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

Eur Eat Disord Rev. 2021 May;29(3):355-370. doi: 10.1002/erv.2824. Epub 2021 Mar 9.

Abstract

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.

Keywords: anorexia nervosa; guided self-help; psychological therapies; relapse prevention; transition support.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Affect
  • Anorexia Nervosa* / psychology
  • Anorexia Nervosa* / therapy
  • Caregivers
  • Feeding and Eating Disorders*
  • Humans