Application criteria of enteral nutrition in patients with anorexia nervosa: correlation between clinical and psychological data in a "lifesaving" treatment.
BACKGROUND
Data and research increasingly point to multiple factors in the genesis of eating-behavior disorders, but the lack of a clear etiological definition prevents a unique therapeutic or prognostic approach from being defined. Therapeutic approaches, as well as scientific research, have separately analyzed the psychological aspects and the clinical-nutrition aspects without integrating the variables or correlating clinical and psychological data. This work has several goals because it aims at considering the problem from the 2 different perspectives. Psychological and clinical variables are analyzed both separately and together in order to assess (a) the minimal criteria to define a cure as "lifesaving" and submit a patient to artificial nutrition; (b) the kind of implementation artificial nutrition should follow; (c) which indicators of the efficacy of artificial nutrition must be taken into account; (d) the results in nutrition terms that may be obtained during the follow-up; (e) if artificial nutrition may be used as a therapeutic tool; (f) if there are any psychological effects after artificial nutrition; (g) if there are any effects due to the patients' age; and (h) the correlation between the psychological profile of a patient and the acceptance of the nutrition treatment.


METHODS
Several psychological and pharmacologic variables, together with clinical and anthropometric data and blood chemical values, were all considered.


CONCLUSIONS
Besides defining minimal criteria for a "lifesaving" cure and proposing 2 ad hoc scales for the assessment of patients' subjective willingness toward feeding and for the objective measurement of feeding itself, clinical data and correlations with psychological data evidenced the importance of artificial nutrition and specifically of enteral nutrition as a therapeutic tool, allowing us to define the modalities of implementation of enteral nutrition. Results show that, because enteral nutrition did not deteriorate the psychological state of the patients, and was found to be accepted more positively than feeding orally in the most critical initial phase, it should be included in the therapy.
Paccagnella
Agostino
A
Faculty of Psychology, University of Padua, Italy. apaccagnella@ulss.tv.it
Mauri
Alessandra
A
Baruffi
Carla
C
Berto
Rita
R
Zago
Raffaella
R
Marcon
Maria Lisa
ML
Pizzolato
Daniela
D
Fontana
Francesca
F
Rizzo
Lenio
L
Bisetto
Mario
M
Agostini
Silvana
S
Foscolo
Giancarlo
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000856:Anorexia Nervosa / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D015992:Body Mass Index; D002648:Child; D004750:Enteral Nutrition / Q000009:adverse effects / Q000523:psychology; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care; D012720:Severity of Illness Index; D016896:Treatment Outcome