Disorders - eating disorders
Bird, E. L., Halliwell, E., Diedrichs, P.
C., Harcourt, D.
This study evaluated an adapted version of 'Happy Being Me', a school-based body image
intervention, with girls and boys aged 10-11 years. Forty-three children participated in a three-week intervention, and 45 children formed a control
group. Both groups completed measures of body satisfaction, risk factors for negative body image, eating behaviors, self-esteem, and intervention
topic knowledge, at baseline, post-intervention, and 3-month follow-up. For girls, participation in the intervention resulted in significant
improvements in body satisfaction, appearance-related conversations, appearance comparisons, eating behaviors and intervention topic knowledge at
post-intervention, although only the change in body satisfaction was maintained. There was also a significant decrease in internalization of cultural
appearance ideals from baseline to follow-up. For boys, participation in the intervention resulted in significant improvements in internalization and
appearance comparisons at post-intervention; however, neither of these changes were sustained at follow-up. There were no improvements in the control
group over time. (copyright) 2013 Elsevier Ltd.
Body Image, 10(3) : 326-
334
- Year: 2013
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Couturier, J., Kimber, M., Szatmari, P.
Objective: To systematically review and quantitatively evaluate the efficacy of
Family-Based Treatment (FBT) compared with individual treatment among adolescents with eating disorders. Method: The literature was reviewed using
the MEDLINE search terms \"family therapy AND Anorexia Nervosa,\" and \"family therapy AND Bulimia Nervosa\". This produced 12 randomized controlled
trials involving adolescents with eating disorders and family therapy which were reviewed carefully for several inclusion criteria including:
allocation concealment, intent-to-treat analysis, assessor blinding, behavioral family therapy compared with an individual therapy, and adolescent
age group. References from these articles were searched. Only three studies met these strict inclusion criteria for meta-analysis. A random effects
model and odds ratio was used for meta-analysis, looking at \"remission\" as the outcome of choice. Results: When combined in a meta-analysis, end of
treatment data indicated that FBT was not significantly different from individual treatment (z = 1.62, p = 0.11). However, when follow-up data from 6
to 12 months were analyzed, FBT was superior to individual treatment (z = 2.94, p < 0.003), and heterogeneity was not significant (p = 0.59).
Discussion: Although FBT does not appear to be superior to individual treatment at end of treatment, there appear to be significant benefits at 6-12
month follow-up for adolescents suffering from eating disorders. (copyright) 2012 by Wiley Periodicals, Inc.
International Journal of Eating Disorders, 46(1) : 3-
11
- Year: 2013
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Family therapy
Dancyger, I., Krakower, S., Fornari, V.
In clinical practice, psychodynamic approaches represent an important component
of the treatment for young people with eating disorders (EDs), even though the research literature remains modest regarding the most effective
treatment for children, adolescents, or adults with an ED. Although there are very few clinical research studies of individual or family
psychodynamic treatments of EDs, there is some evidence for efficacy from clinical trials. This article reviews studies of psychodynamically informed
therapies for the treatment of EDs and discusses how the findings, although limited, suggest that further research into psychodynamic treatments of
EDs in youth is warranted. (copyright) 2013 Elsevier Inc.
Child & Adolescent Psychiatric Clinics of North America, 22(1) : 97-
117
- Year: 2013
- Problem: Eating Disorders
(any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Psychodynamic/Psychoanalysis
Dalle-Grave, R., Calugi, S., Conti, M., Doll, H., Fairburn, C. G.
Background: The aim of this study was to compare the immediate and
longer-term effects of two cognitive behaviour therapy programmes for hospitalized patients with anorexia nervosa, one focused exclusively on the
patients' eating disorder features and the other focused also on mood intolerance, clinical perfectionism, core low self-esteem or interpersonal
difficulties. Both programmes were derived from enhanced cognitive behaviour therapy (CBT-E) for eating disorders. Methods: Eighty consecutive
patients with severe anorexia nervosa were randomized to the two inpatient CBT-E programmes, both of which involved 20 weeks of treatment (13 weeks
as an inpatient and 7 as a day patient). The patients were then followed up over 12 months. The assessments were made blind to treatment condition.
