Treatment in Anorexia Nervosa: The Role of Neuropsychological Features in Predicting Response

2017 ◽  
Vol 41 (S1) ◽  
pp. S286-S287
Author(s):  
P. Meneguzzo ◽  
E. Collantoni ◽  
E. Tenconi ◽  
E. Bonello ◽  
G. Croatto ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Behavioral Therapy ◽  
Cognitive Remediation ◽  
Response To Treatment ◽  
Central Coherence ◽  
Clinical Test ◽  
Prediction Ability ◽  
Full Remission ◽  
Neuropsychological Variables

IntroductionNeuropsychological impairments in anorexia nervosa (AN) have been considered both as putative risk factors and as a target for treatment. However, the role of neuropsychological variables as predictors of outcome is not clear.AimsOur aim is to investigate the role of neuropsychological variables as predictors of response to treatment in a group of individuals affected by AN.MethodsThe study sample consisted of 144 patients diagnosed with acute AN, according to the DSM-5 criteria, referred to the Eating Unit of the Hospital of Padova, Italy. All participants were assessed by means of a neuropsychological and clinical test battery at intake and followed during outpatient treatment for an average of 531 days. Eighty-three percent of the patients underwent cognitive behavioral therapy, the families of 75% of the patients were included in the treatment and 48% of the patients took antidepressants (SSRI).ResultsBoth body mass index at assessment and illness duration appeared to be independent factors significantly affecting the outcome. The role of neuropsychological variables was explored including cognitive performance in a multivariate analysis including BMI at intake, duration of illness and diagnostic subtype. The inclusion in the model of the Wisconsin Sorting Card Task performance and the central coherence index (calculated by the Rey Figure Test) significantly increased the prediction ability of the model for full remission at the end of treatment.ConclusionsThis is the first study to show that neuropsychological characteristics may predict treatment response in AN. These data support the implementation of cognitive remediation techniques in the treatment of AN.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Cognitive remediation, brain function and central coherence: an anorexia nervosa pilot study

2014 ◽  
Vol 13 (1) ◽  
Author(s):  
Leon Fonville ◽  
Vincent Giampietro ◽  
Helen Davies ◽  
Naima Lounes ◽  
Andrew Simmons ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Pilot Study ◽  
Brain Function ◽  
Cognitive Remediation ◽  
Central Coherence

Role of Fluoxetine in Anorexia Nervosa

2003 ◽  
Vol 37 (6) ◽  
pp. 890-892 ◽  
Author(s):  
Sara S Kim
Keyword(s):  
Anorexia Nervosa ◽  
Behavioral Therapy ◽  
Nutritional Therapy ◽  
Obsessive Compulsive ◽  
Acute Therapy ◽  
Data Synthesis ◽  
Compulsive Disorder ◽  
Weight Restoration ◽  
Larger Sample

OBJECTIVE: To evaluate the efficacy of fluoxetine in the treatment of anorexia nervosa. DATA SOURCES: Literature obtained through searching MEDLINE (1966–January 2003). DATA SYNTHESIS: Studies conducted on the efficacy of fluoxetine in treating anorexia nervosa have conflicting results. Study design and methodology should be carefully evaluated. CONCLUSIONS: Fluoxetine played a role in the reduction of symptoms of obsessive–compulsive disorder and depression in anorexic patients. While psychotherapy, nutritional therapy, and behavioral therapy should be the mainstays of treatment, fluoxetine should be considered as an option to prevent relapse or to treat associated symptoms of anorexia nervosa following adequate weight restoration as a part of maintenance therapy and not as a primary or acute therapy. Although fluoxetine appears to be promising for the treatment of patients with anorexia nervosa, further studies need to be performed with a larger sample size and/or better design.

Advances in the treatment of anorexia nervosa: a review of established and emerging interventions

2017 ◽  
Vol 48 (8) ◽  
pp. 1228-1256 ◽  
Author(s):  
T. Brockmeyer ◽  
H.-C. Friederich ◽  
U. Schmidt
Keyword(s):  
Anorexia Nervosa ◽  
Controlled Trial ◽  
Cognitive Remediation ◽  
Non Invasive ◽  
Psychological Therapies ◽  
Pilot Trials ◽  
Emerging Treatments ◽  
Family Based ◽  
Randomised Controlled

