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Day-Hospital Multifocal Integrated Treatment for Anorexia Nervosa in Adolescents: A One-Year Follow-Up

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Abstract

The current guidelines for treatment of Anorexia Nervosa (AN) in children and adolescents recommend an integrated multidisciplinary approach as the elective intervention for this disorder. Nevertheless, there is insufficient evidence on the results of an integrated approach for the treatment of AN adolescent patients, especially in a Hospital setting. This study aims to analyze clinical and psychological changes occurring in adolescent patients after completion of a Day-Hospital Multifocal Integrated Treatment (MIT) for Anorexia Nervosa. The sample consisted of 60 adolescents with AN or Eating Disorder Not Otherwise Specified (EDNOS) restrictive type, aged 11 to 18 years, and their parents. Clinical course was evaluated at 3, 6 and 12-month follow-up periods. Our results showed clinical remission in a good percentage of patients. In general, we found a significant reduction of the eating psychopathology, whereas we did not detect any significant improvement in body dissatisfaction, perfectionism, and relational difficulties. This positive trend was confirmed at 3, 6, and 12-month follow-up, despite the increase of drop-outs. These results suggest that the proposed treatment is reasonably effective, because it aims to contain and reduce the acute phase of the disease in a limited time and in a hospital setting, but it is necessary to continue the treatment with targeted psychotherapeutic interventions to address the deeper psychological discomfort underlying the eating disorder.

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References

  • Abbate Daga, G., Quaranta, M., Notaro, C., & Urani, F., et al. (2011). Terapia familiare e disturbi del comportamento alimentare nelle giovani pazienti: Stato dell’arte. Giornale Italiano di Psicopatologia, 17, 40–47.

    Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.

    Google Scholar 

  • American Psychiatric Association. (2006). Treatment of patients with eating disorders, 3rd edition. American Journal of Psychiatry, 163(7), 4–54.

    Google Scholar 

  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • Dotti A., & Lazzari R. (1998). Validation and reliability of the Italian EAT-26. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 3, 188–194

    Article  Google Scholar 

  • Barkowski, S., Schwartze, D., Strauss, B., Burlingame, G. M., Barth, J., & Rosendahl, J. (2016). Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials. Journal of Anxiety Disorders, 39, 44–64. doi:10.1016/j.janxdis.2016.02.005.

    Article  PubMed  Google Scholar 

  • Bearman, S. K., Presnell, K., Martinez, E., & Stice, E. (2006). The skinny on body dissatisfaction: A longitudinal study of adolescent girls and boys. Journal of Youth and Adolescence, 35(2), 229–241. doi:10.1007/s10964-005-9010-9.

    Article  Google Scholar 

  • Bruch, H. (1978). Obesity and anorexia nervosa. Psychosomatics, 19(4), 208–212. doi:10.1016/S0033-3182(78)70990-4.

    Article  PubMed  Google Scholar 

  • Bruch, H. (1982). Anorexia nervosa: Therapy and theory. American Journal of Psychiatry, 139, 1531–1538. doi:10.1176/ajp.139.12.1531.

    Article  PubMed  Google Scholar 

  • Bühren, K., Schwarte, R., & Fluck, F., et al. (2014). Comorbid psychiatric disorders in female adolescents with first-onset anorexia nervosa. European Eating Disorders Review, 22(1), 39–44. doi:10.1002/erv.2254.

    Article  PubMed  Google Scholar 

  • Camuffo, M., Cerutti, R., Lucarelli, L., & Mayer, R. (1988). CDI Children Depression Inventory. Firenze: Organizzazioni Speciali.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.

  • Cottee-Lane, D., Pistrang, N., & Bryant-Waugh, R. (2004). Childhood onset anorexia nervosa: the experience of parents. European Eating Disorders Review, 12, 169–177. doi:10.1002/erv.560.

    Article  Google Scholar 

  • Crisp, A. H., Norton, K., Gowers, S., Halek, C., Bowyer, C., Yeldham, D., Levett, G., & Bhat, A. (1991). A controlled study of the effect of therapies aimed at adolescent and family psychopathology in anorexia nervosa. The British Journal of Psychiatry, 159, 325–333. doi:10.1192/bjp.159.3.325.

    Article  PubMed  Google Scholar 

  • Cuzzolaro, M., Vetrone, G., & Marano, G., et al. (1999). BUT: una nuova scala per la valutazione del disagio relativo all’immagine del corpo. Psichiatria dell’Infanzia e dell’Adolescenza, 66, 417–28.

