Clinical problems encountered in the treatment of adolescents with anorexia nervosa.
The conceptualization of anorexia nervosa (AN) depends on the diagnostic criteria. Most patients with teenage onset AN seem to remit within 3-10 years depending on the definitions of recovery. The mortality of adolescent onset anorexia nervosa (AN) has fortunately decreased over the last two decades. Based on randomized controlled trials, we review different treatments including individual and group psychotherapy, family therapy, psychopharmacology, and hormone therapy. Treatment settings vary over time for any individual patient. Despite high rates of inpatient treatment, the respective evidence for effectiveness is meager. In underage patients with severe AN clinical, ethical and legal aspects need to be dealt with systematically if intermittent compulsory treatment is deemed necessary. The prolonged and frequently chronic course of AN often entails therapeutic discontinuity; the transition into adulthood requires a graded therapeutic concept that considers the severity of the disorder, developmental and chronological age, and parental involvement. Finally, we consider future clinical and research options to improve treatment and outcome of this eating disorder.
Kliniken und Institut der Universität Duisburg-Essen, <location>Essen, Germany</location>
Susanne
S
Knoll
Manuel
M
Föcker
Johannes
J
Hebebrand
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D003266:Continuity of Patient Care; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008137:Longitudinal Studies; D063868:Patient Outcome Assessment; D016032:Randomized Controlled Trials as Topic; D012075:Remission, Spontaneous; D016019:Survival Analysis; D060305:Transition to Adult Care; D055815:Young Adult
Diagnostische Kriterien; Leitlinien; Transition; Zwangsbehandlung; compulsory treatment; diagnostic criteria; guidelines; randomisiert-kontrollierte Studien; randomized controlled trials; transition