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Nonresponder anorectic patients after 6 months of multimodal treatment: predictors of outcome

Published online by Cambridge University Press:  16 April 2020

S. Fassino ,
G. Abbate Daga ,
F. Amianto ,
P. Leombruni ,
L. Garzaro  and
G.G. Rovera
S. Fassino*
Affiliation:
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, V. Cherasco 11, 10126, Turin, Italy
G. Abbate Daga
Affiliation:
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, V. Cherasco 11, 10126, Turin, Italy
F. Amianto
Affiliation:
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, V. Cherasco 11, 10126, Turin, Italy
P. Leombruni
Affiliation:
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, V. Cherasco 11, 10126, Turin, Italy
L. Garzaro
Affiliation:
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, V. Cherasco 11, 10126, Turin, Italy
G.G. Rovera
Affiliation:
Department of Neurosciences, Psychiatry Section, Service for Eating Disorders, Turin University, V. Cherasco 11, 10126, Turin, Italy
*
*Correspondence and reprints. E-mail address:www.fassino@molinette.unito.it (S. Fassino).
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Summary

Currently the therapy of anorexia nervosa is a relevant clinical problem. The percentage of patients who respond to short-term pharmacotherapy and psychotherapy is still low and the condition often leads to chronic pathology or death. The present study aims to determine outcome predictors beyond personality traits, eating psychopathology, or particular clinical features.

Forty patients with restricter type anorexia nervosa were tested, at T0 and after 180 days, with psychometric tests and clinical evaluation instruments. Patients were then divided into two groups. One group included patients who showed relevant clinical improvement; the other included not-yet-improved patients.

A lower Novelty Seeking, higher levels of Ascetism and Maturity Fears characterised the not-yet-improved group. Correlation showed evidence of diverse bonds between personality and psychopathology in the improved and not-yet-improved groups. The psychopathology of non-yet-improved patients seemed to be more linked to their temperamental features, whereas improved patients seemed to be more influenced by their character. Different levels of psychological functioning can be expressed.

The present data suggest focusing pharmacotherapy and psychotherapy, even family counseling, with a progression more strictly related to the current personality functioning level and psychopathology of each patient.

Keywords

anorexia nervosaoutcomepersonalitypredictorspsychopathology
Type
Original Articles
Information
European Psychiatry , Volume 16 , Issue 8 , December 2001 , pp. 466 - 473
Copyright
Copyright © 2001 Éditions scientifiques et médicales Elsevier SAS

