Alicia Weisz Cobelo

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

The particular aspects of eating disordes in adolescents are reviwed. This article presents the multidisciplinary approach used in this population.

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

ABSTRACT Background: International studies have demonstrated an increase in the prevalence of boys and a decrease of patients’ age at the beginning of outpatient treatment for eating disorders (ED). Objective: To evaluate if these changes are also present in the Brazilian population participating in the PROTAD, a Brazilian ED program, and to discuss its clinical implication for treatment. Methods: Cross-sectional study. We evaluated 150 medical records of patients under 18 years diagnosed with ED (DSM IV-TR). Patients were divided into two groups: G1 (2001-2007) (n = 77) and G2 (2008-2014) (n = 73). The girl/boy proportion and the mean age of patients were compared. Results: In G1, six boys (7.8%) were admitted (girl/boy proportion: 11.8:1), while in G2, 16 (22%) boys were admitted (girl/boy proportion: 3.5:1) (p 0.05). Discussion: The increase in the number of boys treated for EDs reported in international studies was also found at the PROTAD. Contrary to what has been reported in international studies, the mean age of patients at the PROTAD did not decrease significantly. Gender and sexual orientation issues, clinical presentation, prior overweight history and culture/media impact on boys should be addressed by the healthcare team to increase the therapeutic efficacy.

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Background: Efficacy studies on the treatment of anorexia nervosa (AN) in childhood and adolescence are scarce and systematic reviews are almost non-existent. Objective: Systematic review of the literature regarding the modalities of psychological intervention based on evidence used in the treatment of AN in childhood and adolescence. Methods: The research was carried out in the databases: PubMed, PsycINFO and Cochrane, using the combined keywords: anorexia nervosa and evidence-based therapy. Articles published between 1990 and 2015 were assessed. Results: Of the 139 eligible articles, 14 were selected, of which 10 (71.4%) were conducted in the United States and England. The sample ranged from 9 to 167 participants. Randomized Clinical Trial represented the most frequent design (n = 9; 63.4%), with more than half of the interventions structured in 20 or more sessions (n = 9, 64.3%). Nine types of treatments were tested, with the most tested being Family-Based Treatment (FBT) (n = 7; 50%). Interventions involving the family seem to be more effective, however, the rates for complete remission are modest. Discussion: Although evidence of efficacy was verified in the treatments analyzed, the limited number of studies, the various methodological limitations and the methodological heterogeneity between studies make the findings inconclusive.

The mother-daughter relationship in eating disorders: the psychotherapy group of mothers

Intervencoes psicoterapeuticas que promovam a diferenciacao, a separacao, a individuacao e a autonomia na relacao mae-filha sao preconizadas e enfatizadas no tratamento dos transtornos alimentares. Com esse objetivo foi instituido o Grupo Psicoterapeutico de Maes no programa de transtornos alimentares de uma instituicao publica , como uma das abordagens psicoterapeuticas no tratamento multidisciplinar dos pacientes adolescentes e que vem se mostrando uma intervencao pertinente e eficiente no tratamento desses transtornos.Psychotherapeutic interventions that bring about differentiation, separation, individuation and autonomy in the mother-daughter relationship are recommended as treatment for eating disorders. With this goal in mind, a psychotherapy group for mothers was organized in an outpatient program for adolescents with eating disorders at a public institution, as one of the psychotherapeutic approaches in the multidisciplinary treatment of adolescent patients. Evidence suggests that this approach can be relevant and effective in the treatment of eating disorders.

