Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review
This Mini-Review presents recent research into evidence for psychological treatments for people with severe and enduring anorexia nervosa (SEAN). Two psychological therapies, specialist supportive clinical management (SSCM), and cognitive behavior therapy for anorexia nervosa (CBT-AN) have limited (...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00206/full |
| _version_ | 1818924689318215680 |
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| author | James Zhu Yive Yang Stephen Touyz Stephen Touyz Rebecca Park Phillipa Hay Phillipa Hay |
| author_facet | James Zhu Yive Yang Stephen Touyz Stephen Touyz Rebecca Park Phillipa Hay Phillipa Hay |
| author_sort | James Zhu |
| collection | DOAJ |
| description | This Mini-Review presents recent research into evidence for psychological treatments for people with severe and enduring anorexia nervosa (SEAN). Two psychological therapies, specialist supportive clinical management (SSCM), and cognitive behavior therapy for anorexia nervosa (CBT-AN) have limited (one randomized controlled study) evidence of efficacy. Both have had adaptations for SEAN, notably with revision of the primary treatment goal of improved quality of life and full weight recovery a secondary goal. A major issue with existing studies is poor definition of SEAN, and the large deficit in research that has used an agreed definition of SEAN. In particular, it may be problematic to extrapolate from studies of people with either severe and/or enduring but not intractable or “resistant” illness. People with longstanding AN who have not received evidence based care should be offered this with an expectation of recovery. Similarly, people with SEAN may be offered care with judicious mitigation of expectations. In the future, trials should include people with SEAN clearly defined. Trials with a subsample of participants likely to have SEAN, if identified at randomisation, are an opportunity for secondary analyses of such participants. This would widen the evidence base for psychological treatments providing hope for people with this devastating illness. Finally, there is an urgent need not only to strengthen our existing knowledge with studies of sufficient power, but also, fundamentally, to derive novel conceptualizations of what “treatment” involves. |
| first_indexed | 2024-12-20T02:29:19Z |
| format | Article |
| id | doaj.art-b9d85a2350d744d187cd558cffb99d66 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-20T02:29:19Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-b9d85a2350d744d187cd558cffb99d662022-12-21T19:56:36ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-03-011110.3389/fpsyt.2020.00206524915Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini ReviewJames Zhu0Yive Yang1Stephen Touyz2Stephen Touyz3Rebecca Park4Phillipa Hay5Phillipa Hay6South West and North Coast Psychiatry Training Network, Sydney Local Health District, Sydney, NSW, AustraliaSchool of Health Sciences, University of Newcastle, Callaghan, NSW, AustraliaInsideOut Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, AustraliaSchool of Psychology, University of Sydney, Sydney, NSW, AustraliaDepartment of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United KingdomWestern Sydney University, Translational Health Research Institute, Sydney, NSW, AustraliaSouth Western Sydney Local Health District, Camden and Campbelltown Hospitals, Sydney, NSW, AustraliaThis Mini-Review presents recent research into evidence for psychological treatments for people with severe and enduring anorexia nervosa (SEAN). Two psychological therapies, specialist supportive clinical management (SSCM), and cognitive behavior therapy for anorexia nervosa (CBT-AN) have limited (one randomized controlled study) evidence of efficacy. Both have had adaptations for SEAN, notably with revision of the primary treatment goal of improved quality of life and full weight recovery a secondary goal. A major issue with existing studies is poor definition of SEAN, and the large deficit in research that has used an agreed definition of SEAN. In particular, it may be problematic to extrapolate from studies of people with either severe and/or enduring but not intractable or “resistant” illness. People with longstanding AN who have not received evidence based care should be offered this with an expectation of recovery. Similarly, people with SEAN may be offered care with judicious mitigation of expectations. In the future, trials should include people with SEAN clearly defined. Trials with a subsample of participants likely to have SEAN, if identified at randomisation, are an opportunity for secondary analyses of such participants. This would widen the evidence base for psychological treatments providing hope for people with this devastating illness. Finally, there is an urgent need not only to strengthen our existing knowledge with studies of sufficient power, but also, fundamentally, to derive novel conceptualizations of what “treatment” involves.https://www.frontiersin.org/article/10.3389/fpsyt.2020.00206/fulleating disorder anorexia nervosatherapytreatment resistantlongstanding chronictherapy |
| spellingShingle | James Zhu Yive Yang Stephen Touyz Stephen Touyz Rebecca Park Phillipa Hay Phillipa Hay Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review Frontiers in Psychiatry eating disorder anorexia nervosa therapy treatment resistant longstanding chronic therapy |
| title | Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review |
| title_full | Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review |
| title_fullStr | Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review |
| title_full_unstemmed | Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review |
| title_short | Psychological Treatments for People With Severe and Enduring Anorexia Nervosa: A Mini Review |
| title_sort | psychological treatments for people with severe and enduring anorexia nervosa a mini review |
| topic | eating disorder anorexia nervosa therapy treatment resistant longstanding chronic therapy |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2020.00206/full |
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