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Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland

This descriptive study examined patient characteristics, treatment characteristics, and short-term outcomes among patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in routine clinical care. Results for patients receiving full-time treatment were contrasted with results for patients receiv...

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Autores principales: Schopf, Kathrin, Schneider, Silvia, Meyer, Andrea Hans, Lennertz, Julia, Humbel, Nadine, Bürgy, Nadine-Messerli, Wyssen, Andrea, Biedert, Esther, Isenschmid, Bettina, Milos, Gabriella, Claussen, Malte, Trier, Stephan, Whinyates, Katherina, Adolph, Dirk, Teismann, Tobias, Margraf, Jürgen, Assion, Hans-Jörg, Überberg, Bianca, Juckel, Georg, Müller, Judith, Klauke, Benedikt, Munsch, Simone
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313003/
https://www.ncbi.nlm.nih.gov/pubmed/37390075
http://dx.doi.org/10.1371/journal.pone.0280402
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author Schopf, Kathrin
Schneider, Silvia
Meyer, Andrea Hans
Lennertz, Julia
Humbel, Nadine
Bürgy, Nadine-Messerli
Wyssen, Andrea
Biedert, Esther
Isenschmid, Bettina
Milos, Gabriella
Claussen, Malte
Trier, Stephan
Whinyates, Katherina
Adolph, Dirk
Teismann, Tobias
Margraf, Jürgen
Assion, Hans-Jörg
Überberg, Bianca
Juckel, Georg
Müller, Judith
Klauke, Benedikt
Munsch, Simone
author_facet Schopf, Kathrin
Schneider, Silvia
Meyer, Andrea Hans
Lennertz, Julia
Humbel, Nadine
Bürgy, Nadine-Messerli
Wyssen, Andrea
Biedert, Esther
Isenschmid, Bettina
Milos, Gabriella
Claussen, Malte
Trier, Stephan
Whinyates, Katherina
Adolph, Dirk
Teismann, Tobias
Margraf, Jürgen
Assion, Hans-Jörg
Überberg, Bianca
Juckel, Georg
Müller, Judith
Klauke, Benedikt
Munsch, Simone
author_sort Schopf, Kathrin
collection PubMed
description This descriptive study examined patient characteristics, treatment characteristics, and short-term outcomes among patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in routine clinical care. Results for patients receiving full-time treatment were contrasted with results for patients receiving ambulatory treatment. Data of a clinical trial including 116 female patients (18–35 years) diagnosed with AN or BN were subjected to secondary analyses. Patients were voluntarily admitted to one of nine treatment facilities in Germany and Switzerland. Patients received cognitive-behavioral interventions in accordance with the national clinical practice guidelines for the treatment of EDs under routine clinical care conditions, either as full-time treatment or ambulatory treatment. Assessments were conducted after admission and three months later. Assessments included a clinician-administered diagnostic interview (DIPS), body-mass-index (BMI), ED pathology (EDE-Q), depressive symptoms (BDI-II), symptoms of anxiety (BAI), and somatic symptoms (SOMS). Findings showed that treatment intensity differed largely by setting and site, partly due to national health insurance policies. Patients with AN in full-time treatment received on average 65 psychotherapeutic sessions and patients with BN in full-time treatment received on average 38 sessions within three months. In comparison, patients with AN or BN in ambulatory treatment received 8–9 sessions within the same time. Full-time treatment was associated with substantial improvements on all measured variables for both women with AN (d = .48-.83) and BN (d = .48-.81). Despite the relatively small amount of psychotherapeutic sessions, ambulatory treatment was associated with small increases in BMI (d = .37) among women with AN and small improvements on all measured variables among women with BN (d = .27-.43). For women with AN, reduction in ED pathology were positively related to the number of psychotherapeutic sessions received. Regardless of diagnosis and treatment setting, full recovery of symptoms was rarely achieved within three months (recovery rates ranged between 0 and 4.4%). The present study shows that a considerable amount of patients with EDs improved after CBT-based ED treatment in routine clinical care within three months after admission. Intensive full-time treatment may be particularly effective in quickly improving ED-related pathology, although full remission of symptoms is typically not achieved. A small amount of ambulatory sessions may already produce considerable improvements in BN pathology and weight gain among women with AN. As patient characteristics and treatment intensity differed largely between settings, results should not be interpreted as superiority of one treatment setting over another. Furthermore, this study shows that treatment intensity is quite heterogeneous, indicating the possibility for increasing effectiveness in the treatment of EDs in routine clinical care.
