[Treatment of anorexia nervosa in young patients in a special care unit at Robert-Debré Hospital (Paris): guidelines and practical methods].
There are no official guidelines for the treatment of anorexia nervosa in young patients. Some recommendations have been proposed by a group of British experts (N.I.C.E., 2004), based on results from controlled studies. Our inpatient care unit takes into account the different dimensions of anorexia nervosa in this subgroup of young patients and proposes an integrated approach including medical care, nutritional care, and psychological care, as suggested by the N.I.C.E. recommendations. We attempt to take into account variables that are unique to these young patients. More specifically, we insist on weight restoration that will permit adequate growth and we do not systematically separate the patient from his or her family. In addition, family therapy or counseling is systematically provided. The aim of this approach is to support parents, to provide psychoeducational guidance, and to help the family acquire new behaviors and new ways of understanding the eating disorder. Most patients are treated on an outpatient basis, but inpatient care is offered when the patient displays severe medical conditions or a severe comorbid psychiatric illness. Anorexia nervosa is a protracted disorder that requires multidisciplinary outpatient medical follow-up, including the intervention of a general practitioner and a psychiatric team.
Service de psychopathologie de l'enfant et de l'adolescent, hôpital Robert-Debré, AP-HP de Paris, 48 boulevard Sérurier, Paris, France. liova.yon@wanadoo.fr
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Cook-Darzens
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D000293:Adolescent; D000553:Ambulatory Care; D000856:Anorexia Nervosa / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D005194:Family Practice; D005196:Family Therapy; D006760:Hospitalization; D006801:Humans; D033183:Interdisciplinary Communication; D015596:Nutrition Assessment; D018529:Nutritional Support; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D011567:Psychiatric Department, Hospital; D011575:Psychoanalytic Therapy; D011613:Psychotherapy / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods; D015430:Weight Gain