CPG for Eating Disorders

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CLINICAL PRACTICEGUIDELINE FOREATING DISORDERSCLINICAL PRACTICE GUIDELINES IN THE NHSMINISTRY OF HEALTHCARE AND CONSUMER AFFAIRS
This clinical practice guideline (CPG) is an aid for decision-making in health care. It is not in any way an obligedrequirement to adhere to every aspect of this CPG and it does not replace the clinical judgement of health careprofessionals.Edition: 1/February/2009Edited by: Catalan Agency for Health Technology Assessment and ResearchRoc Boronat, 81-9508005 BarcelonaNIPO: 477-08-022-8ISBN: 978-84-393-8010-8Legal Deposit: B-55481-2008© Ministry of Health and Consumer Affairs© Catalan Agency for Health Technology Assessment and Research3CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS
Page 1: Clinical Practice Guidelinefor Eati
Page 6 and 7: Annex 2.7. Diagnostic Criteria for
Page 8 and 9: This CPG aims to provide the popula
Page 11 and 12: External Review of Patient Informat
Page 13 and 14: 14. What is the efficacy and safety
Page 15 and 16: CLINICAL PRACTICE GUIDELINE FOR EAT
Page 17 and 18: D 6.2. In anorexia nervosa (AN), we
Page 19 and 20: D 8.6. Primary care centres should
Page 21 and 22: 9.GM.02. Before initiating artifici
Page 23 and 24: Binge-Eating DisorderA 9.3.3.1. A s
Page 25 and 26: D 9.GP.11. In children and adolesce
Page 27 and 28: Binge-Eating DisorderD 9.GPH.6. In
Page 29 and 30: 11. Prognosis of Eating Disorders (
Page 31 and 32: ED: Eating disorderEDNOS: Eating di
Page 33 and 34: 1. IntroductionBackgroundThe develo
Page 35 and 36: However, there is a need for a guid
Page 37 and 38: Table 2. Studies on the prevalence
Page 39 and 40: 2. Scope and ObjectivesTarget Popul
Page 41 and 42: Aspects not included in the CPGThe
Page 43 and 44: 3. MethodologyThe methodology emplo
Page 45 and 46: - Synthesis and analysis of the sci
Page 47 and 48: 4. Definition and Classification of
Page 49 and 50: - Other psychopathological disturba
Page 51 and 52: Sociocultural factorsThe studies id
Page 53 and 54:
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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CLINICAL PRACTICE GUIDELINE FOR EAT
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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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Page 196 and 197:
Page 198 and 199:
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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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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Page 258 and 259:
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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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
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181. Rivas T, Jiménez M, Bersabé
Page 276 and 277:
224. Fairburn CG, Jones R, Peveler
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262. McCann UD, Agras WS. Successfu
Page 280 and 281:
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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