Evidence map›Paper›PMID 27703724›Full record

ArticleBJPsych open2015

Clinical effectiveness of a skills training intervention for caregivers in improving patient and caregiver health following in-patient treatment for severe anorexia nervosa: pragmatic randomised controlled trial.

Rebecca Hibbs, Nicholas Magill, Elizabeth Goddard, Charlotte Rhind, Simone Raenker, Pamela Macdonald, Gill Todd, Jon Arcelus, John Morgan, Jennifer Beecham and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJPsych open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Participation in the New Maudsley Model Workshops is Associated With Reductions in Caregiver Burden in Eating Disorders.European eating disorders review : the journal of the Eating Disorders Association · 2026
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  14. Patient and carer feedback and engagement with ECHOMANTRA, a digital guided intervention for anorexia nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Rebecca Hibbs, MSc, PhD, Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, UK.
Nicholas Magill, MSc, Biostatistics Department, King's College London, IoPPN, London, UK.
Elizabeth Goddard, PhD, Department of Psychological Medicine, Section of Eating Disorders, King's College London, IoPPN, London, UK.
Charlotte Rhind, MSc, Department of Psychological Medicine, Section of Eating Disorders, King's College London, IoPPN, London, UK.
Simone Raenker, PhD, Department of Psychological Medicine, Section of Eating Disorders, King's College London, IoPPN, London, UK.
Pamela Macdonald, PhD, Department of Psychological Medicine, Section of Eating Disorders, King's College London, IoPPN, London, UK.
Gill Todd, RMN, MSc, South London and Maudsley NHS Foundation Trust, London, UK.
Jon Arcelus, MD, PhD, Eating Disorders Service, Leicestershire Partnership NHS Trust, Leicester, UK.
John Morgan, MD, PhD, Yorkshire Centre for Eating Disorders, Leeds, UK.
Jennifer Beecham, PhD, Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, London, UK.
Ulrike Schmidt, MD, PhD, Department of Psychological Medicine, Section of Eating Disorders, King's College London, IoPPN, London, UK.
Sabine Landau, PhD, Biostatistics Department, King's College London, IoPPN, London, UK.
Janet Treasure, MD, PhD, Department of Psychological Medicine, Section of Eating Disorders, King's College London, IoPPN, London, UK.

Funding

Department of Health RP-PG-0606-1043
6 · The paper itself

Abstract

backgroundFamilies express a need for information to support people with severe anorexia nervosa.

aimsTo examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.

methodPatients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (

resultsPatients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7-12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.

conclusionsSmall but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665. DECLARATION OF INTEREST: J.T. is a co-author of the book used in the ECHO intervention and receives royalties. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Identifiers

PMID27703724
PMCPMC4998946

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.