CPG for Eating Disorders

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10.1.5. The use of questionnaires adapted and validated in the Spanish populationis recommended for assessment of eating disorders.At present, the following specific instruments for eating disorders arerecommended: EAT, EDI, BULIT, BITE, SCOFF, ACTA and ABOS(version selection based on the patient’s age and other application criteria).To assess aspects related with eating disorders, the followingquestionnaires are recommended: BSQ, BIA, BAT, BES and CIMEC (theselection of the version should be based on age and other applicationcriteria).10.2. What instruments are useful for thepsychopathological assessment of eating disorders?(See also chapter 7, “Diagnosis”)10.2.1. ImpulsivenessBIS-11Barratt Impulsiveness Scale, version 11. Patton, et al., 1995The BIS-11 is a self-report survey used to assess impulsiveness. It consists of 30 items groupedinto four subscales: cognitive impulsiveness, motor impulsiveness, non-planned impulsivenessand total impulsiveness. These scales are scored using a 4-point Likert scale. The total score ofthe BIS-11 is a valid and reliable measure of impulsiveness. There are no cut-off points,although a distribution median has been proposed 362 .Spanish version of the BIS-11There is a Spanish version adapted and validated in our setting by M Oquendo,et al., 2001 363 .10.2.2. AnxietySTAIState-Trait Anxiety Inventory. Spielberger, et al., 1970The STAI is a self-report assessment of anxiety as a transitory state (anxiety/state; A/S) and asa latent trait (anxiety/trait; A/T). It can be applied to adolescents (aged 13 and over) and adults.The instrument consists of two parts comprised of 20 questions each. The first section (A/S)assesses a transitory emotional state, characterised by subjective, consciously perceived feelingsof tension and apprehension and by hyperactivity of the autonomous nervous system. Thesecond section (A/T) denotes relatively stable anxiety proneness and characterises individualswith a tendency to perceive situations as threatening. It has adequate validity and reliability 364 .CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS180
Spanish version of the STAIThere is a Spanish version adapted to our setting by TEA Publishing House, 1982 365Children version of the STAI (STAI-C)The STAI-C can be administered to children aged 9 to 15 years and takes 15 to 20 minutes. Itsobjective is the assessment of anxiety-state and anxiety-trait in this age group 366 .Spanish version of the STAI -CThere is a Spanish version adapted to our setting by TEA Publishing House, 1990 367HARSHamilton Anxiety Rating Scale. Hamilton, 1959The HARS is a hetero-administered scale used to assess anxiety by evaluating anxiety, tension,neurovegetative and somatic symptoms. The scale consists of 14 items with values rangingfrom 0 to 4 and determines the intensity of the symptoms it describes in the past month 368 .Spanish version of the HARSThere is a Spanish version that has been adapted to our setting by A Lobo and L Chamorro,2002 369 .CETA - Assessment of Anxiety Disorders in Children andAdolescentsEzpeleta, et al.Spanish original version developed by L Ezpeleta 37010.2.3. DepressionBDI or BeckBeck Depression Inventory. Beck, et al.,1961The BDI o Beck Depression Inventory is a self-report questionnaire used to assess the existenceor severity of depressive symptoms. Given its proven validity and reliability both in clinical andnon-clinical populations it is one of the most widely used tests. It is also useful in the screeningof the general population and somatic patients. It is comprised of 21 items and its objectives areto identify typical symptoms of severe depression and estimate depression severity. The overallscore is used to estimate depression severity. The score obtained ranges from 0 to 63 points andthe cut-off points are as follows: 0-9 (normal), 10-18 (mild depression), 19-29 (moderatedepression) and 30-63 (severe depression). It can be used in patients aged 16 and over 371 .Spanish version of the BDI or Beck depressionThere is an adapted version that has been validated for the Spanish population by C Conde andE Useros, 1975 372 . J Sanz, et al., 2003, later adapted the Beck-II (BDI-II) 373 .HAM-DHamilton Depression Rating Scale. Hamilton, 1959The HAM-D is a hetero-administered questionnaire that assesses the severity of depressivesymptoms, such as insomnia, agitation, anxiety and weight loss. Since its initial publication isCLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS181
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Clinical Practice Guidelinefor Eati
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This clinical practice guideline (C
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Annex 2.7. Diagnostic Criteria for
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This CPG aims to provide the popula
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External Review of Patient Informat
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14. What is the efficacy and safety
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CLINICAL PRACTICE GUIDELINE FOR EAT
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D 6.2. In anorexia nervosa (AN), we
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D 8.6. Primary care centres should
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9.GM.02. Before initiating artifici
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Binge-Eating DisorderA 9.3.3.1. A s
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D 9.GP.11. In children and adolesce
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Binge-Eating DisorderD 9.GPH.6. In
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11. Prognosis of Eating Disorders (
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ED: Eating disorderEDNOS: Eating di
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1. IntroductionBackgroundThe develo
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However, there is a need for a guid
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Table 2. Studies on the prevalence
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2. Scope and ObjectivesTarget Popul
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Aspects not included in the CPGThe
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3. MethodologyThe methodology emplo
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- Synthesis and analysis of the sci
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4. Definition and Classification of
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- Other psychopathological disturba
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Sociocultural factorsThe studies id
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accompany eating disorders. However
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5. Prevention of Eating DisordersKe
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(causal factors). Participants in t
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is a programme that promotes a heal
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MA 1341++MA 1341++No definitive con
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Of all the proposed criteria and re
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Spanish version of the EAT-40In Spa
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of the five dimension results in th
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6.5. It is recommended to use quest
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7.2. How are eating disorders class
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to help them cope with the situatio
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Other examinationsTo ascertain whet
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- Initiating nutritional treatment
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8.2. In eating disorders, what clin
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8.3.2. Criteria for admission to da
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RecommendationsD 8.1. Individuals w
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9. Treatment of Eating DisordersThe
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An RCT (Rigaud, 2007; France) 203 c
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9.2. Nutritional Counselling (NC)9.
