Heterogeneous weight restoration trajectories during partial hospitalization treatment for anorexia nervosa

Berona, Johnny; Richmond, Rebekah L.; Rienecke, Renee D.

doi:10.1002/eat.22922

Cited by 25 publications

(33 citation statements)

References 55 publications

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“…As displayed in Table 1, the specific comorbidities and included diagnostic tools varied considerably. In one study the type of comorbidity was not specified (Berona et al, 2018), and in two studies, comorbidity was assessed only by means of a self‐report questionnaire, the brief symptom inventory (Lockwood et al, 2012; Marcoulides & Waller, 2012). In one of the short‐term studies, patients with psychotic symptoms were excluded (Kuipers et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, the therapeutic interventions varied considerably with different, more or less well‐defined, in‐ and out‐patient treatment programmes. In three studies investigating the effects of FBT, the influence of depression was negative in two (Berona et al, 2018; Lock et al, 2006) whereas no significant effect could be detected in one of these studies (Agras et al, 2014). In two other studies using CBT, anxiety had a negative effect on weight gain in one (Lockwood et al, 2012), whereas it had no effect in the other study (Marcoulides & Waller, 2012).…”

Section: Discussionmentioning

confidence: 99%

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Comorbid depression as a negative predictor of weight gain during treatment of anorexia nervosa: A systematic scoping review

Eskild-Jensen

Støving

Flindt

et al. 2020

Euro Eating Disorders Rev

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Background: Anorexia nervosa (AN) is a serious mental illness with high rates of relapse and mortality. Psychiatric comorbidities are common but their impact on the prognosis is largely unknown. Objective: The aim was to investigate the influence of psychiatric comorbidity on weight gain during treatment of AN. Methods: A systematic search was performed in PubMed/MEDLINE, EMBASE and PsycINFO. Studies evaluating psychiatric comorbidity as a predictor for treatment outcome (weight gain) were included, however, comorbid alcohol/drug addiction was excluded from this review. Results: Four thousand five hundred and twenty six publications were identified from which 15 were included. The majority of the included studies had a prospective open naturalistic study design, a short-term follow-up period, and were based on small populations of primarily adolescent and adult women. Four studies indicate depression, and two obsessiveness as negative prognostic factors, whilst one study indicated moderate depression and yet another, neuroticism, as positive predictors for weight gain. Discussion: The systematic scoping review found a large number of publications whereof only a few directly described the influence of psychiatric comorbidity on weight gain in AN. Overall, studies were heterogeneous in design, purpose and outcome making comparisons difficult. Findings were divergent but depression had a negative influence on weight gain in four studies. Highlights • Several studies suggest psychiatric comorbidity as a negative prognostic factor in Anorexia nervosa, however only a few studies considered the influence on weight gain. • The majority of the published studies had an open naturalistic study design, a short-term follow-up period, and included a small number of patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comorbid depression as a negative predictor of weight gain during treatment of anorexia nervosa: A systematic scoping review

Eskild-Jensen

Støving

Flindt

et al. 2020

Euro Eating Disorders Rev

View full text Add to dashboard Cite

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“…Persons who experienced a cubic pattern of binge‐eating change (i.e., slow beginning, fast in the middle, and slow toward the end of treatment) reported fewer binge‐eating episodes at 6‐month follow‐up (Compare & Tasca, 2016). Similarly, persons with anorexia nervosa gained weight at different rates (Berona, Richmond, & Rienecke, 2018; Lebow et al, 2019; Makhzoumi et al, 2017). The rate of weight gain during treatment was indicative of treatment prognosis at discharge and follow‐up.…”

mentioning

confidence: 99%

Longitudinal trajectories of behavior change in a national sample of patients seeking eating‐disorder treatment

Chapa

Hagan

Forbush

et al. 2020

Intl J Eating Disorders

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Objective: Rapid response to treatment, indicated by substantial decreases in eatingdisorder (ED) symptoms within the first 4-6 weeks of treatment, is the most reliable predictor of treatment outcomes for EDs. However, there is limited research evaluating short-term longitudinal trajectories of ED symptoms during treatment. Thus, it is difficult to know which aspects of ED psychopathology are slow or fast to change. The purpose of this study was to elucidate three-month trajectories of ED psychopathology during treatment and test whether ED diagnosis influenced the direction and rate of change.Method: Participants were Recovery Record users seeking treatment for an ED (N = 4,568; 86.8% female). Participants completed the Eating Pathology Symptoms Inventory once per month for 3 months.Results: Latent growth curve models indicated that ED diagnosis influenced the rate of ED behavior change. Anorexia nervosa was associated with faster reductions in cognitive restraint, excessive exercise, restricting, yet slower reductions in body dissatisfaction, and binge eating. Bulimia nervosa was associated with faster reductions in binge eating, cognitive restraint, excessive exercise, and purging. Binge-eating disorder was associated with faster reductions in body dissatisfaction and binge eating, yet slower reductions in restricting. Conclusions:Our results have implications for future research by providing initial information about the direction and rate of ED change over the course of treatment.If clinicians and researchers know which ED symptoms are slow to change, on average, across diagnostic groups, treatment protocols could be adjusted to target slow changing symptoms more quickly, and therefore improve ED treatment outcomes.

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“…The level of perceived EE from the patients' point of view was independent from age, contact time, and duration of treatment [11]. However, it has consistently been shown that high levels of EE in caregivers, especially in mothers, seem to negatively affect engagement, outcome, and effectiveness of ED treatment [1][2][3]10,12,13]. Thus, considering EE of caregivers in the patients' treatment seems to be highly relevant.…”

Section: Introductionmentioning

confidence: 99%

Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective

Philipp

Truttmann

Zeiler

et al. 2020

JCM

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High expressed emotion (EE) is common in caregivers of patients with anorexia nervosa (AN) and associated with poorer outcome for patients. In this study, we examined the prevalence of high EE in caregivers of adolescents with AN and analyzed predictors for EE using multivariate linear regression models. We further analyzed whether EE is reduced by the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) intervention using general linear mixed models and whether a reduction of EE predicts patients’ outcomes. Caregivers were randomly allocated to the SUCCEAT workshop (N = 50) or online intervention (N = 50) and compared to a comparison group (N = 49). EE and patients’ outcomes were assessed at the baseline, post-intervention, and at the 12-month follow-up. Up to 47% of caregivers showed high EE. Lower caregiver skills, higher AN symptom impact, higher levels of depression and motivation to change in caregivers were significant predictors for high EE. EE significantly decreased in the SUCCEAT groups and the comparison group according to the caregivers’, but not the patients’ perspective. The level of reduction could partially predict subjective improvement and improvement in clinically assessed AN symptoms and body mass index of patients. Implementing interventions for caregivers addressing EE in the treatment of adolescents with AN is strongly recommended.

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Heterogeneous weight restoration trajectories during partial hospitalization treatment for anorexia nervosa

Cited by 25 publications

References 55 publications

Comorbid depression as a negative predictor of weight gain during treatment of anorexia nervosa: A systematic scoping review

Comorbid depression as a negative predictor of weight gain during treatment of anorexia nervosa: A systematic scoping review

Longitudinal trajectories of behavior change in a national sample of patients seeking eating‐disorder treatment

Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective

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