302. McElroy SL, Casuto LS, Nelson EB, Lake KA, Soutullo CA, Keck PE Jr, et al. Placebo-controlledtrial of sertraline in the treatment of binge eating disorder. Am J Psychiatry.2000;157(6):1004-6.303. Laederach-Hofmann K, Graf C, Horber F, Lippuner K, Lederer S, Michel R, et al. Imipramine anddiet counseling with psychological support in the treatment of obese binge eaters: a randomized,placebo-controlled double-blind study. Int J Eat Disord. 1999;26(3):231-44.304. McElroy SL, Hudson JI, Malhotra S,Welge JA, Nelson EB, Keck PE Jr. Citalopram in the treatmentof binge-eating disorder: a placebo-controlled trial. J Clin Psychiatry. 2003;64(7):807-13.305. Hudson JI, McElroy SL, Raymond NC, Crow S, Keck PE Jr, Carter WP, et al. Fluvoxamine in thetreatment of binge-eating disorder: a multicenter placebo-controlled, double-blind trial. Am JPsychiatry. 1998;155(12):1756-62.306. Pearlstein T, Spurell E, Hohlstein LA, Gurney V, Read J, Fuchs C, et al. A double-blind, placebocontrolledtrial of fluvoxamine in binge eating disorder: a high placebo response. Arch WomensMent Health. 2003;6(2):147-51.307. Appolinario JC, Bacaltchuk J, Sichieri R, Claudino AM, Godoy-Matos A, Morgan C, et al. Arandomized, double-blind, placebo-controlled study of sibutramine in the treatment of bingeeatingdisorder. Arch Gen Psychiatry. 2003;60(11):1109-16.308. Dunican KC, DelDotto D. The role of olanzapine in the treatment of anorexia nervosa. AnnPharmacother. 2007;41(1):111-5.309. Vandereycken W, Pierloot R. Pimozide combined with behaviour therapy in the short-term treatmentof anorexia nervosa. A double-blind placebo-controlled cross-over study. Acta Psychiatr Scand.1982;66(6):445-50.310. Vandereycken W. Neuroleptics in the short-term treatment of anorexia nervosa. A doubleblindplacebo-controlled study with sulpiride. Br J Psychiatry. 1984;144:288-92.311. Goldberg SC, Casper RC, Eckert ED. Effects of cyproheptadine in anorexia nervosa.Psychopharmacol Bull. 1980;16:29-30.312. Bulimia as a <strong>for</strong>m of self-addiction: treatment with naltrexone hydrochloride (Trexan (TM))A pilot study. Clin Trials J. 1990;27:77-83.313. Mitchell JE, Christenson G, Jennings J, Huber M, Thomas B, Pomeroy C, et al. A placebocontrolled,double-blind crossover study of naltrexone hydrochloride in s with normal weight bulimia. J ClinPsychopharmacol. 1989;9(2):94-7.314. Hoopes SP, Reimherr FW, Hedges DW, Rosenthal NR, Kamin M, Karim R, et al. Treatment ofbulimia nervosa with topiramate in a randomized, double-blind, placebo-controlled trial, part 1:improvement in binge and purge measures. J Clin Psychiatry. 2003;64(11):1335-41.315. Hedges DW, Reimherr FW, Hoopes SP, Rosenthal NR, Kamin M, Karim R, et al. Treatment ofbulimia nervosa with topiramate in a randomized, double-blind, placebo-controlled trial, part 2:improvement in psychiatric measures. J Clin Psychiatry. 2003;64(12):1449-54.316. McElroy SL, Guerdjikova A, Kotwal R, Welge JA, Nelson EB, Lake KA, et al. Atomoxetine in thetreatment of binge-eating disorder: a randomized placebo-controlled trial. J Clin Psychiatry.2007;68(3):390-8.317. Faris PL, Kim SW, Meller WH, Goodale RL, Oakman SA, Hofbauer RD, et al. Effect of decreasingafferent vagal activity with ondansetron on symptoms of bulimia nervosa: a randomised, doubleblindtrial. Lancet. 2000;355(9206):792-7.318. Brambilla F, García CS, Fassino S, Daga GA, Favaro A, Santonastaso P, et al. Olanzapine therapy inanorexia nervosa: psychobiological effects. Int Clin Psychopharmacol. 2007;22(4):197-204.319. Brambilla F, Monteleone P, Maj M. Olanzapine-induced weight gain in anorexia nervosa:involvement of leptin and ghrelin secretion? Psychoneuroendocrinology. 2007;32(4):402-6.320. Timothy B, Kaplan AS, Attia E, Olmsted M, Parides M, Carter JC, et al. Fluoxetine after weightrestoration in anorexia nervosa: a randomized controlled trial. JAMA.2008;295(22):2605-12.280CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS
321. Leitenberg H, Rosen JC, Wolf J, Vara LS, Detzer MJ, Srebnik D. Comparison of cognitivebehaviourtherapy and desipramine in the treatment of bulimia nervosa. Behav Res Ther.1994;32(1):37-45.322. Cognitive-behavioural, fluoxetine and combined treatment <strong>for</strong> bulimia nervosa: short-andlong-termresults. Eur Eat Disord Rev. 2002;10:179-98.323. Goldbloom DS, Olmsted M, Davis R, Clewes J, HeinmSH M, Rockert W, et al. A randomizedcontrolled trial of fluoxetine and cognitive behavioural therapy <strong>for</strong> bulimia nervosa: short-termoutcome. Behav Res Ther. 1997;35(9):803-11.324. Agras WS, Rossiter EM, Arnow B, Schneider JA, Telch CF, Raeburn SD, et al. Pharmacologic andcognitive-behavioural treatment <strong>for</strong> bulimia nervosa: a controlled comparison. Am J Psychiatry.1992;149(1):82-7.325. Agras WS, Rossiter EM, Arnow B, Telch CF, Raeburn SD, Bruce B, et al. One-year follow-up ofpsychosocial and pharmacologic treatments <strong>for</strong> bulimia nervosa. J Clin Psychiatry.1994;55(5):179-83.326. Wilson GT, Loeb KL, Walsh BT, Labouvie E, Petkova E, Liu X, et al. Psychological versuspharmacological treatments of bulimia nervosa: predictors and processes of change. J Consult ClinPsychol. 