Peculiaridades do tratamento da anorexia e da bulimia nervosa na adolescência: a experiência do PROTAD

Abstract

Os transtornos alimentares são patologias severas, tendo aspectos especiais na adolescência. Este artigo objetiva apresentar a rotina de atendimento e as abordagens empregadas em um serviço de assistência brasileiro especializado no tratamento de transtornos alimentares nessa população.Palavras-chave: Transtornos alimentares, tratamento, adolescência. AbstractThe particular aspects of eating disordes in adolescents are reviwed. This article presents the multidisciplinary approach used in this population.Keywords: Eating disorders, treatment adolescense. IntroduçãoOs transtornos alimentares constituem patologias graves, complexas e com alto grau de morbidade, sobretudo na adolescência, quando freqüentemente iniciam e afetam ampla e severamente o desenvolvimento do indivíduo. Apresentam prognóstico reservado e, caracteristicamente, envolvem a família. O tratamento-padrão deve ser multidisciplinar. Os melhores resultados parecem ocorrer naqueles casos de intervenção precoce durante a adolescência, evitando as formas crônicas e imutáveis das doenças alimentares (Lock et al., 2001). Bryan Lask enfatiza que o sucesso de um programa de atendimento integrado e completo depende de uma equipe multiprofissional e do emprego simultâneo de várias estratégias (Lask e Bryant-Waugh, 2000). Treasure, Todd e Szmukler enfatizam que nenhuma modalidade de tratamento pode ser indicada como única ou isoladamente melhor (Szmukler et al., 1995).Tais pressupostos embasaram a formação do PROTAD, em funcionamento desde novembro de 2001.

A bulimia nervosa como fator de risco para distúrbios da voz: artigo de revisão

“…17 NB manifests in adolescents as compulsive behavior strongly associated with personality disorders, anxiety, obsessive-compulsive disorder, depression, humor disorders, and use or dependency on substances such as alcohol and other stimulants. 3 From a psychological perspective, there is a strong relation between eating disorders, such as NB and NA, and depression. Investigating the time sequence in which comorbid disorders manifest across life is an interesting life of research that has provided important insights.…”

“…15 Although NB usually initiates in adolescence or early adulthood, studies on NB have investigated mostly adult samples, possibly because medical help tends to be sought at this time. 3 A North-American study of eight bulimic singers that also had GERD, aged between 24 and 34 years, revealed that they complained of hoarseness, laryngeal pain, voice fatigue, phlegm, lower-pitched voice, recurring voice loss and ardor. Laryngeal findings in this group were posterior edema, posterior commissure hypertrophy, ventricular obliteration, polypoid-type degeneration and teleangiectasia.…”

“…Its main feature is the rapid and compulsive intake of large amounts of food, followed by the use of purgative methods such as provoked vomiting and the use of laxatives and diuretics, after which patients go through non-purgative periods that include fasting and inanition due to fear of gaining weight. 1,3 There have been few studies aimed at the adolescent population, possibly because only adults with this condition seek specific therapy for NB. On the other hand, there have been more studies on this subject, probably because of the incidence of this disease.…”

“…3 The excessive value given to slim female bodies appears to be linked with an increased occurrence of eating disorders such as anorexia and nervous bulimia.2 Such cultural pressure, the media, and the collective imaginary encourage women in particular to go through sacrifices to attain an idealized body. 3 Therapy for bulimic patients is multidisciplinary, involving mostly physicians, psychologists and nutrition specialists, given the complex factors that compose this disease. Best results tend to occur when early interventions are made in adolescence, which avoids the chronic and immutable states of eating disorders.…”

Adolescência e saúde mental: revisão de artigos brasileiros publicados em periódicos nacionais

“…As intervenções nos transtornos alimentares foram abordadas por meio das experiências de equipes especializadas 79 , da clinica hospitalar 80 e de técnicas grupais 81 , psicodinâmica 82 e cognitiva 83 . Predominaram discussões teóricas baseadas em compreensões das alterações da imagem corporal 84 , da dinâmica da personalidade 78 e de conflitos familiares 85 .…”