Journal ArticleDOI
Update on the treatment of anorexia nervosa; review of clinical trials, practice guidelines and emerging interventions
Hunna J. Watson,Cynthia M. Bulik +1 more
TLDR
An overview of best practices in anorexia nervosa treatment across the age spectrum is provided and a triangulated analysis including controlled research, practice guidelines, and emerging treatments to inform and support clinical decision making is presented.Abstract:
BackgroundAnorexia nervosa is a potentially deadly psychiatric illness that develops predominantly in females around puberty but is increasingly being recognized as also affecting boys and men and women across the lifespan. The aim of this environmental scan is to provide an overview of best practices in anorexia nervosa treatment across the age spectrum.MethodA triangulation approach was used. First, a detailed review of randomized controlled trials (RCTs) for anorexia nervosa published between 1980 and 2011 was conducted; second, clinical practice guidelines were consulted and reviewed; third, information about RCTs currently underway was sourced. This approach facilitated a comprehensive overview, which addressed the extant evidence base, recent advances in evidence and improvements in treatment, and future directions.ResultsThe evidence base for the treatment of anorexia nervosa is advancing, albeit unevenly. Evidence points to the benefit of family-based treatment for youth. For adults no specific approach has shown superiority and, presently, a combination of renourishment and psychotherapy such as specialist supportive clinical management, cognitive behavioral therapy, or interpersonal psychotherapy is recommended. RCTs have neither sufficiently addressed the more complex treatment approaches seen in routine practice settings, such as multidisciplinary treatment or level of care, nor specifically investigated treatment in ethnically diverse populations. Methodological challenges that hinder progress in controlled research for anorexia nervosa are explained.ConclusionsThe review highlights evidence-based and promising treatment modalities for anorexia nervosa and presents a triangulated analysis including controlled research, practice guidelines, and emerging treatments to inform and support clinical decision making.read more
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Journal ArticleDOI
Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa
Hunna J. Watson,Hunna J. Watson,Hunna J. Watson,Zeynep Yilmaz,Laura M. Thornton,Christopher Hübel,Christopher Hübel,Jonathan R. I. Coleman,Jonathan R. I. Coleman,Helena Gaspar,Helena Gaspar,Julien Bryois,Anke Hinney,Virpi M. Leppä,Manuel Mattheisen,Sarah E. Medland,Stephan Ripke,Stephan Ripke,Stephan Ripke,Shuyang Yao,Paola Giusti-Rodríguez,Ken B. Hanscombe,Kirstin L. Purves,Roger A.H. Adan,Roger A.H. Adan,Lars Alfredsson,Tetsuya Ando,Ole A. Andreassen,Jessica H. Baker,Wade H. Berrettini,Ilka Boehm,Claudette Boni,Vesna Boraska Perica,Vesna Boraska Perica,Katharina Buehren,Roland Burghardt,Matteo Cassina,Sven Cichon,Maurizio Clementi,Roger D. Cone,Philippe Courtet,Scott J. Crow,James J. Crowley,James J. Crowley,Unna N. Danner,Oliver S. P. Davis,Martina de Zwaan,George Dedoussis,Daniela Degortes,Janiece E. DeSocio,Danielle M. Dick,Dimitris Dikeos,Christian Dina,Monika Dmitrzak-Weglarz,Elisa Docampo,Laramie E. Duncan,Karin Egberts,Stefan Ehrlich,Geòrgia Escaramís,Tõnu Esko,Tõnu Esko,Xavier Estivill,Anne Farmer,Angela Favaro,Fernando Fernández-Aranda,Manfred M. Fichter,Krista Fischer,Manuel Föcker,Lenka Foretova,Andreas J. Forstner,Monica Forzan,Christopher S. Franklin,Steven Gallinger,Ina Giegling,Johanna Giuranna,Fragiskos Gonidakis,Philip Gorwood,Philip Gorwood,Monica Gratacos Mayora,Sébastien Guillaume,Yiran Guo,Hakon Hakonarson,Hakon Hakonarson,Konstantinos Hatzikotoulas,Joanna Hauser,Johannes Hebebrand,Sietske G. Helder,Stefan Herms,Stefan Herms,Stefan Herms,Beate Herpertz-Dahlmann,Wolfgang Herzog,Laura M. Huckins,Laura M. Huckins,James I. Hudson,Hartmut Imgart,Hidetoshi Inoko,Vladimir Janout,Susana Jiménez-Murcia,Antonio Julià,Gursharan Kalsi,Deborah Kaminská,Jaakko Kaprio,Leila Karhunen,Andreas Karwautz,Martien J H Kas,Martien J H Kas,James L. Kennedy,James L. Kennedy,Anna Keski-Rahkonen,Kirsty Kiezebrink,Youl-Ri Kim,Lars Klareskog,Kelly L. Klump,Gun Peggy Knudsen,Maria La Via,Stephanie Le Hellard,Stephanie Le Hellard,Robert D. Levitan,Robert D. Levitan,Dong Li,Lisa R. Lilenfeld,Bochao Danae Lin,Jolanta Lissowska,Jurjen J. Luykx,Pierre J. Magistretti,Pierre J. Magistretti,Mario Maj,Katrin Männik,Katrin Männik,Sara Marsal,Christian R. Marshall,Morten Mattingsdal,Sara McDevitt,Peter McGuffin,Andres Metspalu,Ingrid Meulenbelt,Nadia Micali,Nadia Micali,Nadia Micali,Karen