REVIEW   

Minerva Psichiatrica 2017 March;58(1):54-69

DOI: 10.23736/S0391-1772.17.01926-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

An update on current clinical management of eating disorders

Ludovica SPATTINI, Giulia RIOLI, Fedora LONGO, Silvia FERRARI, Gian M. GALEAZZI ✉

Section of Psychiatry, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy

INTRODUCTION: Eating disorders (ED) are severe conditions featuring abnormal eating patterns and pervasive and distressing concerns with one’s body image. ED are relatively common and have considerable high mortality rate and costs for Public Health. The aim of this paper was to review recent findings in the field of treatment strategies in ED, including psychotherapeutic, pharmacological and non-pharmacological novel approaches.
EVIDENCE ACQUISITION: A review of all recently published randomized controlled clinical trials (RCTs) on treatment of ED was undertaken and reported, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. The bibliographic search yielded 444 records. After screening, 62 articles were finally included: 22 concerned patients with anorexia nervosa (AN), 9 with bulimia nervosa (BN), 19 with binge-eating disorders (BED) and 12 with mixed ED.
EVIDENCE SYNTHESIS: There have been substantial developments in psychological therapies for ED within the last few years, with evidence conforming the importance of multidisciplinary team approaches and expanding indications of cognitive behavioral and family based interventions. Pharmacological treatment of ED remains poorly evidence-based, while the involvement of carers in treatment programs are increasingly being given importance.
CONCLUSIONS: Further research efforts are needed for elucidating the effectiveness and differential indications of stepped care approaches involving different settings, psychotherapy models, age and type of ED.

KEY WORDS: Anorexia nervosa - Bulimia nervosa - Binge-eating disorder - Feeding and eating disorders