CPG for Eating Disorders

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Table of ContentsPresentation 9Authors and Collaborations 11Key Questions 13CPG Recommendations 171. Introduction 332. Scope and Objectives 393. Methodology 434. Definition and Classification of Eating Disorders 475. Prevention of Eating Disorders 556. Detection of Eating Disorders 637. Diagnosis of Eating Disorders 738. Interventions at the Different Levels of Care in the Management of 81Eating Disorders9. Treatment of Eating Disorders 9110. Assessment of Eating Disorders 17911. Prognosis of Eating Disorders 19112. Legal Aspects Concerning Individuals with Eating Disorders in 195Spain13. Detection, Diagnosis and Treatment Strategies for Eating Disorders 20114. Dissemination and Implementation 21515. Recommendations for Future Research 219ANNEXESAnnex 1. Levels of Evidence and Grades of Recommendation 221Annex 2. Clinical Chapters 223Annex 2.1. Spanish version of the SCOFF survey 223Annex 2.2. Spanish version of the EAT-40 224Annex 2.3. Spanish version of the EAT-26 226Annex 2.4. Spanish version of the ChEAT 227Annex 2.5. Spanish version of the BULIT 228Annex 2.6. Spanish version of the BITE 2345CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS
Page 1 and 2: Clinical Practice Guidelinefor Eati
Page 3: This clinical practice guideline (C
Page 7 and 8: PresentationHealth care practice is
Page 9: Authorship and CollaborationsEating
Page 12 and 13: Key QuestionsDefinition and Classif
Page 14 and 15: 33. Are there prognostic factors fo
Page 16 and 17: CPG RecommendationsIn this section
Page 18 and 19: 7. Diagnosis of Eating Disorders (Q
Page 20 and 21: 8.15. Referral to adult or children
Page 22 and 23: D 9.GM.4. Legal requirements must b
Page 24 and 25: General Recommendations for Psychol
Page 26 and 27: Binge-Eating DisorderB 9.9.3.1.1. S
Page 28 and 29: 10. Assessment of Eating Disorders
Page 30 and 31: Abbreviations, Clinical Questions a
Page 32 and 33: CLINICAL PRACTICE GUIDELINE FOR EAT
Page 34 and 35: In 2002, Gowers SG, et al. 8 publis
Page 36 and 37: Several studies on the incidence of
Page 38 and 39: CLINICAL PRACTICE GUIDELINE FOR EAT
Page 40 and 41: Aspects includedThe CPG includes th
Page 42 and 43: ObjectivesMain objectiveTo provide
Page 44 and 45: 3) To respond to those questions un
Page 46 and 47: - Formulation of research lines. Th
Page 48 and 49: BN is an eating disorder characteri
Page 50 and 51: - Persistent preoccupation with wei
Page 52 and 53: Current literature suggests that ea
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ObesityObesity as a risk factor is
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y Pratt BM and Woolfendern SR (Coch
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experimental group presented sustai
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(advocacy); and d) interventions re
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6. Detection of Eating DisordersKey
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Spanish versionThere is an adapted
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75% specificity, 11% PPV, 99.5% NPV
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Spanish version of the BITEThe adap
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7. Diagnosis of Eating DisordersKey
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Although these two interviews are a
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dental erosion, enamel demineralisa
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7.3. Differential Diagnosis of Eati
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8. Interventions at the Different L
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section), and d) time-frame for the
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8.3. In eating disorders, what clin
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For hospital admission:• Weight d
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D 8.9. Patients with AN whose disor
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5. To treat associated disorders (c
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Recommendations(See also recommenda
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Summary of the EvidenceCPG 30There
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GENERAL RECOMMENDATIONS ON MEDICALM
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(Adopted from recommendation 7.5.3.