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References

Agman, GCorcos, MJeammet, P.Troubles des conduites alimentaires. In: Encyclopédie Médico-Chirurgicale. Paris, France: Edition Techniques; 1994. p. 37-350-A-10, 16 pp.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual for mental disorders4th. ed., Washington, DC: APA; 1994.Google Scholar
Bellodi, LBrambilla, F.Conclusive remarks. Bellodi, LBrambilla, F, Eds.; Eating disorders and obsessive compulsive disorder: an etiopathogenetic link? Torino, Italy: CSE; 1999.Google Scholar
Bulik, CMSullivan, PFWelztzin, TEKaye, WH.Temperament in eating disorder. Int J Eating Disord 1995; 17: 251–61.3.0.CO;2-V>CrossRefGoogle Scholar
Bulik, CMSullivan, PFJoyce, PRCarter, FAMcIntosh, VV.Predictors of 1-year treatment outcome in bulimia nervosa. Compr Psychiatry 1998; 39: 206–14.CrossRefGoogle ScholarPubMed
Cloninger, CR.A practical way to diagnosis personality disorder: a proposal. J Personal Disord 2000; 14: 99–108.CrossRefGoogle ScholarPubMed
Cloninger, CRPrzybeck, TRSvrakic, DMWetzel, RD.The temperament and character inventory: a guide to its development and use. St. Louis, MO: Center for Psychobiology of Personality; 1994.Google Scholar
Cloninger, CRSvrakic, DM.Personality disorders. Sadock, BJSadock, VA, Eds.; Kaplan and Sadock's comprehensive textbook of psychiatry. 7th ed., London: Lippincott Williams & Wilkins; 1999.Google Scholar
Dìaz-Marsà, MCarrasco, JLSaiz, J.A study of temperament and personality in anorexia and bulimia nervosa. J Personality Disord 2000; 14: 352–9.CrossRefGoogle ScholarPubMed
Fassino, SAbbate Daga, GAmianto, FLeombruni, PFornas, BD'Ambrosio, G. et al. Predictors of outcome in anorectic patients after 6 months of multimodal treatment. Psychother Psychosom 2001; 70: 208–11.CrossRefGoogle ScholarPubMed
Fassino, SRovera, GGAbbate Daga, G.Disturbi del Comportamento Alimentare. Sanfilippo, B, Ed.; Itinerari Adleriani. Milano: Franco Angeli Editore; 1998.Google Scholar
Ficther, MMQuadflieg, N.Six-year course and outcome of anorexia nervosa. Int J Eat Disord 1999; 26: 359–85.3.0.CO;2-7>CrossRefGoogle Scholar
Garfinkel, PEDorian, BJ.Factors that may influence future approaches to the eating disorders. Eating Weight Disord 1997; 2: 1–16.CrossRefGoogle ScholarPubMed
Garner, D.Eating Disorder Inventory 2: Professional manual. Odessa, FL: Psychological Assessment Resources, Inc; 1991.Google Scholar
Halmi, KAGarfinkel, PE.Eating disorders. Gabbard, GOAtkinson, SD, Eds.; Synopsis of treatments of psychiatric disorders. 2nd ed., Washington, DC: American Psychiatric Press, Inc; 1996.Google Scholar
Herpertz-Dahlmann, BMWewetzer, CSchulz, ERemschmidt, H.Course and outcome in adolescent Anorexia Nervosa. Int J Eating Disord 1996; 19: 335–45.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Herzog, DBKeller, MBLavori, PWKenny, GMSacks, NR.The prevalence of personality disorders in 210 women with eating disorders. J Clin Psychiatry 1992; 53: 147–52.Google ScholarPubMed
Herzog, WDeter, HCFiehn, WPetzold, E.Medical findings and predictors of long term physical outcome in anorexia nervosa: a prospective, 12-year follow up study. Psychol M 1997; X: xxx.Google Scholar
Herzog, DBDorer, DJKeel, PKSelwyn, SEEkeblad, ERFlores, AT. et al. Recovery and relapse in anorexia and bulimia nervosa: a 7.5-year follow-up study. J Am Acad Child Adolesc Psychiatry 1999; 38: 829–37.CrossRefGoogle ScholarPubMed
MacGlashan, TH.Predictions of outcome in borderline personality disorder. Paris, J, Ed.; Borderline personality disorder etiology and treatment. Washington DC: American Psychiatric Press, Inc; 1993. 245–269.Google Scholar
Morgan, HGHayward, AE.Clinical assessment of anorexia nervosa. The Morgan-Russell Outcome Assessment Schedule. Brit J Psychiatry 1988; 152: 367–71.CrossRefGoogle ScholarPubMed
Mosak, HH.Adlerian psychotherapy. Corsini, RJWedding, D, Eds.; Current psychotherapies. City: F.E. Peacock Publishers Inc; 1995.Google Scholar
North, CGowers, SByram, V.Family functioning and life events in the outcome of adolescent anorexia nervosa. Br J Psychiatry 1997; 171: 545–9.CrossRefGoogle ScholarPubMed
Ramacciotti, C.Aspetti psicopatologici dei disordini del comportamento alimentare. Muller, EEBrambilla, F, Eds.; Disordini del comportamento alimentare. 2nd ed., Milano: Pytagora Press; 1997.Google Scholar
Rovera, GGBalzola, FFassino, SMunno, D.Esperienze cliniche in tema di Anoressia e Bulimia. Arch Psicol Neurol Psich 1995; 2: 233–61.Google Scholar
Schoemaker, X.Does early intervention improve the prognosis in anorexia nervosa? A systematic review of the tratment-outcome literature. Int Journal Eating Disord 1997; 21: 1–15.3.0.CO;2-R>CrossRefGoogle ScholarPubMed
SPSS Base 8.0. Application guide. Chicago: SPSS Inc; 1998.Google Scholar
Steiger, HStotland, S.Prospective study of outcome in bulimics as a function of Axis-II comorbidity: long-term responses on eating and psychiatric symptoms. Int J Eat Disord 1996; 20: 149–61.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Strober, MFreeman, RMorrel, W.The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10–15 years in a prospective study. Int J Eating Disord 1997; 22: 339–60.3.0.CO;2-N>CrossRefGoogle ScholarPubMed
Sullivan, PFBulik, CMFear, JLPickering, A.Outcome of anorexia nervosa: a case-control study. Am J Psychiatry 1998; 155: 939–46.CrossRefGoogle ScholarPubMed
Svrakic, DMWhitehead, CPrzybeck, TRCloninger, CR.Differential diagnosis of personality disorders by the seven factor model of temperament and character. Arch Gen Psychiatry 1993; 50: 991–9.CrossRefGoogle ScholarPubMed
van der Ham, Tvan Strien, DCvan Engeland, HA.A four-year prospective follow-up study of 49 eating-disordered adolescents: Differences in course of illness. Acta Psychiatr Scand 1994; 90: 229–35.Google ScholarPubMed
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