Integrating Psychotherapy and Psychopharmacology: A Handbook for Clinicians (Clinical Topics in Psychology and Psychiatry) by Irismar Reis de Oliveira

Author:Irismar Reis de Oliveira
Language: eng
Format: mobi
ISBN: 9781136302770
Publisher: Taylor and Francis
Published: 2013-12-03T22:00:00+00:00

7

Integrating Psychopharmacology and Psychotherapy in Eating Disorders

Phillipa J. Hay, Josué Bacaltchuk, and Stephen Touyz

Introduction

This chapter focuses on the integrated use of psychopharmacology and psychotherapy as applied to the treatment of patients with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and eating disorder not otherwise specified (EDNOS).

General Description of the Disorder

Prevalence and Diagnostic Features

In a nationally representative study of EDs in the United States in 2001–2003, the lifetime prevalence of AN was 0.9% in women and 0.3% in men; BN was 1.5% in women and 0.5% in men; and BED was 3.5% in women and 2.0% in men (Hudson, Hiripi, Pope, & Kessler, 2007). In the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5; APA, 2000) AN is characterized by a relentless pursuit of thinness, resulting in weight loss or failure to gain weight during growth, a refusal to maintain a normal body weight, and a fear of gaining weight or becoming fat or persistent behaviors to avoid weight gain. In the fifth revision (APA, 2013) an earlier (APA, 2000) the criterion amenorrhoea was removed, and fat phobia was also be removed as an essential criteria. BN diagnostic criteria (APA, 2013) comprise the presence of regular episodes of binge eating (uncontrolled overeating of large amounts of food) followed by extreme weight control compensatory behaviors and an intense preoccupation with weight and shape issues as an expression of self-worth. BED is characterized by recurrent episodes of binge eating with associated distress and an absence of regular use of the compensatory behaviors found in BN. In the DSM-5 other specified eating disorders include patients who appear to have a mixed disorder—for example, regular purging following eating normal-sized food portions or a disorder in which binge eating or purging behaviors are below specified frequency or duration criteria.

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