indici prognostici

[birimba]

ciao a tutti...

ho una domanda a cui spero qualcuno di voi mi possa rispondere.

Sto facendo la tesi sui disturbi alimentari, in particolare sull'anoressia. Mi è stato chiesto dalla mia prof. di scrivere un paragrafo sugli indici prognostici.
c'è qualcuno di voi che mi può spiegare cosa sono....ma a cosa servono?..per la valutazione di un paziente si usa il dsm...quindi gli indici a cosa servono?
non ci sto capendo piu nulla!!infatti si può notare dal messaggio confuso..spero che qualcuno mi possa aiutare...sono in crisi!!

grazie!!!

[Calethiel]

Gli indici prognostici o indicatori prognostici sono, se ricordo bene, quelle caratteristiche che ti permettono di stabilire come evolverà il caso, ad esempio se l'intervento avrà successo. prova a guardare qua, nel paragrafo sui fattori prognostici

L'anoressia nervosa nei maschi - Vertici Network di Psicologia e Scienze Affini

[willy61]

Qualche articolo sulla questione degli indicatori prognostici per l'anoressia:

Social Class and Prognosis in Anorexia Nervosa. By: Gowers, Simon; McMahon, John B.. International Journal of Eating Disorders, Jan89, Vol. 8 Issue 1, p105-109, 5p Abstract: Social class and clinical features were recorded for 100 consecutive cases of anorexia nervosa presenting to the St George's Hospital eating disorders department. A definite skew towards the higher social classes was discovered, but this was less marked than at the time of a similar study in the same department 10 years ago. Low social class has been reported as a poor prognostic indicator, but in this study, it was not related to other prognostic factors. The possible explanations are discussed. [ABSTRACT FROM AUTHOR] (AN 12054159)
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Locus of control as a measure of ineffectiveness in anorexia nervosa. Hood, Jane; Moore, Timothy E.; Garner, David M.; Journal of Consulting and Clinical Psychology, Vol 50(1), Feb 1982. pp. 3-13. [Journal Article] Abstract: Using D. W. Reid and E. E. Ware's (1974) Internal-External Locus of Control Scale (I-E scale), scores of 54 female anorexia nervosa patients were compared to norms. Younger anorexic patients (mean age 16.3 yrs) demonstrated higher internal control compared to norms on items related to fatalism and social-system control. I-E scores for older patients (mean age 21.2 yrs) could not be differentiated from the norms. Comparison of high (external) with low (internal) scorers within the sample revealed significant differences on clinical variables related to weight history, eating habits, and psychosocial behavior. In addition, externality was associated with symptomatic scores on the Beck Depression Scale, Eysenck Personality Questionnaire, Restraint Scale, and 16 PF. It is concluded that the I-E scale may provide a useful prognostic index for the subgroup of anorexic patients who demonstrate external I-E orientation. (35 ref) (PsycINFO Database Record (c) 2008 APA, all rights reserved)
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Treatment of anorexia nervosa in a specialty care continuum. By: Treat, Teresa A.; McCabe, Elizabeth B.; Gaskill, Jill A.; Marcus, Marsha D.. International Journal of Eating Disorders, Sep2008, Vol. 41 Issue 6, p564-572, 9p, 4 charts Abstract: Objective: Inpatient hospitalization has been a mainstay of treatment for anorexia nervosa (AN), but decreasing lengths of inpatient stay have prompted the development of alternative care-continuum models. This study characterizes the 6-month outcomes of 71 patients with AN who completed an inpatient-treatment protocol (∼5 weeks), followed by a day-hospital program (DHP) (∼3 weeks). Method: Data were derived from chart reviews and questionnaire data were collected during routine clinical care. Results: On discharge from DHP, 35.2% of patients showed excellent outcomes, whereas 23.9% exhibited poor outcomes. At 6 months after DHP discharge, 47.9% of the patients were successful in maintaining outpatient treatment status. Patients with successful 6-month outcomes were admitted to inpatient at a higher weight, had fewer previous hospitalizations, were younger, were rated by inpatient staff as more committed to treatment, endorsed less AN psychopathology during inpatient admission, and showed greater weight gain during DHP. Number of previous hospitalizations and weight gain immediately after inpatient discharge predicted 89.2% of outcome classifications 6 months after DHP discharge. Conclusion: These findings highlight both the potential benefits of this care-continuum model for patients who previously have not been hospitalized and the pressing need to develop alternative treatment strategies for patients with more chronic AN. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [ABSTRACT FROM AUTHOR] DOI: 10.1002/eat.20571 (AN 34042934)
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Readiness to change mediates the impact of eating disorder symptomatology on treatment outcome in anorexia nervosa. By: Bewell, Carmen V.; Carter, Jacqueline C.. International Journal of Eating Disorders, May2008, Vol. 41 Issue 4, p368-371, 4p Abstract: Objective: The aim of the present study was to determine if readiness to change eating and weight was predictive of anorexia nervosa (AN) inpatient treatment outcome, and whether it mediates the relationships between AN treatment outcome and other known predictors of outcome. Method: Participants were 127 patients with AN who were consecutively admitted to an intensive in-patient treatment program. They completed the Eating Disorder Inventory at admission and a measure of readiness to change after 4 weeks of treatment. Results: Readiness to change significantly predicted treatment outcome, even after controlling for level of eating disorder symptomatology at admission and AN subtype. It was also found to fully mediate the relationship between eating disorder symptomatology at admission and later treatment outcome. Conclusion: These findings suggest not only that readiness to make changes is an important indicator of future inpatient treatment outcome, but that it is the mechanism by which eating disorder symptomatology predicts success in a treatment program. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008. [ABSTRACT FROM AUTHOR] DOI: 10.1002/eat.20513 (AN 31630612)
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Time to remission for eating disorder patients: A 2½-year follow-up study of outcome and predictors. By: Clausen, Loa. Nordic Journal of Psychiatry, Apr2008, Vol. 62 Issue 2, p151-159, 9p, 4 charts, 1 graph Abstract: The aim of the present study was to analyse outcome, time to remission, and predictors of time to remission in a cohort of Danish eating disorder patients. Seventy-eight patients (35 anorexic, 30 bulimic and 13 unspecified eating disorder patients) were interviewed 2½ years after initial assessment. Method of assessment was Eating Disorder Examination (EDE), Longitudinal Interval Follow-up Evaluation of Eating Disorders (LIFE-EAT-II), Eating Disorder Inventory (EDI), Symptom Check List (SCL-90R), Present State Examination (PSE) and the Structured Clinical Interview for DSM-III-R Axis-II (SCID-II). Method of analysis was Kaplan-Meier estimate of survival, Log Rank test and Cox regression analysis. In total 48.7% reached remission with mean time to remission at 27 months. A trend difference between the diagnostic groups when measuring time to remission was found, i.e. patients with unspecified eating disorders remitted faster than bulimic (BN) patients who in turn remitted faster than anorexic (AN) patients. Body mass index (BMI) at baseline was the best predictor of time to remission for the total sample. Predictors differed when looking at diagnostic groups separately. Final outcome was comparable with earlier studies while relapse frequency was low. Patients with AN remitted faster than found in earlier survival analysis studies, while the remission rate for BN patients was comparable with earlier studies. Despite the prognostic value of BMI for the total sample, predictor analysis implied more disorder diversity than homogeneity. [ABSTRACT FROM AUTHOR] DOI: 10.1080/08039480801984875 (AN 32746301)
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Weight curves as predictors of short-term outcome in anorexia nervosa inpatients. By: Mewes, Ricarda; Tagay, Sefik; Senf, Wolfgang. European Eating Disorders Review, Jan/Feb2008, Vol. 16 Issue 1, p37-43, 7p, 2 charts, 1 graph Abstract: Objective The aim of the present study was to find factors that predict the short-term outcome of inpatients with anorexia nervosa (AN). Method Female inpatients with AN (N = 100) were divided into treatment completers (N = 50) and drop-outs (N = 50). Using stepwise linear regression the relationship of demographic data, illness history and patterns of weight gain to BMI gain up to discharge were analysed. Results Among drop-outs, 69% of the variance in BMI gain up to discharge was explained by length of the first half of treatment (FHT), average weekly BMI gain and average weight loss during FHT. Among completers, 52% of the variance in BMI gain up to discharge was explained by BMI at admission and average weekly BMI gain during the second half of treatment (SHT). Discussion Weight curves offer important information about short-term outcome for patients with AN. Copyright © 2007 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR] DOI: 10.1002/erv.807 (AN 27968745)

