Effects of Dog-Assisted Therapy in Adolescents with Eating Disorders: A Study Protocol for a Pilot Controlled Trial.

BACKGROUND: Eating disorders are characterized by a persistent disturbance that alters food intake and it is often accompanied by anxiety, depression, low self-esteem, or reduced functional capacity and quality of life. Animal-assisted therapies (AAT) have shown benefits in these variables in children and adult populations. Thus, the present pilot study will aim to evaluate the effects of a dog-assisted therapy on the eating disorders symptoms, mental, psychosocial, and physical health, quality of life, and handgrip strength of adolescents suffering from eating disorders. METHODS: The current pilot study will involve 32 patients, who will be assigned to a control or an experimental group. Intervention will be conducted once a week for seven weeks. Neither the experimental nor the control group will discontinue their usual care. The main outcome measures will be the eating disorder symptoms and the health-related quality of life measured with standardized questionnaires, while the secondary variables will be anxiety, depression, character, behavior, strength, and body mass. CONCLUSIONS: This pilot-controlled trial will be the first to evaluate the effects of dog-assisted therapy on the physical and mental health of adolescents with eating disorders. Significant improvements, in the primary and secondary outcomes, may be expected based on the known benefits of AAT on self-esteem, stress, and self-control in different populations. Finally, although the program is focused on the improvement of adolescents' health, animal welfare will be a priority in this study.

Children and adolescents with eating disorders during COVID-19 confinement: Difficulties and future challenges.

OBJECTIVE: To present the adaptations to treatment protocols made in a child and adolescent eating disorders (ED) unit during the eight-week confinement period mandated in response to the COVID-19 pandemic and examine clinical and treatment variables in the outpatient, day hospital, and inpatient care programs. METHOD: Description of the implementation of a combined teletherapy program for outpatient and day-hospital patients and the adaptations made to the inpatient protocol. Retrospective review of medical records and analysis of general and specific variables related to the pandemic and confinement. RESULTS: We held 1,329 (73.10%) telehealth consultations and 489 (26.9%) face-to-face outpatient visits with 365 patients undergoing treatment in the outpatient clinic or day hospital. Twenty-eight (7.67%) were initial evaluations. Twenty-two patients were newly admitted and 68 ED-related emergencies were attended. Almost half of the children and adolescents studied experienced reactivation of ED symptoms despite treatment, and severe patients (25%) presented self-harm and suicide risk. CONCLUSIONS: The implementation of a combined teletherapy program has enabled continuity of care during confinement for children and adolescents with ED. Delivery of treatment to adolescents in the day hospital program posed the biggest challenge due to their greater degrees of severity and higher hospitalization rates. An adapted inpatient program should be maintained throughout confinement, as the need for hospitalization of children and adolescents with ED does not decrease with lockdown.

An mHealth intervention for the treatment of patients with an eating disorder: A multicenter randomized controlled trial.

OBJECTIVE: The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT). METHOD: A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment. RESULTS: Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group. DISCUSSION: The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals.

Update the Multimodal Treatment of ADHD (MTA): twenty years of lessons.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder1 and consists in a persistent pattern of inattention and / or hyperactivity - impulsivity that interferes with the functioning or development of the person who suffers from it. Because it is a disorder that is present since childhood, the treatment of these patients should be multimodal, and it should include doctors, therapists, teachers and parents2. The choice of a pharmacological treatment adjusted to the specific needs of the patient optimizes the results of the intervention programs. In 1997, the National Institute of Mental Health (NIMH) started the study of multimodal treatment of attention deficit hyperactivity disorder (MTA), and this constitutes a landmark in the history of treatment research in child psychopathology. MTA is the largest study of its kind ever undertaken. In the present article we intend to review the existing clinical evidence about the results of the MTA from the nineties to the current date.

Actualización del estudio del Tratamiento Multimodal en TDAH (MTA): dos décadas de aprendizajes / Update the Multimodal Treatment of ADHD (MTA): twenty years of lessons

El Trastorno por Déficit de Atención e Hiperactividad (TDAH) se enmarca dentro de los trastornos del neurodesarrollo 1 y consiste en un patrón persistente de inatención, hiperactividad y/o impulsividad que interfiere con el funcionamiento o el desarrollo de la persona que lo padece. Es un trastorno que se encuentra presente desde la infancia y el tratamiento de estos pacientes debe ser multimodal, y debe incluir a médicos, terapeutas, profesores y padres2. La elección de un tratamiento farmacológico ajustado a las necesidades específicas del paciente, permite optimizar los resultados de los programas de intervención. En 1997 el Instituto Nacional de Salud Mental (NIMH, por sus siglas en inglés) inicia el estudio de tratamiento multimodal del trastorno por déficit de atención con hiperactividad (MTA según sus siglas en inglés) y éste constituye un hito en la historia de la investigación del tratamiento en la psicopatología infantil. Se trata del mayor estudio longitudinal de este tipo, con datos de seguimiento hasta nuestros días. En el presente artículo de revisión se revisan las evidencias clínicas existentes acerca de los resultados del MTA desde los años noventa hasta la fecha actual

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder1 and consists in a persistent pattern of inattention and / or hyperactivity - impulsivity that interferes with the functioning or development of the person who suffers from it. Because it is a disorder that is present since childhood, the treatment of these patients should be multimodal, and it should include doctors, therapists, teachers and parents2. The choice of a pharmacological treatment adjusted to the specific needs of the patient optimizes the results of the intervention programs. In 1997, the National Institute of Mental Health (NIMH) started the study of multimodal treatment of attention deficit hyperactivity disorder (MTA), and this constitutes a landmark in the history of treatment research in child psychopathology. MTA is the largest study of its kind ever undertaken. In the present article we intend to review the existing clinical evidence about the results of the MTA from the nineties to the current date