Journal of Eating Disorders最新文献

{"title":"Cognitive remediation therapy for patients with eating disorders: a qualitative study","authors":"Tora Thorsrud, Marit Aspelund Bang, Camilla Lindvall Dahlgren, Trond Nordfjærn, Siri Weider","doi":"10.1186/s40337-024-01101-0","DOIUrl":"https://doi.org/10.1186/s40337-024-01101-0","url":null,"abstract":"Transdiagnostic Cognitive Remediation Therapy (TCRT) is a new adaptation of cognitive remediation therapy for eating disorders (EDs) developed to address common cognitive difficulties across ED diagnoses (i.e., cognitive flexibility, central coherence, and impulsivity). This is the first evaluation of this novel treatment. The aim of this study was to explore acceptability and patients’ experience of TCRT. Thirteen patients diagnosed with restrictive or binge/purge subtypes of EDs and concurrent cognitive difficulties completed semi-structured qualitative interviews after receiving TCRT. Interview transcripts were analyzed using reflexive thematic analysis. The analysis resulted in four main themes: (1) Treatment fit (2), Treatment experience (3), Perceived outcomes, and (4) Future recommendations. Eleven of the thirteen patients evaluated the treatment positively, found the focus relevant and expressed how it contributed to new insights related to thinking style. Seven of the patients also described it as a starting point for making changes and using new strategies. Importantly, experiencing some challenges related to the cognitive difficulties addressed in the treatment seemed essential for engagement. Offering TCRT as an adjunctive treatment for patients with EDs and concurrent cognitive difficulties can be a way to engage patients in treatment, build therapeutic alliances and provide important awareness and strategies to handle challenges related to thinking style. This study is part of a larger randomized controlled trial, ClinicalTrials.gov Id: NCT03808467. Cognitive difficulties are thought to be one of several factors contributing to the development and maintenance of eating disorders (ED), but are rarely addressed in ED treatments. Cognitive remediation therapy (CRT) for EDs is a supplementary treatment originally developed for patients with anorexia nervosa (AN) that specifically targets cognitive difficulties. However, cognitive difficulties are found across ED diagnoses and not only in patients with AN. In this study, we have adapted CRT to address cognitive difficulties across ED diagnoses. The goal of this study was to explore patients’ experiences of this novel transdiagnostic CRT. We interviewed 13 individuals with various eating disorders after they had received the treatment. Eleven of the participants rated the treatment positively, expressed that it was engaging, offered something new and made them more aware of their thought processes. Seven participants also reported using new strategies to handle challenges related to cognitive difficulties. Importantly, one participant expressed that she did not experience cognitive difficulties and chose to drop out of the treatment, highlighting the importance of finding the treatment relevant to foster engagement.","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"23 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety matters: a pilot lab study into food, weight, and virtual body exposure in anorexia nervosa","authors":"Hanna Melles, Anita Jansen","doi":"10.1186/s40337-024-01094-w","DOIUrl":"https://doi.org/10.1186/s40337-024-01094-w","url":null,"abstract":"Anxiety is a core characteristic of anorexia nervosa and a potential target of exposure therapy, which requires a profound understanding of the patients’ fears in order to be successful. The knowledge about fears in anorexia nervosa that should be targeted during exposure therapy can be enriched by laboratory research to the precise emotional and behavioral responses of anorexia nervosa patients when they are exposed to disorder relevant fear stimuli. In the laboratory, patients with anorexia nervosa (n = 15) and healthy controls (n = 51) were exposed to 1. their own body weight and a 10% higher body weight on the scale, 2. a standardized lab breakfast, and 3. five virtual bodies with different BMIs ranging from extreme underweight to lower healthy weight. The participants emotional (anxiety, disgust, satisfaction, acceptance) and behavioral responses (calorie consumption) were assessed. Patients with anorexia nervosa but not the healthy controls then received an intensive exposure treatment (~ 30 individual exposure sessions) targeting their individual fears, next to standard care. After the exposure treatment, it was investigated whether the patients’ responses to the laboratory tasks changed. Across all tasks, the patients reported more anxiety than healthy controls. The patients also consumed less calories during the breakfast and accepted the different body weights on the scale less than healthy controls. During the virtual body exposure, the patients’ emotional responses did not differ per avatar but they reacted more negatively towards avatars with healthier weights than did healthy controls. After the exposure treatment, the patients reported less fears and they consumed more calories while their BMIs had increased. They were also more accepting of healthier weights. Exposure to food-, body- and weight-related stimuli in the laboratory induces emotional