Document Detail


Treatment of anorexia nervosa: insights and obstacles.
MedLine Citation:
PMID:  18155737     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anorexia nervosa is a behavioral disorder characterized by ego-syntonic self-starvation, denial of illness and ambivalence towards treatment. Treatment refusal and drop-out rates are high and relapse is common. Treatment is best viewed as comprised of two phases, weight restoration and normalization of eating behavior followed by relapse prevention. Most patients verbalize a desire to change, however they seek treatment on their own terms, ideally with minimal or no weight gain. Successful treatment must therefore convince patients to overcome their drive to diet. Evidence-based data on treatment interventions for anorexia nervosa are scarce and methodological problems afflict the few published, controlled trials. Taken together, clinical expertise and data from correlational and controlled trials suggest that chronicity and adult status are associated with a worse prognosis. Outpatient family therapy is effective in weight-restoring the majority of adolescent patients whereas older patients, or those with severe medical or psychiatric comorbidity, often require intensive treatment on an inpatient eating disorders behavioral specialty unit. Correlational data suggest that weight-restored patients are less likely to relapse. Despite limitations of the current knowledge-base, several new areas of research hold promise in elucidating risk factors, in identifying the pathophysiology that sustains anorectic behavior, and in developing more targeted and effective treatments.
Authors:
Angela S Guarda
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-11-22
Journal Detail:
Title:  Physiology & behavior     Volume:  94     ISSN:  0031-9384     ISO Abbreviation:  Physiol. Behav.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-15     Completed Date:  2008-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0151504     Medline TA:  Physiol Behav     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-20     Citation Subset:  IM    
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA. Aguarda@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care
Anorexia Nervosa / drug therapy,  therapy*
Commitment of Mentally Ill
Humans
Patient Acceptance of Health Care
Psychotherapy
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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