Results: Eighty-one percent of the eligible patients accepted inpatient CBT-E, of whom 90% completed the 20 weeks of treatment. The patients in both
programmes showed significant improvements in weight, eating disorder and general psychopathology. Deterioration after discharge did occur but it was
not marked and it was restricted to the first 6 months. There were no statistically significant differences between the effects of the two
programmes. Conclusions: These findings suggest that both versions of inpatient CBT-E are well accepted by these severely ill patients and might be a
viable and promising treatment for severe anorexia nervosa. There appears to be no benefit from using the more complex form of the treatment.
Copyright (copyright) 2013 S. Karger AG, Basel.
Psychotherapy & Psychosomatics, 82(6) : 390-398
- Year: 2013
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
DeBar, L. L., Wilson, G.
T., Yarborough, B. J., Burns, B., Oyler, B., Hildebrandt, T., Clarke, G. N., Dickerson, J., Striegel, R. H.
There is a need for treatment interventions to address the high prevalence of disordered eating throughout adolescence
and early adulthood. We developed an adolescent-specific manualized CBT protocol to treat female adolescents with recurrent binge eating and tested
its efficacy in a small, pilot randomized controlled trial. We present lessons learned in recruiting adolescents, a description of our treatment
approach, acceptability of the treatment for teens and parents, as well as results from the pilot trial. Participants in the CBT group had
significantly fewer posttreatment eating binges than those in a treatment as usual/delayed treatment (TAU-DT) control group; 100% of CBT participants
were abstinent at follow-up. Our results provide preliminary support for the efficacy of this adolescent adaptation of evidence-based CBT for
recurrent binge eating. The large, robust effect size estimate observed for the main outcome (NNT. =. 2) places this among the larger effects
observed for any mental health intervention. (copyright) 2012.
Cognitive & Behavioral Practice, 20(2) : 147-
161
- Year: 2013
- Problem: Eating Disorders
(any), Binge Eating Disorders
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Fichter, M. M., Quadflieg, N., Lindner, S.
Background: To study the longer term effects of an internet-based CBT
intervention for relapse prevention (RP) in anorexia nervosa.Methods: 210 women randomized to the RP intervention group (full and partial completers)
or the control group were assessed for eating and general psychopathology. Multiple regression analysis identified predictors of favorable course
concerning Body Mass Index (BMI). Logistic regression analysis identified predictors of adherence to the RP program.Results: Most variables assessed
showed more improvement for the RP than for the control group. However, only some scales reached statistical significance (bulimic behavior and
menstrual function, assessed by expert interviewers blind to treatment condition). Very good results (BMI) were seen for the subgroup of \" full
completers\" who participated in all nine monthly RP internet-based intervention sessions. \" Partial completers\" and controls (the latter non-
significantly) underwent more weeks of inpatient treatment during the study period than \" full completers\" , indicating better health and less need
for additional treatment among the \" full completers\" Main long-term predictors for favorable course were adherence to RP, more spontaneity, and
more ineffectiveness. Main predictors of good adherence to RP were remission from lifetime mood and lifetime anxiety disorder, a shorter duration of
eating disorder, and additional inpatient treatment during RP.Conclusions: Considering the high chronicity of AN, internet-based relapse prevention
following intensive treatment appears to be promising. (copyright) 2013 Fichter et al.; licensee BioMed Central Ltd.
Journal of Eating
Disorders, 1(1) :
- Year: 2013
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Relapse prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Lebow, J., Sim, L. A., Erwin, P.J., Murad, M. H.
Objective: Given that atypical antipsychotic medications have been increasingly prescribed for improving weight gain in anorexia nervosa
(AN), we conducted a systematic review and meta-analyses to estimate the influence of atypical antipsychotics on BMI, eating disorder, and
psychiatric symptoms in individuals with AN.; Method: Independent reviewers selected studies and extracted study characteristics, methodologic
quality, and outcomes for the intention-to-treat group from randomized clinical trials comparing the effect of atypical antipsychotic use to placebo
or an active control treatment on BMI.; Results: Compared with placebo, atypical antipsychotics were associated with a nonsignificant increase in BMI
(weighted mean difference, WMD = 0.18, 95% CI: -0.36, 0.72; I(2) = 26%) and a nonsignificant effect on the drive for thinness and body
dissatisfaction. Compared with placebo or active control, these medications led to an increase in anxiety and overall eating disorder symptoms.
