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Biomedical subjects

W Vandereycken

Publications and source records attributed to W Vandereycken.

At least 73 records · Page 4Linked to original sources
PubMed1985

Inpatient treatment of anorexia nervosa: some research-guided changes.

Over a period of more than 15 years, our approach to the inpatient treatment of anorexia nervosa has changed considerably. Three major steps may be distinguished in this evolution. Until 1974, weight restoration was induced by a medical regime, and most patients had to stay in a psychotherapeutic community for several months. Between 1974 and 1980, different types of behavior therapy have been tried and compared ending up in a standardized behavioral contract system that is still used now. However, a large follow-up study forced us to question the second psychotherapeutic phase of the program and the long stay in the hospital. Moreover, the increasing number of patients made it practically impossible to treat them all individually. For these reasons, from 1982, an intensive multifaceted group approach was developed, the major components of which are described. It is concluded that continuing research from a scientist-practitioner's viewpoint is the best guide for a fruitful trial-and-error process in the therapeutic approach to patients with eating disorders.

Anorexia Nervosa↗
PubMed1984

Anorexia nervosa in males. A comparative study of 107 cases reported in the literature (1970 to 1980).

The relatively small number of male anorexia nervosa patients is often used as an excuse for the scarce literature on this subject. An exhaustive review of the literature (1970 to 1980), searching for case reports, yielded information about 107 males described as having anorexia nervosa. According to current criteria, the diagnosis was well documented in 37 patients. Data on the clinical picture and the social background were analysed and compared with a sample of 148 female anorectics. It was found that from the clinical point of view anorexia nervosa is strikingly similar in both sexes. A cluster analysis revealed that three subgroups might be distinguished in male cases: a '(pre)pubertal' variant, a 'lower class', and a 'middle class' variant. It is concluded that male patients should be involved in any future research on this syndrome.

Adolescent↗
PubMed1984

Neuroleptics in the short-term treatment of anorexia nervosa. A double-blind placebo-controlled study with sulpiride.

There is a remarkable lack of controlled investigations about the usefulness of psychotropic drugs in anorexia nervosa despite the popular use of neuroleptics in these patients. Inspired by a previous study using pimozide, a double-blind placebo-controlled cross-over study with sulpiride was carried out in 18 female anorexia nervosa inpatients. No direct effect of sulpiride has been established with regard to behavioural and attitudinal characteristics as measured by behaviour observation scales as well as by two self-report questionnaires (Eating Attitudes Test, Body Attitudes Test). Regarding daily weight gain, sulpiride was on the whole superior to placebo, especially in the first treatment period of three weeks. In the cross-over analysis, however, this effect did not reach statistical significance.

Adult↗
PubMed1983

The significance of subclassification in anorexia nervosa: a comparative study of clinical features in 141 patients.

Within a sample of 141 female anorexia nervosa patients comparative investigations were carried out between three subgroups: dieters, binge-eaters, and vomiters/purgers. A number of significant differences were found, especially with respect to age and duration of illness, previous treatment failures, and long-term outcome. The results appear to support the authors' view that the static idea of anorexia nervosa as a unitary illness should be abandoned and replaced by a dynamic dimensional model according to which, in the course of time, changes may occur in the clinical picture of dysorectic patients.

Adolescent↗
PubMed1983

Drop-out during in-patient treatment of anorexia nervosa: a clinical study of 133 patients.

Although anorexia nervosa patients are notorious for their 'resistance' to treatment, the phenomenon of drop-out during in-patient treatment of these patients is scarcely described in the literature. In a consecutive series of 133 hospitalized female anorexia nervosa patients the authors found a remarkably high drop-out rate of about 50 per cent, spread over different phases in the therapeutic process. In order to find some 'risk factors' concerning the probability of premature discharge against medical advice, some clinical, demographic and follow-up data were analysed in a retrospective way. Dropping-out appears to be a function of age at admission, duration of illness, educational level, social class and treatment method. These findings are interpreted with respect to different types of resistance to psychotherapeutic treatment both on the part of the patient and her family. In most cases a drop-out has to be considered as a crisis-related event in the treatment process. It does not only require specific attention, but also reconsideration of the whole therapeutic approach to anorexia nervosa patients.

Adult↗
PubMed1982

An inpatient treatment program for anorexia nervosa patients.

Inpatient treatment for anorexia nervosa can be necessary for medical, psychosocial or psychotherapeutic reasons. In general, these patients are characterized by "negative" selection characteristics (illness duration, failures of previous treatments, unfavourable natural milieu, poor motivation, etc). An inpatient treatment program, in which 145 female patients have been admitted, is described. It consists of two phases: a first "symptom directed" phase aiming at weight restoration and normalization of eating, based mostly on behavior therapy principles; in a second "problem oriented" phase, patients are oriented either towards outpatient treatment (family therapy, individual psychotherapy), or, in the majority of the described cases, to an inpatient psychotherapeutic community program. The difficulties of this approach and some outcome results at long-term follow-up are discussed.

Adolescent↗
PubMed1982

Pimozide combined with behavior therapy in the short-term treatment of anorexia nervosa. A double-blind placebo-controlled cross-over study.

Eighteen female inpatients were included in a double-blind placebo-controlled cross-over study aimed at testing the hypothesis that dopamine blockade may enhance the effectiveness of behavior therapy in the short-term weight restoration of anorexia nervosa patients. The patients were given a uniform contingency management program and, after a baseline period, they alternatingly (3-week periods) received pimozide (4 to 6 mg) or a placebo. During the first two periods pimozide almost significantly enhanced the weight gain induced by the behavior therapy program and beneficially influenced the patients' attitude towards treatment.

