Disorders - Eating disorders not specified
Pittock, A., Hodges, L., Lawrie, S. M.
OBJECTIVE: This review looked at internet-delivered cognitive behavioural therapy (iCBT) as a possible treatment for patients with bulimic
symptoms. CBT has been established as an effective treatment; however, waiting lists lead to delayed initiation of treatment. iCBT is a possible
delivery method to combat this. Medline, EMBASE and PsycInfo were searched for controlled trials using iCBT as a treatment for patients with bulimia
nervosa (BN), subthreshold BN or 'eating disorders not otherwise specified' with bulimic characteristics (EDNOS-BN). The literature search returned
482 papers. 5 met the review criteria and were compared in characteristics, methodological quality and outcomes. Outcomes were analysed by
calculation of effect sizes; iCBT was evaluated on reduction in binge eating and purging post treatment and at follow-up. RESULT(S): Participants
were mostly female with an average age range of 23.7-31 years. 4 studies demonstrated good methodological quality. 1 did not report all of the
outcome data, increasing the likelihood of bias. Only 1 study showed widespread benefit over waiting list controls. iCBT was shown to reduce
behaviours but was not found to be superior to bibliotherapy or waiting list. Further large-scale studies are required to make conclusive
recommendations.
BMC
research notes, 11(1) : 748
- Year: 2018
- Problem: Bulimia Nervosa, Eating disorders not specified
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), 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)
Pittock, A., Hodges, L., Lawrie, S. M.
OBJECTIVE: This review looked at internet-delivered cognitive behavioural therapy (iCBT) as a possible treatment for patients with bulimic
symptoms. CBT has been established as an effective treatment; however, waiting lists lead to delayed initiation of treatment. iCBT is a possible
delivery method to combat this. Medline, EMBASE and PsycInfo were searched for controlled trials using iCBT as a treatment for patients with bulimia
nervosa (BN), subthreshold BN or 'eating disorders not otherwise specified' with bulimic characteristics (EDNOS-BN). The literature search returned
482 papers. 5 met the review criteria and were compared in characteristics, methodological quality and outcomes. Outcomes were analysed by
calculation of effect sizes; iCBT was evaluated on reduction in binge eating and purging post treatment and at follow-up. RESULT(S): Participants
were mostly female with an average age range of 23.7-31 years. 4 studies demonstrated good methodological quality. 1 did not report all of the
outcome data, increasing the likelihood of bias. Only 1 study showed widespread benefit over waiting list controls. iCBT was shown to reduce
behaviours but was not found to be superior to bibliotherapy or waiting list. Further large-scale studies are required to make conclusive
recommendations.
BMC
research notes, 11(1) : 748
- Year: 2018
- Problem: Bulimia Nervosa, Eating disorders not specified
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), 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)
Boerhout, C., Swart, M., Voskamp, M., Troquete, N. A., van-Busschbach, J. T., Hoek, H. W.
Objective: The objective is to evaluate a
body and movement-oriented intervention on aggression regulation, specifically aimed towards reducing anger internalization in patients with an
eating disorder. Method: Patients were randomized to treatment-as-usual (TAU) plus the intervention (n = 38) or to TAU only (n = 32). The
intervention was delivered by a psychomotor therapist. TAU consisted of multidisciplinary day treatment (3-5 days per week during 3-9 months). Anger
coping (Self-Expression and Control Scale) and eating pathology (Eating Disorder Examination-Self-report Questionnaire) were measured at baseline and
follow-up. Differences between pre-intervention and post-intervention scores were tested by using repeated measures ANOVA. Results: The intervention
group showed a significantly larger decrease of anger internalization than the control group (eta2 = 0.16, p = 0.001). Both groups showed a
significant reduction in eating pathology, but differences between groups were not significant. Discussion: A body and movement-oriented therapy
seems a viable add-on for treating anger internalization in patients with an eating disorder. (PsycINFO Database Record (c) 2017 APA, all rights
reserved)
European Eating Disorders Review, 25(1) : 52-
59
- Year: 2017
- Problem: Anorexia Nervosa, Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Boerhout, C., Swart, M., Van-Busschbach, J. T., Hoek, H. W.
OBJECTIVE: The objective of the study is to evaluate the effect of a brief body and movement oriented intervention on aggression
regulation and eating disorder pathology for individuals with eating disorders.\rMETHOD: In a first randomized controlled trial, 40 women were
allocated to either the aggression regulation intervention plus supportive contact or a control condition of supportive contact only. The
intervention was delivered by a psychomotor therapist. Participants completed questionnaires on anger coping and eating disorder pathology.
