A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED)

Abstract

This pilot study assesses the impact of FREED (First Episode Rapid Early Intervention for Eating Disorders [ED]), a novel transdiagnostic service for emerging adults with recent ED onset, on clinical outcomes. Data were collected from 56 patients and 19 carers for 12 months following enrolment. FREED patients showed significant improvements in ED and other symptoms across time. Carers also showed psychological improvements. For FREED anorexia nervosa (AN) patients, body mass index (BMI) at initial clinical assessment was similar to that of comparable patients (audit cohort) seen in our service before (16.4 vs 16.1 kg/m ). By start of treatment, because of their shorter wait, FREED-AN had gained weight whereas audit patients had lost (16.7 vs 15.8 kg/m ). This difference continued throughout treatment, and at 12 months, nearly 60% FREED-AN patients returned to a BMI of 18.5 or greater. FREED shows promise as a service model for emerging adults with EDs.

Eating Disorders During Emerging Adulthood: A Systematic Scoping Review

“…However, this review found that evaluations of adult ED services and treatments adapted to the needs of EAs have produced promising results. Specifically, treatment within the FREED model was associated with significant improvement in ED and co-morbid depression and anxiety symptoms over time, alongside larger BMI improvement in AN patients compared to treatment as usual McClelland et al, 2018;Koskina and Schmidt, 2019). Although this research does not identify mechanism of effect, key aspects of this service model include rapid access to care, flexible caregiver involvement and a focus on identity development and management of transitions.…”

“…Three studies investigated new approaches to intervention for EAs with EDs McClelland et al, 2018;Koskina and Schmidt, 2019). A case-report described the treatment of an EA with recent onset AN.…”

“…The patient showed significant sustained improved in both BMI and ED symptoms, and gave detailed positive feedback on her experience of treatment (Koskina and Schmidt, 2019). One study (reported in two publications) examined the feasibility, acceptability and effectiveness of First Episode Rapid Early Intervention for Eating Disorders (FREED) McClelland et al, 2018). FREED is a service-model for specialist treatment of EAs with a recent onset ED and aims to both minimize wait-times for treatment and provide evidence-based interventions which have been adapted for EAs.…”

Pathways to specialist care for eating disorders: An Italian multicentre study

“…The delay to treatment in psychiatry has been correlated with a usually long duration of illness and negative influences over the further outcome for several psychiatric disorders, whereas a recent meta-analysis on schizophrenic psychoses has supported the association of early diagnosis and more favourable clinical outcomes (Penttilä, Jääskeläinen, Hirvonen, Isohanni, & Miettunen, 2014). In the case of EDs, it is well known that illness duration is a relevant predictor of outcome (Steinhausen, 2002), and several clinical ED treatment models support the implementation of early interventions (Fairburn, Welch, Doll, Davies, & O'Connor, 1997;Lewinsohn, Striegel-Moore, & Seeley, 2000;Currin & Schmidt, 2005;McClelland et al, 2018).…”

Severity of somatic symptoms in outpatients with anorexia and bulimia nervosa

“…In the field of anorexia nervosa, somatic symptom severity significantly predicted impairments in quality of life (Weigel, König, Gumz, Löwe, & Brettschneider, ). Further research to clarify the consequences of somatic symptom severity on psychological and functional impairments in both anorexia and bulimia nervosa is crucial to decrease subjective burden of eating disorders and to improve the clinical management of eating disorders (e.g., McClelland et al, ).…”