This research article provides an insight into the Multifamily Therapy (MFT) for families caring for a patient with an eating disorder at the Centre for Eating Disorders at the First Psychiatric Clinic in Prague. We describe the sometimes rocky path of MFT in Czech healthcare and the challenges we encountered in working with this approach in the Czech Republic. Additionally, we discuss the preliminary results of our followup-pilot study in which we tested the efficacy of our MFT programme on patients' quality of life and self-esteem. Fifteen patients completed the Rosenberg self-esteem scale (RSES) and the brief Schwartz outcome scale (SOS-10) at pre-treatment and post-treatment. Our results show a significant improvement of quality of life (F (1, 14) = 13.03, P = 0.003) and a significant reduction of self-esteem (Z = -2.721 P = 0.07). This pilot study shows divergent results concerning the efficacy of MFT on patients' quality of life and their self-esteem.

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Objective: Impaired psychosocial functioning previously emerged as the only risk factor to predict future onset of each of the four Diagnostic and Statistical Manual of Mental Disorder (5th ed.) (DSM-5) eating disorders. The goal of this follow-up report was to refine understanding of this newly identified risk factor.Method: Combining data from women at risk for eating disorders because of body image concerns (N = 1,153, mean age = 18.5 years, SD = 4.2), we investigated which subdomain(s) and individual item(s) of psychosocial functioning (friends, family, school, and work) at baseline predicted onset of any eating disorder, using Cox regression (CRA) and classification tree analysis (CTA).Results: Psychosocial impairment with friends, family, and at school, but not at work, significantly increased risk for disorder onset over 3-year follow-up in univariate models. A one-unit increase in each domain raw score was associated with a 107, 22, and 43% increased hazard of eating disorder onset, respectively. Multivariate CRA found friends functioning, with a 92% increased hazard of disorder onset, contributed the strongest unique effect. CTA suggested that loneliness was the most potent risk factor with a threefold increased onset risk (eating disorder incidence for high vs. low scorers was 27 and 8%). Three friends functioning items and one school functioning item produced additional CTA branches.Discussion: Results refine understanding of the relation of psychosocial impairment to future onset of eating disorders, suggesting that peer functioning is the most critical. Data imply it would be useful to target young women with impaired psychosocial functioning in prevention programs.

Background: Recent studies have proved the relevance of salutogenetic variables for fatigue management in breast cancer survivors with cancer-related fatigue (CRF). This comprehensive cohort design study is the first to examine the impact of 2 multimodal therapies, multimodal therapy (MT) and combined therapy (CT), compared with standard aerobic training (AT) on salutogenetic variables (self-regulation and internal coherence) and distress in breast cancer survivors with CRF. Methods: A total of 105 patients started the therapies and n = 84 completed the Self-regulation Scale, the Internal Coherence Scale, the Cancer Fatigue Scale, and the Hospital Anxiety and Depression Scale at baseline, 10 weeks after treatment (T1) and n = 81 after 6 months (T2). Patient satisfaction and qualitative feedback regarding therapy quality was assessed at T1. A general linear model including allocation type, therapy arm (MT/CT/AT), and bias-adjusting propensity scores tested the superiority of both multimodal therapies versus AT for all questionnaires at T1 and T2. Results: MT and CT were superior to AT to improve self-regulation and patients’ satisfaction at T1. Additionally, CT showed superiority for self-regulation at T2 (all P < .05). Compared with AT, internal coherence was significantly higher for patients in the MT arms at T2, respectively (all P < .01). Pearson’s correlations between self-regulation, internal coherence, and CRF improved from baseline to T2 (Mean r = −0.60). Qualitative feedback confirmed patients’ benefits in several health-related categories. Conclusions: Self-regulation and internal coherence are manipulable variables with relevant CRF associations. They can be positively affected by multimodal therapies. Alongside patients’ satisfaction and qualitative feedback they help refine treatment.

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