Independent samples t-tests were performed on the difference between pre-treatment and post-treatment scores.\rRESULTS: Twenty-nine participants
completed questionnaires at pre-intervention and post-intervention. The intervention resulted in a significantly greater improvement of anger coping,
as well as of eating disorder pathology.\rDISCUSSION: Results indicate that body and movement-oriented aggression regulation may be a viable add-on
for treating eating disorders. It tackles a difficult to treat emotion which may have a role in blocking the entire process of treating eating
disorders.\rCopyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
European Eating Disorders
Review, 24(2) : 114-21
- Year: 2016
- Problem: Anorexia Nervosa, Binge Eating Disorders, Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
Eisler,
I., Simic, M., Hodsoll, J., Asen, E., Berelowitz, M., Connan, F., Ellis, G., Hugo, P., Schmidt, U., Treasure, J., Yi, I., Landau, S.
Background: Considerable progress has been made in recent years in developing effective treatments for child and adolescent anorexia
nervosa, with a general consensus in the field that eating disorders focussed family therapy (often referred to as Maudsley Family Therapy or Family
Based Treatment) currently offers the most promising outcomes. Nevertheless, a significant number do not respond well and additional treatment
developments are needed to improve outcomes. Multifamily therapy is a promising treatment that has attracted considerable interest and we report the
results of the first randomised controlled trial of multifamily therapy for adolescent anorexia nervosa. Methods: The study was a pragmatic
multicentre randomised controlled superiority trial comparing two outpatient eating disorder focussed family interventions - multifamily therapy
(MFT-AN) and single family therapy (FT-AN). A total of 169 adolescents with a DSM-IV diagnosis of anorexia nervosa or eating disorder not otherwise
specified (restricting type) were randomised to the two treatments using computer generated blocks of random sizes to ensure balanced numbers in the
trial arms. Independent assessors, blind to the allocation, completed evaluations at baseline, 3 months, 12 months (end of treatment) and 18 months.
Results: Both treatment groups showed clinically significant improvements with just under 60% achieving a good or intermediate outcome (on the
Morgan-Russell scales) at the end of treatment in the FT-AN group and more than 75% in the MFT-AN group - a statistically significant benefit in
favour of the multifamily intervention (OR = 2.55 95%; CI 1.17, 5.52; p = 0.019). At follow-up (18 months post baseline) there was relatively little
change compared to end of treatment although the difference in primary outcome between the treatments was no longer statistically significant.
Clinically significant gains in weight were accompanied by improvements in mood and eating disorder psychopathology. Approximately half the patients
in FT-AN and nearly 60% of those in MFT-AN had started menstruating. Conclusions: This study confirms previous research findings demonstrating the
effectiveness of eating disorder focused family therapy and highlights the additional benefits of bringing together groups of families that maximises
the use of family resources and mutual support leading to improved outcomes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
BMC Psychiatry Vol 16 2016, ArtID
422, 16 :
- Year: 2016
- Problem: Anorexia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Family therapy, Other service delivery and improvement
interventions
Lock, J.
Eating
disorders are relatively common and serious disorders in adolescents. However, there are few controlled psychosocial intervention studies with this
younger population. This review updates a previous Journal of Clinical Child and Adolescent Psychology review published in 2008. The recommendations
in this review were developed after searching the literature including PubMed/Medline and employing the relevant medical subject headings. In
addition, the bibliographies of book chapters and treatment guideline articles were reviewed; last, colleagues were asked for suggested additional
source materials. Psychosocial treatments examined include family therapy, individual therapy, cognitive behavioral therapy, interpersonal
psychotherapy, cognitive training, and dialectical behavior therapy. Using the most recent Journal of Clinical Child and Adolescent Psychology
methodological review criteria, family treatment-behavior (FT-B) is the only well-established treatment for adolescents with anorexia nervosa. Family
treatment-systemic and insight oriented individual psychotherapy are probably efficacious treatments for adolescents with anorexia nervosa. There are
no well-established treatments for adolescents with bulimia nervosa, binge eating disorder, or avoidant restrictive food intake disorder. Possibly
efficacious psychosocial treatments for adolescent bulimia nervosa include FT-B and supportive individual therapy. Internet-delivered cognitive
behavioral therapy is a possibly efficacious treatment for binge eating disorder. Experimental treatments for adolescent eating disorders include
enhanced cognitive behavioral therapy, dialectical behavioral therapy, cognitive training, and interpersonal psychotherapy. FT-B is the only well-
established treatment for adolescent eating disorders. Additional research examining treatment for eating disorders in youth is warranted. (PsycINFO
Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of Clinical
Child & Adolescent Psychology, 44(5) : 707-721
- Year: 2015
- Problem: Anorexia Nervosa, Binge Eating Disorders, Bulimia Nervosa, Eating disorders not specified
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Dialectical behavioural therapy
(DBT), Family therapy, Supportive
therapy
Wagner, G., Penelo, E., Wanner, C., Gwinner, P., Trofaier, M-L., Imgart, H., Waldherr, K., Wober-Bingol, C., Karwautz, A. F. K.
