FROM ACROSS THE DESK: New Approaches to Eating Disorders

This issue is all about innovations, beginning with ICED 2017 keynote speaker Dr. Vikram Patel’s work in India. Dr. Patel has taken an innovative approach to the lack of psychologists and medical care in remote areas: teaching local nonmedical lay counselors to deliver brief psychological treatment as primary care for depression and chronic alcoholism (See “Some Highlights of ICED 2017;Taking a New Approach to Diagnosis and Treatment of EDs”). Dr. Patel developed his program to counter the fact that virtually no one in the lower or middle class in India has access to psychological treatment, due to lack of specialists and to a longstanding acceptance of psychological problems as normal. He reported that innovations and technologic advances are helping clinicians reimagine and redesign mental health care. Dr. Patel also credited the field of eating disorders as a leader in the forefront of using innovative techniques, such as guided self-help, self-help manuals, and web-centered training, to reach patients.

In other presentations at the ICED, specialists challenged clinicians to view EDs in a broader scope rather than relying on older methods of diagnosis or concentrating on symptoms alone. Several speakers reported on the National Institute of Mental Health’s Research Domain Criteria (RDoC) program (including informative sessions on atypical eating disorders and ARFID, finding more precise ways to measure eating disorders, and improving understanding and treatment of atypical presentations of EDs). The RDoC program offers “a new framework for understanding and studying basic dimensions of normal and abnormal human functioning and mental disorders,” according to a recent article by EDR’s Emeritus Editor, Dr. Joel Yager, and Dr. Robert E. Feinstein (see J Clin Psychiatry. 2017; 78:423).

Finally, we always like to include articles about ways to use new technology to improve care for ED patients. To address the fact that a third of British patients referred for specialist ED care never appear for the first appointment, a team of British clinicians led by Dr. Sarah Muir designed an internet program, MotivATE. This pilot program encourages patients to develop self-sufficiency and motivation and to negative beliefs and expectations about treatment (see “A Web-based Program Aimed at Overcoming Resistance to Treatment”). And, borrowing from the visual arts, a team of researchers in Germany and Switzerland have turned to 3D technology to better define the effects of body image disorders (see “What Can An Avatar Reveal About Body Image in AN?”).

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