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Flashcards in Eating Disorders Deck (14)
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1
Q

Psychological treatment for anorexia nervosa in adults

A

For adults with anorexia nervosa, consider one of:

individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)

specialist supportive clinical management (SSCM).

2
Q

Individual CBT-ED programmes for adults with anorexia nervosa should:

A

typically consist of up to 40 sessions over 40 weeks, with twice-weekly sessions in the first 2 or 3 weeks

aim to reduce the risk to physical health and any other symptoms of the eating disorder

encourage healthy eating and reaching a healthy body weight

cover nutrition, cognitive restructuring, mood regulation, social skills, body image concern, self-esteem, and relapse prevention

create a personalised treatment plan based on the processes that appear to be maintaining the eating problem

explain the risks of malnutrition and being underweight

enhance self-efficacy

include self-monitoring of dietary intake and associated thoughts and feelings

include homework, to help the person practice in their daily life what they have learned.

3
Q

MANTRA for adults with anorexia nervosa should:

A

typically consist of 20 sessions, with:

weekly sessions for the first 10 weeks, and a flexible schedule after this

up to 10 extra sessions for people with complex problems

base treatment on the MANTRA workbook

motivate the person and encourage them to work with the practitioner

be flexible in how the modules of MANTRA are delivered and emphasised

when the person is ready, cover nutrition, symptom management, and behaviour change

encourage the person to develop a ‘non‑anorexic identity’

involve family members or carers to help the person:

understand their condition and the problems it causes and the link to the wider social context

change their behaviour.

4
Q

SSCM for adults with anorexia nervosa should

A

typically consist of 20 or more weekly sessions (depending on severity)

assess, identify, and regularly review key problems

aim to develop a positive relationship between the person and the practitioner

aim to help people recognise the link between their symptoms and their abnormal eating behaviour

aim to restore weight

provide psychoeducation, and nutritional education and advice

include physical health monitoring

establish a weight range goal

encourage reaching a healthy body weight and healthy eating

allow the person to decide what else should be included as part of their therapy.

5
Q

If individual CBT-ED, MANTRA, or SSCM is unacceptable, contraindicated or ineffective for adults with anorexia nervosa, consider:

A

one of these 3 treatments that the person has not had before or

eating-disorder-focused focal psychodynamic therapy (FPT).

6
Q

FPT for adults with anorexia nervosa should:

A

typically consist of up to 40 sessions over 40 weeks

make a patient-centred focal hypothesis that is specific to the individual and addresses:

what the symptoms mean to the person

how the symptoms affect the person

how the symptoms influence the person’s relationships with others and with the therapist

in the first phase, focus on developing the therapeutic alliance between the therapist and person with anorexia nervosa, addressing pro-anorexic behaviour and ego-syntonic beliefs (beliefs, values and feelings consistent with the person’s sense of self) and building self-esteem

in the second phase, focus on relevant relationships with other people and how these affect eating behaviour

in the final phase, focus on transferring the therapy experience to situations in everyday life and address any concerns the person has about what will happen when treatment ends.

7
Q

Psychological treatment for anorexia nervosa in children and young people

A

Consider anorexia-nervosa-focused family therapy for children and young people (FT-AN), delivered as single-family therapy or a combination of single- and multi-family therapy. Give children and young people the option to have some single-family sessions:

separately from their family members or carers and

together with their family members or carers.

8
Q

FT-AN for children and young people with anorexia nervosa should:

A

typically consist of 18–20 sessions over 1 year

review the needs of the person 4 weeks after treatment begins and then every 3 months, to establish how regular sessions should be and how long treatment should last

emphasise the role of the family in helping the person to recover

not blame the person or their family members or carers

include psychoeducation about nutrition and the effects of malnutrition

early in treatment, support the parents or carers to take a central role in helping the person manage their eating, and emphasise that this is a temporary role

in the first phase, aim to establish a good therapeutic alliance with the person, their parents or carers and other family members

in the second phase, support the person (with help from their parents or carers) to establish a level of independence appropriate for their level of development

in the final phase:

focus on plans for when treatment ends (including any concerns the person and their family have) and on relapse prevention

address how the person can get support if treatment is stopped.

9
Q

Medication for anorexia nervosa

A

Do not offer medication as the sole treatment for anorexia nervosa.

  • However, olanzapine can be given to treat co-morbid conditions
10
Q

Medication for binge eating disorder

A

Do not offer medication as the sole treatment for binge eating disorder.

11
Q

Medication for bulimia nervosa

A

Do not offer medication as the sole treatment for bulimia nervosa.

12
Q

Which drug is not recomended for women with anorexia

A

Bisphosphonates due to lack of data about the benefits and safety, also cannot be used in pre-menopausal females

13
Q

Adults with bulimia nervosa and binge eating disorder can be offered:

A

SSRI (fluoxetine 60mg OD)

14
Q

Binge eating disorder treatment option

A

Lisdexamfetamine