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Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland.
Schopf, Kathrin; Schneider, Silvia; Meyer, Andrea Hans; Lennertz, Julia; Humbel, Nadine; Bürgy, Nadine-Messerli; Wyssen, Andrea; Biedert, Esther; Isenschmid, Bettina; Milos, Gabriella; Claussen, Malte; Trier, Stephan; Whinyates, Katherina; Adolph, Dirk; Teismann, Tobias; Margraf, Jürgen; Assion, Hans-Jörg; Überberg, Bianca; Juckel, Georg; Müller, Judith; Klauke, Benedikt; Munsch, Simone.
Afiliação
  • Schopf K; Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany.
  • Schneider S; Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany.
  • Meyer AH; Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.
  • Lennertz J; Praxis für Psychotherapie, Dortmund, Germany.
  • Humbel N; Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.
  • Bürgy NM; Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.
  • Wyssen A; Institute of Psychology, Clinical Child and Adolescent Psychology, University of Lausanne, Lausanne, Switzerland.
  • Biedert E; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
  • Isenschmid B; Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.
  • Milos G; Center for Eating Disorders and Obesity, Clinic Zofingen, Zofingen, Switzerland.
  • Claussen M; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, Zurich, Switzerland.
  • Trier S; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
  • Whinyates K; Privat Clinic Aadorf, Aadorf, Switzerland.
  • Adolph D; Privat Clinic Schützen Rheinfelden, Rheinfelden, Switzerland.
  • Teismann T; Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany.
  • Margraf J; Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany.
  • Assion HJ; Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany.
  • Überberg B; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, LWL-Klinik Dortmund, Dortmund, Germany.
  • Juckel G; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, LWL-Klinik Dortmund, Dortmund, Germany.
  • Müller J; Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr University Bochum, Bochum, Germany.
  • Klauke B; Christoph-Dornier-Klinik for Psychotherapy, Münster, Germany.
  • Munsch S; Christoph-Dornier-Klinik for Psychotherapy, Münster, Germany.
PLoS One ; 18(6): e0280402, 2023.
Article em En | MEDLINE | ID: mdl-37390075
This descriptive study examined patient characteristics, treatment characteristics, and short-term outcomes among patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in routine clinical care. Results for patients receiving full-time treatment were contrasted with results for patients receiving ambulatory treatment. Data of a clinical trial including 116 female patients (18-35 years) diagnosed with AN or BN were subjected to secondary analyses. Patients were voluntarily admitted to one of nine treatment facilities in Germany and Switzerland. Patients received cognitive-behavioral interventions in accordance with the national clinical practice guidelines for the treatment of EDs under routine clinical care conditions, either as full-time treatment or ambulatory treatment. Assessments were conducted after admission and three months later. Assessments included a clinician-administered diagnostic interview (DIPS), body-mass-index (BMI), ED pathology (EDE-Q), depressive symptoms (BDI-II), symptoms of anxiety (BAI), and somatic symptoms (SOMS). Findings showed that treatment intensity differed largely by setting and site, partly due to national health insurance policies. Patients with AN in full-time treatment received on average 65 psychotherapeutic sessions and patients with BN in full-time treatment received on average 38 sessions within three months. In comparison, patients with AN or BN in ambulatory treatment received 8-9 sessions within the same time. Full-time treatment was associated with substantial improvements on all measured variables for both women with AN (d = .48-.83) and BN (d = .48-.81). Despite the relatively small amount of psychotherapeutic sessions, ambulatory treatment was associated with small increases in BMI (d = .37) among women with AN and small improvements on all measured variables among women with BN (d = .27-.43). For women with AN, reduction in ED pathology were positively related to the number of psychotherapeutic sessions received. Regardless of diagnosis and treatment setting, full recovery of symptoms was rarely achieved within three months (recovery rates ranged between 0 and 4.4%). The present study shows that a considerable amount of patients with EDs improved after CBT-based ED treatment in routine clinical care within three months after admission. Intensive full-time treatment may be particularly effective in quickly improving ED-related pathology, although full remission of symptoms is typically not achieved. A small amount of ambulatory sessions may already produce considerable improvements in BN pathology and weight gain among women with AN. As patient characteristics and treatment intensity differed largely between settings, results should not be interpreted as superiority of one treatment setting over another. Furthermore, this study shows that treatment intensity is quite heterogeneous, indicating the possibility for increasing effectiveness in the treatment of EDs in routine clinical care.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Anorexia Nervosa / Transtornos da Alimentação e da Ingestão de Alimentos / Bulimia Nervosa Tipo de estudo: Guideline / Qualitative_research Limite: Adolescent / Adult / Female / Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Anorexia Nervosa / Transtornos da Alimentação e da Ingestão de Alimentos / Bulimia Nervosa Tipo de estudo: Guideline / Qualitative_research Limite: Adolescent / Adult / Female / Humans País/Região como assunto: Europa Idioma: En Ano de publicação: 2023 Tipo de documento: Article