title: Two-year follow-up of the MOSAIC trial: A multicenter randomized controlled trial comparing two psychological treatments in adult outpatients with broadly defined anorexia nervosa.
abstract: This study reports follow-up data from a multicenter randomized controlled trial (n = 142) comparing the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) with Specialist Supportive Clinical Management (SSCM) in outpatients with broadly defined anorexia nervosa (AN). At 12 months postrandomization, all patients had statistically significant improvements in body mass index (BMI), eating disorder (ED) symptomatology and other outcomes with no differences between groups. MANTRA was more acceptable to patients. The present study assessed whether gains were maintained at 24 months postrandomization.
  
  
  
  Follow-up data at 24 months were obtained from 73.2% of participants. Outcome measures included BMI, ED symptomatology, distress, impairment, and additional service utilization during the study period. Outcomes were analyzed using linear mixed models.
  
  
  
  There were few differences between groups. In both treatment groups, improvements in BMI, ED symptomatology, distress levels, and clinical impairment were maintained or increased further. Estimated mean BMI change from baseline to 24 months was 2.16 kg/m(2) for SSCM and 2.25 kg/m(2) for MANTRA (effect sizes of 1.75 and 1.83, respectively). Most participants (83%) did not require any additional intensive treatments (e.g., hospitalization). Two SSCM patients became overweight through binge-eating.
  
  
  
  Both treatments have value as outpatient interventions for patients with AN. © 2016 Crown copyright. International Journal of Eating Disorders. (Int J Eat Disord 2016; 49:793-800).
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
authors.affiliation: Department of Biostatistics, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Ryan
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Savani
authors.initials: S
authors.lastname: Bartholdy
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Bethany
authors.initials: B
authors.lastname: Renwick
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Keyes
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Caitlin
authors.initials: C
authors.lastname: O'Hara
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Jessica
authors.initials: J
authors.lastname: McClelland
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Anna
authors.initials: A
authors.lastname: Lose
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Martha
authors.initials: M
authors.lastname: Kenyon
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Dejong
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Hannah
authors.initials: H
authors.lastname: Broadbent
authors.affiliation: Oxford Adult Eating Disorder Service, Cotswold House, Warneford Hospital, Oxford, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Loomes
authors.affiliation: Eating Disorders Service, North East London NHS Foundation Trust, Dagenham, Essex, United Kingdom.|Clinical, Educational & Health Psychology, University College London, United Kingdom.
authors.forename: Lucy
authors.initials: L
authors.lastname: Serpell
authors.affiliation: St. Ann's Hospital, The Phoenix Wing, Tottenham, London, United Kingdom.
authors.forename: Lorna
authors.initials: L
authors.lastname: Richards
authors.affiliation: St. Ann's Hospital, The Phoenix Wing, Tottenham, London, United Kingdom.
authors.forename: Eric
authors.initials: E
authors.lastname: Johnson-Sabine
authors.affiliation: Oxford Adult Eating Disorder Service, Cotswold House, Warneford Hospital, Oxford, United Kingdom.
authors.forename: Nicky
authors.initials: N
authors.lastname: Boughton
authors.affiliation: Oxford Adult Eating Disorder Service, Cotswold House, Warneford Hospital, Oxford, United Kingdom.
authors.forename: Linette
authors.initials: L
authors.lastname: Whitehead
authors.affiliation: London School of Economics and Political Science, Personal Social Services Research Unit, London, United Kingdom.
authors.forename: Eva
authors.initials: E
authors.lastname: Bonin
authors.affiliation: London School of Economics and Political Science, Personal Social Services Research Unit, London, United Kingdom.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Beecham
authors.affiliation: Department of Biostatistics, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Sabine
authors.initials: S
authors.lastname: Landau
authors.affiliation: Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D003631:Day Care, Medical / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D010045:Outpatients; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
keywords: MANTRA; SSCM; anorexia nervosa; randomized controlled trial