The dearth of psychological treatment studies for anorexia nervosa

Grange, Daniel Le; Lock, James

doi:10.1002/eat.20085

Cited by 87 publications

(62 citation statements)

References 49 publications

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“…In the present review 9 RCTs were found, a number higher than that found in a systematic review conducted for AN treatment in childhood and adolescence, published in 2005, which found only five studies with this design 11 . Although the RCT design is considered to be the gold standard for evaluating the efficacy of treatments, among the studies analyzed, several methodological limitations have decreased the quality of the scientific evidence produced.…”

Section: Designcontrasting

confidence: 60%

“…However, given the limited number of studies and various methodological limitations found, it is not possible to make a conclusion on the efficacy of the interventions. This aspect, as already identified in a previous review 11 , remains stable and constitutes an important limitation in the field of ED in childhood and adolescence.…”

Section: Resultsmentioning

confidence: 67%

“…The use of proven effective treatments by the respective health care professionals, is therefore fundamental. However, due to the complex interaction of clinical and psychiatric problems, with emphasis on the ambivalent attitudes of patients and their families towards treatment 8,10 , there are significant obstacles that moderate the effectiveness of psychotherapeutic interventions and contribute to a limited number of studies in the area 11,12 .…”

Section: Introductionmentioning

confidence: 99%

“…Another systematic review conducted in 2005 on the treatment of AN in childhood and adolescence only found five available randomized controlled trials (RCTs) 11 . The analysis of the results of these RCTs showed an intermediate or good outcome 17 ranging from 47% 18 to 90% 19 among participants submitted to family-based treatment (adolescent and family members together) and between 18% and 90% for individual treatment or those involving adolescents and families, separately.…”

Section: Introductionmentioning

confidence: 99%

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Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Alckmin-Carvalho

Vega

Cobelo

et al. 2018

Arch. Clin. Psychiatry (São Paulo)

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Background: Efficacy studies on the treatment of anorexia nervosa (AN) in childhood and adolescence are scarce and systematic reviews are almost non-existent. Objective: Systematic review of the literature regarding the modalities of psychological intervention based on evidence used in the treatment of AN in childhood and adolescence. Methods: The research was carried out in the databases: PubMed, PsycINFO and Cochrane, using the combined keywords: anorexia nervosa and evidence-based therapy. Articles published between 1990 and 2015 were assessed. Results: Of the 139 eligible articles, 14 were selected, of which 10 (71.4%) were conducted in the United States and England. The sample ranged from 9 to 167 participants. Randomized Clinical Trial represented the most frequent design (n = 9; 63.4%), with more than half of the interventions structured in 20 or more sessions (n = 9, 64.3%). Nine types of treatments were tested, with the most tested being Family-Based Treatment (FBT) (n = 7; 50%). Interventions involving the family seem to be more effective, however, the rates for complete remission are modest. Discussion: Although evidence of efficacy was verified in the treatments analyzed, the limited number of studies, the various methodological limitations and the methodological heterogeneity between studies make the findings inconclusive.

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Section: Designcontrasting

confidence: 60%

Section: Resultsmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Alckmin-Carvalho

Vega

Cobelo

et al. 2018

Arch. Clin. Psychiatry (São Paulo)

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“…These considerations, however, do not negate the need for effectiveness research (Milne & Paxton, 1998), particularly with adult inpatient populations where the few existing studies show how poorly adult anorexics fare in treatment compared with their adolescent counterparts (Le Grange & Lock, 2005). Recent increases in mid-life eating disorder cases have also spurred interest in the characteristics and needs of older patients with AN (Cumella & Rally, 2008).…”

Section: Introductionmentioning

confidence: 96%

Treatment of chronic anorexia nervosa: a 4‐year follow‐up of adult patients treated in an acute inpatient setting

Long

Fitzgerald

Hollin

2011

Clin Psychology and Psychoth

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Despite evidence from a number of long-term follow-up studies of anorexia nervosa that nearly 50% of patients eventually make a full recovery, controlled trials of psychotherapy for anorexia nervosa are lacking. Those with severe and enduring problems represent a considerable therapeutic challenge. Thirty-four consecutive adult referrals to the inpatient treatment unit who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria for anorexia nervosa were examined pre-admission, post-discharge and 4 years after admission. Characteristics of remitted and non-remitted patients were examined. Secondary analyses considered the differences between patients with anorexia nervosa, restricting type and anorexia nervosa binging/purging type. The findings highlight a number of differences between patients with anorexia nervosa (restricting type) versus anorexia nervosa (binging/purging type) as well as remitted versus non-remitted patients. The use of a comprehensive battery of assessments found that resolution of eating disorder symptomatology was paralleled by improvements in emotional and psychological distress and improvement in body image perception and coping skills. Better results were obtained for those who had continuity of care on an outpatient basis. This pattern is particularly significant given the more 'chronic' nature of the sample that were older, with a higher incidence of binge-eating and purging than previous samples. Results provide some encouragement for the treatment of those adults with anorexia nervosa who typically have less favourable outcomes.

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Family therapy for anorexia nervosa

Fisher¹,

Rushford²,

Hetrick³

2004

Cochrane Database of Systematic Reviews

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The dearth of psychological treatment studies for anorexia nervosa

Abstract: The review highlights the effectiveness of one particular treatment modality for adolescents, but emphasizes the compelling need for further and larger systematic investigation into treatments for both adolescent and adult AN.

Cited by 87 publications

References 49 publications

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Treatment of chronic anorexia nervosa: a 4‐year follow‐up of adult patients treated in an acute inpatient setting

Family therapy for anorexia nervosa

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