Objective: To present the adaptations to treatment protocols made in a child and adolescent eating disorders (ED) unit during the eight-week confinement period mandated in response to the COVID-19 pandemic and examine clinical and treatment variables in the outpatient, day hospital, and inpatient care programs. Method: Description of the implementation of a combined teletherapy program for outpatient and day-hospital patients and the adaptations made to the inpatient protocol. Retrospective review of medical records and analysis of general and specific variables related to the pandemic and confinement. Results: We held 1,329 (73.10%) telehealth consultations and 489 (26.9%) faceto-face outpatient visits with 365 patients undergoing treatment in the outpatient clinic or day hospital. Twenty-eight (7.67%) were initial evaluations. Twenty-two patients were newly admitted and 68 ED-related emergencies were attended. Almost half of the children and adolescents studied experienced reactivation of ED symptoms despite treatment, and severe patients (25%) presented self-harm and suicide risk. Conclusions: The implementation of a combined teletherapy program has enabled continuity of care during confinement for children and adolescents with ED. Delivery of treatment to adolescents in the day hospital program posed the biggest challenge due to their greater degrees of severity and higher hospitalization rates. An adapted inpatient program should be maintained throughout confinement, as the need for hospitalization of children and adolescents with ED does not decrease with lockdown.
Background: Eating disorders are characterized by a persistent disturbance that alters food intake and it is often accompanied by anxiety, depression, low self-esteem, or reduced functional capacity and quality of life. Animal-assisted therapies (AAT) have shown benefits in these variables in children and adult populations. Thus, the present pilot study will aim to evaluate the effects of a dog-assisted therapy on the eating disorders symptoms, mental, psychosocial, and physical health, quality of life, and handgrip strength of adolescents suffering from eating disorders. Methods: The current pilot study will involve 32 patients, who will be assigned to a control or an experimental group. Intervention will be conducted once a week for seven weeks. Neither the experimental nor the control group will discontinue their usual care. The main outcome measures will be the eating disorder symptoms and the health-related quality of life measured with standardized questionnaires, while the secondary variables will be anxiety, depression, character, behavior, strength, and body mass. Conclusions: This pilot-controlled trial will be the first to evaluate the effects of dog-assisted therapy on the physical and mental health of adolescents with eating disorders. Significant improvements, in the primary and secondary outcomes, may be expected based on the known benefits of AAT on self-esteem, stress, and self-control in different populations. Finally, although the program is focused on the improvement of adolescents’ health, animal welfare will be a priority in this study.
ntroducción: En los últimos años ha aumentado la visibilización de los Trastornos de la Conducta Alimentaria (TCA), se diagnostican mejor, de forma más temprana y han adquirido una gran relevancia en la sociedad, tanto por la gravedad de la clínica psíquica como sus comorbilidades. Son trastornos que requieren, en la mayoría de las ocasiones, un largo camino hacia la recuperación, precisando un abordaje de tratamiento multimodal. Objetivo: Realizar una revisión de la bibliografía existente sobre tratamientos psicoterapéuticos en formato grupal en adolescentes con TCA. Material y métodos: Se realiza una búsqueda bibliográfica en PubMed, Cochrane, UptoDate y Google Scholar, incluyendo todos los resultados hasta febrero 2018 (sin límite de fecha de publicación). Los idiomas seleccionados han sido inglés y español. Se han usado las combinaciones de eating disorder (OR anorexia, bulimia, binge) AND adolescence (OR Young) AND group theraphy (OR pshychotheraphy) y los equivalentes en español. Resultados: En la población infanto-juvenil se han publicado cinco trabajos en este ámbito. Uno se trata de una revisión de los tratamientos existentes siendo el resto artículos originales. De entre ellos, dos presentan un enfoque basado en la terapia de rehabilitación cognitiva con buenos resultados en adolescentes. Otro estudioprofundiza sobre la autoestima y las habilidades sociales, hallando una mejoría notable en las mismas tras la terapia. Por último, encontramos un trabajo basado en la terapia cognitivo conductual, mejorando tanto la sintomatología alimentaria como la ansiedad asociada, problemas de autoestima o relaciones interpersonales. Conclusiones: Tanto en población adulta como en adolescentes se encuentran beneficios y efectividad demostrada en terapia grupal como parte del tratamiento de trastornos de la alimentación, no obstante, la evidencia es escasa. Es necesario seguir investigando en este ámbito ya que hay poca bibliografía publicada, a pesar de ser frecuente en la práctica clínica.
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