reactions in patients with anorexia nervosa that are informative for the identification of exposure therapy treatment targets. In addition, exposure therapy targeting individual fears in patients with anorexia nervosa led to symptom reduction and is a promising intervention for the treatment of anorectic fears, though more research is needed to optimize its efficacy. Anxiety is an important characteristic of anorexia nervosa and a target of exposure therapy. Recent research revealed the variety of fears and other emotions (e.g. disgust) that patients with anorexia nervosa display, and that could be addressed in exposure therapy. More nuanced knowledge about potential treatment targets could be derived from experimental research which has so far mainly focused on the fear of food. We aimed to fill this gap by experimentally studying the behavioral and emotional responses of patients with anorexia nervosa (n = 15) and healthy controls (n = 51) when exposed to food-, body-, and weight-related stimuli in the laboratory, and then also tested whether the patients’ responses changed after they re","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"51 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harm reduction in severe and long-standing Anorexia Nervosa: part of the journey but not the destination—a narrative review with lived experience","authors":"Edwin Birch, James Downs, Agnes Ayton","doi":"10.1186/s40337-024-01063-3","DOIUrl":"https://doi.org/10.1186/s40337-024-01063-3","url":null,"abstract":"Questions remain about the best approaches to treatment for the subset of patients with severe and long-standing Anorexia Nervosa, commonly described in the literature as “Severe and Enduring Anorexia Nervosa.” When discussing the optimal strategies and goals for treating this group, there is uncertainty over whether to focus on refining current treatment methods or exploring alternative approaches. One such alternative is “harm reduction,” which has generated a wave of positive interest from patients and clinicians alike because of its emphasis on individual autonomy, personal goals and quality of life. While harm reduction can provide an attractive alternative to seemingly endless cycles of ineffective treatment, this narrative review builds on previous work to highlight the inadequate terminology and possible dangers of considering harm reduction as the endpoint of treatment. In conjunction with perspectives from a lived experience author, we consider wider contextual and ethical issues in the field of eating disorders, which should inform the role of harm-reduction approaches in this patient group. One model of treatment for patients with severe and long-standing Anorexia Nervosa is termed “harm reduction”, which moves away from traditional treatment aimed at full recovery and weight gain. This approach instead prioritises quality of life, giving patients greater control over their care. Harm reduction remains ethically controversial due to concerns about unaddressed malnutrition and issues of consent for this subset of patients. This review examines the inadequacies in how severe and long-standing Anorexia is defined, alongside exploring the ethical concerns of harm reduction with lived experience from one author.","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"34 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Integrated Enhanced Cognitive Behaviour Therapy (I-CBTE) to Severe and Longstanding Eating Disorders (SEED) Paper 1: I am no longer a SEED patient","authors":"Lorna Collins","doi":"10.1186/s40337-024-01089-7","DOIUrl":"https://doi.org/10.1186/s40337-024-01089-7","url":null,"abstract":"This autobiographical paper recounts the recovery journey of Lorna Collins, a survivor of severe and enduring anorexia nervosa (SE-AN). Her story begins with a traumatic brain injury at the age of 18, leading to a complex eating disorder that persisted for over two decades. Despite over 30 hospital admissions and various treatment modalities, her condition only worsened, compounded by other mental health challenges. The paper describes these multifaceted struggles, including mistreatment in healthcare, self-harm, further trauma and near-fatal illness. The author aims to culminate her story in an uplifting manner, by highlighting the pivotal role that integrated cognitive behaviour therapy, artistic expression, and a renewed connection with her family have made on her recovery. Collins’ account is not only a personal testimony but also offers critical insights into the shortcomings of traditional eating disorder treatments and the importance of personalised, holistic approaches in mental health care. Lorna’s story aims to bring hope, challenge the concept of SEED and form part of a growing evidence-base that recovery is possible irrespective of duration or eating disorder severity.","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"110 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early maladaptive schemas mediate the relationship between severe childhood trauma and eating disorder symptoms: evidence from an exploratory study","authors":"Rachele Fasolato, Mariangela De Felice, Corrado Barbui, Mariaelena Bertani, Federica Bonora, Mariasole Castellazzi, Silvia Castelli, Doriana Cristofalo, Rosa Bruna Dall’Agnola, Mirella Ruggeri, Benedetta Signoretto, Chiara