    Google Scholar 

  • D’Onofrio, E., Pace, C. S., & Cavanna, D. (2015). Qualitative research in adolescent psychotherapy: Attachment and reflective functioning as psychotherapy’s outcomes of an adolescent with anorexia nervosa. Research in Psychotherapy: Psychopathology, Process and Outcome, 18(2), 93–101. doi:10.4081/ripppo.2015.181.

    Google Scholar 

  • Dalla Ragione, L. (2005). La casa delle bambine che non mangiano. Identità e nuovi DCA. Roma: Il Pensiero Scientifico Editore.

    Google Scholar 

  • Dalla Ragione, L. (2012). I disturbi del comportamento alimentare: un’epidemia della modernità. In Presidenza del Consiglio dei Ministri, Dipartimento della Gioventù. Il Coraggio di guardare: Prospettive e incontri per la prevenzione dei disturbi del comportamento alimentare, 1, 19–34.

  • Dalle Grave, R. (2011). Eating disorders: progress and challenges. European Journal of Internal Medicine, 22, 153–160. doi:10.1016/j.ejim.2010.12.010.

    Article  PubMed  Google Scholar 

  • Dare, C. (1985). The family therapy of anorexia nervosa. Journal of Psychiatric Research, 19, 435–443. doi:10.1016/0022-3956(85)90050-0.

    Article  PubMed  Google Scholar 

  • Di Pietro, G., Valoroso, L., Fichele, M., Bruno, C., & Sorge, F. (2002). What happens to eating disorder outpatients who withdrew from therapy? Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 7(4), 298–303. doi:10.1007/BF03324976.

    Article  Google Scholar 

  • Doyle, P. M., le Grange, D., & Loeb, K., et al. (2010). Early response to family-based treatment for adolescent anorexia nervosa. International Journal of Eating Disorder, 43(7), 659–662. doi:10.1002/eat.20764.

    Article  Google Scholar 

  • Eisler, I., Dare, C., Russell, G. F. M., Szmukler, M. D., Le Grange, D., & Dodge, E. (1997). Family and individual therapy in anorexia nervosa: A 5-year follow-up. Archives of General Psychiatry, 54, 1025–1030. doi:10.1001/archpsyc.1997.01830230063008.

    Article  PubMed  Google Scholar 

  • Eisler, I., Dare, C., Hodes, M., Russel, G. F., Dodge, E., & Le Grange, D. (2000). Family therapy for adolescent anorexia nervosa: the results of a controlled comparison of two family interventions. Journal of Child Psychology and Psychiatry, 41, 727–736. doi:10.1111/1469-7610.00660.

    Article  PubMed  Google Scholar 

  • Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129–136. doi:10.1126/science.847460.

    Article  PubMed  Google Scholar 

  • Friederich, H. C., Brooks, S., Uher, R., Campbell, I. C., Giampietro, V., & Brammer, M., et al. (2010). Neural correlates of body dissatisfaction in anorexia nervosa. Neuropsychologia, 48(10), 2878–2885. doi:10.1016/j.neuropsychologia.2010.04.036.

    Article  PubMed  Google Scholar 

  • Frigerio, A., & Monterosso, R. (2002). La valutazione su base empirica dei problemi emotivo-comportamentali in età evolutiva. Infanzia e Adolescenza, 1(1), 38–48.

    Google Scholar 

  • Garner, D. M. (2004). Eating Disorder Inventory-3. Professional Manual. Lutz, FL: Psychological Assessment Resources.

    Google Scholar 

  • Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9(2), 273–279. doi:10.1017/S0033291700030762.

    Article  PubMed  Google Scholar 

  • Geist, R., Heinmaa, M., & Sthephens, D., et al. (2000). Comparison of family therapy and family group psychoeducation in adolescents with anorexia nervosa. Canadian Journal of Psychiatry, 45, 173–178.

    PubMed  Google Scholar 

  • Giannini, M., Pannocchia, L., Dalle Grave, R., & Muratori, F. (2008). Adattamento italiano dell’EDI-3. [Eating Disorder Inventory-3]. Firenze: Giunti O.S. Organizzazioni Speciali.

    Google Scholar 

  • Godart, N., Berthoz, S., Curt, F., Perdereau, F., & Rein, Z., et al. (2012). A randomized controlled trial of adjunctive family therapy and treatment as usual following inpatient treatment for anorexia nervosa adolescents. PLoS ONE, 7(1), 282–349. doi:10.1371/journal.pone.0028249.

