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This paper presents the results of an audit of people with eating disorders treated by adult mental health services. Information was obtained about the severity and nature of the eating disorder, treatment received and outcome of treatment for 128 clients who were assessed or treated for an eating disorder by eight adult mental health teams or mental health dietitians between April and September 1994 (inclusive). These teams serve a population of 541986. Referral rates corresponded with those reported by previous studies. Psychiatric comorbidity was commonly reported, particularly depression, however low levels of purging behaviours and alcohol and drug abuse suggest that these behaviours were underreported by clients. The role of generic mental health services in the treatment of people with eating disorders is discussed. [ABSTRACT FROM AUTHOR]

This paper describes an inpatient treatment programme specifically designed for normal- weight bulimia nervosa patients who have a co-morbidity marked by alcohol and drug abuse, ’cutting’, repeated overdosing or stealing, or sexual disinhibition (multi- impulsive bulimia). The programme uses a rigorous ward regime and simple behavioural counselling, under the direction of a nurse-counsellor to bring control to the many addictive and self-damaging behaviours. The underlying emotional and personality issues are addressed by focal-interpretive (psychodynamic) and cognitive techniques in both group and individual sessions. Major use is made of creative therapies and reality-orientated therapies. General psychodynamic groups are mixed with focal groups using cognitive techniques. Patients respond well and the improvement in symptomatology is maintained during follow-up. Those patients who describe poor peer relationships in adolescence and who find engagement in psychotherapy difficult, do poorly. [ABSTRACT FROM AUTHOR]