Valuing patient perspectives in the context of eating disorders

Abstract

Abstract Purpose This paper advocates for the inclusion of patient perspectives in the diagnosis and treatment of eating disorders (EDs) for ethical, epistemological, and pragmatic reasons. We build upon the ideas of a recent editorial published in this journal. Using EDs as their example, the authors argue against dominant DSM-oriented approaches in favor of an increased focus on understanding patients’ subjective experiences. We argue that their analysis stops too soon for the development of practical—and actionable—insights into how to effect the integration of first-person and third-person accounts of EDs. Methods Contextual analysis was used to make the case for patient perspectives. Results We use anorexia nervosa (AN) as an example to demonstrate how the integration of patient manifestations and voices offers a promising methodology to improve patient diagnosis and treatment. We suggest that Acceptance and Commitment Therapy (ACT) can support patients with AN by reconciling their values with the values that arise from a clinician’s duty of care. Conclusions We conclude that there are no good scientific reasons to exclude first-person perspectives of EDs in psychiatry. Level of evidence: Level V: Opinions based on clinical experience.

Keywords

• Anorexia nervosa
• Patient values
• DSM-V
• Acceptance and commitment therapy
• Patient integration