    Article  Google Scholar 

  • Gowers, S. G., Clark, A., Roberts, C., Griffiths, A., & Edwards, V., et al. (2007). Clinical effectiveness of treatments for anorexia nervosa in adolescents: randomized controlled trial. British Journal of Psychiatry, 191, 427–435. doi:10.1192/bjp.bp.107.036764.

    Article  PubMed  Google Scholar 

  • Grange, D. L., Lock, J., Accurso, E. C., Agras, W. S., Darcy, A., Forsberg, S., & Bryson, S. W. (2014). Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa. Journal of the American Academy of Child and Adolescent Psychiatry, 53(11), 1162–1167. doi:10.1016/j.jaac.2014.07.014.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hoek, H. W., & Van Hoeken, D. (2003). Review of the prevalence and incidence of eating disorders. International Journal of Eating Disorder, 34(4), 383–96. doi:10.1002/eat.10222.

    Article  Google Scholar 

  • Hrabosky, J. I., Masheb, R. M., White, M. A., & Grilo, C. M. (2007). Overvaluation of shape and weight in binge eating disorder. Journal of Consulting and Clinical Psychology, 75(1), 175–180. doi:10.1037/0022-006X.75.1.175.

    Article  PubMed  Google Scholar 

  • Jeammet, P. H., Brechon, G., Payan, C., Gorge, A., & Fermanian, J. (1991). Le devenir de l’anorexie mentale: une étude prospective de 129 patients évalués au moins 4 ans après leur première admission. Psychiatrie de l’Enfant XXXIV, 2, 381–442.

    Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Initial Reliability and Validity Data. Journal of the American Academy of Child & Adolescent Psychiatry, 36(7), 980–988

    Article  Google Scholar 

  • Keel, P. K., & Haedt, A. (2008). Evidence-based psychological treatments for eating problems and eating disorders. Journal of Child and Adolescent Psychology, 37, 39–61. doi:10.1080/15374410701817832.

    Article  Google Scholar 

  • Knijnik, D. Z., Kapczinski, F., Chachamovich, E., Margis, R., & Eizirik, C. L. (2004). Psychodynamic group treatment for generalized social phobia. Revista Brasileira de Psiquiatria, 26(2), 77–81.

    Article  PubMed  Google Scholar 

  • Kovacs, M. (1983). The Children’s Depression Inventory: a self-rated depression scale of school-aged youngsters. Pittsburgh, PA: University of Pittsburgh School of Medicine.

    Google Scholar 

  • Krug, I., Villarejo, C., & Jiménez-Murcia, S., et al. (2013). Eating-related environmental factors in underweight eating disorders and obesity: are there common vulnerabilities during childhood and early adolescence? European Eating Disorders Review, 21(3), 202–208. doi:10.1002/erv.2204.

    Article  PubMed  Google Scholar 

  • Laghi, F., Baiocco, R., D’Alessio, M., & Gurrieri, G. (2009). Suicidal ideation and time perspective in high school students. European Psychiatry, 24, 41–46. doi:10.1016/j.eurpsy.2008.08.006.

    Article  PubMed  Google Scholar 

  • Laghi, F., Pompili, S., Zanna, V., Castiglioni, M. C., Criscuolo, M., Chianello, I., Baumgartner, E., & Baiocco, R. (2015a). Are adolescents with anorexia nervosa better at reading minds?. Cognitive Neuropsychiatry, 20(6), 489–501. doi:10.1080/13546805.2015.1091766.

    Article  PubMed  Google Scholar 

  • Laghi, F., Pompili, S., Zanna, V., Castiglioni, M.C., Criscuolo, M., Chianello, I., et al. (2015b). How adolescents with anorexia nervosa and their parents perceive family functioning? Journal of Health Psychology , 10.1177/1359105315597055

  • Laghi, F., McPhie, L. M., Baumgartner, E., Rawana, J. S., Pompili, S., & Baiocco, R. (2016). Family functioning and dysfunctional eating among Italian adolescents: The moderating role of gender. Child Psychiatry and Human Development, 47, 43–52. doi:10.1007/s10578-015-0543-1.

    Article  PubMed  Google Scholar 

  • Lock, J., & Le Grange, D. (2005). Family-based treatment of eating disorders. International Journal of Eating Disorders, 37(1), 64–67. doi:10.1002/eat.20122.

    Article  Google Scholar 

  • Lock, J., & Le Grange, D. (2015). Treatment manual for anorexia nervosa. A family-based approach. 2nd edn. London: The Guilford Press.

