64 research outputs found
Psychopathology predicts mental but not physical bariatric surgery outcome at 3-year follow-up: a network analysis study
No full textPurpose This study aimed to explore the psychopathological variables that may predict bariatric surgery outcomes after 3 years. Methods One hundred ninety-six candidates for bariatric surgery completed self-report questionnaires to assess eating attitudes, eating disorder (ED)-related psychopathology, affective symptoms, interpersonal and psycho-social functioning. One-hundred patients repeated this assessment 3 years after bariatric surgery. A network analysis was run including the pre-surgical measurements in the network. A composite score derived from the combination of the most central network nodes, as well as clinical and socio-demographical variables, was included in a multivariate regression analysis with weight loss, ED psychopathology and psycho-social functioning as outcomes. Results Depression, stress, and shape concerns were the most central network nodes. The composite network score predicted higher ED psychopathology and worse psycho-social functioning at 3-year follow-up, but not weight loss. Higher age, restricting type of bariatric surgery and higher pre-operative BMI were further predictors of reduced weight loss and greater ED psychopathology. Conclusions Affective symptoms and shape concern play a central role in the psychopathology of candidates to bariatric surgery and predict post-surgery ED psychopathology and psycho-social functioning. These variables may allow to identify patients with higher pre-operative risk and in need of further psycho-social interventions
Recovery in bulimia nervosa
No full textThis chapter addresses first issues in definition around the question of recovery in bulimia nervosa (BN), next the natural history, and third the outcome with treatment including predictors that may be modified to enhance remission and reduce relapse or later recurrence rates.
Remission in BN is most often defined as the absence of binge eating and purging behaviours. In addition some studies have used reduction in psychopathology as an alternate indicator of recovery. These studies were based on a quantitative measure of eating disorder weight/shape (or other) concerns e.g. being less than one standard deviation above the community mean of the global Eating Disorder Examination score. There is a consensus that remission is most likely sustained after one year and relapse after that time may be termed recurrence.
Naturalistic studies suggest that about half or more of those with BN may have a good outcome in the longer-term, but for the remainder the disorder is persistent. Treatment outcome studies indicate that for those who engage in specific interventions and evidence based treatments (particularly psychotherapies such as cognitive behaviour therapy for bulimia nervosa) developed since the 1980s the likelihood of recovery is significantly increased. Whilst there are mixed outcomes in studies of prognostic factors, consistent pre-treatment factors identified include a history of psychological adversity, borderline personality structure, depression and obesity. Consistent post-treatment prognostic features are achieving abstinence and good psychosocial adjustment. Thus treatments should address improving psychological resiliency, coping and co-morbidities
Cognitive behaviour therapy for bulimia nervosa, anorexia nervosa and the new 'transdiagnostic' approach
No full textSpecific and efficacious forms of cognitive behaviour therapy (CBT) have been developed for bulimia nervosa, anorexia nervosa and other eating disorders. Indeed the most recent refinement has been a 'transdiagnostic' CBT for all eating disorders. This chapter discusses the most well tested and manualised CBTs for eating disorders, their theoretical basis, evidence and principles of treatment. Specific issues for the overweight patient are also discussed and further reading recommended
Stopping the “revolving door”: “Zeida Laderech,” a unique rehabilitation house for young adults with severe and enduring eating disorders
No full textDying To Be Thin: Attachment to Death in Anorexia Nervosa
Get PDFAnorexia Nervosa (AN) usually follows a prolonged course accompanied by significant morbidity and high mortality. AN patients have been found to have elevated and attempted suicide rates, with suicide being the second most common cause of death in AN after the complications of the disorder itself. The suicide risk in AN is similar to that in major depression or conduct disorder and linked mainly to longer duration of illness, lower weight, bingeing and purging, impulsivity-related manifestations, comorbid substance abuse, and affective disorder. This paper reviews suicidal tendency and disturbed body image, death and eating disorders, and attachment and death with clinical implications related to AN
Comprehensive Community Prevention of Disturbed Attitudes to Weight Control: A Three-Level Intervention Program
No full textEmotional First Aid in Eating Disorders: The Unique Role of Hotlines and Online Services
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