Bakgrund: Ätstörningar blir allt vanligare i samhället och drabbar främst unga kvinnor. Två av de vanligaste ätstörningsdiagnoserna är Anorexia Nervosa och Bulimia Nervosa, i båda fallen är orsakerna okända. Återhämtningen från en ätstörning kan vara en svår utmaning på grund av sjukdomens komplexitet som kan ha en negativ påverkan på det dagliga livet. Arbetsterapi kan främja återhämtningen vid ätstörning till exempel genom att tillgängliggöra meningsfulla aktiviteter. Genom att utgå från den arbetsterapeutiska teoretiska modellen Model of Human Occupation (MOHO) underlättar det för arbetsterapeuten att få en helhetsbild av människan även i komplexa sjukdomstillstånd. Syftet var att ur ett arbetsterapeutiskt perspektiv beskriva återhämtningsprocessen hos kvinnor som levt med någon form av ätstörning. Metod: En litteraturstudie för att sammanställa resultaten från tidigare forskning. Samtliga artiklar som valdes var kvalitativa och grundar sig på kvinnors upplevelser. De databaser som användes var Cinahl with full text och PsychInfo. Artiklarna analyserades utifrån Fribergs analysprocess i fem steg. Analysen gjordes deduktivt med förutbestämda teman utifrån MOHO med målet att identifiera olika upplevelser i återhämtningsprocessen. Huvudresultatet: Resultatet utgick från MOHO’s centrala begrepp: vanebildning, miljö, viljekraft och utförandekapacitet. Kvinnorna som befinner sig i eller har befunnit sig i återhämtningsprocessen upplevde att vanor, strategier och omgivningen är betydelsefull för tillfrisknandet. Slutsats: Återhämtningsprocessen av en ätstörning kan beskrivas ur ett arbetsterapeutiskt perspektiv utifrån MOHO. Vidare forskning inom arbetsterapi kan vara hur arbetsterapeutiska insatser kan tillämpas i återhämtningsprocessen av ätstörning.

Bakgrund: Ätstörningar finns i dagens samhälle i en stor utsträckning. Forskning visar på de allvarliga konsekvenser som uppkommer av tillstånden, både medicinskt, psykiskt och socialt. Att leva med en ätstörning skapar en stor problematik för personen som till slut inte kan kontrollera sig själv, sin vardag eller sitt liv. Trots den forskning som finns som visar hur djupgående dessa tillstånd är, så uppvisas fortfarande brister i vården och omvårdnaden av dessa personer. Syfte: Att beskriva personers upplevelse av att leva med en ätstörning. Metod: En litteraturstudie som bygger på en kvalitativ innehållsanalys med induktiv ansats på 10 vetenskapliga artiklar. Resultat: Ur analysen framställdes 5 slutkategorier: Att känna skam och skuld inför sig själv och andra, Att känna sig dömd och missförstådd av utomstående och samhället, Att använda sjukdomen som coping-strategi när de negativa känslorna tar över, Att uppleva ambivalens inför sitt destruktiva beteende och inför sin kroppsbild och Att inte kunna kontrollera sig själv och sina val. Slutsats: Att förstå att varje person med en ätstörning är unik och har olika föreliggande orsaker trots sina likheter i uttryck. Därav vikten med att inkludera alla delar av den drabbades liv för att kunna bilda sig en uppfattning om hur den drabbade kan nå återhämtning.

This study examined the cost effectiveness of treating Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder Not Otherwise Specified (NOS), as well as the effects that modality of therapy (i.e. individual, family, and mixed therapy), license of therapist, and secondary diagnosis had on recidivism and total cost of treatment in the care of these patients. One-thousand and thirty-eight patients (56 males, 982 females) diagnosed with Anorexia Nervosa, 1,674 patients (56 males, 1,618 females) diagnosed with Bulimia Nervosa, and 1,997 patients (197 males, 1,800 females) diagnosed with Eating Disorder NOS were included in this study. Results revealed that family therapy was the least expensive form of therapy in average total cost of therapy. Individuals who had family therapy were 3.3 times less likely to recidivate than those who had individual therapy and 7.5 times less likely to recidivate than those who had mixed therapy. Having a secondary diagnosis on average increased the total cost of treatment by $437.34, irrespective of the type of secondary diagnosis (i.e. depression, anxiety, or substance-abuse). These findings suggest that modality of therapy should be considered in the treatment of Anorexia Nervosa, Bulimia Nervosa, and Eating Disorder NOS. Future research should examine the effects of treatment for individuals with a secondary diagnosis.

No description available.

No description available.

