Short- and long-term outcome of males treated for anorexia nervosa: a review of the literature

Strobel, Christine; Quadflieg, Norbert; Voderholzer, Ulrich; Naab, Silke; Fichter, Manfred M.

doi:10.1007/s40519-018-0538-6

Cited by 25 publications

(18 citation statements)

References 56 publications

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“…Remission rates after 6 years in our study were nearly identical in males and females treated for AN (40% vs. 41%). Most published studies on the outcome of AN included very small sample sizes of males (7–14 males), studies with higher sample sizes reported mortality only (Strobel et al, ). Length of follow‐up and definition of remission varied between studies.…”

Section: Discussionmentioning

confidence: 99%

“…This should result in distinct differences in outcome between males and females. There are few longitudinal comparisons between treated males and females: A review (Strobel, Quadflieg, Voderholzer, Naab, & Fichter, ) on males with AN found widely varying outcomes after treatment with no clear evidence of gender differences. In addition to the sparse number of reports and small sample sizes, the outcome definitions varied, and males and females were often not adequately matched (Strobel et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…There are few longitudinal comparisons between treated males and females: A review (Strobel, Quadflieg, Voderholzer, Naab, & Fichter, 2018) on males with AN found widely varying outcomes after treatment with no clear evidence of gender differences. In addition to the sparse number of reports and small sample sizes, the outcome definitions varied, and males and females were often not adequately matched (Strobel et al, 2018). Outcome studies reported males with AN to show less ED diagnoses (Deter, Köpp, Zipfel, & Herzog, 1998;Herpertz-Dahlmann et al, 2001;Støving, Andries, Brixen, Bilenberg, & Hørder, 2011;Strober et al, 2006), less body dissatisfaction (Bean et al, 2004;Strober et al, 2006), and less drive for thinness (Murray et al, 2017) than females with AN.…”

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confidence: 99%

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Long‐term outcomes in treated males with anorexia nervosa and bulimia nervosa—A prospective, gender‐matched study

Strobel

Quadflieg

Naab

et al. 2019

Intl J Eating Disorders

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Objective We report on the long‐term outcome of males compared to females treated for anorexia nervosa (AN) or bulimia nervosa (BN). Methods A total of 119 males with AN and 60 males with BN were reassessed 5.8 ± 4.6 and 7.5 ± 5.9 years (respectively) after treatment and compared to matched female patients. Results At follow‐up, males with AN had a higher body weight than females. For AN, remission rates (40% males vs. 41% females) did not differ at follow‐up. And at follow‐up, more males (34%) than females (19%) had an eating disorder not otherwise specified (ED‐NOS; p < .01). At follow‐up of AN, there was no binge‐eating disorder (BED) and obesity was rare. For BN, remission rates (44% males vs. 50% females) and frequency of AN, BN, BED and ED‐NOS did not differ at follow‐up. Males with AN scored lower than females at follow‐up on most subscales of the Eating Disorder Inventory (EDI) and on somatization, obsessive–compulsive symptoms, and depression (Brief Symptom Inventory). Males with BN scored lower than females with BN on perfectionism and higher on interpersonal distrust (EDI) at follow‐up. Discussion Results from the scarce literature on males with ED are inconclusive regarding longer term outcome. In the present study, males with AN showed a slightly better outcome than females. In BN, outcome was about the same in males and females. According to our study, existing treatment is equally effective in both males and females. Additional research on the need of gender‐specific diagnosis and therapy is required.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Long‐term outcomes in treated males with anorexia nervosa and bulimia nervosa—A prospective, gender‐matched study

Strobel

Quadflieg

Naab

et al. 2019

Intl J Eating Disorders

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“…There are few studies addressing mortality exclusively in males. A recent review of selected outcome studies on anorexia nervosa (AN) in males (Strobel, Quadflieg, Voderholzer, Naab, & Fichter, ) reported a total number of 22 deceased out of 553 males included in 21 studies, which allows a rough estimate of overall crude mortality of 4.0% in a heterogeneous group of males. Three deaths (3.1%) occurred in 96 males at less than 5 years follow‐up, and 19 of 457 male participants (4.2%) died after more than 9 years.…”

Section: Introductionmentioning

confidence: 99%

Mortality in males treated for an eating disorder—A large prospective study

Quadflieg

Strobel

Naab

et al. 2019

Intl J Eating Disorders

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Objective To report on the long‐term mortality of eating disorders in male inpatients. Method Crude mortality rates (CMR) and standardized mortality ratios (SMR) were computed for a large sample of males (147 anorexia nervosa [AN], 81 bulimia nervosa [BN], 110 eating disorder not otherwise specified [ED‐NOS]; DSM‐IV). In addition, a survival analysis from onset of eating disorder to death or end of observation was computed. Results CMR was 12.9% in AN, 11.1% in BN, and 6.4% in ED‐NOS. Standardized mortality was significantly elevated in males with AN (SMR = 5.91; 95% confidence interval 3.56–9.23) as well as ED‐NOS (SMR = 3.40; 95% confidence interval 1.37–7.01) but not in males with BN (SMR = 1.88; 95% confidence interval 0.86–3.58). Males with AN died sooner after onset of eating disorder than males with BN or ED‐NOS. Discussion Mortality in male inpatients with eating disorder is high, especially in AN. There is need for developing more effective treatments to achieve better outcome.

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“…• The small clinical samples and their heterogeneity [6]. • In the general population studies, instruments and designs are really different and poorly comparable [7].…”

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confidence: 99%