https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(15)00356-9.pdf

Anorexia nervosa: aetiology, assessment, and treatment

https://research.vu.nl/ws/files/105339237/The_Lancet_Psychiatry_Commission_on_psychological_treatments_research_in_tomorrows_science.pdf

The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science

Objective: The course of eating disorders is often protracted, with fewer than half of adults achieving recovery from anorexia nervosa or bulimia nervosa. Some argue for palliative management when duration exceeds a decade, yet outcomes beyond 20 years are rarely described. This study investigates early and long-term recovery in the Massachusetts General Hospital Longitudinal Study of Anorexia and Bulimia Nervosa. Methods: Females with DSM-III-R/DSM-IV anorexia nervosa or bulimia nervosa were assessed at 9 and at 20 to 25 years of follow-up (mean [SD] = 22.10 [1.10] years; study initiated in 1987, last follow-up conducted in 2013) via structured clinical interview (Longitudinal Interval Follow-Up Evaluation of Eating Disorders [LIFE-EAT-II]). Seventy-seven percent of the original cohort was re-interviewed, and multiple imputation was used to include all surviving participants from the original cohort (N = 228). Kaplan-Meier curves estimated recovery by 9-year follow-up, and McNemar test examined concordance between recovery at 9-year and 22-year follow-up. Results: At 22-year follow-up, 62.8% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa recovered, compared to 31.4% of participants with anorexia nervosa and 68.2% of participants with bulimia nervosa by 9-year follow-up. Approximately half of those with anorexia nervosa who had not recovered by 9 years progressed to recovery at 22 years. Early recovery was associated with increased likelihood of long-term recovery in anorexia nervosa (odds ratio [OR] = 10.5; 95% CI, 3.77-29.28; McNemar χ2 1 = 31.39; P <.01) but not in bulimia nervosa (OR = 1.0; 95% CI, 0.49-2.05; McNemar χ2 1= 0; P = 1.0). Conclusion: At 22 years, approximately two-thirds of females with anorexia nervosa and bulimia nervosa were recovered. Recovery from bulimia nervosa happened earlier, but recovery from anorexia nervosa continued over the long term, arguing against the implementation of palliative care for most individuals with eating disorders.

Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up

Objective This meta-analysis examined the efficacy of cognitive-behavioral therapy (CBT) for eating disorders. Method Randomized controlled trials of CBT were searched. Seventy-nine trials were included. Results Therapist-led CBT was more efficacious than inactive (wait-lists) and active (any psychotherapy) comparisons in individuals with bulimia nervosa and binge eating disorder. Therapist-led CBT was most efficacious when manualized CBT-BN or its enhanced version was delivered. No significant differences were observed between therapist-led CBT for bulimia nervosa and binge eating disorder and antidepressants at posttreatment. CBT was also directly compared to other specific psychological interventions, and therapist-led CBT resulted in greater reductions in behavioral and cognitive symptoms than interpersonal psychotherapy at posttreatment. At follow-up, CBT outperformed interpersonal psychotherapy only on cognitive symptoms. CBT for binge eating disorder also resulted in greater reductions in behavioral symptoms than behavioral weight loss interventions. There was no evidence that CBT was more efficacious than behavior therapy or nonspecific supportive therapies. Conclusions CBT is efficacious for eating disorders. Although CBT was equally efficacious to certain psychological treatments, the fact that CBT outperformed all active psychological comparisons and interpersonal psychotherapy specifically, offers some support for the specificity of psychological treatments for eating disorders. Conclusions from this study are hampered by the fact that many trials were of poor quality. Higher quality RCTs are essential. (PsycINFO Database Record

The efficacy of cognitive-behavioral therapy for eating disorders: a systematic review and meta-analysis

Purpose of reviewThe current systematic review sought to compare available evidence-based clinical treatment guidelines for all specific eating disorders.Recent findingsNine evidence-based clinical treatment guidelines for eating disorders were located through a systematic search. The international

/pdf/evidence-based-clinical-guidelines-for-eating-disorders-3paw13jg5i.pdf

Evidence-based clinical guidelines for eating disorders: international comparison

Objectives:This clinical practice guideline for treatment of DSM-5 feeding and eating disorders was conducted as part of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clini...

https://www.dependencias.pt/ficheiros/conteudos/files/Aust%20N%20Z%20J%20Psychiatry-2014-Hay-977-1008.pdf

David Chinn

Papers

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders