Evidence map›Paper›PMID 34154394›Full record

Trial reportThe American journal of psychiatry2021

Time Course of Relapse Following Acute Treatment for Anorexia Nervosa.

B Timothy Walsh, Tianchen Xu, Yuanjia Wang, Evelyn Attia, Allan S Kaplan

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in The American journal of psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06138782 (Identifying Networks Underlying Compulsivity in Anorexia Nervosa for Targeting With Neuromodulation), which is not on this map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing 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.

NCT06138782 naactive not recruitingnot on this mapstarted 2023, after this paper: background citation

Identifying Networks Underlying Compulsivity in Anorexia Nervosa for Targeting With Neuromodulation

TypeinterventionalSponsorUniversity of California, San FranciscoRan2023 to 2026Enrolled20ConditionsAnorexia NervosaArmsRepetitive Transcranial Magnetic Stimulation (rTMS)
3 · Its place in the literature

Who cites it

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

  1. Momentary physiological indices related to eating disorders: A systematic and methodological review.European eating disorders review : the journal of the Eating Disorders Association · 2024
    Pooled it
  2. Trial
  3. Trial
  4. Examining Facets of Body Image Disturbance Across Anorexia Nervosa Illness and Recovery Stages.European eating disorders review : the journal of the Eating Disorders Association · 2026
    Article
  5. Article
  6. Article
  7. Review
  8. Recovery From Anorexia Nervosa: A Concept Analysis.Journal of advanced nursing · 2026
    Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
  16. 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
    Article
  17. Zinc levels in severe eating disorders.Journal of eating disorders · 2025
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

B Timothy WalshDepartment of Psychiatry, Columbia University Irving Medical Center, New York (Walsh, Attia); New York State Psychiatric Institute, New York (Walsh, Wang, Attia); Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York (Wang); Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto (Kaplan).
Tianchen XuDepartment of Psychiatry, Columbia University Irving Medical Center, New York (Walsh, Attia); New York State Psychiatric Institute, New York (Walsh, Wang, Attia); Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York (Wang); Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto (Kaplan).
Yuanjia WangDepartment of Psychiatry, Columbia University Irving Medical Center, New York (Walsh, Attia); New York State Psychiatric Institute, New York (Walsh, Wang, Attia); Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York (Wang); Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto (Kaplan).
Evelyn AttiaDepartment of Psychiatry, Columbia University Irving Medical Center, New York (Walsh, Attia); New York State Psychiatric Institute, New York (Walsh, Wang, Attia); Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York (Wang); Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto (Kaplan).
Allan S KaplanDepartment of Psychiatry, Columbia University Irving Medical Center, New York (Walsh, Attia); New York State Psychiatric Institute, New York (Walsh, Wang, Attia); Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York (Wang); Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto (Kaplan).

Funding

FLUOXETINE AFTER WEIGHT RESTORATION IN ANOREXIA NERVOSAR01MH060271 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE · PI WALSH, B. TIMOTHY · 2000 to 2004
$1.5M
FLUOXETINE AFTER WEIGHT RESTORATION IN ANOREXIA NERVOSAR01MH060336 · NIMH · UHN TORONTO GENERAL HOSPITAL · PI KAPLAN, ALLAN S · 2000 to 2003
$875k
Integrative Learning to Combine Evidence for Personalized Treatment Strategies.R21MH117458 · NIMH · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI WANG, YUANJIA · 2018 to 2019
$446k
NIMH NIH HHS R01 MH060271NIMH NIH HHS R01 MH060336NIMH NIH HHS R21 MH117458
6 · The paper itself

Abstract

objectiveThere is long-standing interest in how best to define stages of illness for anorexia nervosa, including remission and recovery. The authors used data from a previously published study to examine the time course of relapse over the year following full weight restoration.

methodsFollowing weight restoration in an acute care setting, 93 women with anorexia nervosa were randomly assigned to receive fluoxetine or placebo and were discharged to outpatient care, where they also received cognitive-behavioral therapy for up to 1 year. Relapse was defined on the basis of a priori clinical criteria. Fluoxetine had no impact on the time to relapse. In the present analysis, for each day after entry into the study, the risk of relapse over the following 60 days and the following 90 days was calculated and a parametric function was fitted to approximate the Kaplan-Meier estimator.

resultsThe risk of relapse rose immediately after entry into the study, reached a peak after approximately 60 days, and then gradually declined. There was no indication of an inflection point at which the risk of relapse fell precipitously after the initial peak.

conclusionsThis analysis highlights the fact that adult patients with anorexia nervosa are at increased risk of relapse in the first months following discharge from acute care, suggesting a need for frequent follow-up and relapse prevention-focused treatment during this period. After approximately 2 months, the risk of relapse progressively decreases over time.

Indexed as

Cognitive Behavioral TherapyAdolescentAdultAnorexia NervosaCombined Modality TherapyFemaleFluoxetineHumansMaleRecurrenceSecondary PreventionTime FactorsYoung AdultFluoxetineAnorexia NervosaFeeding and Eating DisordersOutcome StudiesRelapseRemission

Identifiers

PMID34154394
PMCPMC8440387

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Registered trials

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.