Un modelo grupal para el abordaje de los pacientes con trastornos de la conducta alimentaria atendidos en un servicio público de salud mental extrahospitalario de Osakidetza/Servicio Vasco de Salud

Résumé

Background: Treatment of eating disorders should be hierarchic, scaled, multifacetic and integrative and should control the clinical situation at a medical, psychiatric and group level. The aim of this study was to test a group model approach (included in a Specific Treatment Program for Eating Disorders coordinated within a global and individualized treatment plan) to be specifically applied in these disorders. Patients and method: A psychotherapy group model of one year in length undertaken in adolescent women (n = 8, mean age 16 years; mean length of evolution 2 years, 63% with previous treatment failure) is presented. Parameters were evaluated by CGI, EEAG, stage of change, SCL 90, EAT, EDI II and other clinical characteristics of the disease. A mixed 2 * 2 factorial design was carried out for evaluation. Results: The group setting allowed verbalization of the conflicts and personal growth with greater introspective awareness and less impulsiveness. Similarly, obsession for thinness, body insatisfaction, feelings of ineffectiveness and social insecurity and fear of maturity decreased. In the control group a greater rate of group drop out, greater rate of risks of organic-psychosomatic association and a comparatively worse evolution were observed. Conclusions: The group provides the patients with adequate strategies to confront and adapt to the change, an increase in autonomy and personal growth, avoids chronicity, decreases symptomatology and increases awareness-motivation towards treatment. Group intervention and evaluation allow optimization of treatment, making it appropriate to the target population.