CPG for Eating Disorders

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General Directorate for Public Health. Department of Health. Generalitat of Catalunya. Prats R,Prats B, Actuacions preventives a l’adolescència. Guia per a l’atenció primària de salut.Barcelona; 2004 146 .CatSalut. Department of Health. Generalitat of Catalunya. Serra J. Trastorns del comportamentalimentari. Guia per a l’atenció primària de salut. Barcelona; 2003 151 .CatSalut. Department of Health. Generalitat of Catalunya. Recomanacions per a l’atenció alsproblemes de salut mental més freqüents en l’atenció primària de salut. Health Plan. Booknumber. 11. Barcelona; 2000 417 .Ayuso Gutiérrez JL TCA. Psiquiatría en Atención Primaria [educational material]. Madrid;2000 147 .INSALUD. MSC. Moral Iglesias L. Trastornos del comportamiento alimentario. Criterios deordenación de recursos y actividades. Madrid; 2000 19 .MSC. González Briones E, Merino Merino B. Nutrición saludable y prevención de lostrastornos alimentarios. Madrid; 2000 148 .INSALUD. MSC. Protocolo de trastornos del comportamiento alimentario. Madrid;1995 20 .University Clinic. School of Medicine. University of Navarra. Cervera S, Gual MP, Lasa L, PratO, Zandio M, Hernández C., et al., Protocolo de atención a pacientes con TCA. Navarra;1995 418 .Clinical Guide AT. De enfermería a pacientes con TCA. Abordaje interdisciplinario de losTCA en atención primaria de salud [Internet monograph] (2008) 419 .Primary Care Management. Hospital Universitario “Lozano Blesa” Sector Zaragoza III. AragonHealth Service. Cobos A, Flordelís F, Gastón M, Pinilla M, Velilla M. TCA. Zaragoza (2008) 420 .INTERNATIONALOffice of School Food Services and Nutrition, South Carolina Department of Education,Columbia, SC, USA. Pilant VB. Position of the American Dietetic Association: local support fornutrition integrity in schools. 2006 421 .Royal College of Psychiatrists. York A, Lamb C, Editors. Building and sustaining specialistchild and adolescent mental health services. London; 2006 422 .NHS Quality Improvement Scotland. Eating disorders in Scotland: recommendations forhealthcare professionals. Consultation draft. Edinburgh; 2006 423 .CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS258
National Collaborating Centre for Mental Health. Obsessive-compulsive disorder: coreinterventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder.Leicester / London; 2006 424 .American Psychiatric Association. Work Group on Eating Disorders. Practice guideline for thetreatment of patients with eating disorders, third edition. Steering Committee on PracticeGuidelines, US; 2006 14 .Royal College of Psychiatrist. Guidelines for the nutritional management of anorexia nervosa.London; 2005 425 .American Academy of paediatrics. Promotion of healthy weight-control practices in youngathletes. Paediatrics. USA; 2005 426 .Finnish Medical Society Duodecim. “Eating disorders among children and adolescents” In: EBMGuidelines. Evidence-Based Medicine. Helsinki (Finland); 2004 427 .Royal Australian and New Zealand College of Psychiatrist Beumont P, Hay P, Beumont D,Birmingham L, Derham H, Jordan A, et al., Australian and New Zealand clinical practiceguidelines for the treatment of anorexia nervosa. New Zealand; 2004 18 .American Academy of Paediatrics. Identifying and treating eating disorders. Paediatrics.2003 428 .Unit for Child Psychiatry, University of Oulu, University Hospital of Oulu. Ebeling H,Tapanainen P, Joutsenoja A, Koskinen M, Morin-Papunen L, Jarvi L, et al., A practice guidelinefor treatment of eating disorders in children and adolescents. Finland; 2003 429 .Council for Nutritional Strategies in Long-Term Care. Thomas DR, Ashmen W, Morley JE,Evans WJ. Nutritional management in long-term care: development of a clinical guideline.Missouri US; 2000 430 .Annex 6.2. Results of the search, selection and qualityassessment of the evidence based on the stages performed1) 115 documents were identified: guidelines, reviews and ARs. After applying selectioncriteria (to the title and/or abstract), 73 were excluded. The complete document of all 42retrieved documents (14 were potential guidelines) was requested. After review, 28 more wereexcluded (11 of them for not being considered guidelines 421-431 ) and 15 were included (314, 18guidelines and 12 reviews). After assessing the quality with specific instruments, 2 CPGsand 11 reviews were excluded. Only two documents met quality criteria: one NICE CPG 30 andone AHRQ SRSE 31 . The evidence tables in the different chapters state the quality of each SRSE.That is not the case in the only quality CPG, which is described solely as CPG.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS259
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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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elaborated by the AHRQ of the US (2
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SUMMARY OF THE EVIDENCE FORPSYCHOLO
