title: ESCAP Expert Paper: New developments in the diagnosis and treatment of adolescent anorexia nervosa--a European perspective.
abstract: Anorexia nervosa is a potentially life-threatening disorder with a typical onset in adolescence and high rates of medical complications and psychiatric comorbidity. This article summarizes issues relating to classification in DSM-5 and presents a narrative review of key evidence-based medical and behavioral interventions for adolescent AN and subthreshold restricting eating disorders, mainly, but not exclusively published between 2012 and 2014. In addition, it systematically compares the clinical guidelines of four European countries (Germany, Spain, The Netherlands, and United Kingdom) and outlines common clinical practice, in relation to treatment settings, nutritional rehabilitation, family-oriented and individual psychotherapy, and psychopharmacological treatment. With the exception of family-based treatment, which is mainly evaluated and practiced in Anglo-American countries, the evidence base is weak, especially for medical interventions such as refeeding and pharmacological intervention. There is a need for common European research efforts, to improve the available evidence base and resulting clinical guidance.
authors.affiliation: Department of Child & Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Clinics, RWTH Aachen, Neuenhofer Weg 21, 52074, Aachen, Germany. bherpertz@ukaachen.de.
authors.forename: Beate
authors.initials: B
authors.lastname: Herpertz-Dahlmann
authors.affiliation: Department of Social Sciences, Rintveld, Center for Eating Disorders, Altrecht Mental Health Institute, Utrecht University, Utrecht, The Netherlands.
authors.forename: Annemarie
authors.initials: A
authors.lastname: van Elburg
authors.affiliation: Department of Child & Adolescent Psychiatry, Neurosciences Institute, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000592:standards; D005060:Europe; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011613:Psychotherapy / Q000592:standards*; D013030:Spain; D006113:United Kingdom
keywords: Adolescence; Anorexia nervosa; European guidelines; Review; Treatment