Psychological therapies recommended for eating disorders
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《英国医生杂志》
London
People with eating disorders should have prompt access to a range of psychological therapies and be treated as outpatients as much as possible, according to a new guideline.
For the first time psychological interventions such as cognitive behaviour therapy, analytic therapy, and interpersonal psychotherapy are recommended as first line treatments in an evidence based guideline from the National Institute for Clinical Excellence (NICE).
The guidance on eating disorders advocates a holistic approach in caring for people with anorexia nervosa, bulimia nervosa, and less common eating disorders such as binge eating. Families and siblings of children and adolescents with eating disorders should all be included in learning about the condition and how it can be treated because they too can be affected by it, says the guideline.
Wherever possible, patients should be treated by experienced professionals in an outpatient setting suitable for their age. Psychological therapies and guided self help programmes, where patients are supported and encouraged by a clinical professional, should be tried first and pharmacological intervention with antidepressants reserved for second line treatment or the management of comorbid conditions.
Singer Karen Carpenter died of anorexia nervosa, aged 32
Credit: UPPA/TOPFOTO
Stephen Pilling, codirector of the National Collaborating Centre for Mental Health, which helped to produce the guideline, and director of one of the British Psychological Society's research units, commented: "The publication of this guideline offers real opportunity for patients, their carers and health professionals to work together to get the best treatment for those suffering from eating disorders.
"Psychological treatments have a central role in the treatment of eating disorders. Providing those treatments along the lines set out in the eating disorders guideline presents a considerable but welcome challenge for the NHS and those professionals working in it."
Dr Mike Shooter, president of the Royal College of Psychiatrists, welcomed the new guideline on a condition that he described as being "poorly understood by the public and clinicians alike."
"Sufferers have felt stigmatised and carers accused of being to blame," he said. "Treatment has been patchy and idiosyncratic. Most local services have been content to refer patients to remote centres of excellence rather than offering anything themselves."
In 2000 the college identified just 25 teams in the United Kingdom with the specialist training to deal with eating disorders, less than half of what is needed.
However, the professor of adolescent psychiatry at the University of Liverpool, Simon Gowers, believes that services in eating disorders can be improved immediately without any additional resources. "There is an opportunity with the recent development of mental health trusts to facilitate eating disorders units," he said.(Zosia Kmietowicz)
People with eating disorders should have prompt access to a range of psychological therapies and be treated as outpatients as much as possible, according to a new guideline.
For the first time psychological interventions such as cognitive behaviour therapy, analytic therapy, and interpersonal psychotherapy are recommended as first line treatments in an evidence based guideline from the National Institute for Clinical Excellence (NICE).
The guidance on eating disorders advocates a holistic approach in caring for people with anorexia nervosa, bulimia nervosa, and less common eating disorders such as binge eating. Families and siblings of children and adolescents with eating disorders should all be included in learning about the condition and how it can be treated because they too can be affected by it, says the guideline.
Wherever possible, patients should be treated by experienced professionals in an outpatient setting suitable for their age. Psychological therapies and guided self help programmes, where patients are supported and encouraged by a clinical professional, should be tried first and pharmacological intervention with antidepressants reserved for second line treatment or the management of comorbid conditions.
Singer Karen Carpenter died of anorexia nervosa, aged 32
Credit: UPPA/TOPFOTO
Stephen Pilling, codirector of the National Collaborating Centre for Mental Health, which helped to produce the guideline, and director of one of the British Psychological Society's research units, commented: "The publication of this guideline offers real opportunity for patients, their carers and health professionals to work together to get the best treatment for those suffering from eating disorders.
"Psychological treatments have a central role in the treatment of eating disorders. Providing those treatments along the lines set out in the eating disorders guideline presents a considerable but welcome challenge for the NHS and those professionals working in it."
Dr Mike Shooter, president of the Royal College of Psychiatrists, welcomed the new guideline on a condition that he described as being "poorly understood by the public and clinicians alike."
"Sufferers have felt stigmatised and carers accused of being to blame," he said. "Treatment has been patchy and idiosyncratic. Most local services have been content to refer patients to remote centres of excellence rather than offering anything themselves."
In 2000 the college identified just 25 teams in the United Kingdom with the specialist training to deal with eating disorders, less than half of what is needed.
However, the professor of adolescent psychiatry at the University of Liverpool, Simon Gowers, believes that services in eating disorders can be improved immediately without any additional resources. "There is an opportunity with the recent development of mental health trusts to facilitate eating disorders units," he said.(Zosia Kmietowicz)