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Cited by 126Eating Disorders and BehaviorsChild Nutrition and Feeding IssuesNutrition, Health and Food Behavior

L abeling and defining severe and enduring anorexia nervosa: A systematic review and critical analysis

Broomfield, Catherine, Stedal, Kristin, Touyz, Stephen, Rhodes, Paul·2017·International Journal of Eating Disorders
DOI 10.1002/eat.22715
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Abstract

Abstract Objective With anorexia nervosa (AN) having various presentations, attention has been directed towards particularly durable forms of the condition in both research and clinical contexts. A major hindrance in terms of advancing the field is the inconsistent labeling and defining of this subgroup. This has two implications; first, the inconsistent recruitment of participants when researching this sample, and second, the misdiagnosing of patients who may or may not have a durable course of the disease. The current research had the purpose of providing an overview of the current labels and criteria used for defining cases of severe and enduring AN, and critically analysing the implications of these findings. Method In accordance with PRISMA guidelines, a literature search was conducted using four electronic databases (PsycINFO, MEDLINE, Web of Science and Scopus) in order to identify 32 records that met the standards stipulated by the criteria. Data extraction included explicit labeling, the definition or criteria used to describe the subgroup, along with participant age and study design. Results It was found that the terms chronic and severe and enduring were the most commonly used adjectives when referring to this subgroup. In terms of criteria, illness duration and the number of previously failed treatment attempts were the most common defining features within the literature. Discussion It is the aim of the authors to inspire further research into what is the most appropriate label and defining features for the subgroup in order to facilitate a better approach and outcome for the individuals affected. Resumen Objetivo Con la Anorexia Nervosa (AN) teniendo varias presentaciones, tanto en la investigación como en los contextos clínicos, la atención se ha dirigido particularmente hacia las formas duraderas de esta condición. Un obstáculo importante en términos de avanzar en el campo es la inconsistencia en el etiquetado y definición de este subgrupo. Esto tiene dos implicaciones; Primero, el inconsistente reclutamiento de participantes cuando se investiga esta muestra, y segundo, el diagnóstico equivocado de pacientes que pueden o no tener un curso duradero de la enfermedad. La presente investigación tiene el propósito de proporcionar una visión general de las etiquetas actuales y los criterios utilizados para definir los casos de AN severa y duradera, y analizar críticamente las implicaciones de estos hallazgos. Método: De acuerdo con las guías PRISMA, se realizó una búsqueda en la literatura utilizando cuatro bases de datos electrónicas (PsycINFO, MEDLINE, Web of Science y Scopus) para identificar 32 artículos que cumplían con los estándares estipulados por los criterios. La extracción de datos incluyó el etiquetado explícito, la definición o criterio utilizado para describir este subgrupo, junto con la edad del participante y el diseño del estudio. Resultados: Se encontró que los términos crónico, severo y duradero eran los adjetivos más comúnmente utilizados cuando se referían a este subgrupo. En términos de criterios, la duración de la enfermedad y el número de intentos de tratamiento previamente fallidos fueron las características definitorias más comunes dentro de la literatura. Discusión: Uno de los objetivos de los autores es inspirar a que se realice más investigación en torno a cuál sería el etiquetado y la definición más apropiados para este subgrupo y así facilitar un mejor abordaje y resultados para los individuos afectados.

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  • Conceptions of treatment resistance do not distinguish between patients who elect to end treatment for reasons pertaining to the treatment itself and those who ended treatment early due to financial constraints, work and family responsibilities, or because the treatment provider prematurely ended care.

    “Critically, conceptions of treatment resistance also do not distinguish between patients who elect to end treatment for reasons pertaining to the treatment itself and those who ended treatment early due to financial constraints (e.g., inadequate insurance), work and family responsibilities (e.g., lack of childcare or risk of job loss), or because the treatment provider prematurely ended care (e.g.”

    From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [129]

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Authors
Broomfield, C., Stedal, K., Touyz, S., & Rhodes, P.
Affiliations
  • The University of Sydney (AU)
  • Oslo University Hospital (NO)
Corresponding author
Broomfield, Catherine
ORCID
Venue
International Journal of Eating Disorders
Publisher
Wiley
Published
2017-04-25
Volume
50
Issue
6
Pages
611-623
ISSN
  • 0276-3478 (ISSN-L)
  • 1098-108X
DOI
10.1002/eat.22715
OpenAlex
W2608043084
Cited by
126
References
66
Citations by year
2026: 10 · 2025: 16 · 2024: 24 · 2023: 10 · 2022: 13 · 2021: 20 · 2020: 21 · 2019: 6 · 2018: 6
FWCI
1.38
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • International Journal of Eating Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
anorexia nervosa, severe and enduring anorexia nervosa, chronic anorexia nervosa, diagnostic criteria, disease duration, misdiagnosis, participant recruitment, eating disorders, treatment resistance, eating disorder relapse
MeSH terms
Anorexia Nervosa, Humans

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