Inpatient treatment has no impact on the core thoughts and perceptions in adolescents with anorexia nervosa

Fennig, Silvana; Klomek, Anat Brunstein; Shahar, Ben; Sarel-Michnik, Zohar; Hadas, Arie

doi:10.1111/eip.12234

Cited by 38 publications

(34 citation statements)

References 36 publications

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“…These findings are in line with a recent study in adolescent AN inpatients (Fennig, Brunstein Klomek, Shahar, Sarel-Michnik, & Hadas, 2017) in which improvement in BMI during inpatient treatment was correlated with improvement in restraint and eating concern, but not in body dissatisfaction and weight/shape concerns. Moreover, at discharge from inpatient treatment, when achieving recovery of weight and stabilization of disordered eating, the suicidal ideation of these patients actually increased (Fennig et al, 2017). Similarly, adult ED patients have shown a correlation between suicidal ideation and preoccupation with weight and shape (Milos, Spindler, Hepp, & Schnyder, 2004).…”

Section: Discussionsupporting

confidence: 92%

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Shilton

Enoch‐Levy

Giron

et al. 2019

Intl J Eating Disorders

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Objective Major depressive disorder (MDD) is common in anorexia nervosa (AN), associated with worse outcome and greater suicide risk. Electroconvulsive therapy (ECT) is highly effective in the treatment of MDD refractory to antidepressive treatment. We describe a case series of female adolescents with AN receiving ECT for MDD resistant to treatment and/or with severe suicide risk. Method We retrospectively analyzed the files of all 30 adolescent females hospitalized in our department because of AN between 1998 and 2017 and treated with ECT. Severity of eating disorder (ED) and depressive symptoms was retrospectively assessed using the Clinical Global Impression‐Severity Scale. Results Patients were severely depressed and suicidal on admission. All were resistant to antidepressants. A significant deterioration in depression, with severe suicidality, occurred from admission to pre‐ECT, with concomitant improvement in ED symptoms and increase in body mass index (BMI). Significant improvement in depressive and ED symptoms and increase in BMI occurred following ECT, continuing to discharge. Adverse effects were mostly minimal. Fifty‐three percentage of the patients were rehospitalized within the first year after ECT, mostly because of deterioration of depression and attempted suicide. Several years after discharge, 46.6% of the patients had no evidence of depression, suicidality, and ED‐symptomatology, and another 23% had only evidence of ED symptomatology. Discussion ECT is safe and well tolerated in AN with severe comorbid treatment resistant MDD and/or with increased suicide risk. Many AN patients undergoing ECT may be remitted at long‐term follow‐up.

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Section: Discussionsupporting

confidence: 92%

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Shilton

Enoch‐Levy

Giron

et al. 2019

Intl J Eating Disorders

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“…These results agree with other previous studies in which no significant improvement was obtained after weight recovery in adolescents with AN. 12,37 However, Iniesta Sepúlveda et al 10 observed a decrease in core pathological features, while Hatch et al 11 obtained improvements in only two of the five psychopathological variables. Several studies have reported the existing gap between physical recovery and psychological change since they did not find significant associations between them, 12,34 which could explain the high rate of relapse of AN after discharge from inpatient units.…”

Section: Discussionmentioning

confidence: 98%

“…Some studies found an improvement in general psychopathology, 10,11 while others did not find changes despite weight recovery. 12 Likewise, research on the efficacy and impact of interventions for AN should include evaluation of body image disturbance, in addition to changes in weight and medical stability. 13 An increase in physical activity (PA) can be considered a significant factor for the onset and maintenance of the illness.…”

Section: Introductionmentioning

confidence: 99%

Clinical, Psychopathological, Physical, and Sleep Evolution in Adolescents with Restrictive Anorexia Nervosa Participating in a Day Hospital Program

Martínez-Sánchez¹,

Martínez-García²,

Munguía‐Izquierdo

2020

Psychiatry Investig

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Objective To analyze the clinical, psychopathological, physical, and sleep-related evolution of adolescents with restricting-type of anorexia nervosa (AN-R) after 10 weeks of a daytime hospital program.Methods Body composition, physical activity and sleep were measured objectively before and after 10 weeks of treatment. In addition, psychopathology and body image disturbances were measured with a self-report questionnaire.Results Fourteen female adolescents with AN-R (14.3±1.6 years old) participated in the study. A significant increase was found in eight of the ten variables for body composition (p<0.05). There were no significant changes in psychopathology, body image disturbances or physical activity. Concerning sleep, a significant, moderately standardized and substantial increase in night latency was found (p=0.002), and there was a significant, small standardized and substantial decrease in night efficiency (p=0.035).Conclusion After 10 weeks of follow-up with adolescent patients with AN-R who attended a day hospital program, there was a positive evolution of body composition. However, with regard to sleep patterns, there was a worsening of latency and night efficiency. Therefore, sleep care should be addressed in acute treatment programs for adolescents with AN-R.

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“…In understanding this behaviour, it is necessary to acknowledge that consumers with AN experience internal turmoil and distress from weight gain throughout hospitalization (Fennig et al . ). Nurses then experience challenges when delivering care that is not necessarily agreed to by the consumer.…”

Section: Introductionmentioning

confidence: 97%

Dynamics of nurses’ authority in the inpatient care of adolescent consumers with anorexia nervosa: A qualitative study of nursing perspectives

Zugai

Stein‐Parbury

Roche

2019

Int J Mental Health Nurs

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Nurses caring for adolescent consumers with anorexia nervosa in the inpatient setting are challenged in a unique way, in that they are caring for people with whom they do not have a mutually held concept of well-being. Their efforts to ensure weight gain are frequently against the wishes of the consumer. This dissonance results in challenging interactions, where nursing care and authority may be undermined. This study investigated the dynamics of nurses' authority within this context. Interviews with nurses (n = 10) were conducted and analysed through thematic analysis. Nurses reported that consumers, compelled by the psychopathology of anorexia nervosa, often sought to challenge or undermine their authority. Some nurses experienced the opposition and conflict as demoralizing, whereas others were able to maintain confidence in the therapeutic merit of their care. Younger, inexperienced nurses in this study were particularly vulnerable to interactions that mitigated their authority, due to their tendency to engage in friendlike relationships. Nurses caring for adolescents with anorexia nervosa should be prepared to be confronted by interactions that overtly and surreptitiously undermine their capacity to exercise professional authority. It is important that nurses recognize the importance of maintaining their authority, and how it can be threatened in subtle and unexpected ways.

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Inpatient treatment has no impact on the core thoughts and perceptions in adolescents with anorexia nervosa

Cited by 38 publications

References 36 publications

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

A retrospective case series of electroconvulsive therapy in the management of comorbid depression and anorexia nervosa

Clinical, Psychopathological, Physical, and Sleep Evolution in Adolescents with Restrictive Anorexia Nervosa Participating in a Day Hospital Program

Dynamics of nurses’ authority in the inpatient care of adolescent consumers with anorexia nervosa: A qualitative study of nursing perspectives

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