Outcome Predictors in Anorectic Patients after 6 Months of Multimodal Treatment

Abstract

Background: Anorexia nervosa is asevere disorder that often responds poorly to treatment. At this time, little is known about pretreatment predictors of response. Methods: A sample of 42 restrictor type anorectics was tested at the assessment phase and after 180 days retested using the Temperament and Character Inventory and Eating Disorder Inventory 2 along with other clinical evaluation instruments. After 180 days of treatment with multimodal ‘network’ therapy, the patients were divided into two groups. The first group included patients who showed relevant clinical improvement; the second group included patients considered ‘not yet responding’. Data collected from the not-yet-responding group were compared by the t test with the other group’s data to evaluate prognostic indexes. Results: Diagnosis of personality disorder, which afflicted about 50% of patients, seemed not to be a relevant prognostic factor. However, a lower novelty seeking was characteristic of the nonresponder group. Higher levels of asceticism and maturity fears also characterized the nonresponder group. Conclusion: Present data suggest some elements that could be useful to focus pharmacotherapy, psychotherapy and family counseling on the current psychopathology of each patient.

Dropout from Brief Psychotherapy in Anorexia nervosa

“…This result is not consistent with data obtained by Vandereycken and Pierloot [13]in inpatients. A multimodal approach might allow valid support and protection from the anorectic symptoms [35], thus making it possible for therapists and patients to face anorectic cognition without increasing the dropout risk. This further emphasizes the fact that in this sample, the dropout phenomenon was not related to the severity of the clinical condition.…”

“…Reducing anxiety, enhancing self-esteem, encouragement, advising, reframing, focus on the creative self, attention to and not interpretation of transference, clarification, confrontation and interpretation are some of the methodologic features of IPBP [35]. The flexibility of this approach allows for many combinations of techniques from the cognitive, behavioral, analytic, existential and client-centered approaches.…”

“…The goal of IPBP is to increase the patient’s level of social interest in relatedness and ability to function more effectively. This intervention was carried out in the context of a network model [35]including also nutritional controls, family counseling (for all patients) and psychopharmacologic treatment with benzodiazepines (when required).…”

Avaliação dos traços de personalidade em pacientes com anorexia nervosa, segundo o Inventário de Temperamento e Caráter de Cloninger

“…Nesse sentido, o ITC também tem sido aplicado para a percepção dos traços de personalidade de pacientes com TA e inferências para estudos neuropsicológicos, terapêuticos e prognósticos (BULIK et al, 1998;SVRAKIC, 1999;FASSINO et al, 2001a).…”

“…O traço Autodirecionamento (ITC) diminuído nos pacientes com AN, em relação ao grupo controle, parece ser um consenso nos estudos que utilizam o ITC em pacientes com AN (KLUMP et al, 2000;FASSINO et al, 2001a;FASSINO et al, 2001b;FASSINO et al, 2002;DIÁZ-MARSÁ, 2000). Karwautz et al (2003) correlacionam tais achados do ITC à presença de transtornos de personalidade.…”