CPG for Eating Disorders

More documents

Recommendations

Info

Summary of the EvidenceCPG 30There is limited evidence to indicate that CBT is more acceptable than NC ininpatients with AN after weight restoration (1 RCT; N=33; Pike, 2003) 210 ..Recommendations(See recommendations 9.GM.1. to 9.GM.5.)9.2.2. Bulimia nervosa9.2.2.1. What is the efficacy of NC in patients with BN?The answer is based on the NICE CPG (2004) 30 . High-quality (1++) SRSE have also been takeninto account, one elaborated by the AHRQ of the US (2006) 31 and a more recently published oneby Shapiro, et al., . (2007) 211 , which include the same RCT. The updated search has not yieldednew evidence. Results are presented according to the variables studied in the RCT.Variables: reduction/ remission of binge-eating and purging episodesThere is limited evidence to suggest that CBT-BN is more effective than NC in reducingthe frequency of purging episodes by the end of treatment (SMD: -0.95; 95% CI: -1.70 to-0.20) and strong evidence for post-treatment follow-up (SMD: -1.34; 95% CI: -2.13 to -0.55) according to 1 RCT (N=31; Sundgot-Borgen, 2002) 212 .There is no evidence or insufficient evidence to determine that CBT-exposure withresponse prevention (ERP) for binge-eating episodes differs from NC (nutritionaltherapy) in the remission of binge-eating and purging (2 RCTs; N=90; Hsu, 2001 213 ;Jansen, 2002 214 ; RR: 0,82; 95% CI: 0.65 a 1.04) and in the frequency of binge-eating andpurging (1 RCT; N=49; Hsu, 2001 213 ; SMD: 0.43; 95% CI: -0.14 to 0.99) by the end oftreatment.RCT1++RCT1 ++Variables: depression and/or interpersonal and psychosocialfunctioning and/or general psychiatric symptomsThere is no evidence or insufficient evidence to determine that CBT-ERP differs from NC(nutritional therapy) in the scores obtained from the instrument used to assess depression (1RCT; N=49; Hsu, 2001 213 ; SMD: 0.15; 95% CI: -0.41 to 0.72). RCT 1 ++Summary of the EvidenceSRSE 311++If a cognitive component is added to NC (nutritional therapy) its effectivenessimproves (Hsu, 2001) 213 ..92CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS
Recommendations(See recommendations 9.GM.6. to 9.GM.9.)9.2.2.2. What is the safety of NC in patients with BN?The answer is based on the evidence described for NC efficacy (question9.2.2.1.).Summary of the Evidence1++ There is limited evidence to indicate significant differences between CBT-BNvs. NC in the number of dropouts by the end of treatment (1 RCT; N=31;Sundgot-Borgen, 2002 212 ; SMD: -0.95; 95% CI: -0.70 to -0.20).1++ There is not sufficient evidence of clinically significant differences betweenCBT-ERP and NC (nutritional therapy) in the number of dropouts for anyreason by the end of treatment (2 RCTs; N=90; Hsu, 2001 213 ; Jansen,2002 214 ; RR: 0.95; 95% CI: 0.16 to 5.51).Recommendations(See recommendations 9.GM.6. to 9.GM.9.)CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS93
Page 1 and 2:
Clinical Practice Guidelinefor Eati
Page 3:
This clinical practice guideline (C
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
Page 55 and 56: 5. Prevention of Eating DisordersKe
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
Page 67 and 68: of the five dimension results in th
Page 69 and 70: 6.5. It is recommended to use quest
Page 71 and 72: 7.2. How are eating disorders class
Page 73 and 74: to help them cope with the situatio
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 and 82: 8.2. In eating disorders, what clin
Page 83 and 84: 8.3.2. Criteria for admission to da
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: 9.2. Nutritional Counselling (NC)9.
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
Page 117 and 118: In yet another RCT (Carter, 1998 26
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
Page 132 and 133: elaborated by the AHRQ of the US (2
Page 134 and 135: SUMMARY OF THE EVIDENCE FORPSYCHOLO
Page 136 and 137: D 9.GP.6. For patients with AN who
Page 138 and 139: PHARMACOLOGICAL TREATMENTIn this se
Page 140 and 141: 9.9.1.2. What is the safety of anti
Page 142 and 143:
There is strong evidence that antid
Page 144 and 145:
Summary of the EvidenceSRSE 311++SR
Page 146 and 147:
There is insufficient evidence sugg
Page 148 and 149:
An RCT (Appolinario, 2003; Brazil)
Page 150 and 151:
9.10. AntipsychoticsEvidence in AN
Page 152 and 153:
9.11.2. What is the safety of cypro
Page 154 and 155:
9.13.1.2. What is the safety of top
Page 156 and 157:
Recommendations(See recommendations
Page 158 and 159:
SUMMARY OF THE EVIDENCE FORPHARMACO
Page 160 and 161:
COMBINED INTERVENTIONSThis section
Page 162 and 163:
Antidepressants vs. antidepressants
Page 164 and 165:
There is insufficient evidence to s
Page 166 and 167:
Summary of the EvidenceSRSE 311++SR
Page 168 and 169:
9.16.3. Binge-eating disorder9.16.3
Page 170 and 171:
TREATMENT OF EATING DISORDERS THATO
Page 172 and 173:
TREATMENT OF CHRONIC EATING DISORDE
Page 174 and 175:
10. Assessment of Eating DisordersK
Page 176 and 177:
EDI-2 (Version 2 of the EDI-1)Later
Page 178 and 179:
BIABody Image Assessment. Collins,
Page 180 and 181:
10.1.5. The use of questionnaires a
Page 182 and 183:
has been widely used. It consists o
Page 184 and 185:
out as the most adequate, given its
Page 186 and 187:
abuse/dependency, low sensation see
Page 188 and 189:
the freedom of articles 17 of the S
Page 190 and 191:
12.2. Is the informed consent of an
Page 192 and 193:
RecommendationAccording to current
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Algorithm 2. Intervention if there
Page 200 and 201:
9) Day care admission criteria:- Fr
Page 202 and 203:
- Oral nutritional support in eatin
Page 204 and 205:
Algorithm 4. Treatment of BN and BE
Page 206 and 207:
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
Page 230 and 231:
Within each guideline some variatio
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:
Page 258 and 259:
General Directorate for Public Heal
Page 260 and 261:
2) We identified 20 documents elabo
Page 262 and 263:
estimator, establishing the followi
Page 264 and 265:
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
show all

CPG for Eating Disorders

Create successful ePaper yourself

Delete template?

Save as template?