1999;67(4):451-9.327. Mitchell JE, Halmi K, Wilson GT, Agras WS, Kraemer H, Crow S. A randomized secondarytreatment study of women with bulimia nervosa who fail to respond to CBT. Int J Eat Disord.2002;32(3):271-81.328. Walsh BT, Fairburn CG, Mickley D, Sysko R, Parides MK. Treatment of bulimia nervosa in aprimary care setting. Am J Psychiatry. 2004;161(3):556-61.329. Grilo CM, Masheb RM, Wilson GT. Efficacy of cognitive behavioural therapy and fluoxetine <strong>for</strong> thetreatment of binge eating disorder: a randomized double-blind placebo-controlled comparison. BiolPsychiatry. 2005;57(3):301-9.330. Grilo CM, Masheb RM, Salant SL. Cognitive behavioural therapy guided self-help and orlistat <strong>for</strong>the treatment of binge eating disorder: a randomized, double-blind, placebo-controlled trial. BiolPsychiatry. 2005;57(10):1193-201.331. Devlin MJ, Goldfein JA, Petkova E, Liu L,Walsh BT. Cognitive behavioural therapy and fluoxetine<strong>for</strong> binge eating disorder: two-year follow-up. Obesity (Silver Spring). 2007;15(7):1702-9.332. Fairburn CG, Peveler RC, Jones R, Hope RA, Doll HA. Predictors of 12month outcome in bulimianervosa and the influence of attitudes to shape and weight. J Consult Clin Psychol.1993;61(4):696-8.333. Crow SJ,Agras WS, Crosby R, Halmi K, Mitchell JE. <strong>Eating</strong> disorder symptoms in pregnancy:a prospective study. Int J Eat Disord. 2008;41(3):277-9.334. Franko DL,Walton BE. Pregnancy and eating disorders: a review and clinical implications. IntJ Eat Disord. 1993;13(1):41-7.335. Fairburn C, Welch S. The impact of pregnancy on eating habits and attitudes to shape and weight.Int J Eat Disord. 1990;9(2):153-60.336. Brinch M, Isager T, Tolstrup K. Patient's evaluation of their <strong>for</strong>mer treatment <strong>for</strong> anorexia nervosa.Nordisk Psykiatrisk Tidsskrift. 1988;42:445-8.337. Bulik CM, Sullivan PF, Fear JL, Pickering A, Dawn A, McCullin M. Fertility and reproduction inwomen with anorexia nervosa: A controlled study. J Clin Psychiatry. 2008;60:130-5.338. Treasure JL, Russell GF. Intrauterine growth and neonatal weight gain in babies of women withanorexia nervosa. Br Med J (Clin Res Ed). 1988;296(6628):1038.339. Russell GF, Treasure J, Eisler I. Mothers with anorexia nervosa who underfeed their children:their recognition and management. Psychol Med. 1998;28(1):93-108.340. Wezel-Meijler G, Wit JM. The offspring of mothers with anorexia nervosa: a high-risk group <strong>for</strong>undernutrition and stunting? Eur J Pediatr. 1989;149:130-5.281CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS
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Clinical Practice Guidelinefor Eati
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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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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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- 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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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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Summary of the Evidence(See summary
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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
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IntegralcareOutcomeSatisfaction ind
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15. Future research recommendations
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Annex 1. Levels of Evidence and Gra
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Annex 2. Clinical chaptersAnnex 2.1
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30. I eat diet food.31. I feel food
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Annex 2.4. Spanish version of the C
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6. Do you feel you have control ove
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20. I feel sad after eating more th
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33. APPLICABLE ONLY TO WOMEN. My la
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12. Do you eat reasonable amounts o
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Annex 2.7. Diagnostic Criteria for
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