa Corporal , Depressão/diagnóstico , Feminino , Humanos , Masculino , Prevalência , Autoimagem , Índice de Gravidade de Doença , Inquéritos e Questionários , Suécia/epidemiologia
17.
Nord J Psychiatry ; 60(1): 44-50, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16500799

RESUMO

The aim of the current study was to validate the Eating Disorders Inventory 2 (EDI-2) in a Swedish population by investigating how it discriminates between three female samples aged 18 to 50 years: patients with eating disorders (n = 978), psychiatric outpatients (n = 106) and normal controls (n = 602), as well as between different eating disorder diagnoses. The internal consistency of the EDI-2 was above 0.70 for most subscales. The EDI-2 discriminated well between patients with eating disorders and normal controls on all subscales. On the symptom-related subscales, eating disorder patients scored highest followed by psychiatric controls and normals. All subscales except Perfectionism, Interoceptive awareness and Asceticism discriminated eating disorder patients and psychiatric controls. Bulimia patients scored higher than anorexics on the symptom subscales. It is concluded that the EDI-2 discriminates well between eating disorder patients and both psychiatric and normal controls.


Assuntos
Assistência Ambulatorial , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Inquéritos e Questionários , Adolescente , Adulto , Bulimia Nervosa/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Inventário de Personalidade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Suécia
18.
Int J Eat Disord ; 39(2): 117-27, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16231341

RESUMO

OBJECTIVE: The current study examined the effectiveness of individual (IND) versus group (GRP) therapy for patients with bulimia nervosa (BN), using a manual of sequenced treatment with cognitive-behavioral therapy (CBT) followed by interpersonal psychotherapy (IPT). METHOD: Eighty-six participants with BN were matched and randomized to 23 sessions of IND or GRP. Participants were measured pretreatment and posttreatment and at 1-year and 2.5-year follow-ups using both intent-to-treat and completer samples. RESULTS: The intent-to-treat analysis revealed that the percentage of participants recovered and remitted was equivalent between IND and GRP. Significant group differences were found between completers on binge eating and compensatory behavior with greater improvement for IND. On most measures, effect sizes were larger for IND at 1-year follow-up. CONCLUSION: Sequencing CBT and IPT worked well in both IND and GRP formats. We found few outcome differences between IND as opposed to GRP.


Assuntos
Bulimia/terapia , Terapia Cognitivo-Comportamental/métodos , Psicoterapia Centrada na Pessoa/métodos , Psicoterapia de Grupo/métodos , Adolescente , Adulto , Bulimia/diagnóstico , Bulimia/psicologia , Terapia Combinada , Feminino , Humanos , Relações Interpessoais , Pacientes Desistentes do Tratamento/psicologia , Determinação da Personalidade
19.
Scand J Psychol ; 44(4): 303-10, 2003 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12887551

RESUMO

The Rating of Anorexia and Bulimia interview (RAB) is a Swedish semi-structured interview for clinical and research purposes for a wide range of eating disorder symptoms and related psychopathology. The objectives were to evaluate the reliability and validity of a revised RAB version (RAB-R). The RAB-R was assessed in terms of internal consistency, inter-rater and test-retest reliability, and criterion and convergent validity. Samples included a clinical sample of eating disorder patients (n = 71) and a sample of randomly drawn female controls (n = 31). The RAB-R showed satisfactory internal consistency, inter-rater and test-retest reliability, correlated well with related measures, and discriminated between patients and normal controls. We conclude that the RAB-R is a promising interview instrument and continued evaluation should focus on comparing subgroups of eating disorder patients with other clinical groups.


Assuntos
Anorexia Nervosa/diagnóstico , Bulimia/diagnóstico , Entrevista Psicológica , Adolescente , Adulto , Feminino , Humanos , Reprodutibilidade dos Testes
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