ESCAP Expert Paper: New developments in the diagnosis and treatment of adolescent anorexia nervosa—a European perspective

Abstract

Anorexia nervosa is a potentially life-threatening disorder with a typical onset in adolescence and high rates of medical complications and psychiatric comorbidity. This article summarizes issues relating to classification in DSM-5 and presents a narrative review of key evidence-based medical and behavioral interventions for adolescent AN and subthreshold restricting eating disorders, mainly, but not exclusively published between 2012 and 2014. In addition, it systematically compares the clinical guidelines of four European countries (Germany, Spain, The Netherlands, and United Kingdom) and outlines common clinical practice, in relation to treatment settings, nutritional rehabilitation, family-oriented and individual psychotherapy, and psychopharmacological treatment. With the exception of family-based treatment, which is mainly evaluated and practiced in Anglo-American countries, the evidence base is weak, especially for medical interventions such as refeeding and pharmacological intervention. There is a need for common European research efforts, to improve the available evidence base and resulting clinical guidance.

Epidemiologie psychischer Störungen bei Kindern und Jugendlichen

“…die Hälfte aller Anorexie-Neuerkrankungen scheint zwischen dem 14.-19. Lebensjahr aufzutreten, und es gibt Hinweise, dass die Prävalenz der Erkrankungen bei Jugendlichen ansteigt und sich das Ersterkrankungsalter nach unten verschiebt [14].…”

Anorexia nervosa: diagnosis, risk factors and evidence‐based treatments

“…73,78 The Maudsley FBT is the most established treatment model for adolescents with AN, and several RCTs have demonstrated evidence for symptom remission and weight rehabilitation.…”

All that glisters is not an endophenotype: rethinking endophenotypes in anorexia nervosa

“…Anorexia nervosa (AN) is a serious mental health disorder with devastating consequences for sufferers and their families [1]. AN has a peak of onset in early adolescence [2], an age of many developmental changes.…”