ArticleJournal of eating disorders2022
Integrated enhanced cognitive behavioural (I-CBTE) therapy significantly improves effectiveness of inpatient treatment of anorexia nervosa in real life settings.
Article in Journal of eating disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Digital augmentation of aftercare for patients with anorexia nervosa: the TRIANGLE RCT and economic evaluation.Health technology assessment (Winchester, England) · 2025Trial
- Collective responsibility and ecological thinking in eating disorders: moving beyond individualistic models of illness and recovery.Journal of eating disorders · 2026Article
- Do new labels solve old problems? Conceptual, ethical, and clinical challenges of constructing restrictive eating behaviours as "self-harm".Journal of eating disorders · 2026Article
- Conceptualising trauma in eating disorders: a reflexive commentary on the role of neglect, iatrogenic harm, and epistemic injury.Journal of eating disorders · 2026Article
- Bridging inpatient and community treatment: feasibility, acceptability, and short-term outcomes of step care, a virtual CBT-E pathway for adults with severe eating disorders.Journal of eating disorders · 2026Article
- Broad considerations for improving eating disorder care: a lived experience and quality improvement perspective.Journal of eating disorders · 2025Article
- "I could be living a totally different life right now": lived experience and caregiver perspectives on the prevention of eating disorders.Journal of eating disorders · 2025Article
- Medical management and differential diagnosis of restrictive eating disorders in men: a case study report with co-produced recommendations.Journal of eating disorders · 2025Article
- Equity in eating disorders: a dialectical approach to stigma, expertise, and the coproduction of knowledge.Journal of eating disorders · 2025Article
- Redefining prevention and early intervention to include longstanding and severe eating disorders.Journal of eating disorders · 2025Article
- Improving eating disorder care for underserved groups: a lived experience and quality improvement perspective.Journal of eating disorders · 2025Article
- Applying integrated enhanced cognitive behaviour therapy (I-CBTE) to severe and longstanding eating disorders (SEED) Paper 2: An in-depth case study for clinicians.Journal of eating disorders · 2024Article
- Harm reduction in severe and long-standing Anorexia Nervosa: part of the journey but not the destination-a narrative review with lived experience.Journal of eating disorders · 2024Review
- Applying Integrated Enhanced Cognitive Behaviour Therapy (I-CBTE) to Severe and Longstanding Eating Disorders (SEED) Paper 1: I am no longer a SEED patient.Journal of eating disorders · 2024Article
- Experiences of intensive treatment for people with eating disorders: a systematic review and thematic synthesis.Journal of eating disorders · 2024Review
- Care pathways for longstanding eating disorders must offer paths to recovery, not managed decline.BJPsych bulletin · 2024Article
- The importance of individualised care, good communication and trust for reducing nasogastric tube feeding under physical restraint: qualitative multi-informant study.BJPsych open · 2024Article
- Article
- 'Terminal anorexia': a lived experience perspective on the proposed criteria.Journal of eating disorders · 2023Article
- Patients' experiences of clinical team meetings (ward rounds) at an adult in-patient eating disorders ward: mixed-method service improvement project.BJPsych bulletin · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInpatient treatment of anorexia nervosa can be lifesaving but is associated with high rates of relapse and poor outcomes. To address this, the Oxford service has adapted the enhanced cognitive behavioural treatment (CBTE) model, first developed for inpatients in Italy to a UK national health service (NHS) setting. In this study, we compared the outcomes from treatment as usual (TAU), integrated CBTE (I-CBTE), and alternative treatment models in routine UK clinical practice.
methodsThis is a longitudinal cohort study, using routinely collected data between 2017 and 2020 involving all adults with anorexia nervosa admitted to specialist units from a large geographical area in England covering a total population of 3.5 million. We compared TAU with (1) I-CBTE (13 weeks inpatient CBTE, restoration to a healthy weight, combined with 7 weeks day treatment followed by 20 weeks of outpatient CBTE; (2) standalone inpatient CBTE (due to insufficient resources since the pandemic; and (3) 6-8 weeks admission with partial weight restoration as crisis management. Primary outcome measures (min. 1 year after discharge from hospital) were defined as: (1) good outcome: Body Mass Index (BMI) > 19.5 and no abnormal eating or compensatory behaviours; (2) poor outcome: BMI < 19.5 and/or ongoing eating disorder behaviours; (3) readmission; or (4) deceased. Secondary outcomes were BMI on discharge, and length of stay.
results212 patients were admitted to 15 specialist units in the UK depending on bed availability. The mean age was 28.9 (18-60) years, mean admission BMI was 14.1 (10-18.3), 80% were voluntary. At minimum 1-year follow up after discharge, 70% of patients receiving I-CBTE and 29% standalone inpatient CBTE maintained good outcomes, in contrast with < 5% TAU and crisis management admission. Readmission rates of I-CBTE were 14.3% vs ~ 50% (χ
conclusionsOur main finding is that in a real-life setting, I-CBTE has superior short- and minimum 1 year outcomes as compared with alternative inpatient treatment models. Dissemination of I-CBTE across the care pathway has the potential to transform outcomes of inpatient treatment for this high-risk patient population and reduce personal and societal costs.
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