Adolescent↗
PubMed1982

Paradoxical strategies in a blocked sex therapy.

The Masters and Johnson method in treating sexual dysfunctions may be, contrary to the common belief, not as simple and successful as one used to expect. In cases where sex therapy is stagnating or sabotaged, some paradoxical strategies could be useful to unblock the treatment process.

Erectile Dysfunction↗
PubMed1981

Anorexia nervosa in twins.

In 1979, Askevold and Heiberg made an interesting contribution to the discussion on the hereditability of anorexia nervosa by reviewing a series of case reports concerning monozygotic twins. Their data, however, were not entirely accurate and they also overlooked some important references which are briefly discussed. 3 cases of the authors' own practice are added. A final examination of the available data with respect to anorexia nervosa in twins does not substantially support the assumption that genetic factors may play a determining role in the etiology of this syndrome.

Adolescent↗
PubMedDate not supplied

Hospitalization of obsessive-compulsive patients: the "forgotten" factor in the behavior therapy literature.

The role of hospitalization in the treatment of obsessive-compulsive patients has been neglected to a great extent in the behavior therapy literature. For this reason existing therapeutic programs, as described and evaluated in the literature, are briefly reviewed with regard to the use of a hospital setting in the course of treatment. The advantages and limitations of both inpatient and outpatient treatment are discussed. Finally, a few guidelines are offered to decide which patients may require admission to an inpatient psychiatric setting.

Behavior Therapy↗
PubMedDate not supplied

Stealing behavior in eating disorders: characteristics and associated psychopathology.

The objective of the study was to identify, in detail, the characteristics of stealing behavior and eventual associated psychopathology in a large group of eating-disordered patients. A sample of 155 females meeting DSM-III-R criteria for anorexia nervosa (AN) or bulimia nervosa BN completed the Stealing Behavior Questionnaire (SBQ) and other self-reporting measures, including the Dissociation Questionnaire (DIS-Q). In a subgroup of 80 patients, the SBQ was repeated after 2 months' treatment. A total of 47.1% of the patients admitted a history of stealing; compared with restricting AN (35.3%), the proportion of stealers was higher in binge-eating/purging AN (54.8%) and BN (48.7%). The number of patients admitting to stealing did not change after 2 months of intensive treatment. Compared with other patients, stealers did not differ in signs of general psychopathology, but showed more abnormal scores on the DIS-Q (especially "loss of control"). The patients whose stealing was clearly related to their eating disorder did not show a distinct pattern of eating pathology or associated psychopathology. If studied in a systematic way, stealing appears to be more frequent than expected; with its relationship to bulimic tendencies and "loss of control," it might indicate a more severe (stage of an) eating disorder and, as such, deserves more attention from researchers and clinicians than the scarce literature is reflecting up to now.

Adult↗
PubMedDate not supplied

Body size estimation in anorexia nervosa patients: the significance of overestimation.

Using the video distortion method on a life-size screen, we have studied body size estimation in 100 female restricting anorexia nervosa patients. About half of the patients were accurate in estimating their own body dimensions and only 20% clearly showed overestimation. We then tested whether differences in accuracy of estimation were related to scores on the following questionnaires: Eating Disorder Inventory; Body Attitude Test; and Symptom Checklist (SCL-90). Overestimators reported a more negative body attitude and a more "neurotic profile" on the SCL-90. These differences might have both prognostic and therapeutic implications.

Adolescent↗
PubMedDate not supplied

[Body image and anorexia nervosa. The use of confrontation via video in psychomotor therapy].

The body image of the patient suffering from anorexia nervosa is not only an important diagnostic criterion, but also an important aspect of therapy. In the patient unit of the university clinic for psychiatry at Kortenberg (K.U. Leuven), which specialises in the treatment of anorexia nervosa, a great deal of attention is given to body-image through the video confrontation technique. Video recordings are made of each patient on her arrival and departure. The recordings are shown to the patient and her group and discussed afterwards. It is expected that such confrontations will improve the attitude of the patient towards her own body. In order to evaluate these possible changes, the therapist fills out questionnaires at the start and the end of the program. The results of this method are analysed in this article.

Adolescent↗
PubMedDate not supplied

Are anorexia nervosa and bulimia variants of affective disorders?

There exists a growing tendency to view anorexia nervosa and bulimia as special forms of depressive illness. An association between eating disorders and affective disorders has been increasingly reported in the recent literature but it still remains a controversial issue. This is due to the confusing data from studies on this association in the following areas: phenomenology, course of illness, biological research, family history, and treatment response. Though some association between eating disorders and mood disturbances is incontrovertible, the hypothesis that anorexia nervosa is just a variant of affective disorder has not been proven. There is more evidence that the aforementioned association--whatever its real nature--prevails more clearly in a subgroup of bulimic patients.

Anorexia Nervosa↗
PubMedDate not supplied

Methodological problems of body image research in anorexia nervosa patients.

The significance of the disturbed body image as a psychopathological phenomenon in anorexia nervosa patients is quite evident to clinicians. It appears to be difficult, however, to assess this disturbance in a more objective way. The studies on body image perception discussed here make use of objective psychometric methods of measurement: image marking procedure, visual size estimation apparatus, distorting photograph technique, and video distortion. The following methodological problems are discussed: reliability, validity, experimental situation, and selection of subjects. Experimental data are presented on 52 anorectic patients as well as 210 control subjects, studied with three different perceptual tasks.

Anorexia Nervosa↗