CPG for Eating Disorders

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8.3. In eating disorders, what clinical criteria may beuseful to assess inpatient care (completehospitalisation) in one of the health care resourcesavailable in the NHS?8.3.1. Inpatient care (complete hospitalisation) criteria• Biological state that entails a risk of serious complications (no food intake, especiallyliquids, BMI
8.3.2. Criteria for admission to day patient care (day hospital)• From the adult or children MHC. If the patient does not meet emergency medical care oremergency psychiatric admission criteria and does meet any of the following criteria:– The patient is unable due to the psychopathology presented to follow the guidelines inthe outpatient programme: frequency of visits, limitation of physical activity,recommended diet, etc.– There are serious behavioural problems at home, conflicts in family relationshipsand/or family psychopathology that cannot be modified at an outpatient level.– Weight evolution does not follow the rate indicated in the outpatient programme forweight restoration.• From complete hospitalisation (once discharge criteria have been fulfilled). If additionaleating and behaviour management is necessary, but can be carried out on an outpatientbasis. Also in those cases in which psychopathological intensity requires psychologicaltreatment to modify the patient’s image, beliefs, assertiveness and other aspects relatedwith eating disorders.8.4. In eating disorders, what clinical criteria may beuseful to assess discharge from health care resourcesavailable in the NHS?8.4.1. Criteria for discharge from inpatient care (completehospitalisation)• Normalisation of biological disturbances that have led to complete hospitalisation.• Weight restoration as is established in an individualised programme.• Improved psychopathological state.• Elimination of self-injurious behaviour.• Remission of abnormal eating behaviour and compensatory behaviour.• Improved family conflicts.• Improved general functioning.8.4.2. Criteria for discharge from day patientcare (day hospital)In order to refer to outpatient care (adult or children MHCs):• Weight restoration and/or maintenance as established in the ITP.• Completion of group programmes that had been initiated.• Improved eating pattern and compensatory behaviour (if any).• Improved family conflicts and general functioning that enable outpatient treatment.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS83
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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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Page 33 and 34: 1. IntroductionBackgroundThe develo
Page 35 and 36: However, there is a need for a guid
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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
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Page 51 and 52: Sociocultural factorsThe studies id
Page 53 and 54: accompany eating disorders. However
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Page 57 and 58: (causal factors). Participants in t
Page 59 and 60: is a programme that promotes a heal
Page 61 and 62: MA 1341++MA 1341++No definitive con
Page 63 and 64: Of all the proposed criteria and re
Page 65 and 66: Spanish version of the EAT-40In Spa
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Page 69 and 70: 6.5. It is recommended to use quest
Page 71 and 72: 7.2. How are eating disorders class
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Page 75 and 76: Other examinationsTo ascertain whet
Page 77 and 78: CLINICAL PRACTICE GUIDELINE FOR EAT
Page 79 and 80: - Initiating nutritional treatment
Page 81: 8.2. In eating disorders, what clin
Page 85 and 86: RecommendationsD 8.1. Individuals w
Page 87 and 88: 9. Treatment of Eating DisordersThe
Page 89 and 90: An RCT (Rigaud, 2007; France) 203 c
Page 91 and 92: 9.2. Nutritional Counselling (NC)9.
Page 93 and 94: Recommendations(See recommendations
Page 95 and 96: Anorexia nervosaRecommendationsD 9.
Page 97 and 98: PSYCHOLOGICAL THERAPIESIn this sect
Page 99 and 100: Summary of the Evidence(See also th
Page 101 and 102: There is limited evidence to sugges
Page 103 and 104: In an RCT (Wilson, 2002; USA) 234 C
Page 105 and 106: SRSE 2401++SRSE 2401++CBT treatment
Page 107 and 108: In an RCT (Bulik, 1998) 236 the ove
Page 109 and 110: Evidence indicates that it is unlik
Page 111 and 112: A 9.3.3.1. Adult patients with BED
Page 113 and 114: In an RCT (Carter, 2003; Canada) 24
Page 115 and 116: Variable: reduction / remission of
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Page 120 and 121: Scientific EvidenceThere is insuffi
Page 122 and 123: Recommendations(See also recommenda
Page 124 and 125: Summary of the Evidence(See summary
Page 126 and 127: 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
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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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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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