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      The Eating Disorders Section of the Development and Well-Being Assessment (DAWBA): development and validation Translated title: Sessão de Transtornos Alimentares do Development and Well-Being Assessment (DAWBA): desenvolvimento e validação

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      1 , 2 , 1 , 2 , 3 , 1 , 2 , 1 , 2 , 1 , 2 , 1 , 2 , 2 , 4
      Revista Brasileira de Psiquiatria
      Associação Brasileira de Psiquiatria - ABP
      Eating disorders, Eating disorders, Food habits, Anorexia nervosa, Bulimia, Diagnostic and statistical manual of mental disorders, Interview, psychological, Mental disorders, Children, Adolescent, Transtornos da alimentação, Transtornos da alimentação, Hábitos alimentares, Anorexia nervosa, Bulimia, Manual diagnóstico e estatístico de transtornos mentais, Entrevista psicológica, Transtornos mentais, Crianças, Adolescente

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          Abstract

          OBJECTIVE: Development and validation of the Eating Disorders Section of the Development and Well-Being Assessment (DAWBA). It is a package of questionnaires, interviews and evaluation techniques, designed to generate DSM-IV and ICD-10 based diagnoses of anorexia, bulimia nervosa and the respective partial syndromes in epidemiological studies, in subjects who are 7 to 17 years old. The parents are interviewed in all cases, as are young people aged 11 or more. METHODS: 174 girls, divided into three groups, were assessed with the Eating Disorders Section of the Development and Well-Being Assessment: 48 with eating disorders, 55 clinical controls (with depression, obsessive-compulsive disorder or gastrointestinal disease) and 71 community controls. The sensitivity, specificity and predictive values of the assessment were investigated by comparing the Development and Well-Being Assessment diagnoses with independent psychiatric diagnoses. The test-retest reliability was investigated by reapplying the measure on 55 subjects after 2 or 3 weeks. RESULTS: For the detection of any DSM-IV and ICD-10 eating disorder, the final Development and Well-Being Assessment diagnosis had a sensitivity of 100%, specificity of 94%, positive predictive value of 88%, and a negative predictive value of 100%; there was 95% agreement between the initial and repeat diagnoses (a kappa of 0.81). CONCLUSION: The Eating Disorders Section of the Development and Well-Being Assessment has suitable psychometric properties for use in clinical and epidemiological studies.

          Translated abstract

          OBJETIVOS: Desenvolvimento e validação da Sessão de Transtornos Alimentares do Development and Well-Being Assessment (DAWBA). Essa sessão é um pacote de questionários, entrevistas e técnicas de avaliação, desenvolvido para gerar diagnósticos baseados no DSM-IV e CID-10 de anorexia, bulimia nervosa e as respectivas síndromes parciais em estudos epidemiológicos, em jovens de 7 a 17 anos. Os pais são entrevistados em todos os casos, assim como as jovens de 11 anos ou mais. MÉTODOS: 174 meninas, divididas em três grupos, foram avaliadas com a Sessão de Transtornos Alimentares do Development and Well-Being Assessment: 48 jovens com transtornos alimentares, 55 controles clínicos (com depressão, transtorno obsessivo-compulsivo ou doença gastrintestinal) e 71 controles da comunidade. Sensibilidade, especificidade e valores preditivos do instrumento foram pesquisados pela comparação dos diagnósticos pelo Development and Well-Being Assessment com diagnósticos psiquiátricos independentes. A confiabilidade teste-reteste foi investigada reaplicando-se o instrumento em 55 sujeitos após duas ou três semanas. RESULTADOS: Para a detecção de qualquer transtorno alimentar segundo o DSM-IV e o CID-10, o diagnóstico final pelo Development and Well-Being Assessment apresentou sensibilidade de 100%, especificidade de 94%, valor preditivo positivo de 88%, valor preditivo negativo de 100% e 95% de concordância entre testes e retestes (Kappa de 0,81). CONCLUSÃO: A Sessão de Transtornos Alimentares do Development and Well-Being Assessment tem boas propriedades psicométricas para o uso em estudos clínicos e epidemiológicos.

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          Most cited references28

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          Mortality in anorexia nervosa.

          The author's goal was to shed light on the debate regarding the mortality rate over time associated with anorexia nervosa. He conducted a meta-analytic study using weighted linear regression to combine crude mortality proportions from 42 published studies to estimate the mortality associated with anorexia nervosa over time. The crude rate of mortality due to all causes of death for subjects with anorexia nervosa in these studies was 5.9% (178 deaths in 3,006 subjects). The aggregate mortality rate was estimated to be 0.56% per year, or approximately 5.6% per decade. The aggregate estimated mortality rate for subjects with anorexia nervosa is substantially greater than that reported for female psychiatric inpatients and for the general population.
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            The consequences and costs of the eating disorders.

            Eating disorders are severe, relatively chronic conditions that are associated with comorbid psychopathology and adverse medical conditions. The death rate for patients with AN is the highest among psychiatric conditions, with high suicide rates and deaths from physiologic causes. In addition, the costs of therapy for AN are higher than those for schizophrenia. Although somewhat less chronic, BN and binge-eating disorder are costly conditions to treat, similar to or more expensive than the costs for the treatment of OCD. Although antidepressant medication seems to be the most cost-effective treatment in the short term, given the higher relapse rates with antidepressants, it seems that, in the end, CBT may be the most cost-effective approach to the treatment of BN. It is possible that similar figures would occur for binge-eating disorder. The issue of the comparative cost-effectiveness of various treatments for psychiatric disorders has been neglected in the research literature to date. It is important that large-scale RCTs add a sophisticated cost-effectiveness analysis to the design so that physicians can better choose the most effective and cost-effective sequence of therapies for their patients.
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              • Article: not found

              The struggle to be thin: a survey of anorexic and bulimic symptoms in a non-referred adolescent population.

              Ninety-one per cent of a county-wide high school population (N = 5596) completed the Eating Symptoms Inventory (ESI) and the Eating Attitudes Test (EAT). Being female, older and heavier are far more strongly associated with anorexic and bulimic symptoms than is social class. ESI approximations of the DSM-III criteria for anorexia nervosa or bulimia suggest that while both conditions are rare (less than 1%), bulimia is the more prevalent disorder.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbp
                Revista Brasileira de Psiquiatria
                Rev. Bras. Psiquiatr.
                Associação Brasileira de Psiquiatria - ABP (São Paulo )
                1809-452X
                March 2005
                : 27
                : 1
                : 25-31
                Affiliations
                [1 ] Childhood and Adolescence Eating Disorders' Attending, Teaching and Research Project
                [2 ] Universidade de São Paulo Brazil
                [3 ] King's College
                [4 ] Universidade de São Paulo Brazil
                Article
                S1516-44462005000100008
                10.1590/S1516-44462005000100008
                15867980
                81e72cb9-bc2d-4c42-aec3-3a52d2b245c3

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1516-4446&lng=en
                Categories
                PSYCHIATRY

                Clinical Psychology & Psychiatry
                Crianças,Eating disorders,Food habits,Anorexia nervosa,Bulimia,Transtornos da alimentação,Diagnostic and statistical manual of mental disorders,Interview, psychological,Mental disorders,Children,Adolescent,Hábitos alimentares,Manual diagnóstico e estatístico de transtornos mentais,Entrevista psicológica,Transtornos mentais,Adolescente

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