Are obsessive-compulsive personality traits associated with a poor outcome in anorexia nervosa? A systematic review of randomized controlled trials and naturalistic outcome studies.
OBJECTIVE
Obsessive-compulsive personality disorder (OCPD) traits are commonly associated with anorexia nervosa (AN). The aim of this review was to systematically search the literature to examine whether OCPD traits have an impact on the outcome of AN.


METHODS
A systematic electronic search of the literature (using Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials) was undertaken to identify relevant publications (randomized controlled trials (RCT's) and naturalistic studies), until February 2006.


RESULTS
Eleven prospective longitudinal studies and 12 RCT's met criteria for inclusion. A meta-analysis was not feasible as the studies were too heterogeneous. Just over half of published longitudinal studies found that OCPD traits were associated with a negative outcome in AN. Additionally, results from three RCTs suggested that these traits may moderate outcome. OCPD traits were reduced after treatment in five RCTs.


CONCLUSIONS
There is tentative support to suggest that individuals with AN and concomitant OCPD traits have a poorer prognosis, and that these traits moderate outcome. A reduction in these traits may mediate this change. An individualized case formulation with treatment tailored to OCPD traits may improve the outcome of AN.
Crane
Anna M
AM
Eating Disorders Research Unit, Institute of Psychiatry, King's College, London, United Kingdom.
Roberts
Marion E
ME
Treasure
Janet
J
D000856:Anorexia Nervosa / Q000523:psychology* / Q000534:rehabilitation*; D003193:Compulsive Personality Disorder / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome