Pseudocyesis in a case with anorexia nervosa: etiologic factors and treatment approach

Families universally agree that Anorexia Nervosa takes over almost every aspect of their lives, becoming the central organizing principle of the family's life.Over the last years focus for family interventions has been the Multiple Family Day Treatment approach (MFDT), which has a strong focus on helping families to maximize their strengths and resources, in order to help their patient member to recover. An important goal of MFDT is to help break the interconnections that have developed between the symptom and family interactions, and help overcome the sense of being unable to move and communicate freely about the problems. When families come together they witness each other, revealing their narratives about developed rules, roles, rituals and myths. The differences in the way that individual families have coped, allows for the possibility to look for alternative ways of managing the problem within the family.The authors describe their first experience with MFDT, which occurred in a Portuguese hospital with 17 families of anorectic patients.The shared experience of what it is like for families to live with anorexia quickly helps to create group cohesion and a supportive atmosphere in which difficulties can be tackled. Hearing how other families have overcome problems helps families to broaden their own time frame and consider trying new things.The MFDT has attracted considerable interest has an innovative and effective treatment, and feedback received from families has been very positive emphasizing in particular the collaborative nature of the treatment.

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Family members’ reflections upon a family-based inpatient treatment program for adolescent anorexia nervosa: a thematic analysis

Journal of Eating Disorders ◽

10.1186/s40337-020-00360-x ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Jan-Vegard Nilsen ◽

Øyvind Rø ◽

Inger Halvorsen ◽

Hanne Weie Oddli ◽

Trine Wiig Hage

Keyword(s):

Anorexia Nervosa ◽

Eating Disorder ◽

Treatment Program ◽

Inpatient Treatment ◽

Treatment Approach ◽

Family Members ◽

Adolescent Anorexia Nervosa ◽

Family Based Treatment ◽

Family Based ◽

Treatment Settings

Abstract Background Family-based outpatient treatment is usually recommended as the treatment of choice when a child develops anorexia nervosa. However, some young persons will inevitably require higher levels of care. Qualitative research on family perspectives may help inform strategies to adapt family-based practices into intensified treatment settings. Our overarching aim was to investigate family members’ perspectives following a family-based inpatient treatment program for adolescent anorexia nervosa and to discuss clinical implications for treatment providers. Methods A subsample of eight families taking part in a naturalistic outcome study at a specialized eating disorder unit participated in the study (8 patients, 14 parents, and 10 siblings). The thematic analyses were inductive, predominantly descriptive, and guided by a multi-perspective framework. Results Five main themes were identified: 1: Expectations and evaluation of needs. Entering treatment from different vantage points, 2: Interactions with peers during the admission as highly beneficial or problematic, 3: Perspectives on staff expertise and the eating disorder unit’s structure, 4: Influencing within family relationships in different ways, and 5: Being admitted is at best only half the job: reflections on leaving the eating disorder unit. Conclusions Our study offers insight into how former inpatients and their family members experienced an inpatient treatment program designed to align treatment with the central elements of an outpatient family-based treatment approach for adolescent anorexia nervosa. Overall, the findings support emerging research underlining the necessity of strengthening the family-based treatment approach within intensified treatment settings. Moreover, the results emphasized the need for more knowledge on how to optimize inpatient treatment as well as the importance of providing smooth transitions between care settings.

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Restorative Dental Treatment Approach on an Anorexia Nervosa Patient: A Case Report

10.7176/jstr/7-10-05 ◽

2021 ◽

Keyword(s):

Anorexia Nervosa ◽

Case Report ◽

Dental Treatment ◽

Treatment Approach

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Motivation to Change in the Course of a Pilot Study of a Step-Down Treatment Approach of Inpatient and Anorexia Nervosa-Specific Home Treatment and Its Effects on Treatment Outcome

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.693103 ◽

2021 ◽

Vol 12 ◽

Author(s):

Kathrin Sophie Heider ◽

Astrid Dempfle ◽

Sophie Altdorf ◽

Beate Herpertz-Dahlmann ◽

Brigitte Dahmen

Keyword(s):