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Recommendations(See recommendations
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Anorexia nervosaRecommendationsD 9.
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PSYCHOLOGICAL THERAPIESIn this sect
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Summary of the Evidence(See also th
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There is limited evidence to sugges
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In an RCT (Wilson, 2002; USA) 234 C
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SRSE 2401++SRSE 2401++CBT treatment
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In an RCT (Bulik, 1998) 236 the ove
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Evidence indicates that it is unlik
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A 9.3.3.1. Adult patients with BED
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In an RCT (Carter, 2003; Canada) 24
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Variable: reduction / remission of
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In yet another RCT (Carter, 1998 26
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Scientific EvidenceThere is insuffi
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Recommendations(See also recommenda
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Summary of the Evidence(See summary
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In an RCT (Lock, 2005) 271 , 20% of
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Summary of the Evidence(See summary
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Page 134 and 135: SUMMARY OF THE EVIDENCE FORPSYCHOLO
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Page 138 and 139: PHARMACOLOGICAL TREATMENTIn this se
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Page 144 and 145: Summary of the EvidenceSRSE 311++SR
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Page 156 and 157: Recommendations(See recommendations
Page 158 and 159: SUMMARY OF THE EVIDENCE FORPHARMACO
Page 160 and 161: COMBINED INTERVENTIONSThis section
Page 162 and 163: Antidepressants vs. antidepressants
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Page 166 and 167: Summary of the EvidenceSRSE 311++SR
Page 168 and 169: 9.16.3. Binge-eating disorder9.16.3
Page 170 and 171: TREATMENT OF EATING DISORDERS THATO
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Page 176 and 177: EDI-2 (Version 2 of the EDI-1)Later
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Page 182 and 183: has been widely used. It consists o
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Page 188 and 189: the freedom of articles 17 of the S
Page 190 and 191: 12.2. Is the informed consent of an
Page 192 and 193: RecommendationAccording to current
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Page 198 and 199: Algorithm 2. Intervention if there
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Page 204 and 205: Algorithm 4. Treatment of BN and BE
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Page 208 and 209: IntegralcareOutcomeSatisfaction ind
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Page 212 and 213: Annex 1. Levels of Evidence and Gra
Page 214 and 215: Annex 2. Clinical chaptersAnnex 2.1
Page 216 and 217: 30. I eat diet food.31. I feel food
Page 218 and 219: Annex 2.4. Spanish version of the C
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Within each guideline some variatio
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Bulimia nervosa (307.51)Diagnostic
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Annex 2.8. Spanish version of the E
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Formula:Patients with eating disord
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Annex 3. Information for patients w
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Alert SignsWhat signs can alert us
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members can seek support and guidan
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therapist who guides the sessions a
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negative attitudes towards weight a
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PizotifenThis drug belongs to the g
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TopiramateAnticonvulsant psychoacti
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BULIT Bulimia TestBULIT-R Revised v
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ISCIII Carlos III Health InstituteI
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General Directorate for Public Heal
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2) We identified 20 documents elabo
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estimator, establishing the followi
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17. Detecció i orientacions terap
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59. Lo importante es tu vida. No la
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98. Garner DM. Pathogenesis of anor
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141. Wilksch SM, Tiggemann M, Wade
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181. Rivas T, Jiménez M, Bersabé
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224. Fairburn CG, Jones R, Peveler
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262. McCann UD, Agras WS. Successfu
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302. McElroy SL, Casuto LS, Nelson
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341. Hodes M, Timimi S, Robinson P.
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388. Steinhausen HC. The outcome of
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427. Finnish Medical Society Duodec
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CPG for Eating Disorders

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