Abandono do tratamento em anorexia nervosa e bulimia: uma revisão crítica

Autores

  • Flávia Machado Seidinger-Leibovitz Universidade Estadual de Campinas
  • Larissa Rodrigues Universidade Estadual de Campinas
  • Celso Garcia Júnior Universidade Estadual de Campinas
  • Carla Maria Vieira Universidade Metodista de Piracicaba

Palavras-chave:

Anorexia Nervosa, Bulimia Nervosa, Pacientes Internados, Assistência Ambulatorial, Pacientes Desistentes de Tratamento

Resumo

Trata-se de revisão crítica de publicações científicas sobre abandono de tratamento ambulatorial e em internação, em anorexia nervosa ou bulimia nervosa, com levantamento de artigos indexados no PubMed/Medline, LILACS, Cochrane e PsycINFO utilizando-se os descritores: dropout, anorexia nervosa, bulimia nervosa e eatingdisorders em variadas combinações, selecionados por título, resumo e leitura do artigo na íntegra. Incluídos estudos sobre abandono em regime ambulatorial ou internação investigando AN e BN isoladas ou junto a outros transtornos alimentares. Em sua maioria os estudos abordam AN em internação. Encontradas contradições na busca de preditores; o subtipo purgativo é o preditor mais sustentado; a seguir, severidade de sintomas na triagem, menor nível educacional e aspectos familiares. Encontrou-se relação do abandono com aspectos psicopatológicos e aliança terapêutica. Sugerem-se estratégias de adesão: tratamento estruturado por fases, foco na aliança terapêutica, participação familiar, flexibilidade e prontidão da equipe no manejo das dificuldades dos pacientes com: impulsividade, controle e no relacionamento interpessoal. Há necessidade de amostras adequadas e termos padronizados na pesquisa quantitativa; estudos qualitativos para compreender os significados implicados no abandono. Destaque para a relação do abandono com diferentes expectativas entre paciente/equipe e dificuldades interpessoais inerentes a estes pacientes, portanto, em constituir a aliança terapêutica.

Biografia do Autor

Flávia Machado Seidinger-Leibovitz, Universidade Estadual de Campinas

Membro do Laboratório de Pesquisa Clínico-Qualitativa (CNPq), bolsista CAPES, auxílio-pesquisa FAPESP no. 2011/20469-8, Psicóloga, psicanalista, membro da CEPPAN e do Centro Lacaniano de Investigação da Ansiedade (CLIN-a), mestre em Ciências Médicas/Saúde Mental (FCM-Unicamp) e membro do Grupo Interdisciplinar de Assistência e Estudos em Transtornos Alimentares (GETA - UNICAMP).

Larissa Rodrigues, Universidade Estadual de Campinas

Membro do Laboratório de Pesquisa Clínico-Qualitativa (CNPq), Faculdade de Enfermagem – Unicamp

Celso Garcia Júnior, Universidade Estadual de Campinas

Membro do Laboratório de Pesquisa Clínico-Qualitativa (CNPq) e membro do Grupo Interdisciplinar de Assistência e Estudos em Transtornos Alimentares (GETA - UNICAMP).

Carla Maria Vieira, Universidade Metodista de Piracicaba

Membro do Laboratório de Pesquisa Clínico-Qualitativa (CNPq) e Curso de Nutrição/Universidade Metodista de Piracicaba (SP)

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Publicado

2016-06-03

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Seidinger-Leibovitz, F. M., Rodrigues, L., Júnior, C. G., & Vieira, C. M. (2016). Abandono do tratamento em anorexia nervosa e bulimia: uma revisão crítica. Revista Interface (Porto Nacional), 11(11). Recuperado de https://sistemas.uft.edu.br/periodicos/index.php/interface/article/view/2139