Anorexia Nervosa ◽

Treatment Outcome ◽

Inpatient Treatment ◽

Treatment Approach ◽

Illness Severity ◽

Home Treatment ◽

Motivation To Change ◽

Sum Score ◽

Step Down

Introduction: Anorexia nervosa (AN) is a serious mental disorder that typically manifests in adolescence. Motivation to change is an important predictor for treatment outcome in adolescent AN, even though its development over the often long therapeutic process, with transitions between treatment settings, has not yet been studied. In this pilot study, the course of motivation to change and its effect on treatment outcome were investigated over the course of a step-down treatment approach during a 12-month observation period.Methods: Twenty-one adolescents admitted to inpatient treatment because of AN received multidisciplinary home treatment (HoT) with several weekly visits after short inpatient stabilization. Eating disorder (ED-)specific cognitive [Eating Disorder Inventory 2 (EDI-2) subscales] and physical [% expected body weight (%EBW)] illness severity and motivation to change [Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ)] were assessed at the time of admission, discharge from hospital, at the end of HoT, and at a 12-month follow-up. Changes in motivation over time and its relationship with treatment outcome were investigated.Results: Mean motivation to change improved significantly over the course of treatment from the contemplation stage [2nd stage, mean ANSOCQ sum score 47.26 (SD 17.60)] at admission to the action stage [4th stage, mean ANSOCQ sum score 77.64 (SD 18.97)] at the end of HoT (p < 0.001) and remained stable during the follow-up period. At each assessment, higher motivation to change was significantly correlated with lower ED-specific cognitive illness severity (Spearman ρs: −0.53 to −0.77, all p < 0.05). Only pretreatment motivation to change significantly predicted ED-specific cognitive illness severity after the first inpatient treatment phase when taking prior illness severity into account.Conclusions: Motivation to change is an important aspect of treatment success in adolescent AN, especially in the early phase of treatment. In addition, home treatment contributed significantly to a higher motivation. Further longitudinal research into how motivation to change in adolescent patients with AN is related to outcome in this often severe and enduring disease and into targeted therapeutic strategies and interventions that reliably enhance the motivation to change in adolescent patients with AN seems promising.

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Pseudocyesis in a patient with anorexia nervosa: etiologic factors and treatment approach

Psychiatry and Clinical Psychopharmacology ◽

10.1080/24750573.2017.1342826 ◽

2017 ◽

Vol 27 (3) ◽

pp. 322-324

Author(s):

Ahmet Gul ◽

Hesna Gul ◽

Nurper Erberk Ozen ◽

Salih Battal

Keyword(s):

Anorexia Nervosa ◽

Treatment Approach

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Comparing the clinical effectiveness, acceptability and cost-effectiveness of a ‘stepping into day treatment’ approach versus inpatient treatment as usual for anorexia nervosa

http://isrctn.com/ ◽

10.1186/isrctn10166784 ◽

2020 ◽

Author(s):

Bethan Dalton ◽

Ulrike Schmidt ◽

Madeleine Irish

Keyword(s):

Anorexia Nervosa ◽

Cost Effectiveness ◽

Inpatient Treatment ◽

Treatment Approach ◽

Day Treatment ◽

Clinical Effectiveness ◽

Treatment As Usual

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The Impact of Social Skills Training within an Established In-Patient Treatment Programme for Anorexia Nervosa

The British Journal of Psychiatry ◽

10.1192/bjp.139.6.533 ◽

1981 ◽

Vol 139 (6) ◽

pp. 533-539 ◽

Cited By ~ 22

Author(s):

M. Pillay ◽

A. H. Crisp

Keyword(s):

Anorexia Nervosa ◽

Social Skills ◽

Social Skills Training ◽

Treatment Approach ◽

Skills Training ◽

Patient Treatment ◽

Controlled Study ◽

Treatment Programme ◽

The Impact

SummaryThe paper reports a controlled study of the impact of social skills training within a longer treatment approach to patients with anorexia nervosa. Under these circumstances social skills training was not found to be a very powerful form of intervention. Possible reasons for this are touched on.

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