Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 977-1008 |
| Journal | Australian and New Zealand Journal of Psychiatry |
| Volume | 48 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2014 |
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Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. / Hay, P.; Chinn, D.; Forbes, David; Madden, S.; Newton, R.W.N.; Sugenor, L.; Touyz, S.W.; Ward, W.K.
In: Australian and New Zealand Journal of Psychiatry, Vol. 48, No. 11, 2014, p. 977-1008.Research output: Contribution to journal › Article
TY - JOUR
T1 - Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders
AU - Hay, P.
AU - Chinn, D.
AU - Forbes, David
AU - Madden, S.
AU - Newton, R.W.N.
AU - Sugenor, L.
AU - Touyz, S.W.
AU - Ward, W.K.
PY - 2014
Y1 - 2014
N2 - © 2014 The Royal Australian and New Zealand College of Psychiatrists. Objectives: This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. Methods: The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. Results: In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to guide practice. Conclusions: Specific evidence based psychological and pharmacological treatments are recommended for most eating disorders but more trials are needed for specific therapies in AN, and research is urgently needed for all aspects of ARFID assessment and management.
AB - © 2014 The Royal Australian and New Zealand College of Psychiatrists. Objectives: This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guidelines (CPG) Project 2013-2014. Methods: The CPG was developed in accordance with best practice according to the National Health and Medical Research Council of Australia. Literature of evidence for treatments of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified and unspecified eating disorders and avoidant restrictive food intake disorder (ARFID) was sourced from the previous RANZCP CPG reviews (dated to 2009) and updated with a systematic review (dated 2008-2013). A multidisciplinary working group wrote the draft CPG, which then underwent expert, community and stakeholder consultation, during which process additional evidence was identified. Results: In AN the CPG recommends treatment as an outpatient or day patient in most instances (i.e. in the least restrictive environment), with hospital admission for those at risk of medical and/or psychological compromise. A multi-axial and collaborative approach is recommended, including consideration of nutritional, medical and psychological aspects, the use of family based therapies in younger people and specialist therapist-led manualised based psychological therapies in all age groups and that include longer-term follow-up. A harm minimisation approach is recommended in chronic AN. In BN and BED the CPG recommends an individual psychological therapy for which the best evidence is for therapist-led cognitive behavioural therapy (CBT). There is also a role for CBT adapted for internet delivery, or CBT in a non-specialist guided self-help form. Medications that may be helpful either as an adjunctive or alternative treatment option include an antidepressant, topiramate, or orlistat (the last for people with comorbid obesity). No specific treatment is recommended for ARFID as there are no trials to guide practice. Conclusions: Specific evidence based psychological and pharmacological treatments are recommended for most eating disorders but more trials are needed for specific therapies in AN, and research is urgently needed for all aspects of ARFID assessment and management.
U2 - 10.1177/0004867414555814
DO - 10.1177/0004867414555814
M3 - Article
VL - 48
SP - 977
EP - 1008
JO - Australian & New Zealand Journal of Psychiatry
JF - Australian & New Zealand Journal of Psychiatry
SN - 0004-8674
IS - 11
ER -