Bonetto","doi":"10.1186/s40337-024-01103-y","DOIUrl":"https://doi.org/10.1186/s40337-024-01103-y","url":null,"abstract":"Childhood trauma history has frequently been linked to eating disorders (EDs); nevertheless, the scientific literature calls for extending knowledge regarding mediators between EDs and childhood trauma. This study explored whether ED symptoms and early maladaptive schemas were more severe in ED patients with severe childhood trauma than in ED patients with no/mild childhood trauma and whether early maladaptive schemas mediated the relationship between childhood trauma and ED symptom severity. Data were extracted from the Regional Centre for Eating Disorders registry at the University Hospital of Verona. The extracted data included self-reported data, including the Eating Disorder Inventory-3 score, Young Schema Questionnaire score, Childhood Experience and Experience of Care and Abuse Questionnaire score, and sociodemographic and clinical information on the ED outpatients seeking care. A mediation analysis using the structural equation modeling procedure was conducted. Forty-two outpatients, 31% of whom exhibited severe childhood trauma, satisfied the criteria for registry data extraction. The severity of ED symptoms, as well as the early maladaptive schemas’ scores for emotional deprivation, defectiveness, failure, vulnerability, insufficient self-control, and negativity, were greater in ED outpatients with severe childhood trauma. Furthermore, early maladaptive schemas related to defectiveness, failure, and negativity had a mediating role in the relationship between severe childhood trauma and ED symptom severity. This exploratory study provides preliminary evidence about the importance of early maladaptive schemas in the relationship between trauma history and ED psychopathology. In addition, ED symptoms may represent a dysfunctional attempt to avoid unpleasant emotions associated with schema activation. The results support the need to consider early maladaptive schemas in the treatment of traumatized patients with ED symptoms. Study limitations, research and clinical implications are discussed. Eating disorder psychopathology was found to be related to a history of trauma. Nonetheless, our understanding of the mediators of the relationship between childhood trauma and eating disorders remains to be improved. The current study revealed that certain early maladaptive schemas (i.e., defectiveness, failure, and negativity) mediated the relationship between childhood trauma and eating disorder symptoms and that outpatients who experienced severe childhood trauma reported more severe eating disorder symptoms and greater severity of certain early maladaptive schemas, such as emotional deprivation, defectiveness, failure, vulnerability, insufficient self-control, and negativity. Our findings support the need to consider early maladaptive schemas in the treatment of traumatized patients with eating disorders.","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"104 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The validation of short eating disorder, body dysmorphia, and Weight Bias Internalisation Scales among UK adults","authors":"Dorottya Lantos, Darío Moreno-Agostino, Lasana T. Harris, George Ploubidis, Lucy Haselden, Emla Fitzsimons","doi":"10.1186/s40337-024-01095-9","DOIUrl":"https://doi.org/10.1186/s40337-024-01095-9","url":null,"abstract":"When collecting data from human participants, it is often important to minimise the length of questionnaire-based measures. This makes it possible to ensure that the data collection is as engaging as possible, while it also reduces response burden, which may protect data quality. Brevity is especially important when assessing eating disorders and related phenomena, as minimising questions pertaining to shame-ridden, unpleasant experiences may in turn minimise any negative affect experienced whilst responding. We relied on item response theory to shorten three eating disorder and body dysmorphia measures, while aiming to ensure that the information assessed by the scales remained as close to that assessed by the original scales as possible. We further tested measurement invariance, correlations among different versions of the same scales as well as different measures, and explored additional properties of each scale, including their internal consistency. Additionally, we explored the performance of the 3-item version of the modified Weight Bias Internalisation Scale and compared it to that of the 11-item version of the scale. We introduce a 5-item version of the Eating Disorder Examination Questionnaire, a 3-item version of the SCOFF questionnaire, and a 3-item version of the Dysmorphic Concern Questionnaire. The results revealed that, across a sample of UK adults (N = 987, ages 18–86, M = 45.21), the short scales had a reasonably good fit. Significant positive correlations between the longer and shorter versions of the scales and their significant positive, albeit somewhat weaker correlations to other, related measures support their convergent and discriminant validity. The results followed a similar pattern across the young adult subsample (N = 375, ages 18–39, M = 28.56). These results indicate that the short forms of the tested scales may perform similarly to the full versions. This manuscript introduces short versions of existing measures of eating disorders and body dysmorphia, specifically the Eating Disorder