scholarly journals Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial

2012 ◽  
Vol 201 (5) ◽  
pp. 392-399 ◽  
Author(s):  
Ulrike Schmidt ◽  
Anna Oldershaw ◽  
Fatima Jichi ◽  
Lot Sternheim ◽  
Helen Startup ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Service Utilisation ◽  
Recovery Rates ◽  
Psychological Therapies ◽  
Novel Treatment ◽  
Randomised Controlled ◽  
Eating Disorders Examination

BackgroundVery limited evidence is available on how to treat adults with anorexia nervosa and treatment outcomes are poor. Novel treatment approaches are urgently needed.AimsTo evaluate the efficacy and acceptability of a novel psychological therapy for anorexia nervosa (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) compared with specialist supportive clinical management (SSCM) in a randomised controlled trial.MethodSeventy-two adult out-patients with anorexia nervosa or eating disorder not otherwise specified were recruited from a specialist eating disorder service in the UK. Participants were randomly allocated to 20 once weekly sessions of MANTRA or SSCM and optional additional sessions depending on severity and clinical need (trial registration: ISRCTN62920529). The primary outcomes were body mass index, weight and global score on the Eating Disorders Examination at end of treatment (6 months) and follow-up (12 months). Secondary outcomes included: depression, anxiety and clinical impairment; neuropsychological outcomes; recovery rates; and additional service utilisation.ResultsAt baseline, patients randomised to MANTRA were significantly less likely to be in a partner relationship than those receiving SSCM (3/34 v. 10/36; P < 0.05). Patients in both treatments improved significantly in terms of eating disorder and other outcomes, with no differences between groups. Strictly defined recovery rates were low. However, MANTRA patients were significantly more likely to require additional in-patient or day-care treatment than those receiving SSCM (7/34 v. 0/37; P=0.004).ConclusionsAdults with anorexia nervosa are a difficult to treat group. The imbalance between groups in partner relationships may explain differences in service utilisation favouring SSCM. This study confirms SSCM as a useful treatment for out-patients with anorexia nervosa. The novel treatment, MANTRA, designed for this patient group may need adaptations to fully exploit its potential.

scholarly journals A randomised controlled trial of three psychological treatments for anorexia nervosa

2017 ◽  
Vol 47 (16) ◽  
pp. 2823-2833 ◽  
Author(s):  
S. Byrne ◽  
T. Wade ◽  
P. Hay ◽  
S. Touyz ◽  
C. G. Fairburn ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Healthy Weight ◽  
Psychological Treatments ◽  
Psychosocial Impairment ◽  
Eating Disorder Psychopathology ◽  
Randomised Controlled

BackgroundThere is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.MethodA multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.ResultsTreatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.ConclusionThe findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/

scholarly journals Clinical effectiveness of a skills training intervention for caregivers in improving patient and caregiver health following in-patient treatment for severe anorexia nervosa: pragmatic randomised controlled trial

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Rebecca Hibbs ◽  
Nicholas Magill ◽  
Elizabeth Goddard ◽  
Charlotte Rhind ◽  
Simone Raenker ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Skills Training ◽  
Patient Treatment ◽  
Training Intervention ◽  
Randomised Controlled ◽  
The Impact

BackgroundFamilies express a need for information to support people with severe anorexia nervosa.AimsTo examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.MethodPatients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (n=178) and caregiver (n=268) outcomes were measured at discharge and 6 and 12 months after discharge.ResultsPatients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7–12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.ConclusionsSmall but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665.

Wirksamkeit, Moderatoren und Mediatoren manualisierter familienbasierter Therapie bei Jugendlichen mit Essstörungen: Eine systematische Übersichtsarbeit

2019 ◽  
Vol 70 (03/04) ◽  
pp. 112-121
Author(s):  
Sandra Schlegl ◽  
Ulrich Voderholzer ◽  
Julia Maier ◽  
Silke Naab ◽  
James Lock
Keyword(s):  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Bulimia Nervosa ◽  
Controlled Trial ◽  
Systematische Übersichtsarbeit ◽  
Randomised Controlled

