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Predictors of outcome among young adult patients with anorexia nervosa in a randomised controlled trial
Örebro University, School of Health Sciences.ORCID iD: 0000-0002-9808-5414
Department of Clinical Neuroscience, Resource Centre for Eating Disorders, Karolinska Institute, Stockholm, Sweden.
Örebro University, School of Medical Sciences. University Health Care Research Centre.ORCID iD: 0000-0002-3227-2487
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Clinical Neuroscience, Resource Centre for Eating Disorders, Karolinska Institute, Stockholm, Sweden; University Health Care Research Centre, Region Örebro County, Örebro, Sweden; Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-1460-4238
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2019 (English)In: European eating disorders review, ISSN 1072-4133, E-ISSN 1099-0968, Vol. 27, no 1, p. 76-85Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The prognosis in cases of anorexia nervosa (AN) is unsatisfactory, and it is therefore important to examine pretreatment predictors of outcome.

METHODS: Female AN patients (N = 74) included in a randomised controlled trial receiving individual cognitive behavioural therapy (CBT) or family-based treatment (FBT) were included. Predictors of the outcome were explored using pretreatment eating disorder psychopathology.

RESULTS: In the CBT group, lower levels of emotional dysregulation and greater deficits in identifying and coping with inner states were predictors of weight increase, explaining 37.7% of the variance. In the FBT group, lower interoceptive deficits predicted an increase in weight (explaining 17.7% of the variance), whereas bulimic behaviour (32.4%) and problems with emotional regulation (23.3%) were predictors of increased diagnostic symptoms.

CONCLUSIONS: Bulimic symptoms and the ability to identify and cope with emotional states appear to be important aspects that should be addressed in the treatment of young adult patients with AN.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 27, no 1, p. 76-85
Keywords [en]
BMI, anorexia nervosa, outcome, prediction, young adults
National Category
Psychiatry Psychology
Identifiers
URN: urn:nbn:se:oru:diva-68439DOI: 10.1002/erv.2630ISI: 000453012700008PubMedID: 30094893Scopus ID: 2-s2.0-85052807835OAI: oai:DiVA.org:oru-68439DiVA, id: diva2:1238464
Funder
Vårdal FoundationAvailable from: 2018-08-13 Created: 2018-08-13 Last updated: 2022-08-24Bibliographically approved
In thesis
1. Anorexia nervosa - The journey towards recovery: A randomized controlled treatment trial: assessment, prediction, treatment outcome and clinical change
Open this publication in new window or tab >>Anorexia nervosa - The journey towards recovery: A randomized controlled treatment trial: assessment, prediction, treatment outcome and clinical change
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to study young adult women with anorexia nervosa (AN) participating in an randomized controlled trial in relation to assessment, treatment outcome, prediction, and clinical change. 

The results confirm the Eating Disorder Inventory-3 as a valid instrument for measuring eating disorder symptoms and general psychopathology. AN patients, however, rate themselves significantly lower than patients with other eating disorder diagnoses, and interoceptive deficits are the best predictive subscale for AN diagnosis. Patients significantly improved in terms of weight and eating disorder psychopathology, with no differences between individual CBT and family therapy (FT). Most patients did not fulfill the diagnostic criteria at post-assessment, at 76% and 86% at followup. Patients in FT were considered completers to a higher extent than patients receiving CBT, and 8% were prematurely discharged, in comparison to 30% for CBT. Bulimic symptoms and emotional dysregulation at baseline had a negative effect on diagnostic symptoms, and lower levels of interoceptive deficits predicted weight increase in the FT group. Lower levels of emotional dysregulation and higher levels of interoceptive deficits explained 37% of the variance in BMI changes in the CBT group. The classifications of CS/RCI were shown to be valid when compared to normal controls. Patients classified as clinically significantly improved constituted 35-47% of all patients, and only three patients fulfilled the proposed definition of recovery. The agreement of the diagnostic criteria was fair.

The results suggest that individual CBT and FT are effective treatments for young adults. The ability to acknowledge, interpret, and handle emotions is an important aspect of treatment. Self-report measurements are useful for evaluating individual changes; however, diagnostic criteria do not accord with self-reported symptom changes and physical, behavioral, and psychological measurements are important for a complete estimation of recovery.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 98
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 245
Keywords
Anorexia nervosa, young adults, randomized controlled trial, outpatient psychotherapy, treatment outcome, predictors, recovery
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-92420 (URN)978-91-7529-396-7 (ISBN)
Public defence
2021-09-17, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2021-06-17 Created: 2021-06-17 Last updated: 2022-08-24Bibliographically approved

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Nyman-Carlsson, ErikaEngström, IngemarGustafsson, Sanna Aila

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