Examination Questionnaire, the SCOFF Questionnaire, and the Dysmorphic Concern Questionnaire. We further investigate the properties of the recently introduced 3-item short version of the modified Weight Bias Internalisation Scale. Across analyses including measurement invariance testing and bivariate correlations aiming to assess convergent and discriminant validity, we find support that the short scales may perform similarly to their longer versions. These short scales may contribute in meaningful ways to research where the brevity of questionnaire-type measures may make a difference by contributing to data quality.","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"37 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping eating disorders in adolescents and young adults: an investigation of geographic distribution and access to care in Ontario, Canada","authors":"Nelson Pang, Jason M. Nagata, Alexander Testa, Kyle T. Ganson","doi":"10.1186/s40337-024-01098-6","DOIUrl":"https://doi.org/10.1186/s40337-024-01098-6","url":null,"abstract":"There is limited research on the spatial distribution of eating disorders and the proximity to available eating disorder services. Therefore, this study investigates the distribution of eating disorders among adolescents and young adults in Ontario, Canada, with a specific focus on geographic disparities and access to publicly-funded specialized eating disorder services. A community sample of 1,377 adolescents and young adults ages 16–30 across Ontario between November and December 2021 participated in this study and completed the Eating Disorder Examination Questionnaire. Utilizing Geographic Information System (GIS) technology, we mapped the geographic prevalence of eating disorders and examined proximity to specialized eating disorder services. Multiple linear and logistic regression analyses were utilized to determine the association between geographic region and eating disorder symptomatology. Additionally, t-tests were utilized to examine differences between time/distance to specialized services and clinical risk for eating disorders. Applying geospatial analysis techniques, we detected significant spatial clusters denoting higher eating disorder scores in rural areas and areas with fewer specialized services. Likewise, our findings report disparities between rural and urban areas, suggesting that rural regions exhibit elevated rates of eating disorders. There were no associations between distance/time to services and eating disorder symptomology. The discrepancies in eating disorder symptomology between urban/rural may stem from stigma and unique socio-cultural contexts in rural communities. The study underscores the need for targeted intervention, including telehealth, in addressing the eating disorder challenges faced by adolescents and young adults in rural regions. This study explores how common eating disorders are among adolescents and young adults in Ontario, Canada, with a specific focus on the geographic disparities of eating disorders. This study uses mapping technology to assess where eating disorders were more common and how close these areas were to specialized eating disorder treatment services. The findings showed that places with fewer services, especially rural areas, had higher rates of eating disorders. However, there wasn’t a clear link between how far people lived from these services and the severity of their eating disorders. This may suggest that those in rural areas might struggle more with eating disorders due to greater stigma and different social and cultural factors compared to urban areas. This study emphasizes the need for targeted interventions, like telehealth, to address these disparities. This research is pivotal in guiding equitable healthcare solutions for eating disorders, particularly in underserved rural communities.","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"5 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142212962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between childhood maltreatment and obsessive-compulsive disorder comorbid with eating disorders: a cross-sectional study.","authors":"Salma Attar, Jinane Jomaah, Rhéa El Khoury, Colin Cordahi, Maude Seneque, Philippe Courtet, Rami Bou Khalil, Sebastien Guillaume","doi":"10.1186/s40337-024-01090-0","DOIUrl":"10.1186/s40337-024-01090-0","url":null,"abstract":"<p><strong>Background: </strong>Obsessive-compulsive disorder (OCD) and eating disorders (ED) share common features, including the presence of obsessions and compulsions, and they often co-occur. Additionally, there is a significant comorbidity between ED and childhood traumatic experiences (CTE), as well as between CTE and OCD. Various biological and environmental factors have been proposed to explain the connection between ED, OCD, and CTE. This study explores the link between CTE and the comorbidity of ED and OCD, with the hypothesis that specific types of CTE may increase the risk of developing OCD in individuals with ED.</p><p><strong>Methods: </strong>Participants (N = 562) were enrolled at an eating disorder unit in Montpellier, France, between March 2013 and January 2020. The Childhood Trauma Questionnaire (CTQ), Eating Disorder Examination Questionnaire (EDE-Q), and Mini International Neuropsychiatric Interview (MINI) were used to evaluate childhood maltreatment, assess clinical characteristics associated with ED, and categorize participants into two groups: patients with and without OCD.