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Summary of the Evidence(See also th
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95% CI: 0.58 to 1.63) and purging (
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Variables: depression and/or interp
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no differences between groups in te
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There is insufficient evidence to d
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There is evidence that indicates it
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differences were observed in other
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9.4. Self-Help (SH) and Guided Self
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Scientific EvidenceThere is insuffi
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Summary of the EvidenceSRSE 311++SR
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Scientific EvidenceIn an RCT (McIns
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to -0.22) and at post-treatment fol
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Scientific EvidenceIn an RCT (Crisp
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D 9.6.1.1.2. Family members of chil
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esults related with eating disorder
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9.7.2. Bulimia nervosa9.7.2.1. What
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menstrual cycle. At one year of tre
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Recommendations(See recommendations
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SRSE 311++The best psychological tr
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B 9.GP.14. Health care professional
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In an RCT (Kaye, 2001; USA) 279 flu
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SRSE 311++SRSE 311++Due to the smal
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Variables: depression and/or interp
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D 9.9.2.1.4. Amongst SSRI antidepre
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9.9.3. Binge-Eating Disorder9.9.3.1
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Scientific EvidenceThere is insuffi
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9.10.1.2. What is the safety of Ant
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9.12.1.2. What is the safety of opi
Page 155 and 156:
9.13.2.2. What is the safety of top
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Summary of the EvidenceCPG 30There
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D 9.GPH.4. If drugs with adverse ca
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The CBT-olanzapine group obtained b
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(desipramine, fluoxetine) differs f
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An RCT (Walsh, 2004; USA) 328 compa
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There is insufficient evidence to d
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Summary of the EvidenceRSEC 31 The
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RecommendationsD 9.18.1. Treatment
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TREATMENT OF EATING DISORDERS INSPE
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10.1.1. Specific instruments for th
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of assessing attitude regarding cha
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cut-off point of 23/24 points 89 .
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Spanish version of the STAIThere is
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assessment and confirmation of diag
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11. Prognosis of Eating DisordersKe
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12. Legal Aspects Concerning Patien
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Current legislation- Article 10 of
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Current legislation- Organic Law 1/
Page 193 and 194:
13. Detection, diagnosis and treatm
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CLINICAL PRACTICE GUIDELINE FOR EAT
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Algorithm NotesAlgorithm 1. Detecti
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Criteria for referral from PC to em
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Algorithm 3. Treatment of AN1) It i
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- Following hospital discharge, pat
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Health care professionals can consi
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Table 1. Proposed indicatorsAreaTyp
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Page 211 and 212:
manuals) and remote help (online, t
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CBody of evidence composed of studi
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Annex 2.2. Spanish version of the E
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Annex 2.3. Spanish version of the E
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Annex 2.5. Spanish version of the B
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13. I am afraid of eating because I
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26. If I eat too much at night, I f
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Annex 2.6. Spanish version of the B
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29. If you binge eat, do feel very
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c) Body image distortion that consi
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disorders. In 1994, the fourth vers
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food (for example, self-induced vom
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Annex 2.10. Description of proposed
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Proportion of patients seen with th
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shape. Perfectionism and low self-e
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team of psychiatrists, psychologist
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Annex 4. GlossaryCounsellingPerform
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of skills to fend off social persua
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MoclobemideMAOI antidepressant, mai
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Cognitive-Behavioural Therapy(CBT)P
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Annex 5. AbbreviationsABOS Anorecti
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EDE-Q Eating Disorders Examination-
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correlation coefficient rRR Relativ
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Annex 6. OthersAnnex 6.1. Protocols
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National Collaborating Centre for M
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Commissioned and Published by: Nati
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Consulted bibliographic databases:
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References1. Grupo de trabajo sobre
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36. Grieve F. A conceptual model of
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78. Mercader JM, Saus E, Aguera Z,
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120. Nielsen S. Eating disorders in
Page 273 and 274:
161. Perry L, Morgan J, Reid F, Bru
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203. Rigaud D, Brondel L, Poupard A
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andomized controlled trial. Am J Ps
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Psychopharmacol. 1985;5(1):10-6.282
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321. Leitenberg H, Rosen JC, Wolf J
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364. Spielberger C, Gorsuch R, Lush
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408. Convenio Europeo para la Prote
Page 287:
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