[Antidepressants sometimes lead to rapid remission in the treatment of anorexia nervosa]. / Az antidepresszívumok az anorexia nervosa kezelésében néha gyors remisszióhoz vezetnek.

In the treatment of anorexia nervosa the dominant role of psychotherapies is proposed, while pharmacotherapy has a limited effi cacy. Because of the broad comorbidity spectrum of the disorder, other psychiatric disorders are often present. Among them depression is frequent, so one of the selective theories of eating disorders stresses the importance of the relationship with depression. In everyday practice we frequently encounter anorexic patients whose depressive symptoms are mild or moderate, and these are often regarded as usual accompanying phenomena of anorexia. The three case reports described in the present study support that it is worth to consider the application of antidepressants in such situations. In all three cases antidepressants were initiated following ineffi cacy of psychotherapy, and they produced a dramatic eff ectiveness not only in depressive symptoms, but also in the whole anorexic syndrome. In the complex therapy of anorexia nervosa antidepressants may yield a very good therapeutic eff ect in cases with comorbid, even subthreshold depression.

Linguistic characteristics of patients with bulimic symptomatology in an online post-treatment program: an exploratory study.

BACKGROUND: No former investigation has been performed related to the linguistic characteristics of patients with eating disorders using online synchronous communication mediums like chats. OBJECTIVE: The purpose of this study was to investigate the linguistic predictors of improvement in eating disorder-related attitudes, behaviours and emotional distress of patients with eating disorders. METHODS: Thirty-nine women, who had received treatment for bulimia nervosa or related eating disorders not otherwise specified, utilized the moderated therapeutic group chats of an Internet-based program for 4 months. The main themes of 134 session transcripts were created using a general inductive approach. The frequency of dictionary words in the text corpus was processed by the NooJ linguistic software. Eating Disorder Examination Questionnaire and Depression Anxiety Stress Scale were administered at the beginning and at the end of 4 months. No valid questionnaire data could be obtained from 11 participants, so the statistical analyses were performed in a sample of 28 subjects. RESULTS: According to the results of multiple linear regression analyses, higher ratio of words related to "family of origin" was associated with improvements in eating disorder-related attitudes, emotional distress, and reduction in the frequency of binge eating episodes (ß = 0.73, p < 0.001; ß = 0.67, p = 0.002; ß = 0.53, p = 0.039, respectively). DISCUSSION: The expression of "family of origin" words following treatment termination was a linguistic predictor of improvement during group chat communication of patients with bulimic symptomatology. The results show the importance of family issues in enhancing the treatment outcome and provide preliminary evidence to address this topic during online chat moderation.

A randomized controlled trial of an internet-based posttreatment care for patients with eating disorders.

BACKGROUND: Despite effective treatment approaches, relapses are frequent in eating disorders. Posttreatment care is essential to enhance continuous recovery and prevent deterioration. This study evaluated the effects of an Internet-based intervention following routine care. MATERIALS AND METHODS: One hundred five women who received treatment for bulimia nervosa and related eating disorders not otherwise specified were randomly assigned either to an immediate Internet-based support program (EDINA) over 4 months or to a 4-month waiting-list treatment as usual (TAU) control condition. The primary outcome was eating disorder-related attitudes at baseline and after 4 months assessed by the Eating Disorder Examination Questionnaire (EDE-Q). RESULTS: The program proved feasible and was well accepted. A significant reduction in eating disorder-related attitudes could be shown for both groups at the end of the 4 months. There was a tendency for participants of the aftercare intervention to show better results on all outcome measures. In total, 40.6% (13/32) of the EDINA participants and 24.4% (10/41) of the TAU participants showed statistically reliable improvement on the EDE-Q total score by the end of the intervention period [χ(2)(1)=2.195, p=0.138]. CONCLUSIONS: The Internet-based support program was feasible and well accepted but did not prove efficacious in a heterogeneous sample of patients following routine care.