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spelling pubmed-103130032023-07-01 Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland Schopf, Kathrin Schneider, Silvia Meyer, Andrea Hans Lennertz, Julia Humbel, Nadine Bürgy, Nadine-Messerli Wyssen, Andrea Biedert, Esther Isenschmid, Bettina Milos, Gabriella Claussen, Malte Trier, Stephan Whinyates, Katherina Adolph, Dirk Teismann, Tobias Margraf, Jürgen Assion, Hans-Jörg Überberg, Bianca Juckel, Georg Müller, Judith Klauke, Benedikt Munsch, Simone PLoS One Research Article This descriptive study examined patient characteristics, treatment characteristics, and short-term outcomes among patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN) in routine clinical care. Results for patients receiving full-time treatment were contrasted with results for patients receiving ambulatory treatment. Data of a clinical trial including 116 female patients (18–35 years) diagnosed with AN or BN were subjected to secondary analyses. Patients were voluntarily admitted to one of nine treatment facilities in Germany and Switzerland. Patients received cognitive-behavioral interventions in accordance with the national clinical practice guidelines for the treatment of EDs under routine clinical care conditions, either as full-time treatment or ambulatory treatment. Assessments were conducted after admission and three months later. Assessments included a clinician-administered diagnostic interview (DIPS), body-mass-index (BMI), ED pathology (EDE-Q), depressive symptoms (BDI-II), symptoms of anxiety (BAI), and somatic symptoms (SOMS). Findings showed that treatment intensity differed largely by setting and site, partly due to national health insurance policies. Patients with AN in full-time treatment received on average 65 psychotherapeutic sessions and patients with BN in full-time treatment received on average 38 sessions within three months. In comparison, patients with AN or BN in ambulatory treatment received 8–9 sessions within the same time. Full-time treatment was associated with substantial improvements on all measured variables for both women with AN (d = .48-.83) and BN (d = .48-.81). Despite the relatively small amount of psychotherapeutic sessions, ambulatory treatment was associated with small increases in BMI (d = .37) among women with AN and small improvements on all measured variables among women with BN (d = .27-.43). For women with AN, reduction in ED pathology were positively related to the number of psychotherapeutic sessions received. Regardless of diagnosis and treatment setting, full recovery of symptoms was rarely achieved within three months (recovery rates ranged between 0 and 4.4%). The present study shows that a considerable amount of patients with EDs improved after CBT-based ED treatment in routine clinical care within three months after admission. Intensive full-time treatment may be particularly effective in quickly improving ED-related pathology, although full remission of symptoms is typically not achieved. A small amount of ambulatory sessions may already produce considerable improvements in BN pathology and weight gain among women with AN. As patient characteristics and treatment intensity differed largely between settings, results should not be interpreted as superiority of one treatment setting over another. Furthermore, this study shows that treatment intensity is quite heterogeneous, indicating the possibility for increasing effectiveness in the treatment of EDs in routine clinical care. Public Library of Science 2023-06-30 /pmc/articles/PMC10313003/ /pubmed/37390075 http://dx.doi.org/10.1371/journal.pone.0280402 Text en © 2023 Schopf et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schopf, Kathrin
Schneider, Silvia
Meyer, Andrea Hans
Lennertz, Julia
Humbel, Nadine
Bürgy, Nadine-Messerli
Wyssen, Andrea
Biedert, Esther
Isenschmid, Bettina
Milos, Gabriella
Claussen, Malte
Trier, Stephan
Whinyates, Katherina
Adolph, Dirk
Teismann, Tobias
Margraf, Jürgen
Assion, Hans-Jörg
Überberg, Bianca
Juckel, Georg
Müller, Judith
Klauke, Benedikt
Munsch, Simone
Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland
title Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland
title_full Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland
title_fullStr Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland
title_full_unstemmed Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland
title_short Eating disorder treatment in routine clinical care: A descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in Germany and Switzerland
title_sort eating disorder treatment in routine clinical care: a descriptive study examining treatment characteristics and short-term treatment outcomes among patients with anorexia nervosa and bulimia nervosa in germany and switzerland
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313003/
https://www.ncbi.nlm.nih.gov/pubmed/37390075
http://dx.doi.org/10.1371/journal.pone.0280402
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