    Google Scholar 

  • Lock, J., Couturier, J., Bryson, S., & Agras, S. (2006a). Predictors of dropout and remission in family therapy for adolescent anorexia nervosa in a randomized clinical trial. International Journal of Eating Disorders, 39, 639–647. doi:10.1002/eat.20328.

    Article  PubMed  Google Scholar 

  • Lock, J., Couturier, J., & Agras, W. S. (2006b). Comparison of long term outcomes in adolescents with anorexia nervosa treated with family therapy. American Journal of Child & Adolescent Psychiatry, 45, 666–672. doi:10.1097/01.chi.0000215152.61400.ca.

    Article  Google Scholar 

  • March, J. S. (1998). Manual for the multidimensional anxiety scale for children (MASC). Toronto, ON: Multi-Health Systems.

    Google Scholar 

  • Mohr, H., Zimmerman, J., Roder, C., Lenz, C., Overbeck, G., & Grabhon, R. (2010). Separating two components of body image in anorexia nervosa using fMRI. Psychological Medicine, 40, 1519–1529. doi:10.1017/S0033291709991826.

    Article  PubMed  Google Scholar 

  • Morgan, H. G., & Hayward, A. E. (1988). Clinical assessment of anorexia nervosa. The Morgan-Russel ooutcome assessment schedule. The British Journal of Psychiatry, 152(3), 367–371. doi:10.1192/bjp.152.3.367.

    Article  PubMed  Google Scholar 

  • National Institute for Clinical Excellence (2004). Eating disorders. Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. Clinical Guidelines, 9, 1–36.

    Google Scholar 

  • Onnis, L., Barbara, E., Bernardini, M., & Caggese, A., et al. (2012). Family relations and eating disorders. The effectiveness of an integrated approach in the treatment of anorexia and bulimia in teenagers: Results of a case-control systemic research. Eating Weight Disorder, 17(1), 36–48. doi:10.1007/BF03325326.

    Article  Google Scholar 

  • Pace, C. S., Cavanna, D., Guiducci, V., & Bizzi, F. (2015). When parenting fails: Alexithymia and attachment states of mind in mothers of female patients with eating disorders. Frontiers in Psychology, 6, 1145 doi:10.3389/fpsyg.2015.01145.

    PubMed  PubMed Central  Google Scholar 

  • Pace, C. S., Guiducci, V., & Cavanna, D. (2016). Attachment in eating-disordered outpatients with and without borderline personality disorder. Journal of Health Psychology. doi:10.1177/1359105316636951.

    Google Scholar 

  • Paulson-Karlsson, G., Engström, I., & Nevonen, L. (2009). A pilot study of a family-based treatment for adolescent anorexia nervosa: 18- and 36-month follow-up. Eating Disorders, 17, 72–88. doi:10.1080/10640260802570130.

    Article  PubMed  Google Scholar 

  • Pasold, T. L., Boateng, B. A., & Portilla, M. A. (2010). The use of a parent support group in the outpatient treatment of children and adolescents with eating disorders. Eating Disorders, 18(3), 18–332. doi:10.1080/10640266.2010.490121.

    Google Scholar 

  • Plath, D., Lauren, T.W., Wood, C. (2016). Clinicians’ views on parental involvement in the treatment of adolescent anorexia nervosa. Eating Disorders, first published online. 10.1080/10640266.2016.1189796

  • Prestano, C., Lo Coco, G., Gullo, S., & Lo Verso, G. (2008). Group Analytic Therapy for Eating Disorders: Preliminary Results in a Single-Group Study. European. Eating Disorders Review, 16, 302–310. doi:10.1002/erv.871.

    Article  PubMed  Google Scholar 

  • Preti, A., de Girolamo, G., & Vilagut, G., et al. (2009). The epidemiology of eating disorders in six European countries: Results of the ESEMeD-WMH project. Journal of Psychiatric Research, 43(14), 1125–1132. doi:10.1016/j.jpsychires.2009.04.003.

    Article  PubMed  Google Scholar 

  • Robin, A. L., Siegel, P. T., & Moye, A. W., et al. (1999). A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa. Journal of American Academy of Child and Adolescent Psychiatry, 38, 1482–9. doi:10.1097/00004583-199912000-00008.

    Article  Google Scholar 

  • Russell, G. F., Szmukler, G. I., Dare, C., & Eisler, I. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives General Psychiatry, 44(12), 1047–1056. doi:10.1001/archpsyc.1987.01800240021004.

