Clinical Observations of the Impact of Maudsley Therapy in Improving Eating Disorder Symptoms, Weight, and Depression in Adolescents Receiving Treatment for Anorexia Nervosa

Abstract

This article describes a comparison of adolescent patients with a diagnosis of anorexia nervosa receiving treatment with and without family-based therapy. Sixteen patients with anorexia nervosa were evaluated and compared pretreatment and post-treatment. The family-based program used is an adaptation of the Maudsley approach; a parallel treatment program used the standard multidisciplinary treatment at Rogers Memorial Hospital. The outcome measures in both programs were depression, eating disorder symptoms, weight, and body mass index. Individuals treated with the Maudsley approach made significant improvements in all outcomes measured. These preliminary findings support the notion that parental involvement in the treatment of anorexia nervosa is effective in significantly reducing overall eating disorder behaviors, decreasing symptoms of depression, and improving weight.

Naturalistic outcomes for a day‐hospital programme in a mixed diagnostic sample of adolescents with eating disorders

“…Mean levels of eating disorder symptoms, as indicated by the EDE‐Q (see Table ), were consistent with past studies in DHP or residential samples that used the same measurement (range = 2.60–3.80; Bean, Louks, Kay, Cornella‐Carlson, & Weltzin, ; Hoste, ; Rienecke et al, 2018). Past treatment outcomes studies in nonunderweight, outpatient samples that used the EDE‐Q also reported similar global means (range = 2.79–3.60; Dalle Grave, Calugi, Doll, & Fairburn, ; Dalle Grave, Calugi, Sartirana, & Fairburn, ).…”

Augmentative Approaches in Family‐Based Treatment for Adolescents with Restrictive Eating Disorders: A Systematic Review

“…As demonstrated in Table , there was considerable variability in the content, structure, and mode of delivery of the described interventions. The specific reasons for the application of an augmentative FBT approach could not be determined in one study reporting on the combination of separated and conjoint FBT (Paulson‐Karlsson et al, ), nor could the reasons for which patients were referred to a FBT‐based partial hospitalisation program rather than to outpatient therapy in another study by Bean, Louks, Kay, Cornella‐Carlson, and Weltzin (). Further, while several partial hospitalisation or intensive outpatient programs were described as designed for adolescents requiring a more intensive level of care for severe ED symptoms, it was not clear as to how the severity of such presentations was determined (Girz et al, ; Hoste, ; Rienecke et al, ; Robinson et al, ).…”

“…Two studies reported on different samples participating in the same partial hospitalisation program (Hoste, ; Rienecke et al, ). All such studies except one (Bean et al, ) were described as designed for patients and families requiring a higher‐intensity level of care due to medical instability or more severe ED symptom severity.…”

“…Of the remaining three comparative studies, two included non‐FBT based control conditions. Firstly, in a retrospective case–control study of 16 AN patients, Bean et al () reported equivalent weight improvements between patients attending a 10‐week FBT‐based or non‐FBT‐based partial hospitalisation program. While both groups had similarly significant reductions in depressive symptoms, ED symptom improvements at EOT were significantly greater among those attending the FBT‐based program.…”

Family‐based treatment for adolescent anorexia nervosa: What happens to rates of comorbid diagnoses?

“…Although research supports the efficacy of a focused family intervention for adolescents with AN, little is known about the impact of this treatment on comorbid psychiatric conditions. There is evidence that depressive symptoms improve after FBT for adolescents with AN, perhaps in part due to improved nutrition and weight gain during FBT (Accurso, Ciao, Fitzsimmons‐Craft, Lock, & Le Grange, ; Bean, Louks, Kay, Cornella‐Carlson, & Weltzin, ; Le Grange et al, ). Similarly, increases in positive affect and decreases in negative affect are evident after both FBT and a separated format of FBT, parent‐focused treatment (PFT; Murray, Pila, Le Grange, Sawyer, & Hughes, ).…”