Table 1.
Included studies.
| References | Follow-up week | Trt arm | N | N drop out | Setting | TrtType | Study quality |
|---|---|---|---|---|---|---|---|
| (A) RCTs ADOLESCENT SAMPLES | |||||||
| Agras et al. (38) | 88 | 1 | 78 | 20 | Outpatient | FT_AN | Moderate |
| 2 | 80 | 20 | Outpatient | FST | |||
| Eisler et al. (39) | 52 | 1 | 21 | 2 | Outpatient | FT_AN sep. | Moderate |
| 2 | 19 | 2 | Outpatient | FT_AN conj. | |||
| Eisler et al. (40) | 52 | 2 | 86 | 9 | Outpatient | MFT | High |
| 1 | 83 | 9 | Outpatient | FT_AN | |||
| Gowers et al. (41) | 52 | 1 | 55 | 17 | Outpatient | Complex-op ° | Moderate |
| 2 | 55 | 14 | Outpatient | FT_AN&X * | |||
| 3 | 57 | 29 | Inpatient | Complex-ip | |||
| Herpertz-Dahlmann et al. (42) | 68 | 1 | 85 | 10 | Inpatient | Complex-ip | High |
| 2 | 87 | 25 | Day hospital | Compex-dh | |||
| Le Grange et al. (43) | 52 | 1 | 55 | 9 | Outpatient | FT_AN conj. | Moderate |
| 2 | 52 | 8 | Outpatient | FT_AN sep. | |||
| Lock et al. (44) | 52 | 1 | 44 | 7 | Outpatient | FT_AN | High |
| 2 | 42 | 10 | Outpatient | FT_AN&X # | |||
| Lock et al. (45) | 52 | 1 | 60 | 4 | Outpatient | PD&X | Moderate |
| 2 | 61 | 13 | Outpatient | FT_AN | |||
| Madden et al. (46) | 52 | 1 | 41 | 5 | In/outpatient | Complex-ip short* | Moderate |
| 2 | 41 | 8 | Inpatient | Complex-ip | |||
| Robin et al. (47) | 63.6 | 1 | 19 | 1 | Outpatient | FT_AN | Low |
| 2 | 18 | 1 | Outpatient | PD&X | |||
| (B) RCTs ADULT SAMPLES | |||||||
| Crisp et al. (35)** | 104 | 2 | 20 | 2 | Outpatient | Complex-op°° | Moderate |
| 4 | 20 | 0 | Outpatient | TAU | |||
| Dalle Grave et al. (37)* | 76 | 1 | 42 | 5 | Inpatient | Complex-ip | High |
| 2 | 38 | 3 | Inpatient | Complex-ip&X ## | |||
| Dare et al. (48) | 52 | 1 | 19 | 7 | Outpatient | FPT | Low |
| 2 | 21 | 5 | Outpatient | FT_AN | |||
| 3 | 22 | 9 | Outpatient | CAT | |||
| 4 | 17 | 4 | Outpatient | TAU | |||
| Hall et al. (36) | 1 | 15 | 1 | Outpatient | Complex-op °°° | Low | |
| 2 | 15 | 4 | Outpatient | Diet&X | |||
| Lock et al. (11) | 24 | 1 | 23 | 3 | Outpatient | CBT&X## | Moderate |
| 1 | 23 | 8 | Outpatient | CBT | |||
| McIntosh et al. (49) | 20 | 1 | 19 | 7 | Outpatient | CBT | Moderate |
| 2 | 21 | 9 | Outpatient | IPT | |||
| 3 | 16 | 5 | Outpatient | SSCM | |||
| Schmidt et al. (8) | 52 | 1 | 72 | 18 | Outpatient | MANTRA | High |
| 2 | 70 | 29 | Outpatient | SSCM | |||
| Schmidt et al. (50) | 52 | 1 | 34 | 10 | Outpatient | MANTRA | High |
| 1 | 37 | 16 | Outpatient | SSCM | |||
| Touyz et al. (51) | 56 | 1 | 31 | 1 | Outpatient | CBT | High |
| 2 | 32 | 2 | Outpatient | SSCM | |||
| Treasure et al. (52) | 52 | 1 | 16 | 6 | Outpatient | CBT | Moderate |
| 2 | 14 | 4 | Outpatient | CAT | |||
| Zipfel et al. (53) | 52 | 1 | 80 | 8 | Outpatient | FPT | High |
| 2 | 80 | 17 | Outpatient | CBTE | |||
| 3 | 82 | 29 | Outpatient | TAU | |||
| (C) NATURALISTIC STUDIES ADOLESCENT SAMPLES | |||||||
| Dalle Grave et al. (54) | 100 | 1 | 46 | 17 | Outpatient | CBTE | Low |
| Dalle Grave et al. (55) | 100 | 1 | 27 | 1 | Inpatient | Complex-ip | Low |
| Herpertz-Dahlmann et al. (56) | 108 | 1 | 39 | ? | Inpatient | Complex-ip | Low |
| Schlegl et al. (57) | 11.7 | 1 | 262 | 47 | Inpatient | Complex-ip | Moderate |
| (D) NATURALISTIC STUDIES ADULT SAMPLES | |||||||
| Abbate-Daga et al. (58) | 72 | 1 | 56 | 6 | Day Hospital | Complex-dh | Moderate |
| Bowers et al. (59) | 33 | 1 | 32 | ? | Inpatient | Complex-ip | Low |
| Channon et al. (60) | 61 | 1 | 45 | ? | Inpatient | Complex-ip | Low |
| Fairburn et al. (61) | 100 | 1 | 50 | 19 | Outpatient-GB | CBTE | Moderate |
| 2 | 49 | 17 | Outpatient-I | CBTE | |||
