Press Release No 05/2022 Eating Disorders: a first map of NHS Eating Disorders Centres produced by the ISS

Rome, 24 January 2022

An online interactive platform that is updatable in real time, where all the centres dedicated to the treatment of eating disorders (ED) are registered, is the result achieved through the MA.NU.AL project that the Ministry of Health has entrusted, as part of the Central Actions of the CCM, to the National Addiction and Doping Centre of the Istituto Superiore di Sanità (Italian National Institute of Health). This is the first census in Italy of outpatient, residential and semi-residential facilities belonging to the National Health Service and starting from 2022 it will also involve accredited private facilities. The data will be presented tomorrow, 25 January, on the occasion of the webinar "The territorial mapping of centres dedicated to the treatment of Nutrition and Eating Disorders".

As at 31 December 2021, the map counted 91 facilities across the national territory: 48 centres in the North (of which 16 in Emilia Romagna), 14 in Central Italy and 29 in the South and Islands.

There are 963 professionals working in the centres, all with updated training: above all psychologists (24%), child psychiatrists or neuropsychiatrists (17%), nurses (14%) and dieticians (11%). There are also professional educators (8%), internists and paediatricians (5%), medical specialists in clinical nutrition and food science (5%), psychiatric rehabilitation experts (3%), social workers (2%) and, finally, physiotherapists (1%) and motor rehabilitation experts (1%).

The constantly updated figures also provide information about the users receiving treatment. 65% of the centres surveyed provide treatment to over 8000 patients. Just under three thousand have been in treatment for more than 5 years and in the last year of reference (2020) alone, the patients who saw a doctor about their condition for the first time were about 4,700. The users in treatment are predominantly women 90% while 10% are men. 59% of users are between 13 and 25 years of age, 6% are under 12. Compared to the most frequent diagnoses, anorexia nervosa accounts for 42.3% of cases, bulimia nervosa 18.2%, and binge eating disorder 14.6%.

The diagnostic tool that is most frequently used is the DSM5 (Diagnostic and Statistical Manual of Mental Disorders): 87%.

The treatment programs offered to patients comprise different types of intervention: psychotherapy (100%), psycho-education (99%), education about nutrition (99%), pharmacotherapy (99%), monitoring of the psychic-physical-nutritional conditions (99%) and physical and social rehabilitation (62%). Psychotherapeutic interventions include individual (98%), family (78%) and group (66%) therapy, with many patients doing both individual and family or group therapy.

Access to services is usually direct, upon request by the patients (83%). The services are generally provided against the co-payment of a NHS ticket (78%) but they can also be provided free of charge (29%) or in intramoenia (i.e. patients pay the professionals who work privately within the facility (9%). Almost all the facilities in the survey make a diagnosis of the disorder at its onset (98%), at the time between onset and when treatment is provided (97%), and after previous treatments (98%).

The centres surveyed offer multimodal therapeutic programs, the levels of care are mainly of the outpatient or specialist type (92%), but also intensive outpatient or semi-residential care is provided (62%), while intensive residential rehabilitation is provided in 17% of the facilities.

"The project - says Roberta Pacifici, head of the National Centre for Addiction and Doping of the ISS - was created with the aim of offering the patients affected by these disorders, their families and the health professionals who provide the treatment, with a map of the resources present in their community and of the type of care offered, thus making access easier"

Furthermore, the pandemic emergency has had heavy effects on people suffering from these disorders, amplifying the problem as a whole for a series of contributing causes.

"The COVID-19 emergency context has not, however, stopped the fight against DCA - Dr. Pacifici goes on to say – The pandemic has called for a strong and effective common commitment to direct political and public intervention strategies towards new forms of governance. For this reason, being aware of the additional inconvenience that this health emergency has caused to patients and their families, the Ministry of Health and the Istituto Superiore di Sanità have acknowledged the more than ever fundamental importance of making available a "first point of reference" and, to this end, they strongly supported the territorial mapping of the Centres dedicated to the treatment of DNA in order to ensure that the people affected by these diseases and their families have access to appropriate care"

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