ZusammenfassungFamilienbasierte Therapie (FBT) ist derzeit die Therapie bei Jugendlichen mit Essstörungen mit der höchsten Evidenz. Ziel der Übersichtsarbeit ist es, die bisherigen Forschungsergebnisse hinsichtlich der Wirksamkeit der manualisierten FBT nach Lock und Le Grange zusammenzufassen sowie Moderatoren und Mediatoren darzustellen. In 5 randomisiert-kontrollierten Studien (engl. randomised controlled trial, RCT) bei Anorexia nervosa (N=560) zeigten sich Remissionsraten zwischen 21,2–42% am Ende der Behandlung, zwischen 21,8–40% bei der 6-Monats-Katamnese und zwischen 29–49% bei der 12-Monats-Katamnese. Die Remissionsraten bei Bulimia nervosa (2 RCTs, N=210) lagen bei 39% bzw. 29–44% bzw. 49%. Wünschenswert wären Replikationen der Ergebnisse durch unabhängige Arbeitsgruppen und in anderen Ländern. Es wäre zudem interessant, FBT im Vergleich zur Kognitiven Verhaltenstherapie sowie zur tiefenpsychologisch fundierten Therapie zu untersuchen und weitere Strategien für Non-Responder zu explorieren.

scholarly journals Study protocol for a randomised controlled trial investigating two different refeeding formulations to improve safety and efficacy of hospital management of adolescent and young adults admitted with anorexia nervosa

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038242
Author(s):  
Elizabeth Parker ◽  
Victoria Flood ◽  
Mark Halaki ◽  
Christine Wearne ◽  
Gail Anderson ◽  
...  
Keyword(s):  
Young Adults ◽  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Hospital Admission ◽  
Enteral Feeding ◽  
Controlled Trial ◽  
Local Health ◽  
Adolescent And Young Adults ◽  
Enteral Formula ◽  
Randomised Controlled

IntroductionProviding effective nutritional rehabilitation to patients hospitalised with anorexia nervosa (AN) is challenging, partly due to conservative recommendations that advocate feeding patients at low energy intakes. An ‘underfeeding syndrome’ can develop when patients are not provided with adequate nutrition during treatment, whereby malnourished patients fail to restore weight in a timely matter, and even lose weight. Of particular concern, the reintroduction of carbohydrate in a starved patient can increase the risk of developing electrolyte, metabolic and organ dysfunction. The proposed trial assesses the efficacy and safety of a lower carbohydrate enteral formula (28% carbohydrate) against a standard enteral formula (54% carbohydrate), in adolescent and young adult patients (aged 15–25 years), hospitalised with AN.Methods and analysisThe study employs a double-blind randomised controlled trial design. At admission to hospital, malnourished adolescent and young adults with AN will be randomly allocated to commence feeding on a standard enteral feeding formula (1.5 kcal/mL, 54% carbohydrate) or a lower carbohydrate isocaloric enteral feeding formula (1.5 kcal/mL, 28% carbohydrate). Assessments of nutritional intake, weight and biochemistry (phosphate, magnesium, potassium) will be conducted at baseline and during the first 3 weeks of hospital admission. The primary outcome measure will be incidence of hypophosphatemia. Secondary outcomes include weight gain, oedema, other electrolyte distortion, length of hospital admission, admission to the Intensive Care Unit (ICU) and number of days to reach medical stability, using defined parameters.Ethics and disseminationThe protocol was approved by the Western Sydney Local Health District Human Research Ethics Committee and institutional research governance approvals were granted. Written informed consent will be sought prior to study enrolment. Study findings will be widely disseminated through peer-reviewed publications and conference presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617000342314); Pre-results.

scholarly journals Transition Care in Anorexia Nervosa Through Guidance Online from Peer and Carer Expertise (TRIANGLE): Study Protocol for a Randomised Controlled Trial

2017 ◽  
Vol 25 (6) ◽  
pp. 512-523 ◽  
Author(s):  
Valentina Cardi ◽  
Suman Ambwani ◽  
Emily Robinson ◽  
Gaia Albano ◽  
Pamela MacDonald ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Study Protocol ◽  
Controlled Trial ◽  
Transition Care ◽  
Randomised Controlled
Sign in / Sign up

Export Citation Format

Share Document