S. Mitchell,Alessio Maria Monteleone,Palmiero Monteleone,Melissa A. Munn-Chernoff,Benedetta Nacmias,Marie Navratilova,Ioanna Ntalla,Julie K. O'Toole,Roel A. Ophoff,Roel A. Ophoff,Leonid Padyukov,Aarno Palotie,Aarno Palotie,Aarno Palotie,Jacques Pantel,Hana Papezova,Dalila Pinto,Raquel Rabionet,Raquel Rabionet,Anu Raevuori,Nicolas Ramoz,Ted Reichborn-Kjennerud,Ted Reichborn-Kjennerud,Valdo Ricca,Valdo Ricca,Samuli Ripatti,Samuli Ripatti,Franziska Ritschel,Marion Roberts,Marion Roberts,Marion Roberts,Alessandro Rotondo,Dan Rujescu,Dan Rujescu,Filip Rybakowski,Paolo Santonastaso,André Scherag,Stephen W. Scherer,Ulrike Schmidt,Ulrike Schmidt,Nicholas J. Schork,Alexandra Schosser,Jochen Seitz,Lenka Slachtova,P. Eline Slagboom,Margarita C T Slof-Op 't Landt,Agnieszka Słopień,Sandro Sorbi,Beata Świątkowska,Jin P. Szatkiewicz,Ioanna Tachmazidou,Elena Tenconi,Alfonso Tortorella,Alfonso Tortorella,Federica Tozzi,Janet Treasure,Janet Treasure,Artemis Tsitsika,Marta Tyszkiewicz-Nwafor,Konstantinos Tziouvas,Annemarie A. van Elburg,Eric F. van Furth,Gudrun Wagner,Esther Walton,Elisabeth Widen,Eleftheria Zeggini,Stephanie Zerwas,Stephan Zipfel,Andrew W. Bergen,Joseph M. Boden,Harry Brandt,Steven Crawford,Katherine A. Halmi,L. John Horwood,Craig Johnson,Allan S. Kaplan,Allan S. Kaplan,Walter H. Kaye,James E. Mitchell,Catherine M. Olsen,John F. Pearson,Nancy L. Pedersen,Michael Strober,Michael Strober,Thomas Werge,David C. Whiteman,D. Blake Woodside,Garret D. Stuber,Scott D. Gordon,Jakob Grove,Anjali K. Henders,Anders Juréus,Katherine M. Kirk,Janne Tidselbak Larsen,Janne Tidselbak Larsen,Richard Parker,Liselotte Petersen,Liselotte Petersen,Jennifer Jordan,Martin A. Kennedy,Grant W. Montgomery,Grant W. Montgomery,Tracey D. Wade,Andreas Birgegård,Andreas Birgegård,Paul Lichtenstein,Claes Norring,Claes Norring,Mikael Landén,Mikael Landén,Nicholas G. Martin,Preben Bo Mortensen,Preben Bo Mortensen,Patrick F. Sullivan,Patrick F. Sullivan,Gerome Breen,Gerome Breen,Cynthia M. Bulik,Cynthia M. Bulik +258 more
TL;DR: The genetic architecture of anorexia nervosa mirrors its clinical presentation, showing significant genetic correlations with psychiatric disorders, physical activity, and metabolic (including glycemic), lipid and anthropometric traits, independent of the effects of common variants associated with body-mass index.
Journal ArticleDOI
Anorexia nervosa: aetiology, assessment, and treatment
Stephan Zipfel,Katrin Elisabeth Giel,Katrin Elisabeth Giel,Cynthia M. Bulik,Cynthia M. Bulik,Phillipa Hay,Ulrike Schmidt +6 more
TL;DR: To successfully fight this enigmatic illness, understanding of the underlying biological and psychosocial mechanisms has to be enhanced, strategies for prevention and early intervention improved, and treatments targeted through improved understanding of specific disease mechanisms targeted.
Journal ArticleDOI
Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders
Phillipa Hay,Phillipa Hay,David Chinn,David Forbes,Sloane Madden,Richard Newton,Lois Sugenor,Stephen Touyz,Warren Ward +8 more
TL;DR: Specific evidence based psychological and pharmacological treatments are recommended for most eating disorders but more trials are needed for specific therapies in anorexia nervosa, and research is urgently needed for all aspects of ARFID assessment and management.
Journal ArticleDOI
Significant Locus and Metabolic Genetic Correlations Revealed in Genome-Wide Association Study of Anorexia Nervosa.
Laramie E. Duncan,Zeynep Yilmaz,Helena Gaspar,Raymond K. Walters,Jackie Goldstein,Verneri Anttila,Brendan Bulik-Sullivan,Stephan Ripke,Laura M. Thornton,Anke Hinney,Mark J. Daly,Patrick F. Sullivan,Eleftheria Zeggini,Gerome Breen,Cynthia M. Bulik +14 more
TL;DR: Anorexia nervosa is a complex heritable phenotype for which this study has uncovered the first genome-wide significant locus on chromosome 12, and has large and significant genetic correlations with both psychiatric phenotypes and metabolic traits.
Journal ArticleDOI
Focal psychodynamic therapy, cognitive behaviour therapy, and optimised treatment as usual in outpatients with anorexia nervosa (ANTOP study): randomised controlled trial
Stephan Zipfel,Beate Wild,Gaby Groß,Hans-Christoph Friederich,Martin Teufel,Dieter Schellberg,Katrin Elisabeth Giel,Martina de Zwaan,Andreas Dinkel,Stephan Herpertz,Markus Burgmer,Bernd Löwe,Sefik Tagay,Jörn von Wietersheim,Almut Zeeck,Carmen Schade-Brittinger,Henning Schauenburg,Wolfgang Herzog +17 more
TL;DR: Focal psychodynamic therapy proved advantageous in terms of recovery at 12-month follow-up, and enhanced cognitive behaviour therapy was more effective with respect to speed of weight gain and improvements in eating disorder psychopathology.
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