Ätstörningar är en sjukdom som drabbar många och resulterar i stort lidande samt en påverkan i vardagen. Behandlingen som ges är bara delvis effektiv då många aldrig blir friska, en stor risk för återfall och även dödsfall finns. Syftet med studien var att undersöka vilken effekt arbetsterapeutiska och icke-arbetsterapeutiska interventioner baserade på aktivitet hade på patienter med ätstörningar. En systematisk litteraturstudie användes för att besvara syftet och åtta artiklar inkluderades i studien. Resultatet visade på en bredd av interventioner där majoriteten kretsade kring att träna på aktiviteter kopplat till att äta och laga mat. Aktivitetsbaserade interventioner kan ha god effekt på person med ätstörningar och arbetsterapeutiska interventioner kan bland annat bidra med ökad motivation. Resultatet och tidigare forskning tyder på att en kombination av olika professioner och interventioner kan vara fördelaktig i ätstörningsvården.  Mer forskning behövs i ämnet och då framför allt kontrollerade studier med specifika arbetsterapeutiska interventioner.

Introdução: O estado nutricional da gestante constitui importante fator para o desenvolvimento do feto e da gravidez saudável. Mulheres que apresentam ingestão inadequada de nutrientes têm maior probabilidade de desenvolver gestação de risco. Essa problemática é especialmente intensa quando a mulher apresenta quadro de transtorno alimentar (TA). Este trabalho abordou aspectos históricos, etiologia e epidemiologia dos TA, contemplou os critérios diagnósticos, concebeu os TA no período gravídico puerperal e dissertou sobre TA, sintomatologia ansiosa e depressiva. Os objetivos deste estudo foram determinar a prevalência de TA em gestantes com intercorrências clínicas e verificar a associação com sintomatologia ansiosa, depressiva e atitudes alimentares. Método: Estudo prospectivo transversal foi realizado com 913 gestantes com intercorrências clínicas que estavam no 2° ou 3° trimestre gestacional no ambulatório da Divisão de Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foi utilizada entrevista dirigida, para avaliação de picacismo; o EAT-26, para avaliar as atitudes alimentares; Structured Clinical Interview for DSM Disorders, para diagnóstico clínico de TA e a escala Hospital Anxiety and Depression, para análise da sintomatologia ansiosa e depressiva. Os dados deste estudo foram submetidos à análise quantitativa e avaliados por meio do programa IBM SPSS for Windows versão 20.0. Resultados: constatou-se prevalência de transtorno alimentar em 7,6% (n=69) (IC 95%: 5,84%-9,28%), sendo 0,1% (n=1), anorexia nervosa; 0,7% (n=6), bulimia nervosa; 1,1% (n=10), transtorno da compulsão alimentar e 5,7% (n=52), picacismo. Encontrou-se significância estatística quando associado TA com as variáveis: religião (p=0,02), abortamento provocado anterior (p < 0,01), tempo de relacionamento (p=0,01), renda per capita (p=0,04), número de gestações (p < 0,01) e número de filhos vivos (p < 0,01). Quanto às atitudes alimentares, observou-se significância estatística com \"sentir-se mal após comer doces\" (p=0,02) e \"passar muito tempo pensando em comida\" (p < 0,01). Constatou-se ainda associação positiva com sintomatologia ansiosa (p < 0,01) e com sintomatologia depressiva (p < 0,01). Conclusão: a prevalência de TA encontrada (7,6%) e sua associação com sintomatologia ansiosa e depressiva, durante a gestação, apontam para a necessidade de cuidados especializados no que diz respeito à prevenção, diagnóstico e tratamento. Dada a importância da alimentação adequada no período gestacional, tanto no que diz respeito à saúde materna, quanto ao desenvolvimento fetal, torna-se necessário implementar, pelos profissionais de saúde, avaliação específica com protocolo predeterminado para diagnóstico de TA no período gestacional / Introduction: The nutritional status of the pregnant woman represents an important factor for the development of the fetus and for a healthy pregnancy. Women who have inadequate nutrient intake are more likely to develop a risky pregnancy. This problem is particularly severe when the woman presents an eating disorder (ED). This paper discusses the historical aspects, etiology and epidemiology of ED, considers the diagnostic criteria, delineates ED in the puerperal pregnancy period and addresses ED, anxiety and depression symptoms. The aims of this study were to estimate the prevalence of ED in pregnant women with clinical complications and to assess the relationship between anxiety and depression symptoms and eating attitudes. Methods: A transversal and prospective study was conducted with 913 women between 2nd and 3rd trimester with high-risk pregnancies in the Obstetrics Clinic Division of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. We conducted structured interviews for the assessment of pica, Structured Clinical Interview for DSM Disorders for diagnostic of ED and Hospital Anxiety and Depression Scale for anxiety and depression symptoms, and applied the EAT-26 questionnaire for eating attitudes. The data analysis was quantitative and conducted with the IBM SPSS for Windows, version 20.0. Results: Lifetime prevalence of ED was 7.6% (n=69) (95% CI: 5.84%-9.28%), 0.1% (n=1) for anorexia nervosa; 0.7% (n=6) for bulimia nervosa; 1.1% (n=10) for binge eating disorder, and 5.7% (n=52) for pica. ED was statistically significant with respect to the following variables: religion (p=0.02), previous induced abortion (p < 0.01), being in a relationship (p=0.01), per capita income (p=0,04), number of previous pregnancies (p<0.01) and number of children (p < 0.01). For the eating attitudes, statistical significance was found with \"feeling ill after eating sweets\" (p < 0.02) and \"spend too much time thinking about food\" (p=0.05), as well as between ED and anxiety (p < 0.01) and depressive symptoms (p < 0.01). Conclusion: The prevalence of ED (7.6%) and its association with anxiety and depression symptoms during pregnancy highlights the need for specialist care for prevention, diagnosis and treatment. Given the importance of proper nutrition during pregnancy, both with regard to maternal health and fetal development, it is necessary to have specific predetermined evaluation protocols implemented by health care professionals for the diagnosis of ED during pregnancy

