The Maudsley Anorexia Nervosa Treatment for Adults (MANTRA): A Feasibility Case Series of an Integrated Group Based Approach.

2021 ◽  
Author(s):  
Helen Startup ◽  
Mary Franklin-Smith ◽  
William Barber ◽  
Nicola Gilbert ◽  
Yael Brown ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Case Series ◽  
Group Processes ◽  
Community Services ◽  
Medium Effect ◽  
Social And Emotional ◽  
Alternative Intervention ◽  
Psychological Therapies ◽  
Relational Aspect

Abstract BackgroundIndividuals with Anorexia Nervosa (AN) typically struggle to negotiate their social and emotional worlds. Yet, current NICE recommended psychological therapies do not provide sufficient opportunities for live, in situ, relational and emotional experiences that enable growth in these areas. An Integrated Group Based approach for the delivery of MANTRA - The Maudsley Anorexia Nervosa Treatment for Adults - could address this omission by augmenting the treatment with group processes and live experiential practice. A feasibility case series of the approach, delivered across three NHS community services is presented.MethodsA case series design, comprising four Integrated Group MANTRA treatments delivered across three NHS sites (N=29), was used. Preliminary feasibility data is reported regarding: retention, acceptability and effectiveness; alongside the use of qualitative methods to capture participant experiences of treatment.ResultsPrimary outcomes suggest that Integrated Group MANTRA treatment was acceptable. Participants remained committed to the treatment with only 2 dropouts. Quantitative outcomes suggested significant change with medium effect sizes for both eating disorder cognitions and symptoms (as measured by the global score on EDEQ) and BMI. Five core themes emerged from qualitative analysis of participant feedback, capturing the value of the relational aspect of the treatment, the incorporation of experiential methods, and of the opportunity to draw on the support of the group members to reduce shame and stigma.ConclusionsPreliminary indication is that an Integrated Group based MANTRA approach is a feasible and effective alternative intervention for community Eating Disorder services.

scholarly journals The Maudsley Anorexia Nervosa Treatment for Adults (MANTRA): a feasibility case series of an integrated group based approach

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Helen Startup ◽  
Mary Franklin-Smith ◽  
William Barber ◽  
Nicola Gilbert ◽  
Yael Brown ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Case Series ◽  
Community Services ◽  
Medium Effect ◽  
Social And Emotional ◽  
Group Context ◽  
Alternative Intervention ◽  
Group Members ◽  
Relational Aspect

Abstract Background Individuals with Anorexia Nervosa (AN) typically struggle in social and emotional contexts. An Integrated Group Based approach for the delivery of MANTRA - The Maudsley Anorexia Nervosa Treatment for Adults – extends current NICE recommended therapy by augmenting treatment with opportunities for experiential practice in a group context. A feasibility case series, delivered across three NHS community services is presented. Methods The design was a case series of four Integrated Group MANTRA treatments delivered across three NHS sites (N = 29). Feasibility data of: retention, acceptability and effectiveness; alongside the qualitative capture of participant experiences of treatment is presented. Results Primary outcomes suggest treatment acceptability. Participants committed to treatment with only 2 dropouts. There was significant change with medium effect sizes for eating disorder cognitions and symptoms (as measured by the global score on EDEQ) and BMI. Core themes emerging from qualitative analysis captured the value of the relational aspect of the treatment, the incorporation of experiential methods, and the opportunity to draw on the support of the group members to reduce shame and stigma. Conclusions An Integrated Group based MANTRA approach is a feasible and effective alternative intervention for community Eating Disorder services.

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.

Post-Surgical Refusal to Eat: Anorexia Nervosa, Bulimia Nervosa or a New Eating Disorder? A Case Series

2004 ◽  
Vol 14 (3) ◽  
pp. 353-360 ◽  
Author(s):  
Adriano Segal ◽  
Debora Kinoshita Kussunoki ◽  
Maria Aparecida Larino
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Case Series

Post-Viral Onset of Anorexia Nervosa

1995 ◽  
Vol 166 (3) ◽  
pp. 386-389 ◽  
Author(s):  
R. J. Park ◽  
S. M. Lawrie ◽  
C. P. Freeman
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Case Series ◽  
Retrospective Case ◽  
Releasing Hormone ◽  
Glandular Fever ◽  
Retrospective Case Series

BackgroundThe pathogenesis of anorexia nervosa (AN) is controversial.MethodA retrospective case series was studied to investigate the post-viral onset of AN.ResultsFour consecutive in-patients with severe restrictive AN spontaneously volunteered histories of ‘glandular fever’-like illnesses immediately before the onset of their eating disorder. This association has not previously been described. Possible pathogenic pathways include both non-specific and specific viral disruptions in central homeostasis, particularly involving corticotrophin-releasing hormone (CRH) regulation.ConclusionSuch mechanisms are speculative, but biologically and historically plausible.

Cutaneous Manifestations of Eating Disorders

2002 ◽  
Vol 6 (4) ◽  
pp. 345-353 ◽  
Author(s):  
Ingrid Tyler ◽  
Marni C. Wiseman ◽  
Richard I. Crawford ◽  
C. Laird Birmingham
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Case Reports ◽  
Case Series ◽  
Cutaneous Manifestations ◽  
Medline Search ◽  
Ovid Medline ◽  
Underlying Disorder

Background and Objective: No complete review of the cutaneous manifestations of eating disorders exists. We therefore, set out to review and systematically describe the clinical and histopathologic features of dermatologic conditions associated with anorexia nervosa, bulimia nervosa, and obesity. Differential diagnosis, pathophysiology, laboratory studies, and treatment are also reviewed. Methods: Index Medicus review (1966 to present) using Ovid-MEDLINE. Search terms included eating disorders, anorexia nervosa, bulimia nervosa, eating disorders not otherwise specified (ED-NOS), and obesity, as well as the terms dermatology skin and cutaneous manifestations, with cross-referencing sources. These were combined with our own clinical experience. All relevant publications, including case reports, case series, cohort studies, and histopathologic studies giving at least Level II-3 evidence (evidence from comparisons between times or places with or without the intervention, including dramatic results in uncontrolled experiments), were selected. Conclusions: Forty dermatological signs have been reported in eating disorder patients. Eating disorders have many cutaneous manifestations and cutaneous signs may lead to the diagnosis of an occult eating disorder. The resolution of skin eruptions in eating disorder patients often depends on treatment of the underlying disorder.

Pharmacotherapy for Eating Disorders

2017 ◽  
Author(s):  
Susan McElroy ◽  
Anna I. Guerdjikova ◽  
Nicole Mori ◽  
Paul E. Keck
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Mental Disorders ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Night Eating Syndrome ◽  
Night Eating

This chapter addresses the pharmacotherapy of the eating disorders (EDs). Many persons with EDs receive pharmacotherapy, but pharmacotherapy research for EDs has lagged behind that for other major mental disorders. This chapter first provides a brief rationale for using medications in the treatment of EDs. It then reviews the data supporting the effectiveness of specific medications or medication classes in treating patients with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other potentially important EDs, such as night eating syndrome (NES). It concludes by summarizing these data and suggesting future areas for research in the pharmacotherapy of EDs.

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