    Article  Google Scholar 

  • Schneider, N., Frieler, K., Pfeiffer, E., Lehmkuhl, U., & Salbach-Andrae, H. (2009). Comparison of body size estimation in adolescents with different types of eating disorders. European Eating Disorder Review, 17, 468–474. doi:10.1002/erv.956.

    Article  Google Scholar 

  • Selvini Palazzoli, M., Cirillo, S., Selvini, M., & Sorrentino, A. M. (1998). Ragazze anoressiche e bulimiche. La terapia familiare. Milano: Raffaello Cortina.

    Google Scholar 

  • Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406–414. doi:10.1007/s11920-012-0282-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Swanson, S. A., Crow, S. J., Le Grange, D., Swendsen, J., & Merikangas, K. R. (2011). Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 68(7), 714–723. doi:10.1001/archgenpsychiatry.2011.22.

    Article  PubMed  Google Scholar 

  • Tambelli, R., Laghi, F., Odorisio, F., & Notari, V. (2012). Attachment relationships and internalizing and externalizing problems among Italian adolescents. Children and Youth Service Review, 34, 1465–1471. doi:10.1016/j.childyouth.2012.04.004.

    Article  Google Scholar 

  • Thornton, L. M., Welch, E., Munn-Chernoff, M. A., Lichtenstein, P., & Bulik, C. M. (2016). anorexia nervosa, major depression, and suicide attempts: Shared genetic factors. Suicide and Life-Threatening Behavior. doi:10.1111/sltb.12235.

    Google Scholar 

  • Uehara, T., Kawashima, Y., Goto, M., Tasaki, S., & Someya, T. (2001). Psychoeducation for the families of patients with eating disorders and changes in expressed emotion: A preliminary study. Comprehensive Psychiatry, 42, 132–138. doi:10.1053/comp.2001.21215.

    Article  PubMed  Google Scholar 

  • Vicari, S., Zanna, V., & Castiglioni, M. C. (2014). I disturbi del comportamento alimentare nell’infanzia e nell’adolescenza: Nuove classificazioni. In (a cura di) L. Dalla Ragione, & L. Giombini (Eds.), Solitudini Imperfette. Le buone pratiche di cura nei Disturbi del Comportamento Alimentare (pp. 37–50). Ministero della Salute, Presidenza del Consiglio dei Ministri, Dipartimento della Gioventù, Rome, Italy.

  • Wersebe, H., Sijbrandij, M., & Cuijpers, P. (2013). Psychological group-treatments of social anxiety disorder: A meta-analysis. PLoS One, 8(11), e79034. doi:10.1371/journal.pone.0079034.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zanna, V., & Castiglioni, M. C. (2014). Il modello dell’Ospedale Pediatrico Bambino Gesù. In (a cura di) Bancheri, L. Implicazioni della terapia familiare e della coppia genitoriale in alcuni modelli teorico-clinici istituzionali italiani che adottano il trattamento integrato dell’anoressia. Interazioni, 2, 114–115.

    Google Scholar 

  • Zappa, L. E. (2009). Alice in fuga dallo specchio. Il disturbo dell’immagine corporea nell’anoressia nervosa e nei DCA. Un modello integrato di trattamento. Franco Angeli Editore, Milano.

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Author Contributions

V.Z. and S.V.: designed and executed the study and wrote the paper. F.L. and M.C.: collaborated with the design and writing of the study. F.L. and M.C.: analyzed the data and wrote part of the results. I.C., C.C., F.L., and S.M.: collaborated with the design and writing of the study. M.C., I.C., M.E., C.I., and G.C.: collaborated in the writing and editing of the final manuscript.

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  1. Department of Neuroscience-I.R.C.C.S., Neuropsychiatry Unit, Children Hospital Bambino Gesù, Rome, Italy

    Valeria Zanna, Maria Chiara Castiglioni, Michela Criscuolo, Ilenia Chianello, Maria Elisei, Giulia Cinelli & Stefano Vicari

  2. Faculty of Medicine and Psychology, Sapienza Università di Roma, Rome, Italy

    Fiorenzo Laghi & Silvia Mazzoni

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  1. Valeria Zanna
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  2. Maria Chiara Castiglioni
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Correspondence to Valeria Zanna.

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Zanna, V., Castiglioni, M., Criscuolo, M. et al. Day-Hospital Multifocal Integrated Treatment for Anorexia Nervosa in Adolescents: A One-Year Follow-Up. J Child Fam Stud 26, 1460–1471 (2017). https://doi.org/10.1007/s10826-017-0666-z

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