We need your ideas—How to deliver developmentally informed treatment and care for emerging adults with eating disorders? A special European Eating Disorder Research issue about age transitions in eating disorders

Herpertz‐Dahlmann, Beate; Schmidt, Ulrike

doi:10.1002/erv.2951

Cited by 5 publications

(3 citation statements)

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“…The framework of the interview was based on extensive clinical experience with patients in the transition process and literature research (Herpertz-Dahlmann & Schmidt, 2023). The interview questions were developed in collaboration between the both authors (the English translation of this interview can be found in the supplementary material together with the reflexivity statement).…”

Section: Interviewmentioning

confidence: 99%

“…The age at the transfer from a child and adolescent eating disorder service (CAEDS) to an adult service has traditionally been handled more strictly in Anglo‐Saxon countries such as the UK and Australia, as well as in Spain, where patients are asked to move to adult services at the age of 18; however, in other countries such as Italy, France, and Germany (but also currently in most child and adolescent mental health services [CAMHS] in the UK), this transfer is handled more flexibly (for more details, see Herpertz‐Dahlmann & Schmidt, 2023; Winston et al., 2023; Royal College of Psychiatrists, 2017). Patients and parents are often overwhelmed by the transition process; they complain of a lack of information, difficulties in accessing adult services, having too little time for preparation and insufficient support.…”

Section: Introduction and Aimsmentioning

confidence: 99%

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Lost in between–the transition process from a child and adolescent eating disorder service to adult mental health services in the German health care system

Gilsbach,

Borzikowsy,

Herpertz‐Dahlmann

2024

Euro Eating Disorders Rev

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IntroductionIn young adults with anorexia nervosa (AN), the process of transition from a child and adolescent mental health service (CAMHS) to an adult mental health service (AMHS) has been recognized as critical, and many patients fear falling through the gap between the two types of service. As reports about the transition process in emerging adults with AN are scarce, the present study aimed to explore the problems and experiences of this age group.MethodWe screened our registry for patients with AN who had been treated as inpatients during childhood and/or adolescence and come of age during the last 3 years. Thirty‐two female patients [mean age 20.3 (1.2) y.] agreed to participate in a semistructured personal or telephone interview assessing their demographic and clinical data, whether they had finalised the transition, and their wishes and experiences regarding the transition process.ResultsOnly approximately one‐third of the participants had already undergone the transition. Nearly 60% of the former patients were still cared for by a CAMHS, and only 12.5% had stopped treatment for AN. Approximately 60% were exclusively or additionally cared for by their general practitioner. More than 50% of the participants still lived with their parents. Approximately 90% of the participants who remained in a CAMHS expressed concerns about transitioning, mostly about losing their trusted therapist and the assumption of personal responsibility.ConclusionPatients with AN often delay the transition from a CAMHS to an AMHS, which they experience as intimidating and overwhelming. Thus, patients should be better prepared for the transition, which should be linked to “developmental readiness” and not to chronological age. Because many patients still live with their family of origin, parents and their family physician should be closely involved in the transition process.

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Section: Interviewmentioning

confidence: 99%

Section: Introduction and Aimsmentioning

confidence: 99%

Lost in between–the transition process from a child and adolescent eating disorder service to adult mental health services in the German health care system

Gilsbach,

Borzikowsy,

Herpertz‐Dahlmann

2024

Euro Eating Disorders Rev

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“…AN affects about 1.4% of young women and girls and 0.2% of boys and men at one point during their lifetime [ 2 ]. The typical onset age is between 14 and 22 years [ 3 ], and clinicians are thus often challenged with the decision of child- vs. adult-centered care, as many healthcare systems clearly distinguish between these services [ 4 ]. For patients treated at a transitional age, e.g., in late adolescence between ages 18 and 20, physicians and therapists may need to evaluate early treatment responses and take decisions with regard to the duration, intensity, and setting of treatment.…”

Section: Introductionmentioning

confidence: 99%

Exploring Gender Differences in Early Weight Change and Variability in Adolescents with Anorexia Nervosa during Inpatient Treatment

Halbeisen,

Braks,

Huber

et al. 2024

JCM

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Background: Adolescents’ early responses and overall outcomes during anorexia nervosa (AN) treatment may differ by patient gender, raising the question of whether evaluating clinical data during AN treatment may require different criteria. Methods: We investigated, using patient records, whether young men and young women with AN differed in terms of early treatment response (defined as weight change and variability within the first 14 days) and whether early treatment responses predicted treatment outcomes similarly across genders. Results: Weight changes predicted patient discharge weight across all gender groups. Weight variability predicted higher disordered eating psychopathology and higher body image insecurities at discharge. Gender differences emerged only for weight gain, which was more pronounced for young men, and gender modulated the effects of weight gain and variability on general psychopathology outcomes. Conclusions: The present findings suggest that early weight changes and weight variability are similarly important predictors of AN treatment outcomes in adolescents but also hint at possible gender differences in terms of the link between weight change and, respectively, variability on general psychopathology.

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The Maudsley model of anorexia nervosa treatment for adolescents and emerging adults: A multi‐centre cohort study

Wittek

Zeiler

Truttmann

et al. 2023

Euro Eating Disorders Rev

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ObjectiveThe aim of this study was examining the efficacy of the Maudsley Model of Anorexia Nervosa Treatment for Adolescents and Young Adults (MANTRa) compared to individual psychotherapy that can be considered as standard in Austria (TAU‐O).MethodIn this cohort study, 92 patients between 13 and 21 years suffering from full‐syndrome, atypical or weight‐restored anorexia nervosa (AN) received either 24–34 individual MANTRa sessions (n = 45) or TAU‐O (n = 47). Outcome variables were age‐ and sex‐related BMI, eating disorder and comorbid psychopathology at 6‐, 12‐ and 18‐month post baseline as well as acceptability of treatment and therapeutic alliance.ResultsBoth treatments resulted in significant improvements in age‐ and sex related BMI and reductions in eating disorder and comorbid psychopathology over time with significant differences between groups in favour of MANTRa. The percentage of participants with fully remitted AN was significantly higher in the MANTRa group compared to TAU‐O at 18‐month follow‐up (MANTRa: 46% vs. TAU‐O: 16%, p = 0.006). Satisfaction with both treatments was high.ConclusionsMANTRa is an effective treatment programme for adolescents and young adults with AN. Randomised controlled trials comparing MANTRa with existing treatments are necessary.Trial registrationThe trial was registered at clinicaltrials.gov (Identifier: NCT03535714).

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We need your ideas—How to deliver developmentally informed treatment and care for emerging adults with eating disorders? A special European Eating Disorder Research issue about age transitions in eating disorders

Cited by 5 publications

References 35 publications

Lost in between–the transition process from a child and adolescent eating disorder service to adult mental health services in the German health care system

Lost in between–the transition process from a child and adolescent eating disorder service to adult mental health services in the German health care system

Exploring Gender Differences in Early Weight Change and Variability in Adolescents with Anorexia Nervosa during Inpatient Treatment

The Maudsley model of anorexia nervosa treatment for adolescents and emerging adults: A multi‐centre cohort study

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