The impact of duration of illness on treatment nonresponse and drop‐out: Exploring the relevance of enduring eating disorder concept

Fernández‐Aranda, Fernando; Treasure, Janet; Paslakis, Georgios; Agüera, Zaida; Giménez, Mónica; Granero, Roser; Sánchez, Isabel; Serrano‐Troncoso, Eduardo; Gorwood, Philip; Herpertz‐Dahlmann, Beate; Bonin, Eva-Maria; Monteleone, Palmiero; Jiménez‐Murcia, Susana

doi:10.1002/erv.2822

Cited by 62 publications

(63 citation statements)

References 53 publications

(58 reference statements)

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“…Those who showed full or partial remission of their symptoms were included in the good outcome group (n = 166; 71.2%), and those who did not show remission or abandoned the treatment were included in the bad outcome group (n = 67; 28.8%). The treatment results obtained were similar to those reported previously [53].…”

Section: Treatmentsupporting

confidence: 90%

Neuropsychological Learning Deficits as Predictors of Treatment Outcome in Patients with Eating Disorders

et al. 2021

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Eating disorders (EDs) are severe psychiatric illnesses that require individualized treatments. Decision-making deficits have been associated with EDs. Decision-making learning deficits denote a lack of strategies to elaborate better decisions that can have an impact on recovery and response to treatment. This study used the Iowa Gambling Task (IGT) to investigate learning differences related to treatment outcome in EDs, comparing between patients with a good and bad treatment outcome and healthy controls. Likewise, the predictive role of impaired learning performance on therapy outcome was explored. Four hundred twenty-four participants (233 ED patients and 191 healthy controls) participated in this study. Decision making was assessed using the Iowa Gambling Task before any psychological treatment. All patients received psychological therapy, and treatment outcome was evaluated at discharge. Patients with bad outcome did not show progression in the decision-making task as opposed to those with good outcome and the healthy control sample. Additionally, learning performance in the decision-making task was predictive of their future outcome. The severity of learning deficits in decision making may serve as a predictor of the treatment. These results may provide a starting point of how decision-making learning deficits are operating as dispositional and motivational factors on responsiveness to treatment in EDs.

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Section: Treatmentsupporting

confidence: 90%

Neuropsychological Learning Deficits as Predictors of Treatment Outcome in Patients with Eating Disorders

et al. 2021

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“…The few studies that have considered treatment outcomes in PD, when compared with other EDs, suggest that PD has similar (relatively good) treatment outcomes to BN patients (MacDonald et al., 2017; MacDonald & Trottier, 2019; Tasca et al., 2012). However, consistent with other subthreshold EDs, PD groups demonstrate higher drop‐out rates (Riesco et al., 2018) and a greater risk for ED chronicity (Fernández‐Aranda et al., 2021). A study by our team, using a sample of 176 female patients diagnosed with OSFED (82 Atypical‐AN, 57 PD and 37 subthreshold BN [Sub‐BN]) found similar ED and general psychopathology symptoms and personality constellations at baseline and post‐treatment for these OSFED diagnoses.…”

Section: Introductionsupporting

confidence: 62%

“…(2013) who found a longer duration of illness in PD compared to both BN‐P and AN‐BP. Our findings may be explained by the fact that the presence of objective binge eating episodes, which are present in both BN and BED, are related to a more chronic illness course (Fernández‐Aranda et al., 2021). This could support the longer illness duration finding for the BN and BED groups in our study.…”

Section: Discussionmentioning

confidence: 82%

Where does purging disorder lie on the symptomatologic and personality continuum when compared to other eating disorder subtypes? Implications for the DSM

Krug

Giles

Granero

et al. 2021

Euro Eating Disorders Rev

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Objectives To assess the clinical significance and distinctiveness of purging disorder (PD) from other eating disorder (ED) diagnoses. Method Participants included 3127 women consecutively admitted to an ED treatment centre (246 PD, 465 anorexia nervosa restrictive [AN‐R], 327 AN‐binge purging [AN‐BP], 1436 bulimia nervosa [BN], 360 binge eating disorder [BED], 177 atypical AN and 116 unspecified feeding or eating disorder [UFED]) who were diagnosed according to DSM‐5 criteria. Additionally, 822 control participants were recruited from the community. All participants completed measures assessing ED symptoms (EDI‐2), general psychopathology (SCL‐90‐R) and personality (TCI‐R). Results Patients with PD, when compared to controls, scored significantly higher on the EDI‐2 and SCL‐90‐R, and most TCI‐R dimensions. Most of the significant differences between PD and the other ED diagnoses emerged between PD and AN‐R, followed by Atypical‐AN, UFED, AN‐BP and BED, with patients with PD typically reporting higher scores on the EDI‐2 and SCL‐90‐R subscales. Significant differences between PD and BN were also present, but to a lesser extent. The findings for personality varied amongst the different ED diagnoses. Conclusions PD is a clinically significant disorder, which seems to be more similar to BN than it is to AN and the other ED subtypes.

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“…Although patients with BN, BED, and OSFED were placed in separate groups of therapy, all the treatment groups were based on the same CBT program. This program and its complementary material have already been manualized and published in Spanish [47] with demonstrated effectiveness [48][49][50][51].…”

Section: Treatmentmentioning

confidence: 99%

Lifetime Weight Course as a Phenotypic Marker of Severity and Therapeutic Response in Patients with Eating Disorders

et al. 2021

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The association between lifetime weight fluctuations and clinical characteristics has been widely studied in populations with eating disorders (ED). However, there is a lack of literature examining the potential role of weight course as a transdiagnostic factor in ED so far. Therefore, the aim of this study is to compare ED severity and treatment outcomes among four specific BMI profiles based on BMI-trajectories across the lifespan: (a) persistent obesity (OB-OB; (n = 74)), (b) obesity in the past but currently in a normal weight range (OB-NW; n = 156), (c) normal weight throughout the lifespan (NW-NW; n = 756), and (d) current obesity but previously at normal weight (NW-OB; n = 314). Lifetime obesity is associated with greater general psychopathology and personality traits such as low persistence and self-directedness, and high reward dependence. Additionally, greater extreme weight changes (NW-OB and OB-NW) were associated with higher psychopathology but not with greater ED severity. Higher dropout rates were found in the OB-OB group. These results shed new light on the BMI trajectory as a transdiagnostic feature playing a pivotal role in the severity and treatment outcome in patients with ED.

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The impact of duration of illness on treatment nonresponse and drop‐out: Exploring the relevance of enduring eating disorder concept

Cited by 62 publications

References 53 publications

Neuropsychological Learning Deficits as Predictors of Treatment Outcome in Patients with Eating Disorders

Neuropsychological Learning Deficits as Predictors of Treatment Outcome in Patients with Eating Disorders

Where does purging disorder lie on the symptomatologic and personality continuum when compared to other eating disorder subtypes? Implications for the DSM

Lifetime Weight Course as a Phenotypic Marker of Severity and Therapeutic Response in Patients with Eating Disorders

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