Abstract
IntroductionAccording to the most widely influential treatment guidelines from the National Institute for Health and Clinical Excellence and the American Psychiatric Association, existing evidence for adult AN treatment is weak, and more treatment studies are needed.Objectives/aimsThe primary objective of this project is to gain knowledge about the effectiveness of CBT-E in the treatment of Anorexia Nervosa (AN). Secondary objectives are to prospectively examine baseline predictors of treatment outcome/drop-out and to examine variables related to treatment process and patient engagement as predictors of outcome/drop-out. Thirdly, in a multidisciplinary approach, to focus on selected pathophysiological mechanisms including disturbed neuropsychological functioning, changes in the gut microbiota, immunological and genetic measures in patients with severe AN in different stages of the disease, and further to investigate to what extent they are related to treatment outcome.MethodsThe sample consists of patients aged ≥ 16 years with AN admitted to outpatient treatment (CBT-E) at Section for Eating Disorders, Haukeland University Hospital, Bergen, Norway. Outcome measures include BMI, self-reported eating disorder symptoms (EDE-Q), depression (BDI), anxiety (BAI) general psychiatric symptomatology (SCL-90-R, M.I.N.I 6.0), health related quality of life (CIA, RAND-36), physical activity (accelerometers) and neuropsychological functioning. The main measurement points are at the start of treatment, 3 months, end of treatment and one year follow-up. Baseline predictors of treatment outcome and drop-out will be examined as well as the association between early adherence, behavioral change, therapeutic alliance and treatment outcome. In addition biochemical, genetic and bacteriological assessments will be conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Highlights
Anorexia nervosa (AN) is a debilitating psychiatric disorder associated with a wide array of negative health complications and psychiatric comorbidity
Evaluation of outpatient cognitive behavioral therapy (CBT)-E as a standard treatment for adult AN patients in a public hospital As discussed above, the existing evidence for AN treatment is weak and no empirically supported treatment has been reliably established for adults with AN [12, 14, 15]
The cognitive behavioral therapy (CBT-E) model is based on the assumption that common cognitive mechanisms, such as overevaluation of body shape and weight, underlie all eating disorders [17]
Summary
Anorexia nervosa (AN) is a debilitating psychiatric disorder associated with a wide array of negative health complications and psychiatric comorbidity. General overview Anorexia nervosa (AN) is a debilitating psychiatric disorder characterized by abnormal eating behaviors, severe weight loss, intense fear of gaining weight or becoming fat (despite being underweight), and having a disturbed body image [1]. AN is associated with a wide array of negative health complications that cause suffering. This condition is associated with a poor prognosis, including high rates. A substantial proportion of AN patients develop severe and enduring AN [11]. The adverse effects of AN combined with the high risk of severe and enduring AN indicate a substantial need for effective treatment options
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