AbstractBackgroundAnorexia nervosa (AN) is a disabling, deadly and costly mental disorder. Until recently, treatment recommendations were based on expert opinion and limited evidence. The aim of this systematic review is to synthesise recent evidence on established and emerging AN treatments and to forecast trends for future developments.MethodsWe systematically review trials of established treatments and associated process outcome studies from the last 5 years, published since a previous review in this journal. ‘Established’ treatments were those that are widely used in AN, recommended by guidelines and/or have been tested in at least one large randomised controlled trial. Secondly, we summarise emerging treatments for AN, i.e. those that have only been (or are currently being) tested in proof-of concept, feasibility or pilot trials.ResultsWe identified 19 published trials of established treatments (15 of high or moderate quality), mostly assessing psychological therapies (n = 17). We also found 11 published trials of emerging treatments, and a total of 34 registered, as yet unpublished trials. Promising emerging treatments include cognitive remediation therapy, exposure therapy and non-invasive neuromodulation.ConclusionsEvidence generation on the treatment of AN has dramatically accelerated, with our understanding of the role of family-based approaches for adolescents more nuanced and a range of psychological approaches available for the treatment of adults. Evidence on emerging treatments and from forthcoming trials suggests that there is a shift towards more targeted brain-based interventions. Future studies need to focus on elucidating mechanisms of action of treatments and what works best for whom.

scholarly journals Predictors of Positive Treatment Outcome in People With Anorexia Nervosa Treated in a Specialized Inpatient Unit: The Role of Early Response to Treatment

2016 ◽  
Vol 24 (5) ◽  
pp. 417-424 ◽  
Author(s):  
Jackie Wales ◽  
Nicola Brewin ◽  
Rebecca Cashmore ◽  
Emma Haycraft ◽  
Jonathan Baggott ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Early Response ◽  
Inpatient Unit ◽  
Response To Treatment ◽  
Positive Treatment

Cognitive Remediation Therapy as a Feasible Treatment for a Young Person With Anorexia Nervosa and Autism Spectrum Disorder Comorbidity: A Case Study

2019 ◽  
Vol 19 (2) ◽  
pp. 115-132 ◽  
Author(s):  
Yasemin Dandil ◽  
Claire Baillie ◽  
Kate Tchanturia
Keyword(s):  
Autism Spectrum Disorder ◽  
Anorexia Nervosa ◽  
Cognitive Remediation ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Self Report ◽  
Complex Case ◽  
Central Coherence ◽  
Cognitive Remediation Therapy

Anorexia nervosa (AN) is a challenging illness to treat with inefficiencies in central coherence and set-shifting known to be cognitive maintaining factors for the eating disorder. AN is further complicated by comorbidities such as autism spectrum disorder (ASD). Cognitive remediation therapy (CRT) aims to address problems with cognitive style and meta-cognition by stimulating the neural connections involved in cognitive processing through cognitive tasks, reflection, and behavioral experiments. However, to date, no reported studies are supporting individual CRT for patients with AN and ASD comorbidity. This single complex case study provides preliminary evidence to support the efficacy of individual CRT in the treatment of a 21-year-old female patient with AN and ASD comorbidity. Clinical and self-report data collected before and after CRT indicate improvements in cognitive flexibility and central coherence, alongside an increase in body mass index (BMI). This case study reflects the possible ways to adapt and calibrate treatment to individual needs and the efficacy of CRT, before proceeding to more complex individual psychological work, such as cognitive behavioral therapy.

Juvenile xanthogranuloma of the subdural spaces mimicking chronic hematoma with positive FDG uptake on PET: case report

2020 ◽  
Vol 26 (4) ◽  
pp. 449-453
Author(s):  
Jacob A. Kahn ◽  
Jeffrey T. Waltz ◽  
Ramin M. Eskandari ◽  
Cynthia T. Welsh ◽  
Michael U. Antonucci
Keyword(s):  
Potential Role ◽  
Response To Treatment ◽  
Juvenile Xanthogranuloma ◽  
Imaging Features ◽  
Limited Information ◽  
Advanced Imaging ◽  
Systemic Involvement ◽  
The Central Nervous System ◽  
Infancy And Early Childhood

The authors report an unusual presentation of juvenile xanthogranuloma (JXG), a non–Langerhans cell histiocytosis of infancy and early childhood. This entity typically presents as a cutaneous head or neck nodule but can manifest with more systemic involvement including in the central nervous system. However, currently there is limited information regarding specific imaging features differentiating JXG from other neuropathological entities, with diagnosis typically made only after tissue sampling. The authors reviewed the initial images of a young patient with shunt-treated hydrocephalus and enlarging, chronic, extraaxial processes presumed to reflect subdural collections from overshunting, and they examine the operative discovery of a mass lesion that was pathologically proven to be JXG. Their results incorporate the important associated histological and advanced imaging features, including previously unreported metabolic activity on FDG PET. Ultimately, the case underscores the need to consider JXG in differential diagnoses of pediatric intracranial masses and highlights the potential role of PET in the initial diagnosis and response to treatment.

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