Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Karapavlou Dafni-Alexandra
Dissertation committee:
Δημήτρης Δικαίος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χαράλαμπος Παπαγεωργίου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ρωσσέτος Γουρνέλλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αρτέμιος Πεχλιβανίδης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Μιχόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Φραγκίσκος Γονιδάκης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαρία-Τζινιέρη Κοκκώση, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Διερεύνηση μη ειδικών θεραπευτικών παραγόντων που σχετίζονται με θετική έκβαση των ψυχοθεραπευτικών παρεμβάσεων σε πάσχουσες από Διαταραχή Πρόσληψης Τροφής
Translated title:
Evaluation of non specific therapeutic factors associated with positive outcomes of psychotherapy in eating disorders
Summary:
Eating Disorders (ED) are severe and debilitating mental disorders. There are still unmet needs in the treatment of ED, since their course and consequences, high dropouts and low recovery rates need to be improved. It is only recently that patient perspective on ED treatment is being considered in research, with the finding that there are some points of discrepancy between patient’s and clinician’s view. Aim of the present study was to investigate which non specific treatment factors and criteria for recovery are important according to patients’ view. Non specific therapeutic factors (therapeutic alliance being the most important among them) are elements of the therapeutic process which do not belong solely in the theoretical framework of a specific therapeutic intervention.
Ninety four patients with ED (Anorexia Nervosa, Bulimia Nervosa and ED Not Otherwise Specified), predominantly women, aged 17 to 49 years old, participated in the study. Patients were offered one year treatment of CBT. Participants were asked at baseline to complete the eating disorders questionnaire (EDE-Q), the WHO questionnaire on quality of life (WHOQoL-BREF) and the personality disorders questionnaire (PDQ-4+). After 6 and 12 months of treatment they were asked to complete EDE-Q and WHOQoL-BREF again; in addition they were asked to complete a questionnaire for patients with ED on their subjective evaluation of recovery (CRED-39) and a questionnaire on their assessment of the importance of various treatment factors in ED (QEDT). Results showed that patients, at six months of treatment, had improved substantially in the EDE-Q total score (z=-2,07, p<0.05) and in their quality of life, especially in the WHOQoL-BREF psychological health subscale (z=-4,91, p<0.001). Patients rated as most important aspect of the quality of treatment the feeling of acceptance from their therapists and the bond with them. Regarding recovery, subjective evaluation of recovery seems to highly correlate with the improvement in the ED symptomatology, as it is measured by the EDE-Q, and with the quality of life, as it is measured by the WHOQoL-BREF. The strongest associations were found between subjective improvement in the self-image subscale of the CRED-39 and the psychological health and physical health subscales of the WHOQoL-BREF (r=0.85 και r=0.81, respectively, both p<0.001). Moreover, based on multiple regression analysis it was found that the level of improvement in ED symptomatology along with improvement in quality of life, especially regarding psychosocial well-being, explains 85% of the variance of subjective improvement in self-image (F=89.54, p<0.001).
These findings taken together, confirm that recovery in ED symptomatology per se is pivotal but is not sufficient by itself to lead the patient to a feeling of “full recovery”; psychological and social factors are equally important in order to improve therapeutic outcomes.
Main subject category:
Health Sciences
Keywords:
Eating disorders, Psychotherapy, Patient’s view, Objective improvement, Therapeutic factors
Number of references:
267
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