| Fichter and Quadflieg (62) | 104 | 1 | 103 | ? | Inpatient | Complex-ip | Low |
| Fittig et al. (63) | 20 | 1 | 100 | 26 | Day clinic | Complex-dh | Low |
| Goddard et al. (64) | 26.4 | 1 | 150 | ? | Inpatient | Complex-ip | Moderate |
| Kohle et al. (65) | 260 | 1 | Inpatient | Complex-ip | Low | ||
| Long et al. (66) | 208 | 1 | 34 | 5 | Inpatient | Complex-ip | Moderate |
| Ricca et al. (67) | 40 | 1 | 53 | 10 | Outpatient | CBT | Moderate |
| Treat et al. (68) | 4.8 | 1 | 73 | 2 | Inpatient | Complex-ip | Low |
| Wade et al. (69) | 72 | 1 | 28 | 5 | Outpatient | MANTRA | Low |
| Willinge et al. (70) | 4.7 | 1 | 33 | 8 | Day hospital | Complex-dh | Low |
Classification of treatments in some cases had to be adapted to specific circumstances of the method and the sample of included studies: For example, there are studies comparing variants of a specific treatment, e.g., various forms of family-based treatment as a short or long term intervention or seeing the whole family vs. parents and patient separately (39, 44). In these cases, we identified the most typical treatment arm for a treatment class (e.g., psychodynamic therapy PD) and labeled the other(s) as its variant by adding “&X” (e.g., PD&X). Inpatient and day hospital programs as well as outpatient interventions entailing a broad range of treatment elements were labeled “complex” treatments.
CBTE, cognitive-behavior therapy enhanced; CBT, cognitive behavior therapy; MFT, multi family therapy; FT_AN, family based treatment for anorexia nervosa; FST, Family systems therapy; MANTRA, Maudsley Model of Anorexia nervosa Treatment for Adults; IPT, Interpersonal Psychotherapy; SSCM, Specialist Supportive Clinical Management; CRT, Cognitive Remediation Therapy; FPT, Focal Psychodynamic Psychotherapy; CAT, Cognitive-Analytic Therapy; PD, Psychodynamic Therapy; complex, several treatment components; -ip, inpatient; -dc, day clinic; -op, outpatient; sep., separate (familiy therapy); conj., conjoint (family therapy); diet, dietary advice; GB, Great Britain; I = Italy;
FT_AN in a short version was labeled as a variant: FT_AN&X;
CBT-E in an inpatient setting in a focussed (CBT-Ef) and a more “broad” form (CBT-Eb) were compared (addessing additional problems like mood intolerance and perfectionism);
This arm was labeled “treatment as usual in the general community,” but was family-based treatment combined with dietary advice, individual supportive sessions and medical management;
Two arms of the study could not be included, as no follow-up data were reported;
CBT + parental feedback and counselling + dietary advice;
Individual + family sessions (psychodynamic orientation);
Individual sessions (psychodynamic orientation) + family session + dietary advice;
CBT&X consisted of 8 initial sessions of CRT (Cognitive Remediation Therapy) plus CBT; “ = inpatient treatment only until medical stabilization.
TAU (treatment as usual) in the study of Dare et al. (48) was low-contact supportive out-patient management by psychiatric trainees; TAU in the study of Crisp et al. (35) was labeled “no treatment,” but consisted in management by the local family doctor or consultant who got detailed advice (patients got a range of different interventions); TAU in the study of Zipfel et al. (53), labeled “optimized treatment as usual,” was the referral of patients to experienced outpatient psychotherapists and their family doctors who got advice for medical management (overall, patients received a comparable number of psychotherapy sessions as in FPT and CBT-E) N drop out, drop out from therapy; ?, no data or only study drop outs reported.