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Thursday, July 28, 2016

Eating disorders

The lifetime prevalence of all eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and related syndromes) is about 5%.1 “Recent comprehensive estimates suggest that 20 million people in the European Union have an eating disorder, with a cost of about €1 trillion per year (financial costs of about €249 billion plus burden of disease costs of about €763 billion)”.2 Eating disorders can be associated with substantial and prolonged physical and psychosocial morbidity. The causes of eating disorders are incompletely understood. New treatments are being developed and tested but progress is slow because of insufficient research funding.1, 2 For example in the UK the funding disparity is reflected by the difference in funding for eating disorders—0·4% of mental health research expenditure—versus 4·9% for psychosis and 7·2% for depression.3 It is therefore imperative that research funds are directed to the questions that are important to those affected.
  • 1
    Which factors influence the duration of recovery and the possibility of complete recovery?
  • 2
    Which patient and disorder-related features can be used to provide more personalised treatment?
  • 3
    Is it more effective to address the eating disorder symptoms first or the underlying problems?
  • 4
    What is the most effective treatment (and order of treatment) for patients with an eating disorder and a co-morbid disorder?
  • 5
    Which treatment setting (outpatient, at home, day treatment, inpatient or residential, with or without parents) provides the best treatment outcome?
  • 6
    How can loved ones contribute to the recovery process of the eating disorder?
  • 7
    Are there specific risk factors for the development of an eating disorder, and if so, how can prevention target these?
  • 8
    What is the influence of the quality of the working relationship between the treatment team and the patient on treatment outcome?
  • 9
    Is it better to use a protocol based on a guideline or to tailor treatment to the individual?
  • 10
    What causes the need for self-destructive behaviour in patients with an eating disorder?

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