Chronic anorexia nervosa: Patient characteristics and treatment approaches

Starzomska, Małgorzata; Rosińska, Paulina; Bielecki, Jan

doi:10.12740/pp/onlinefirst/118601

Cited by 6 publications

(7 citation statements)

References 37 publications

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“…By acknowledging the patient as the central figure in the therapy, interventions should involve intrapersonal work, collaboration with significant others, and identity development beyond the confines of Anorexia Nervosa. Factors identified by Starzomska et al, including enhanced insight, externalization and devaluation of the disorder, and improved interpersonal understanding, play crucial roles in fostering self-determined recovery efforts [ 87 ]. Furthermore, therapeutic strategies should extend beyond towards the patient’s interpersonal relationships, involving caregivers and family members, in order to embrace the recent Maudsley AN treatment approach in adults [ 88 ].…”

Section: Discussionmentioning

confidence: 99%

Severe enduring anorexia nervosa (SE-AN) treatment options and their effectiveness: a review of literature

Marcolini,

Ravaglia,

Tempia Valenta

et al. 2024

J Eat Disord

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Introduction For nearly 20% of patients diagnosed with Anorexia Nervosa (AN), the eating disorder (ED) is prolonged and becomes long-lasting. It has been reported that patients diagnosed with Severe Enduring Anorexia Nervosa (SE-AN) have worse ED symptoms, higher rates of lifetime hospitalization, and lower psychosocial well-being compared to patients with shorter disease duration. Objectives This review aims to describe the treatments proposed to date and their effectiveness on SE-AN-related outcomes. Methods We conducted a PubMed search for studies addressing the issue of treatment approach to SE-AN adults, that were published between 2003 and 2023, peer-reviewed, written in the English language, and available in full-text. Next, we inductively created relevant macro-themes by synthesizing the data from the included articles. Results Of 251 PubMed studies, 25 articles were considered for data extraction, all published between 2003 and 2022. We identified three macro-themes. The first macro-theme, “Psychotherapy”, mostly takes into consideration treatment effectiveness of cognitive behavioral therapy (CBT). Various reports determined its greater effectiveness compared to Specialist Supportive Clinical Management (SSCM), and one study proved that outpatient CBT is a valid alternative to hospitalization. The second one involves “Pharmacological Treatments”. Research on dronabinol, a synthetic orexigenic cannabinoid, antipsychotics (in particular, olanzapine and haloperidol), and ketamine showed some mixed results regarding the often-complementary areas of weight gain and improvement in ED-related symptoms. Regarding the third macro-theme, “Brain Stimulation Therapies,” such as Repetitive Transcranial Magnetic Stimulation (rTMS) and Deep Brain Stimulation (DBS), we found promising results in improving ED-related psychological traits (such as mood and anxiety), affective regulation, and quality of life. However, we have observed divergent results regarding outcome measures such as BMI and weight gain. Conclusions SE-AN patients are predicted to encounter both medical complications and psychological distress of increasing severity that will inevitably affect their quality of life; to our knowledge, research evidence on treatment options for SE-AN remains limited, and the methodological quality of studies is generally low. These findings denote the need to focus future research efforts on effective treatment strategies specific to long-lasting EDs.

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Section: Discussionmentioning

confidence: 99%

Severe enduring anorexia nervosa (SE-AN) treatment options and their effectiveness: a review of literature

Marcolini,

Ravaglia,

Tempia Valenta

et al. 2024

J Eat Disord

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“…Denial and minimization of illness is common among individuals with eating disorders (Starzomska & Tadeusiewicz, 2016 ; Viglione et al, 2006 ). Our findings indicate that raising the threshold for young people reduces false positives (fewer unnecessary additional assessments) at the expense of false negatives (more undetected cases).…”

Section: Discussionmentioning

confidence: 99%

How does the increase in eating difficulties according to the Development and Well‐Being Assessment screening items relate to the population prevalence of eating disorders? An analysis of the 2017 Mental Health in Children and Young People survey

O'Logbon

Newlove‐Delgado

McManus³

et al. 2022

Intl J Eating Disorders

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“…Consequently, they are likely to give up their struggle to regain health and normal life, sometimes applying for palliative care (Draper, 2000). It should be noted that eating disorders are chronic conditions which are not fully treatable, with the sufferers being haunted by the lingering spectre of relapse (Mander et al, 2013;Starzomska et al, 2020;Wildes et al, 2017). One of the numerous questions concerning the existential aspects of the functioning of persons with eating disorders is, beyond any doubt, the question of their perception of time.…”

Section: Introductionmentioning

confidence: 99%

Stuck in painful time: perception of time by individuals with eating disorders depending on their mood

Starzomska¹,

Sas²,

Rosińska³

et al. 2021

Psychiatr Psychol Kli

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Introduction: Eating disorders still pose a formidable challenge to health care professionals. The suffering of eating-disordered individuals may be profound, with the main contributing factors being low self-esteem, guilt and depression, a sense of hopelessness, and loneliness. The objective of the study was to determine how patients with eating disorders perceive time, and in particular whether their experience of time differs from that of healthy individuals. Another goal was to examine the relationship between the mood of the subjects and their time perspective. Materials and methods: The subjects were 30 women with eating disorders and 30 age-matched healthy female controls. The three measures applied were: the Time Metaphors Questionnaire by Małgorzata Sobol-Kwapińska, the Time Perspective Inventory by Philip Zimbardo, and the UWIST Mood Adjective Checklist (UMACL) by Gerald Matthews et al. Results: As expected, statistical analyses revealed that women with eating disorders were characterised by a more negative perception of time than healthy subjects. The study also confirmed the expected correlations between positive and negative time perceptions and mood. Conclusion: The results appear to have a considerable scholarly and practical value, and should be used in the psychotherapy of eating-disordered individuals focusing on existential aspects, including in particular topics regarding the experience of time by sufferers.

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Chronic anorexia nervosa: Patient characteristics and treatment approaches

Cited by 6 publications

References 37 publications

Severe enduring anorexia nervosa (SE-AN) treatment options and their effectiveness: a review of literature

Severe enduring anorexia nervosa (SE-AN) treatment options and their effectiveness: a review of literature

How does the increase in eating difficulties according to the Development and Well‐Being Assessment screening items relate to the population prevalence of eating disorders? An analysis of the 2017 Mental Health in Children and Young People survey

Stuck in painful time: perception of time by individuals with eating disorders depending on their mood

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