A systematic review of interventions to support transitions from intensive treatment for adults with anorexia nervosa and/or their carers

TY - JOUR

T1 - A systematic review of interventions to support transitions from intensive treatment for adults with anorexia nervosa and/or their carers

AU - Bryan, Danielle Clark

AU - Cardi, Valentina

AU - Willmott, Daniel

AU - Teehan, Eimear Eileen

AU - Rowlands, Katie

AU - Treasure, Janet

N1 - Funding Information: This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Health Technology Assessment Programme (Grant Reference Number: 14/68/09). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. We also acknowledge the support of the NIHR Clinical Research Network. JT & VC acknowledge financial support from the NIHR Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. VC is supported by a grant from MIUR (Dipartimenti di Eccellenza DM 11/05/2017 n. 262) to the Department of General Psychology. Publisher Copyright: © 2021 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/5

Y1 - 2021/5

N2 - Aim: In the short term, intensive treatment focusing on restoring weight for anorexia nervosa can remediate many symptoms. However, there is a high level of relapse after discharge. This paper examines interventions developed to bridge the transition from intensive to less intensive forms of treatment for adult anorexia nervosa. Method: We undertook a systematic review of the literature on interventions aimed at providing transition support. The Template for Intervention Description and Replication was used to describe components of the transition interventions. Patient's drop-out rates, weight, eating disorder psychopathology and mood data were extracted at end of treatment and follow-up to describe preliminary efficacy. Results: Fourteen studies were selected: nine used psychological interventions delivered through face-to-face talking therapy or guided self-help, three examined the use of fluoxetine and two assessed stepped-care approaches. Transition support was delivered to patients in 11 studies, to patients and carers in two studies, and carers alone in another study. Conclusions: There was a great heterogeneity in the content and structure of the transition interventions evaluated. Overall, drop-out rates were lower for psychological support than pharmacological interventions or stepped-care approaches. Changes in eating disorder outcomes and mood were small to moderate throughout for studies that included a comparison group.

AB - Aim: In the short term, intensive treatment focusing on restoring weight for anorexia nervosa can remediate many symptoms. However, there is a high level of relapse after discharge. This paper examines interventions developed to bridge the transition from intensive to less intensive forms of treatment for adult anorexia nervosa. Method: We undertook a systematic review of the literature on interventions aimed at providing transition support. The Template for Intervention Description and Replication was used to describe components of the transition interventions. Patient's drop-out rates, weight, eating disorder psychopathology and mood data were extracted at end of treatment and follow-up to describe preliminary efficacy. Results: Fourteen studies were selected: nine used psychological interventions delivered through face-to-face talking therapy or guided self-help, three examined the use of fluoxetine and two assessed stepped-care approaches. Transition support was delivered to patients in 11 studies, to patients and carers in two studies, and carers alone in another study. Conclusions: There was a great heterogeneity in the content and structure of the transition interventions evaluated. Overall, drop-out rates were lower for psychological support than pharmacological interventions or stepped-care approaches. Changes in eating disorder outcomes and mood were small to moderate throughout for studies that included a comparison group.

KW - anorexia nervosa

KW - guided self-help

KW - psychological therapies

KW - relapse prevention

KW - transition support

UR - http://www.scopus.com/inward/record.url?scp=85100910393&partnerID=8YFLogxK

U2 - 10.1002/erv.2824

DO - 10.1002/erv.2824

M3 - Review article

AN - SCOPUS:85100910393

SN - 1072-4133

VL - 29

SP - 355

EP - 370

JO - European Eating Disorders Review

JF - European Eating Disorders Review

IS - 3

ER -