Relação mãe-filha nos transtornos alimentares: o grupo psicoterapêutico de mães

Intervencoes psicoterapeuticas que promovam a diferenciacao, a separacao, a individuacao e a autonomia na relacao mae-filha sao preconizadas e enfatizadas no tratamento dos transtornos alimentares. Com esse objetivo foi instituido o Grupo Psicoterapeutico de Maes no programa de transtornos alimentares de uma instituicao publica , como uma das abordagens psicoterapeuticas no tratamento multidisciplinar dos pacientes adolescentes e que vem se mostrando uma intervencao pertinente e eficiente no tratamento desses transtornos.Psychotherapeutic interventions that bring about differentiation, separation, individuation and autonomy in the mother-daughter relationship are recommended as treatment for eating disorders. With this goal in mind, a psychotherapy group for mothers was organized in an outpatient program for adolescents with eating disorders at a public institution, as one of the psychotherapeutic approaches in the multidisciplinary treatment of adolescent patients. Evidence suggests that this approach can be relevant and effective in the treatment of eating disorders.

La relación madre-hija en los trastornos alimentarios: el grupo psicoterapéutico de madres

Intervencoes psicoterapeuticas que promovam a diferenciacao, a separacao, a individuacao e a autonomia na relacao mae-filha sao preconizadas e enfatizadas no tratamento dos transtornos alimentares. Com esse objetivo foi instituido o Grupo Psicoterapeutico de Maes no programa de transtornos alimentares de uma instituicao publica , como uma das abordagens psicoterapeuticas no tratamento multidisciplinar dos pacientes adolescentes e que vem se mostrando uma intervencao pertinente e eficiente no tratamento desses transtornos.Psychotherapeutic interventions that bring about differentiation, separation, individuation and autonomy in the mother-daughter relationship are recommended as treatment for eating disorders. With this goal in mind, a psychotherapy group for mothers was organized in an outpatient program for adolescents with eating disorders at a public institution, as one of the psychotherapeutic approaches in the multidisciplinary treatment of adolescent patients. Evidence suggests that this approach can be relevant and effective in the treatment of eating disorders.

Multifamily psycho-educational group and treatment of adolescents with eating disorders

The psycho-educational multifamily group is part of a multidisciplinary treatment offered to adolescents with eating disorders and their families, in the out-patient Program for Children and Adolescents with Eating Disorders - PROTAD - of the Institute of Psychiatry, of Hospital das Clinicas, Medicine College, University of Sao Paulo, PROTAD-AMBULIM-HC-IPq-FMUSP. This article is based at the experience from the monthly meetings with the families and caregivers, from the out-patient program for adolescent patients with eating disorders, and exhibit the employed psycho-educational group model, linking it to the specific literature and the clinical practice.The psycho–educational multifamily group is part of a multidisciplinary treatment offered to adolescents with eating disorders and their families, in the out-patient Program for Children and Adolescents with Eating Disorders – PROTAD – of the Institute of Psychiatry, of Hospital das Clinicas, Medicine College, University of Sao Paulo, PROTAD-AMBULIM-HC-IPq-FMUSP. This article is based at the experience from the monthly meetings with the families and caregivers, from the out-patient program for adolescent patients with eating disorders, and exhibit the employed psycho-educational group model, linking it to the specific literature and the clinical practice.

Grupo psicoeducativo multifamiliar y tratamiento de adolescentes con trastornos de la conducta alimentaria

The psycho-educational multifamily group is part of a multidisciplinary treatment offered to adolescents with eating disorders and their families, in the out-patient Program for Children and Adolescents with Eating Disorders - PROTAD - of the Institute of Psychiatry, of Hospital das Clinicas, Medicine College, University of Sao Paulo, PROTAD-AMBULIM-HC-IPq-FMUSP. This article is based at the experience from the monthly meetings with the families and caregivers, from the out-patient program for adolescent patients with eating disorders, and exhibit the employed psycho-educational group model, linking it to the specific literature and the clinical practice.The psycho–educational multifamily group is part of a multidisciplinary treatment offered to adolescents with eating disorders and their families, in the out-patient Program for Children and Adolescents with Eating Disorders – PROTAD – of the Institute of Psychiatry, of Hospital das Clinicas, Medicine College, University of Sao Paulo, PROTAD-AMBULIM-HC-IPq-FMUSP. This article is based at the experience from the monthly meetings with the families and caregivers, from the out-patient program for adolescent patients with eating disorders, and exhibit the employed psycho-educational group model, linking it to the specific literature and the clinical practice.