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D 9.GP.6. For patients with AN who
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PHARMACOLOGICAL TREATMENTIn this se
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9.9.1.2. What is the safety of anti
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There is strong evidence that antid
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Summary of the EvidenceSRSE 311++SR
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There is insufficient evidence sugg
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An RCT (Appolinario, 2003; Brazil)
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9.10. AntipsychoticsEvidence in AN
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9.11.2. What is the safety of cypro
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9.13.1.2. What is the safety of top
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Recommendations(See recommendations
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SUMMARY OF THE EVIDENCE FORPHARMACO
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COMBINED INTERVENTIONSThis section
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Antidepressants vs. antidepressants
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There is insufficient evidence to s
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Summary of the EvidenceSRSE 311++SR
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9.16.3. Binge-eating disorder9.16.3
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TREATMENT OF EATING DISORDERS THATO
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TREATMENT OF CHRONIC EATING DISORDE
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10. Assessment of Eating DisordersK
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EDI-2 (Version 2 of the EDI-1)Later
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BIABody Image Assessment. Collins,
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10.1.5. The use of questionnaires a
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has been widely used. It consists o
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out as the most adequate, given its
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abuse/dependency, low sensation see
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the freedom of articles 17 of the S
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12.2. Is the informed consent of an
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RecommendationAccording to current
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Algorithm 2. Intervention if there
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9) Day care admission criteria:- Fr
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- Oral nutritional support in eatin
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Algorithm 4. Treatment of BN and BE
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14.Dissemination and implementation
Page 208 and 209: IntegralcareOutcomeSatisfaction ind
Page 210 and 211: 15. Future research recommendations
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
Page 220 and 221: 6. Do you feel you have control ove
Page 222 and 223: 20. I feel sad after eating more th
Page 224 and 225: 33. APPLICABLE ONLY TO WOMEN. My la
Page 226 and 227: 12. Do you eat reasonable amounts o
Page 228 and 229: Annex 2.7. Diagnostic Criteria for
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Page 232 and 233: Bulimia nervosa (307.51)Diagnostic
Page 234 and 235: Annex 2.8. Spanish version of the E
Page 236 and 237: Formula:Patients with eating disord
Page 238 and 239: Annex 3. Information for patients w
Page 240 and 241: Alert SignsWhat signs can alert us
Page 242 and 243: members can seek support and guidan
Page 244 and 245: therapist who guides the sessions a
Page 246 and 247: negative attitudes towards weight a
Page 248 and 249: PizotifenThis drug belongs to the g
Page 250 and 251: TopiramateAnticonvulsant psychoacti
Page 252 and 253: BULIT Bulimia TestBULIT-R Revised v
Page 254 and 255: ISCIII Carlos III Health InstituteI
Page 256 and 257: CLINICAL PRACTICE GUIDELINE FOR EAT
Page 260 and 261: 2) We identified 20 documents elabo
Page 262 and 263: estimator, establishing the followi
Page 264 and 265: CLINICAL PRACTICE GUIDELINE FOR EAT
Page 266 and 267: 17. Detecció i orientacions terap
Page 268 and 269: 59. Lo importante es tu vida. No la
Page 270 and 271: 98. Garner DM. Pathogenesis of anor
Page 272 and 273: 141. Wilksch SM, Tiggemann M, Wade
Page 274 and 275: 181. Rivas T, Jiménez M, Bersabé
Page 276 and 277: 224. Fairburn CG, Jones R, Peveler
Page 278 and 279: 262. McCann UD, Agras WS. Successfu
Page 280 and 281: 302. McElroy SL, Casuto LS, Nelson
Page 282 and 283: 341. Hodes M, Timimi S, Robinson P.
Page 284 and 285: 388. Steinhausen HC. The outcome of
Page 286 and 287: 427. Finnish Medical Society Duodec
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