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Minerva Psichiatrica 2005 March;46(1):13-28

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: Italian

Pharmacological, psychotherapeutic and rehabilitative treatments in eating disorders

Fassino S., Abbate Daga G., Mondelli V., Levi M., Pierò A., Amianto F., Leombruni P.

In consideration of the high incidence of eating disorders (EDs) in western countries, several studies focused their attention on the need of outlining effective treatments for these psychopathological conditions. The aim of this article is to review the different approaches for the treatment of EDs. Stated the multifactorial pathogenesis of these disorders, a multidisciplinary approach is needed for all the EDs. Up to date, there are no resolving pharmacological options regarding the treatment of anorexia nervosa (AN), even if the use of novel antipsychotics is hopeful. The most effective treatments for AN are represented by individual, cognitive or psychodynamic, psychotherapy and by the family therapy. As regards bulimia nervosa (BN), the selective serotonin re-uptake inhibitors (SSRIs) represent an effective treatment option and the recent study of anticonvulsivants could provide a further therapeutic chance. As regards the psychotherapeutic approach, the treatment of choice is represented by cognitive-behavioral therapy, although other psychotherapeutic approaches are effective in BN. Up to now, few treatment studies have been effected on binge eating disorder. However, the preliminary results show a good efficacy of SSRIs and cognitive-behavioral therapy. Stated the chronicity and the complexity of these disorders, the issue of rehabilitative treatments, that have received little attention from international literature, is also discussed.
In conclusion, new multicentric randomized controlled studies on wide samples of patients with EDs are requested, in order to delineate more defined and sharable guidelines.