Staging anorexia nervosa: conceptualizing illness severity

Maguire, Sarah; Grange, Daniel Le; Surgenor, Lois J.; Marks, Peta; Lacey, Hubert; Touyz, Stephen

doi:10.1111/j.1751-7893.2007.00049.x

Cited by 39 publications

(39 citation statements)

References 60 publications

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“…In contrast, Hasler et al [143] observed that the stages of change are an independent dimension. Maguire et al [132] noted that an individual’s stage of change is only one marker of the illness within a variety of different disease presentations. An individual can be at severe medical risk as a consequence of AN, yet still present in a highly motivated stage of change.…”

Section: Resultsmentioning

confidence: 99%

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Staging of Mental Disorders: Systematic Review

Cosci

Fava

2012

Psychother Psychosom

210

224

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Background: The staging method, whereby a disorder is characterized according to its seriousness, extension, development and features, is attracting increasing attention in clinical psychology and psychiatry. The aim of this systematic review was to critically summarize the tools that are available for reproducing and standardizing the clinical intuitions that are involved in a staging formulation. Methods: A comprehensive research was conducted on the MEDLINE, PsycINFO, EMBASE and Cochrane databases from inception to May 2012. The following search terms were used: ‘stage/staging’ AND ‘psychiatric disorder/mental disorder/schizophrenia/mood disorder/anxiety disorder/substance use disorder/eating disorder’. Results: A total of 78 studies were identified for inclusion in the review. We discussed studies addressing or related to the issue of staging in a number of mental disorders (schizophrenia, unipolar depression, bipolar disorder, panic disorder, substance use disorders, anorexia and bulimia nervosa). The literature indicates that disorders have a longitudinal development or a treatment history that can be categorized according to stages. We proposed staging formulations for the above-mentioned psychiatric disorders. Conclusion: Staging models offer innovative assessment tools for clinical psychologists and psychiatrists. Characterizing each stage of an illness demarcates major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same psychiatric diagnosis. A stage 0 to denote an at-risk condition does not appear to be warranted at the current state of research.

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Section: Resultsmentioning

confidence: 99%

“…More recently, Maguire et al [132] proposed a staging model of AN which took into account the severity and duration of the illness.…”

Section: Resultsmentioning

confidence: 99%

Staging of Mental Disorders: Systematic Review

Cosci

Fava

2012

Psychother Psychosom

210

224

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“…The process of revising the DSM-IV [6] criteria for DSM-5 resulted in a re-examination of the validity of the AN-R/AN-BP subtyping scheme as well as consideration of alternative subgrouping or staging strategies [7–9]. The AN-R and AN-BP subtypes were retained in DSM-5 given higher levels of suicidality [10,11], impulsivity and substance use [11–14], and co-occurring psychiatric symptoms [15–17] reported in AN-BP compared to AN-R samples.…”

Section: Introductionmentioning

confidence: 99%

“…Taxometric studies have yielded inconsistent findings about whether AN-R and AN-BP (and bulimic behavior more generally) are distinct entities or exist on a continuum [25,26], with some evidence from taxometric and latent structure analyses suggesting that AN-BP is more similar to bulimia nervosa than to AN-R [27–29]. In addition, considerable data suggest that subtypes remain inconsistent over time, with individuals with AN-R often crossing over into the AN-BP classification [7,18,30]. …”

Section: Introductionmentioning

confidence: 99%

Examining the utility of narrowing anorexia nervosa subtypes for adults

Peterson

Pisetsky

Swanson

et al. 2016

Comprehensive Psychiatry

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Objective The purpose of this investigation was to examine whether narrowing the criteria of anorexia nervosa (AN) subtypes among adults based on further delineations of current binge eating and purging (i.e., binge eating only, purging only, binge eating and purging, and restricting only) improves the potential clinical utility of the current DSM-5 system that specifies two types (i.e., current binge eating and/or purging and restricting, specified as the absence of current binge eating and/or purging). Method Self-reported eating disorder and psychiatric symptoms based on the Eating Disorder Questionnaire were examined in 347 adults from a multisite clinical sample who met DSM-IV criteria for AN. Classification based on binge eating and purging symptoms yielded the following subtypes: 118 restricting only (AN-R; no current binge eating or purging); 133 binge eating and purging (AN-B & P; current binge eating and purging); 43 binge eating only (AN-B; current binge eating and no current purging); and 53 purging only (AN-P; current purging and no current binge eating). Results The AN-R group had lower current body mass index compared to AN-B & P and AN-P with no group differences in highest, lowest, or desired body mass index. The probability of amenorrhea was higher for the AN-R and AN-B & P groups than the AN-P group. The probability of diet pill use was elevated for the AN-B & P and AN-P groups compared to the AN-R group. The AN-P group also had a higher probability of fasting than the AN-R group. The probability of substance use including tobacco was lower in the AN-R group than the other three groups. No group differences were found on measures of hospitalization, body image, physical symptoms, exercise, or dieting behaviors. Conclusions These findings do not support the validity or clinical utility of classifying AN into narrower subtypes based on current binge eating, purging, and binge eating with purging given that few differences were found among groups who reported any combination of current binge eating and purging. Future research is needed to replicate these findings and to further examine the AN subtype classification schemes.

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“…Research may be aided by comparing subcategories within the present diagnoses. Moreover, it might be useful to consider whether other dichotomies, such as mild and severe or acute and chronic, might be a more practical way to classify eating disorders (Maguire, Le Grange, Surgenor, Marks, Lacey, & Touyz, 2008). Comparing males with females, different ages of onset or precipitating factors, or experimentally different groups may help reveal the causal pathways of eating disorders.…”

Section: Resultsmentioning

confidence: 99%