However, there was a significant reduction over placebo or active control on level of depression.; Copyright © 2012 Wiley Periodicals, Inc.
International Journal of Eating
Disorders, 46(4) : 332-339
- Year: 2013
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation)
Lock, J., Agras, W. S., Fitzpatrick, K. K., Bryson, S. W., Jo, B., Tchanturia, K.
Objective There are limited data supporting specific treatments for adults with anorexia nervosa (AN). Randomized clinical trials (RCTs)
for adults with AN are characterized by high attrition limiting the feasibility of conducting and interpreting existing studies. High dropout rates
may be related to the inflexible and obsessional cognitive style of patients with AN. This study evaluated the feasibility of using cognitive
remediation therapy (CRT) to reduce attrition in RCTs for AN. Method Forty-six participants (mean age of 22.7 years and mean duration of AN of 6.4
years) were randomized to receive eight sessions of either CRT or cognitive behavioral therapy (CBT) over 2 months followed by 16 sessions of CBT for
4 months. Results During the 2-month CRT vs. CBT treatment, rates of attrition were lower in CRT (13%) compared with that of CBT (33%). There were
greater improvements in cognitive inefficiencies in the CRT compared with that of the CBT group at the end of 2 months. There were no differences in
other outcomes. Discussion These results suggest that CRT is acceptable and feasible for use in RCTs for outpatient treatment of AN. CRT may reduce
attrition in the short term. Adequately powered future studies are needed to examine CRT as an outpatient treatment for AN. (copyright) 2013 by Wiley
Periodicals, Inc. (Int J Eat Disord 2013; 46:567-575) Copyright (copyright) 2013 Wiley Periodicals, Inc., A Wiley Company.
International Journal of Eating Disorders, 46(6) : 567-
575
- Year: 2013
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Cognitive remediation
therapy
Loria-Kohen, V., Gomez-Candela, C., Palma-Milla, S., Amador-Sastre, B., Hernanz, A., Bermejo, L. M.
Background& Aims: Several authors have reported low folate intake in patients with eating disorders (ED). This
vitamin plays an essential role in synthesis reactions for neurotransmitters and structural elements of neurons, and therefore its deficiency has
been associated with the presence of different disorders linked to mental function. The aim of this study was to determine the effect of folic acid
supplementation on homocysteine levels and the cognitive and depressive status of a group of patients with eating disorders with low folate intake.;
Subjects/methods: The study was designed as a randomised, prospective clinical trial, which included 24 participants assigned to two treatment groups
for six months: supplemented group (SG) (10 mg/day of folic acid [ACFOL]) and a placebo group (PG). Both groups maintained their medical, dietary and
psychological treatment. At baseline and end of the intervention, anthropometric, dietary and biochemical parameters (plasma homocysteine [Hcy],
serum and red blood cell folate) were recorded. Cognitive and depressive status questionnaires were administered (Stroop Test, Trail Making Test and
Beck Depression Inventory).; Results: Twenty-two patients completed the study (SG: 12, PG: 10, mean age: 24.2 ± 8.8 years, BMI 18.9 ± 3.5 kg/m2). The
SG significantly increased their serum and red blood cell folate levels and lowered Hcy levels (9.4 ± 2.4 µmol/l vs. 7.5 ± 1.7 µmol/l, P < 0.01). The
SG also significantly improved most of their test scores for cognitive and depressive status. The PG showed no significant changes in any of the
evaluated variables.; Conclusions: The results show that folic acid supplementation may be used as another tool within the comprehensive and
multidisciplinary treatment applied to patients with ED.; Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.
Nutrición Hospitalaria, 28(3) : 807-815
- Year: 2013
- Problem: Eating Disorders
(any)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Vitamins and supplements
Marco, J. H., Perpina, C., Botella, C.