Introdução: O estado nutricional da gestante constitui importante fator para o desenvolvimento do feto e da gravidez saudável. Mulheres que apresentam ingestão inadequada de nutrientes têm maior probabilidade de desenvolver gestação de risco. Essa problemática é especialmente intensa quando a mulher apresenta quadro de transtorno alimentar (TA). Este trabalho abordou aspectos históricos, etiologia e epidemiologia dos TA, contemplou os critérios diagnósticos, concebeu os TA no período gravídico puerperal e dissertou sobre TA, sintomatologia ansiosa e depressiva. Os objetivos deste estudo foram determinar a prevalência de TA em gestantes com intercorrências clínicas e verificar a associação com sintomatologia ansiosa, depressiva e atitudes alimentares. Método: Estudo prospectivo transversal foi realizado com 913 gestantes com intercorrências clínicas que estavam no 2° ou 3° trimestre gestacional no ambulatório da Divisão de Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foi utilizada entrevista dirigida, para avaliação de picacismo; o EAT-26, para avaliar as atitudes alimentares; Structured Clinical Interview for DSM Disorders, para diagnóstico clínico de TA e a escala Hospital Anxiety and Depression, para análise da sintomatologia ansiosa e depressiva. Os dados deste estudo foram submetidos à análise quantitativa e avaliados por meio do programa IBM SPSS for Windows versão 20.0. Resultados: constatou-se prevalência de transtorno alimentar em 7,6% (n=69) (IC 95%: 5,84%-9,28%), sendo 0,1% (n=1), anorexia nervosa; 0,7% (n=6), bulimia nervosa; 1,1% (n=10), transtorno da compulsão alimentar e 5,7% (n=52), picacismo. Encontrou-se significância estatística quando associado TA com as variáveis: religião (p=0,02), abortamento provocado anterior (p < 0,01), tempo de relacionamento (p=0,01), renda per capita (p=0,04), número de gestações (p < 0,01) e número de filhos vivos (p < 0,01). Quanto às atitudes alimentares, observou-se significância estatística com \"sentir-se mal após comer doces\" (p=0,02) e \"passar muito tempo pensando em comida\" (p < 0,01). Constatou-se ainda associação positiva com sintomatologia ansiosa (p < 0,01) e com sintomatologia depressiva (p < 0,01). Conclusão: a prevalência de TA encontrada (7,6%) e sua associação com sintomatologia ansiosa e depressiva, durante a gestação, apontam para a necessidade de cuidados especializados no que diz respeito à prevenção, diagnóstico e tratamento. Dada a importância da alimentação adequada no período gestacional, tanto no que diz respeito à saúde materna, quanto ao desenvolvimento fetal, torna-se necessário implementar, pelos profissionais de saúde, avaliação específica com protocolo predeterminado para diagnóstico de TA no período gestacional / Introduction: The nutritional status of the pregnant woman represents an important factor for the development of the fetus and for a healthy pregnancy. Women who have inadequate nutrient intake are more likely to develop a risky pregnancy. This problem is particularly severe when the woman presents an eating disorder (ED). This paper discusses the historical aspects, etiology and epidemiology of ED, considers the diagnostic criteria, delineates ED in the puerperal pregnancy period and addresses ED, anxiety and depression symptoms. The aims of this study were to estimate the prevalence of ED in pregnant women with clinical complications and to assess the relationship between anxiety and depression symptoms and eating attitudes. Methods: A transversal and prospective study was conducted with 913 women between 2nd and 3rd trimester with high-risk pregnancies in the Obstetrics Clinic Division of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. We conducted structured interviews for the assessment of pica, Structured Clinical Interview for DSM Disorders for diagnostic of ED and Hospital Anxiety and Depression Scale for anxiety and depression symptoms, and applied the EAT-26 questionnaire for eating attitudes. The data analysis was quantitative and conducted with the IBM SPSS for Windows, version 20.0. Results: Lifetime prevalence of ED was 7.6% (n=69) (95% CI: 5.84%-9.28%), 0.1% (n=1) for anorexia nervosa; 0.7% (n=6) for bulimia nervosa; 1.1% (n=10) for binge eating disorder, and 5.7% (n=52) for pica. ED was statistically significant with respect to the following variables: religion (p=0.02), previous induced abortion (p < 0.01), being in a relationship (p=0.01), per capita income (p=0,04), number of previous pregnancies (p<0.01) and number of children (p < 0.01). For the eating attitudes, statistical significance was found with \"feeling ill after eating sweets\" (p < 0.02) and \"spend too much time thinking about food\" (p=0.05), as well as between ED and anxiety (p < 0.01) and depressive symptoms (p < 0.01). Conclusion: The prevalence of ED (7.6%) and its association with anxiety and depression symptoms during pregnancy highlights the need for specialist care for prevention, diagnosis and treatment. Given the importance of proper nutrition during pregnancy, both with regard to maternal health and fetal development, it is necessary to have specific predetermined evaluation protocols implemented by health care professionals for the diagnosis of ED during pregnancy

Univerzita Karlova Pedagogická fakulta Katedra Pedagogiky DIPLOMOVÁ PRÁCE Znalost záva nosti a d sledk poruch p jmu potravy ák Z Knowledge of the severity and consequences of eating disorders of elementary school pupils Bc. S tlana Z bransk Vedoucí práce: Mgr. Jana Ko , Ph.D. Studijní program: N7504: U itelst pro st edn kol Studijní obor: N-PG-VZ 2020 ABSTRAKT Na Z kladn kole v Praze, kterou jsem vybrala pro diplomovou práci, u uji p edm t V cho a ke zdraví druhým rokem. V diplomové práci jsem se rozhodla zmapovat nalosti a nosti a d sledk poruch p jmu potravy k 2. stupn e jmeno an kol . Teoretick st pr ce obsahuje informace z odborné literatury, vztahující se k problematice poruch p jmu potra (dále jen PPP). V ojo m l tnostem adolescence, významu primární prevence a obsahu koln ho d l ac ho pl nu p edm tu V cho a ke zdraví na zkoumané kole. Praktick st pr ce popisuje pr b h dota n ko ho et en , jeho se astnilo celkem 172 k . Hodnot nalosti k , pokud se týká charakteristiky, ri iko ch faktor , a nosti a d sledk PPP. Hodnotí p nos preventivních aktivit v rámci programu primární prevence zkoumané kol , ch ej c ho Národní strategie primární pre ence ri iko ho cho n d t a ml de e. áci kouman kol maj po dom o a nosti a d sledc ch PPP. V ichni ci , e poruch p jmu potra mohou b t onemocn n smrtelná. Z et en pl...

The present study aimed to examine the relationship between maladaptive schemas and treatment outcomes of adolescent and adult women with an eating disorder receiving residential treatment. Existing data were obtained from 67 females aged 11 to 47 years (m =18.61) that had entered residential treatment for anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) at a Western United States residential eating disorder treatment facility. Pre- and posttreatment data were collected by the personnel at the facility on eating disorder symptomatology, mood, and core beliefs. Three hypotheses were tested: (a) that maladaptive schemas would be positively correlated with eating disorder symptom severity, (b) that females endorsing more maladaptive schemas at admission or those with stable maladaptive schemas across their course of treatment would have less favorable posttreatment outcomes at the time of their discharge from residential treatment than females with lower scores initially or improved scores over the course of their treatment and follow-up, and (c) that females endorsing more maladaptive schemas or with greater stability of their maladaptive schemas across treatment will spend more time in residential treatment. To address the above hypotheses a series of hierarchical linear regressions, linear mixed-effects models, and Cox proportional-hazards regressions were conducted. Results ndicated that maladaptive schemas at the start of treatment were predominantly predictive of admit rather than discharge symptomatology. Different combinations of maladaptive schemas were found to have both positive and negative relationships to one's symtomatology across time. The most common maladaptive schemas found to be significantly associated with symptomatology were impaired limits, impaired autonomy and performance, and overvigilance and inhibition. Lastly, a relationship existed between both impaired limits and overvigilance and inhibition and a participant's length of stay in treatment. The results of this study suggest that maladaptive schemas provide some predictability of treatment outcomes and are important targets for psychological interventions aimed at recovery. Furthermore, the results of the study highlight the complexity associated with maladaptive schemas in females with eating disorders and the need for longitudinal research to examine common patterns and therapeutic targets based on diagnosis and status in treatment.