</p><p><strong>Results: </strong>Bivariate analysis revealed that patients with comorbid ED and OCD had higher EDE-Q scores (p < 0.001), more anxiety disorders (p < 0.001), depressive disorders (p = 0.02), post-traumatic stress disorder (PTSD) (p < 0.001), and a higher incidence of sexual abuse (p < 0.001) and physical neglect (p = 0.04) compared to those without OCD. Multivariate analysis showed that the association between CTE and OCD was influenced by the presence of an anxiety disorder (p = 0.01) and a higher EDE-Q total score (p = 0.03), with a significant association with a history of sexual abuse (p = 0.04).</p><p><strong>Conclusions: </strong>This demonstrates that CTE increases the risk of comorbid OCD in ED patients, correlating with more clinically severe ED and a higher likelihood of anxiety disorders.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"12 1","pages":"135"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11380211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the ethical complexities of severe and enduring (longstanding) eating disorders: tools for critically reflective practice and collaborative decision-making.","authors":"Sacha Kendall Jamieson, Jacinta Tan, Kym Piekunka, Shannon Calvert, Stephen Anderson","doi":"10.1186/s40337-024-01082-0","DOIUrl":"10.1186/s40337-024-01082-0","url":null,"abstract":"<p><p>Decisions about the treatment of eating disorders do not occur in a socio-political vacuum. They are shaped by power relations that produce categories of risk and determine who is worthy of care. This impacts who gets access to care and recognition of rights in mental health services. Globally, there are calls for more human rights-based approaches in mental health services to reduce coercion, improve collaborative decision making and enhance community care. Treating individuals with longstanding, Severe and Enduring Eating Disorders (SEED) or Severe and Enduring Anorexia Nervosa (SE-AN) can be particularly problematic when it involves highly controversial issues such as treatment withdrawal and end-of-life decisions and, where legally permissible, medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in mental health services.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"12 1","pages":"134"},"PeriodicalIF":3.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing hospitalized adult patients with chronic anorexia nervosa with versus without prior hospitalizations.","authors":"Mary K Martinelli, Colleen C Schreyer, Angela S Guarda","doi":"10.1186/s40337-024-01092-y","DOIUrl":"10.1186/s40337-024-01092-y","url":null,"abstract":"<p><strong>Background: </strong>Anorexia nervosa (AN) is a severe psychiatric disorder, from which recovery is often protracted. The role of prior specialized inpatient treatment on subsequent treatment attempts for adults with chronic AN and predictors of treatment response for severe and enduring AN (SE-AN) are needed to improve outcomes.</p><p><strong>Method: </strong>Participants (N = 135) with chronic AN (ill ≥7 years) admitted to an integrated inpatient-partial hospitalization eating disorders (ED) unit with prior ED hospitalization(s) (+ PH; n = 100) were compared to those without prior ED hospitalizations (-PH; n = 35) on admission characteristics (BMI, length of illness, outpatient ED treatment history, symptomatology (ED, anxiety, and depressive), history of suicide attempts or non-suicidal self-injury (NSSI)), treatment motivation and recovery self-efficacy, and discharge outcomes (discharge BMI, rate of weight gain, length of stay, clinical improvement).</p><p><strong>Results: </strong>Groups were similar with regard to age, years ill, and admission BMI. The + PH group had lower desired weight, lifetime nadir BMI and self-efficacy for normative eating, and higher state and trait anxiety than the -PH group. +PH were also more likely to endorse history of NSSI and suicide attempt. Regarding discharge outcomes, most patients achieved weight restoration at program discharge (mean discharge BMI = 19.8 kg/m²). Groups did not differ on rate of weight gain, likelihood of attending partial hospital, partial hospital length of stay, program discharge BMI, or likelihood of clinical improvement (p's > 0.05) although inpatient length of stay was longer for the + PH group.</p><p><strong>Conclusions: </strong>Participants with chronic AN + PH exhibited more severe psychiatric comorbidity and lower self-efficacy for normative eating than AN -PH, however short-term discharge outcomes were similar. Future research should determine whether weight restoration and targeting comorbidities impacts relapse risk or need for rehospitalization among chronic and severe + PH. Despite similar illness durations, those with chronic AN -PH may be able to transition to partial hospital earlier. Conversely there is risk of undertreatment of chronic AN + PH given the recent shift promoting briefer self-directed admissions for adults with SE-AN. Research comparing + PH and -PH adults with chronic AN may facilitate efforts to individualize care and characterize relapse risk following intensive treatment.</p>","PeriodicalId":48605,"journal":{"name":"Journal of Eating Disorders","volume":"12 1","pages":"132"},"PeriodicalIF":3.5,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}