Body image disturbance is a significant maintenance and prognosis factor in eating disorders. Hence, existing
eating disorder treatments can benefit from direct intervention in patients' body image. No controlled studies have yet compared eating disorder
treatments with and without a treatment component centered on body image. This paper includes a controlled study comparing Cognitive Behavioral
Treatment (CBT) for eating disorders with and without a component for body image treatment using Virtual Reality techniques. Thirty-four participants
diagnosed with eating disorders were evaluated and treated. The clinical improvement was analyzed from statistical and clinical points of view.
Results showed that the patients who received the component for body image treatment improved more than the group without this component.
Furthermore, improvement was maintained in post-treatment and at one year follow-up. The results reveal the advantage of including a treatment
component addressing body image disturbances in the protocol for general treatment of eating disorders. The implications and limitations of these
results are discussed below. (copyright) 2013 Elsevier Ireland Ltd.
Psychiatry
Research, 209(3) : 619-625
- Year: 2013
- Problem: Eating Disorders
(any)
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Herpertz-Dahlmann, B.
Introduction:
There are very few randomized, controlled studies exploring the effectiveness of treatment setting in adolescent Anorexia nervosa (AN). Method: In
this multicenter trial, 176 female adolescents with a first admission for AN were randomized to either continued IP or DP treatment after a three-
week inpatient stabilization period. The treatment program did not differ between the study arms. Results: DP was not inferior to IP with respect to
weight gain at the 1-year follow-up (p<0.0001). Patients in the DP arm tended to have better psychosocial outcomes. The number of treatment-related
serious adverse events did not differ between the study arms. Conclusions: DP treatment after short inpatient medical stabilization in adolescent
patients with non-chronic AN was as effective as IP for weight restoration and thus may be a safe and less costly alternative to IP. Various
prognostic factors as well as treatment acceptance will be analyzed and presented.
European Child & Adolescent
Psychiatry, 22(2) : S96
- Year: 2013
- Problem: Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other service delivery and improvement
interventions
Misra, M., Katzman, D. K., Estella, N. M., Eddy, K. T., Weigel, T., Goldstein, M. A., Miller, K. K., Klibanski, A.
Objective: Anorexia nervosa is
characterized by low weight, aberrant eating attitudes, body image distortion, and hypogonadism. Anxiety is a common comorbid condition. Estrogen
replacement reduces anxiety in animal models, and reported variations in food intake across the menstrual cycle may be related to gonadal steroid
levels. The impact of estrogen replacement on anxiety, eating attitudes, and body image has not been reported in anorexia nervosa. We hypothesized
that physiologic estrogen replacement would ameliorate anxiety and improve eating attitudes without affecting body image in anorexia nervosa. Method:
Girls 13-18 years old with anorexia nervosa (DSM-IV) were randomized to transdermal estradiol (100 (mu)g twice weekly) with cyclic progesterone or
placebo patches and pills for 18-months, between 2002 and 2010. The State-Trait Anxiety Inventory for Children (STAIC), the Eating Disorders
Inventory-2 (EDI-2), and the Body Shape Questionnaire (BSQ-34) were administered. 72 girls completed these measures at baseline (n = 38 [girls
receiving estrogen] and n = 34 [girls receiving placebo]) and 37 at 18 months (n = 20 [girls receiving estrogen] and n = 17 [girls receiving
placebo]). The primary outcome measure was the change in these scores over 18 months. Results: Estrogen replacement caused a decrease in STAIC-trait
scores (-3.05 [1.22] vs 2.07 [1.73], P = .02), without impacting STAIC-state scores (-1.11 [2.17] vs 0.20 [1.42], P = .64). There was no effect of
estrogen replacement on EDI-2 or BSQ-34 scores. Body mass index (BMI) changes did not differ between groups, and effects of estrogen replacement on
STAIC-trait scores persisted after controlling for BMI changes (P = .03). Increases in serum estradiol were significantly associated with decreases
in STAIC-trait scores (Spearman (rho) = -0.45, P = .03). Conclusions: Estrogen replacement improved trait anxiety (the tendency to experience
anxiety) but did not impact eating attitudes or body shape perception. (copyright) Copyright 2013 Physicians Postgraduate Press, Inc.
Journal of Clinical Psychiatry, 74(8) : e765-
e771
- Year: 2013
- Problem: Anxiety Disorders (any), Eating Disorders
(any), Anorexia Nervosa
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions