from Part III - Specific treatments
Published online by Cambridge University Press: 12 May 2010
Editor's note
As is the situation in many disorders of childhood and adolescence, there is very little good data to support any particular type of intervention in eating disorders that occur during this time period. While all would agree on multi-modal treatment, there are no RCTs to examine that particular type of intervention. What little evidence there is to support any type of intervention leads us to primarily family therapy interventions in this patient population. While there may be a need for psychopharmacology, cognitive-behavioral therapy and nutrition counseling, there is little evidence that can point us to better outcomes when these other interventions are employed. There is probably a role for hospitalization here, but hospitalizations keep people alive but do not necessarily alter the long-term outcome. Both the USA and the UK have practice guidelines, but these guidelines are not rooted in interventions that have withstood methodological rigor.
Introduction
There are now abundant data showing that eating disorders, including anorexia and bulimia nervosa, originate in late childhood and early adolescence (American Academy of Pediatrics, Committee on Adolescence, 2003). The vast majority of patients with eating disorders are diagnosed prior to age 25 years, with the age of onset for anorexia nervosa peaking between ages 13 and 15 years and onset of bulimia nervosa peaking between 17 and 25. Evidence for an increased incidence exists for bulimia nervosa (for example) from cohort studies (Bushnell et al., 1990; Kendler et al., 1991).
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