Anxiety Scores: Factorial repeated measures MANOVA showed a time*intervention effect (p<0.014). Patients in the control group stayed at “moderate” anxiety score (t-test p<0.42; d=0.12) Patients in the intervention group went from “severe” to “mild” anxiety scores ((t-test p<0.003; d=1.26)

• Pilot Group (2012): N=17 attended, N=10 were measured pre-post; 10 sessions were offered. Measures were applied at admission and after 8 weeks.  Aims: test patients and techniques (duration, adaptation,

etc);  Significant lower results were found for Anxiety scores on

BAI for those who attended more than 5 sessions (N=5; p< 0.47)

• Control Group (2013): N=14; TAU. Measures were applied at admission and after 8 weeks.  Treatment as usual comprises psychiatric care, nutritional

support, psychological group therapy, individual psychological therapy, family therapy and occupational therapy groups.

•  Intervention Group (2014): N=12; TAU + MT. Measures were applied at admission and after 8 weeks.  Open (rolling) group;  Two times a week, one hour duration each session;  Each session had three exercises that lasted 6-8 minutes:

I.  Mindfulness of present moment; II.  Mindfulness exercises with a more playful note; III.  Mindfulness of breathing or loving-kindness;

  All patients wrote testimonials after each exercise.

Aims of the project: To determine if a tailored mindfulness intervention would augment the treatment of severe patients with Eating Disorders (mainly Anorexia and Bulimia Nervosa)

•  Primary: mindfulness meditation training would lower scores on measures of anxiety, depression and mental rumination. •  Secondary: mindfulness meditation training would help patients to have a more realistic body image, be more mindful and be less rigid psychologicaly.

A TAILORED INTERVENTION WITH MINDFULNESS FOR INPATIENTS WITH EATING DISORDERS

Main hypothesis were confirmed by results, showing that MT can help inpatients lower symptoms often seen as comorbidities and making prognosis worse. This is a modified delivery mode in a challenging setting which has significant promise specially given that we reached a high attendance rate and engagement. Factors around delivery including therapist experience needs further elaboration before real clinical application can be offered.

Katya S. Stübing - Master’s Student, Department and Institute of Psychiatry, USP, Brazil. Tamara Russell - Visiting Lecturer, Institute of Psychiatry, King’s College, London, UK. Francisco Lotufo Neto – Associate Professor, Department and Institute of Psychiatry, USP, Brazil

DEPARTAMENT & INSTITUTE OF PSYCHIATRY UNIVERSITY OF SÃO PAULO, BRAZIL

Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are Eating Disorders (ED) that share symptoms and psychopathological characteristics such as deregulated feeding habits, extreme methods for weight control, high levels of anxiety and depression. Severe and chronic patients with ED have several psychiatric and medical comorbidities that help sustain the pathology and make prognosis worse. The need for new therapeutic approaches is highly stressed in the literature. Mindfulness training (MT) may help inpatients deal with depression, anxiety and other comorbidities that sustain Eating Disorders. MT can help inpatients become more psychologically flexible and empathetic so they can engage better in treatment as a whole.

RESULTS

METHODS AND DESIGN

Measures used: Beck Depression Inventory (BDI); Beck Anxiety Inventory (BAI); Acceptance and Action Questionnaire II (AAQ-II); Ruminative Response Scale for Eating Disorders (RRS-ED); Five Facets of Mindfulness (FFMQ); Eating Attitudes Test (EAT-26); Body Shape Questionnaire (BSQ).

DISCUSSION

0

5

10

15

20

25

30

35

Control Intervention

Anxiety (BAI)

Pre Post

**

Depression scores: Factorial repeated measures MANOVA showed a time*intervention effect (p<0.032). Patients in the control group stayed at “moderate” depression score (t-test p<0.82; d=0.08) Patients in the intervention group went from “moderate” to “mild” anxiety scores ((t-test p<0.002; d=1.06) 0

5

10

15

20

25

30

35

Control Intervention

Depression (BDI)

Pre Post

**

0

5

10

15

20

25

30

35

Observe Non Judge Describe Act w Awa Non React

Mindfulness (FFMQ)

Control Pre Control Post Inter Pre Inter Post

MEANS Pilot Control Intervention

N 10 14 (2 men) 12 (1 man)

Age 28.4 (18-46) 30.6 (20-56) 35.9 (20-50)

Age of Diagnosis 15.5 (14-18) y.o. 17.6 (10-36) y.o. 17.2 (8-42) y.o.

Time of ED 12.9 (4-28) years 12.9 (4-30) years 18.6 (5-34)

Type of ED AN=6; BN=3; EDNOS=1

AN=7; BN=5; EDNOS=2

AN=4; BN=2; EDNOS=6

BMI at admission 17.7 (10.5 – 30) 20.6 (13.3 – 37.9) 18.2 (10.4 – 25.2)

0

5

10

15

20

25

30

Control Intervention

Rumination (RRS-ED)

Pre Post

0

5

10

15

20

25

30

35

40

Control Intervention

Eating Attitudes (EAT-26)

Pre Post

0

20

40

60

80

100

120

140

Control Intervention

Body Image (BSQ)

Pre Post

**

36

38

40

42

44

46

48

50

Control Intervention

Psychological Flexibility (AAQ-II)

Pre Post *

Rumination Scores: Factorial repeated measures MANOVA showed a time effect (p<0.0318), but not an time*intervention effect (p<0.465). Patients in the control group showed a signitficant result for brooding subscale (t-test p<0.03; d=1.78). Total d=1.62. Patients in the intervention group didn’t show any statistical significance (t-test p<0.21) and a small effect size (d=0.43).

Rigidity Scores: Factorial repeated measures MANOVA showed a time effect (p<0.0318), but not an time*intervention effect (p<0.465). All patients stayed in the “highly rigid” scores with t-test showing a significant decrease for patients in the intervention group (p<0.034; d=0.33)

** * *

Higher scores are

good

* **