A possible overlap between autism spectrum disorder (ASD) and anorexia nervosa (AN), in terms of both behavioural and cognitive features, has led to new areas of research. The aim of the present study was to examine the occurrence of eating behaviours frequently seen in ASD among adolescents and young adults with AN. The participants were females within the age range 15-25 years: 36 with current AN (32 were followed up after 1 year), 19 with ASD, and 30 healthy females. The participants completed the SWedish Eating Assessment for Autism spectrum disorders (SWEAA) and the Autism Spectrum Quotient tool (AQ). AN groups had significantly higher SWEAA scores than the healthy comparison group, also when patients had gained weight. Typical autistic eating behaviours, such as selective eating, were more common in the AN groups than in the ASD group. This is the first time that SWEAA has been implemented in an AN population. Eating behaviours frequently seen in ASD seem to be frequent in AN and some remain also after weight gain.
The current study evaluated a new Internet-based self-help guide based on cognitive-behavioural therapy for patients with bulimic symptoms. Thirty-eight participants from a waiting list at an eating-disorder outpatient unit were assessed pre-treatment, post-treatment and at a 2-month follow-up using the Rating of Anorexia and Bulimia interview-revised version, an anamnesis questionnaire, the Eating Disorder Inventory-2 (EDI-2) and Symptom Check List-90-Revised (SCL-90R). The SCL-90R Global Severity Index and most EDI-2 subscales showed significant differences from pre-to post-treatment and the 2-month follow-up, apart from ineffectiveness, impulse regulation and social insecurity. Expert ratings revealed a significant reduction in vomiting, dietary restraints and weight phobia, with the exception of binge eating from pre-treatment to the 2-month follow-up. Exercise increased significantly, indicating that participants changed their method of compensation. An Internet-based self-help guide for bulimic symptoms is a promising new tool and can be used effectively as the first step in a stepped-care model. Further evaluations with randomized controlled trials are necessary.
The current study evaluated the outcome of family-based treatment for female adolescents with anorexia nervosa (N = 32), at the Anorexia-Bulimia Outpatient Unit in Göteborg, Sweden. Patients/parents were assessed pre-treatment, at 18- and 36-month follow-ups concerning eating disorder symptoms, general psychopathology, family climate and BMI. At the 36-month follow-up, 75% of the patients were in full remission with reduction in eating disorder symptoms and internalizing problems and they experienced a less distant and chaotic atmosphere in their families. These results show that family-based treatment appears to be effective in adolescent anorexia nervosa patients regarding areas examined in this study.
Patient satisfaction plays a central role in treatment alliance and outcome. Investigating patient expectations and experiences of treatment sheds light on its importance. This study examines adolescent anorexia nervosa patients and their parents' satisfaction with family-based treatment. Patients and parents answered a questionnaire at the eighteen-month follow-up focusing on expectations and experiences of treatment, therapists, aims of treatment and accomplishment. The results show that 73 per cent of the patients and 83 per cent of the parents felt that their pretreatment expectations had been fulfilled. The majority agreed that individual patient sessions and parental sessions were of great help, while the patients valued family therapy sessions as being less helpful than did parents. In overall terms, parents were more pleased with the therapists than were the patients. These data suggest that family-based treatment with individual sessions for patients, in parallel with parental sessions combined with family sessions, corresponds well to patients' and parents' treatment expectations.
In this study, we evaluate the efficacy of outpatient individual cognitive behavioral therapy for young adults (CBT-YA) and combined family/individual therapy for young adults (FT-YA) for anorexia nervosa (AN). Method: Participants (aged 17-24 years) with AN in Sweden were recruited and assigned to 18 months of CBT-YA or FT-YA. Treatment efficacy was assessed primarily using BMI, presence of diagnosis, and degree of eating-related psychopathology at posttreatment and follow-up. Secondary outcomes included depression and general psychological psychopathology. The trial was registered at http://www.isrctn.com/, ISRCTN (25181390). Results: Seventy-eight participants were randomized, and seventy-four of them received allocated treatment and provided complete data. Clinical outcomes from within groups resulted in significant improvements for both groups. BMI increased from baseline (CBT-YA 16.49; FT-YA 16.54) to post-treatment (CBT-YA 19.61; FT-YA 19.33) with high effect sizes. The rate of weight restoration was 64.9% in the CBT-YA group and 83.8% in the FT-YA group. The rate of recovery was 76% in both groups at post-treatment, and at follow-up, 89% and 81% had recovered in the CBT-YA and FT-YA groups respectively. Conclusions: Outpatient CBT-YA and FT-YA appear to be of benefit to young adults with AN in terms of weight restoration and reduced eating disorder and general psychopathology.
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