Background: Cognitive-behavioural therapy (CBT)-based guided self-help is recommended as a first step
in the treatment of bulimia nervosa.; Aims: To evaluate in a randomised controlled trial (Clinicaltrials.gov registration number: NCT00461071) the
long-term effectiveness of internet-based guided self-help (INT-GSH) compared with conventional guided bibliotherapy (BIB-GSH) in females with
bulimia nervosa.; Method: A total of 155 participants were randomly assigned to INT-GSH or BIB-GSH for 7 months. Outcomes were assessed at baseline,
month 4, month 7 and month 18.; Results: The greatest improvement was reported after 4 months with a continued reduction in eating disorder
symptomatology reported at month 7 and 18. After 18 months, 14.6% (n = 7/48) of the participants in the INT-GSH group and 25% (n = 7/28) in the BIB-
GSH group were abstinent from binge eating and compensatory measures, 43.8% (n = 21/48) and 39.2% (n = 11/28) respectively were in remission. No
differences regarding outcome between the two groups were found.; Conclusions: Internet-based guided self-help for bulimia nervosa was not superior
compared with bibliotherapy, the gold standard of self-help. Improvements remain stable in the long term.;
British Journal of Psychiatry, 202 : 135-
141
- Year: 2013
- Problem: Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Self-help, Technology, interventions delivered using technology (e.g. online, SMS)
Schmidt, Ulrike, Oldershaw,
Anna, Jichi, Fatima, Sternheim, Lot, Startup, Helen, McIntosh, Virginia, Jordan, Jennifer, Tchanturia, Kate, Wolff, Geoffrey, Rooney, Michael, Landau, Sabine, Treasure, Janet
Background: Very limited evidence is available on how to treat adults with anorexia nervosa and
treatment outcomes are poor. Novel treatment approaches are urgently needed.; Aims: To evaluate the efficacy and acceptability of a novel
psychological therapy for anorexia nervosa (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) compared with specialist supportive
clinical management (SSCM) in a randomised controlled trial.; Method: Seventy-two adult out-patients with anorexia nervosa or eating disorder not
otherwise specified were recruited from a specialist eating disorder service in the UK. Participants were randomly allocated to 20 once weekly
sessions of MANTRA or SSCM and optional additional sessions depending on severity and clinical need (trial registration: ISRCTN62920529). The primary
outcomes were body mass index, weight and global score on the Eating Disorders Examination at end of treatment (6 months) and follow-up (12 months).
Secondary outcomes included: depression, anxiety and clinical impairment; neuropsychological outcomes; recovery rates; and additional service
utilisation.; Results: At baseline, patients randomised to MANTRA were significantly less likely to be in a partner relationship than those receiving
SSCM (3/34 v. 10/36; P<0.05). Patients in both treatments improved significantly in terms of eating disorder and other outcomes, with no
differences between groups. Strictly defined recovery rates were low. However, MANTRA patients were significantly more likely to require additional
in-patient or day-care treatment than those receiving SSCM (7/34 v. 0/37; P = 0.004).; Conclusions: Adults with anorexia nervosa are a difficult to
treat group. The imbalance between groups in partner relationships may explain differences in service utilisation favouring SSCM. This study confirms
SSCM as a useful treatment for out-patients with anorexia nervosa. The novel treatment, MANTRA, designed for this patient group may need adaptations
to fully exploit its potential.;
British Journal of Psychiatry, 201(5) : 392-
399
- Year: 2012
- Problem: Anorexia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Stiles-Shields, C., Smyth, A., Glunz, C., Hoste, R. R., Boepple, L., le Grange, D.
Eating disorders frequently have their onset in adolescence. This is problematic as
Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Eating Disorder Not Otherwise Specified (EDNOS) often present with serious psychiatric and medical
sequelae that can affect an adolescent's physical and emotional development. It is well documented that complications from eating disorders in
adolescence can result in long-term health consequences, rendering effective psychiatric and medical treatments a necessity. To combat the medical
consequences associated with eating disorders in adolescents, pediatricians must identify, treat, and monitor medical complications. Pediatricians
are also responsible for assessing the need for hospitalization due to medical instability. Some advances have been made regarding
psychopharmacological treatments for eating disorders. For example, antidepressant medications, such as SSRIs, have demonstrated efficacy in the
treatment of adults with BN. The true effectiveness of these medications in adolescent populations remains unknown. A multidisciplinary team approach
is a common treatment model in outpatient practice, but further research is required to investigate how to facilitate the collaboration of
psychiatric and medical professionals. The majority of psychiatric and medical trials for eating disorder patients have involved adult participants,
and most studies have investigated either psychiatric or medical treatments for eating disorders. In this review, we will add to the current
literature by focusing on both psychiatric and medical treatments for eating disorders, with particular emphasis on studies conducted with
adolescents. (copyright) 2011 Bentham Science Publishers.