Readiness for change and short-term outcomes of female adolescents in residential treatment for anorexia nervosa. By: McHugh, Matthew D.. International Journal of Eating Disorders, Nov2007, Vol. 40 Issue 7, p602-612, 11p, 4 charts, 1 graph Abstract: Objective: To determine if readiness for change (RFC) at admission predicted length of stay (LOS) and short-term outcomes among female adolescents in residential treatment for anorexia nervosa (AN). Method: Using a prospective cohort design to collect data from participants (N = 65) at admission and discharge, Kaplan–Meier survival analysis and Cox regression tested whether RFC on admission predicted time in LOS to a favorable short-term outcome—a composite endpoint based on minimum criteria for weight gain, drive for thinness, depression, anxiety, and health-related quality of life (HRQOL). Results: Participants with low RFC had a mean survival time to a favorable short-term outcome of 59.4 days compared to 34.1 days for those with high RFC (log rank = 8.44, df = 1, p = .003). The probability of a favorable short-term outcome was 5.30 times greater for participants with high RFC. Conclusion: Readiness for change is a useful predictor of a favorable short-term outcome and should be considered in the assessment profile of patients with AN. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2007 [ABSTRACT FROM AUTHOR] (AN 26945046)

Buona vita

Guglielmo

[birimba]

grazie mille per le indicazione e gli articoli ora mi dedico alla lettura...
approfitto per chiedervi un 'alteriore cosa sugli indici prognostici.

Secondo voi in una ricerca sull'anoressia sapere gli indici prognostici cosa potrebbe servire?

scusate la cofusione!!!!

grazie mille ancora!!!!!!siete dei grandi