The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.
Treating severe and enduring anorexia nervosa: a randomized controlled trial
Abstract
Background: There are no evidence-based treatments for severe and enduring anorexia nervosa (SE-AN). This study evaluated the relative efficacy of cognitive behavioral therapy (CBT-AN) and specialist supportive clinical management (SSCM) for adults with SE-AN. Method: Sixty-three participants with a diagnosis of AN, who had at least a 7-year illness history, were treated in a multi-site randomized controlled trial (RCT). During 30 out-patient visits spread over 8 months, they received either CBT-AN or SSCM, both modified for SE-AN. Participants were assessed at baseline, end of treatment (EOT), and at 6- and 12-month post-treatment follow-ups. The main outcome measures were quality of life, mood disorder symptoms and social adjustment. Weight, eating disorder (ED) psychopathology, motivation for change and health-care burden were secondary outcomes. Results: Thirty-one participants were randomized to CBT-AN and 32 to SSCM with a retention rate of 85% achieved at the end of the study. At EOT and follow-up, both groups showed significant improvement. There were no differences between treatment groups at EOT. At the 6-month follow-up, CBT-AN participants had higher scores on the Weissman Social Adjustment Scale (WSAS; p = 0.038) and at 12 months they had lower Eating Disorder Examination (EDE) global scores ( p = 0.004) and higher readiness for recovery ( p = 0.013) compared to SSCM. Conclusions: Patients with SE-AN can make meaningful improvements with both therapies. Both treatments were acceptable and high retention rates at follow-up were achieved. Between-group differences at follow-up were consistent with the nature of the treatments given.
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“Person-centred recovery and harm-reduction approaches may be particularly beneficial, especially for individuals with SE-AN [140–142], and recovery-model approaches for SE-AN may benefit both patients and clinicians [143].”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [141]
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Metadata
- Authors
- Touyz, S., Le Grange, D., Lacey, H., Hay, P., Smith, R., Maguire, S., Bamford, B., Pike, K. M., & Crosby, R. D.
- Affiliations
- The University of Sydney (AU)
- St George's, University of London (GB)
- Western Sydney University (AU)
- Columbia University (US)
- University of North Dakota (US)
- Corresponding author
- Touyz, S.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-05-03
- Volume
- 43
- Issue
- 12
- Pages
- 2501-2511
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2133783100
- Cited by
- 291
- References
- 44
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 31 · 2023: 21 · 2022: 21 · 2021: 21 · 2020: 24 · 2019: 19 · 2018: 21 · 2017: 29 · 2016: 26 · 2015: 24 · 2014: 24 · 2013: 8
- FWCI
- 30.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline - JCU (James Cook University) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- severe and enduring anorexia nervosa, treatment efficacy, social adaptation, eating disorder psychopathology, quality of life, treatment retention, chronic disease
- MeSH terms
- Adult, Anorexia Nervosa, Depression, Female, Follow-Up Studies, Humans, Middle Aged, Motivation, Quality of Life, Severity of Illness Index, Social Adjustment, Social Support, Cognitive Behavioral Therapy, Treatment Outcome, Cost of Illness, Disease Management, Young Adult
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