Current Psychiatry Reviews, 7(3) : 177-
188
- Year: 2011
- Problem: Anorexia Nervosa, Bulimia Nervosa, Eating disorders not specified
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any)
Sanchez-Ortiz, V. C., Munro, C., Stahl, D., House, J., Startup, H., Treasure, J., Williams, C., Schmidt, U.
Bulimic eating disorders are common among female students, yet
the majority do not access effective treatment. Internet-based cognitive-behavioural therapy (iCBT) may be able to bridge this gap. Seventy-six
students with bulimia nervosa (BN) or eating disorder not otherwise specified (EDNOS) were randomly assigned to immediate iCBT with e-mail support
over 3 months or to a 3-month waiting list followed by iCBT [waiting list/delayed treatment control (WL/DTC)]. ED outcomes were assessed with the
Eating Disorder Examination (EDE) at baseline, 3 months and 6 months. Other outcomes included depression, anxiety and quality of life. Students who
had immediate iCBT showed significantly greater improvements at 3 and 6 months than those receiving WL/DTC in ED and other symptoms. iCBT with e-mail
support is efficacious in students with bulimic disorders and has lasting effects.
Psychological Medicine, 41(2) : 407-
417
- Year: 2011
- Problem: Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled 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)
Katzman, Melanie A., Bara-Carril, Nuria, Rabe-
Hesketh, Sophia, Schmidt, Ulrike, Troop, Nicholas, Treasure, Janet
Objective: Methods: Results: Conclusions:
To conduct a randomized, controlled, two-stage trial in the treatment of bulimia nervosa, comparing cognitive-behavioral therapy (CBT) versus
motivational enhancement in Phase 1 followed by group versus individual CBT in Phase 2.A total of 225 patients with bulimia nervosa or eating
disorder not otherwise specified (EDNOS) were recruited into a randomized controlled trial lasting 12 weeks with follow-ups at 1 year and 2.5
years.Patients improved significantly across all of the interventions with no differences in outcome or treatment adherence. Including motivational
enhancement therapy rather than a CBT first phase of treatment did not affect outcome.Outcome differences between individual and group CBT were
minor, suggesting that group treatment prefaced by a short individual intervention may be a cost-effective alternative to purely individual
treatment.
Psychosomatic Medicine, 72(7) : 656-
663
- Year: 2010
- Problem: Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Motivational interviewing, includes Motivational Enhancing Therapy
Carei, T. Rain, Fyfe-Johnson, Amber L., Breuner, Cora C., Brown,
Margaret A.
Purpose: Methods: Results: Conclusions: This was a pilot project designed to assess the effect of
individualized yoga treatment on eating disorder outcomes among adolescents receiving outpatient care for diagnosed eating disorders (anorexia
nervosa, bulimia nervosa, eating disorder not otherwise specified).A total of 50 girls and 4 boys aged 11-21 years were randomized to an 8-week trial
of standard care vs. individualized yoga plus standard care. Of these, 27 were randomized to standard care and 26 to yoga plus standard care
(attrition: n = 4). Standard care (every other week physician and/or dietician appointments) was required to meet ethical guidelines. The No Yoga
group was offered yoga after study completion as an incentive to maintain participation. Outcomes evaluated at baseline, end of trial, and 1-month
follow-up included Eating Disorder Examination (EDE), Body Mass Index (BMI), Beck Depression Inventory, State-Trait Anxiety Inventory, and Food
Preoccupation questionnaire.The Yoga group demonstrated greater decreases in eating disorder symptoms. Specifically, the EDE scores decreased over
time in the Yoga group, whereas the No Yoga group showed some initial decline but then returned to baseline EDE levels at week 12. Food preoccupation
was measured before and after each yoga session, and decreased significantly after all sessions. Both groups maintained current BMI levels and
decreased in anxiety and depression over time.Individualized yoga treatment decreased EDE scores at 12 weeks, and significantly reduced food
preoccupation immediately after yoga sessions. Yoga treatment did not have a negative effect on BMI. Results suggest that individualized yoga therapy
holds promise as adjunctive therapy to standard care.; Copyright 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights
reserved.
Journal of Adolescent Health, 46(4) : 346-351
- Year: 2010
- Problem: Anorexia Nervosa, Bulimia Nervosa, Eating disorders not specified
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Mind-body exercises (e.g. yoga, tai chi, qigong)