Therapy outcome of day treatment for people with anorexia nervosa before and during the COVID‐19 pandemic

Carr, Anna; Toloza, Cindy; Li, Zhuo; Nazar, Bruno Palazzo; Himmerich, Hubertus

doi:10.1002/brb3.2604

Cited by 6 publications

(9 citation statements)

References 60 publications

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“…The clinical effectiveness of online treatment during the pandemic, compared to in-person care prepandemic, was examined in uncontrolled ( n = 55–159) [ 38 , 40 ] and small, nonrandomized controlled studies ( n = 9–365) [ 65 , 73 – 76 ]. Although the results are preliminary, the switch to online treatment as an alternative for in-person treatment was found to be as effective, safe, and well-tolerated as face-to-face treatment in most studies in outpatients [ 65 , 73 – 75 , 77 ▪ ].…”

Section: Online Treatmentmentioning

confidence: 99%

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Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Meier

Hoeken

Hoek

2022

Current Opinion in Psychiatry

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Purpose of reviewTo review the recent literature on the impact of the coronavirus disease-2019 (COVID-19) pandemic on incidence and severity of symptoms of eating disorders (EDs).Recent findingsA worrying increase of EDs in- and outpatients has been reported since the COVID-19 pandemic began in 2019/2020. Restrictions implemented during the pandemic to protect populations against COVID-19 increased the risk for onset and for worsening of EDs by disrupting eating and exercise routines, social isolation, lack of support, and limited access to healthcare. Substantial increases since the start of the pandemic have been reported for overall incidence (15%), hospital admissions (48%) and emergency department visits (11%) for EDs, with even higher increases among women and children or adolescents with an ED. During the pandemic, ED patients reported increased severity of ED-specific symptoms and increased anxiety, depression and suicidal ideations and -attempts. Treatments shifted largely toward online methods for continuity of care, despite concerns about the quality of care provided and difficulties in self-monitoring. Our review provides preliminary evidence for a similar effectiveness of online treatment to prepandemic face-to-face treatment. In-person assessment remains essential for detecting EDs and for those requiring medical admission.SummaryAlthough the ongoing COVID-2019 pandemic affected mental health globally, research shows that it particularly affected individuals with an ED diagnosis or at risk for an ED, especially women, children and adolescents, and those with anorexia nervosa.

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Section: Online Treatmentmentioning

confidence: 99%

“…In most studies, clinical effectiveness on weight gain and psychopathology was found to be similar before and after the switch to online treatment [73][74][75]. One controlled study observed that face-to-face day treatment for patients with AN resulted in higher rates of weight restoration in comparison to online day treatment [76].…”

Section: Online Treatmentmentioning

confidence: 99%

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Meier

Hoeken

Hoek

2022

Current Opinion in Psychiatry

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“…Despite being designed as an in‐person intervention, elements of SPEAKS worked well being delivered online, but for the experiential sessions, it was widely felt by patients and therapists that in‐person sessions were preferable. Research specific to AN treatment delivery and outcomes, such as findings from Carr et al (2022), found no significant advantage for either in‐person or online delivery. Furthermore, experiential methods such as chairwork are reported to be feasibly delivered online (Pugh et al, 2021), suggesting that factors such as patient preference and therapist confidence in delivery have influence over how these are received This study adds to those previous findings by highlighting views of online therapy for this specific patient group.…”

Section: Discussionmentioning

confidence: 97%

Acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS): A novel intervention for anorexia nervosa

Rennick,

Papastavrou Brooks,

Singh Basra

et al. 2024

Intl J Eating Disorders

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ObjectiveInvestigate the acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS), a novel intervention for anorexia nervosa (AN), conducted as a feasibility trial to provide an initial test of the intervention.MethodsSPEAKS therapy lasting 9–12 months was provided to 34 people with AN or atypical AN by eight specialist eating disorder therapists trained in the model across two NHS Trusts in the UK (Kent and Sussex) during a feasibility trial. All participants were offered a post‐therapy interview; sixteen patients and six therapists agreed. All patient participants were adult females. Interviews were semi‐structured and asked questions around individuals' experience of SPEAKS, the acceptability of the intervention and of the research methods. Interviews were analyzed using thematic analysis.ResultsKey areas explored in line with research questions led to 5 overarching themes and 14 subthemes: (1) shift in treatment focus and experience, (2) balancing resources and treatment outcomes, (3) navigating the online treatment environment, (4) therapist adaptation and professional development, and (5) research processes.DiscussionSPEAKS was found to be an acceptable intervention for treating AN from the perspective of patients and therapists. The findings provide strong support for delivery of a larger scale randomized control trial. Recommendations for future improvements, particularly pertaining to therapist understanding of the treatment model are detailed, alongside broader clinical implications.Public SignificanceWe aimed to evaluate the acceptability of a new anorexia nervosa treatment called SPEAKS. Interviews were conducted with patients and therapists involved in the pilot study and responses were analyzed. Results showed that both patients and therapists found SPEAKS to be an acceptable treatment for anorexia nervosa. The study suggests that SPEAKS meets the criteria for moving forward with a larger trial to assess its effectiveness.

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“…For instance, the systematic review by Sideli and colleagues [ 16 ] found the worsening of symptoms to occur more often in individuals with self-reported ED than in those attending ED services. Carr and colleagues [ 17 ] compared online treatment after the beginning of the pandemic to the previously delivered face-to-face day service treatment and found it effective in decreasing EDE-Q scores but not for weight improvement. These data point to the need for a better characterization of individuals with ED who attended specialized services during the pandemic, in order to evidence both differential (e.g., with respect to either the pre-existence or the severity of the disorder) areas of vulnerability and protective factors connected to specific aspects of the treatment delivered.…”

Section: Introductionmentioning

confidence: 99%

Increased General, Eating, and Body-Related Psychopathology in Inpatients in a Specialized Eating Disorders Unit after the Beginning of the COVID-19 Pandemic: A Retrospective Comparison with the Pre-Pandemic Period

Martini

Longo

Delsedime

et al. 2023

JCM

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The study of the effects of the COVID-19 pandemic on individuals who attended mental health services is needed to identify the specific vulnerabilities associated to this challenging period. Despite several analyses reporting the worsening of eating disorders symptomatology after the beginning of the pandemic, characterizations of adult inpatients with eating disorders are still lacking. We conducted a retrospective analysis to assess whether adult individuals who underwent hospitalization in a specialized eating disorders unit in the two years after the beginning of the COVID-19 pandemic differed in clinical presentation, psychopathological measures, and treatment outcomes from inpatients hospitalized in the two years before. In the comparison between the two groups, the individuals who began treatment after the start of the pandemic presented with more physical hyperactivity and more severe psychopathological scores in most of the areas investigated, with differences in eating symptoms still evident at discharge. Notably, body-related symptoms (i.e., body shape concerns, body checking, body avoidance) were associated with the pandemic, and also for inpatients with extreme anorexia nervosa. This retrospective analysis does not allow us to separate the impact of COVID-19 from other potentially relevant co-occurring factors; however, these findings help in understanding how the pandemic could have affected individuals that needed specialized intensive treatment.

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Therapy outcome of day treatment for people with anorexia nervosa before and during the COVID‐19 pandemic

Cited by 6 publications

References 60 publications

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Review of the unprecedented impact of the COVID-19 pandemic on the occurrence of eating disorders

Acceptability of Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS): A novel intervention for anorexia nervosa

Increased General, Eating, and Body-Related Psychopathology in Inpatients in a Specialized Eating Disorders Unit after the Beginning of the COVID-19 Pandemic: A Retrospective Comparison with the Pre-Pandemic Period

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