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      The Maudsley model of anorexia nervosa treatment for adolescents and young adults (MANTRa): a study protocol for a multi-center cohort study

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          Abstract

          Background

          The treatment of anorexia nervosa (AN) is often challenging due to medical complications as well as high relapse and mortality rates. Studies about effective treatment options for people with AN are particularly scarce in the adolescent population. This paper is a study protocol for a multi-center cohort study assessing the feasibility, acceptability and efficacy of a new, manualized treatment program, the “Maudsley Model of Anorexia Nervosa Treatment for Adolescents and Young Adults” (MANTRa) compared to psychotherapeutic treatment as usual (TAU).

          Methods/design

          One hundred patients between 13 and 21 years who meet the inclusion criteria will receive 24 to 34 individual weekly MANTRa therapy sessions or weekly TAU sessions. Primary outcome variables will be BMI and eating disorder psychopathology 12 months after baseline. Further changes in central coherence, cognitive flexibility, emotion recognition, comorbid psychopathology (e.g. depression, obsessive-compulsive and anxiety disorders, non-suicidal self-injury), personality factors and therapeutic alliance will be assessed.

          Discussion

          This multi-center study will examine the utility of the treatment program MANTRa for adolescents with AN and, therefore enhances the current knowledge about potential treatments for this patient group.

          Trial registration

          ClinicalTrials.gov Identifier: NCT03535714. Registered: 24/05/2018 (retrospectively registered, still recruiting).

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s40337-021-00387-8.

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          Most cited references70

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          Diagnostic and Statistical Manual of Mental Disorders

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            Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide

            Without a complete published description of interventions, clinicians and patients cannot reliably implement interventions that are shown to be useful, and other researchers cannot replicate or build on research findings. The quality of description of interventions in publications, however, is remarkably poor. To improve the completeness of reporting, and ultimately the replicability, of interventions, an international group of experts and stakeholders developed the Template for Intervention Description and Replication (TIDieR) checklist and guide. The process involved a literature review for relevant checklists and research, a Delphi survey of an international panel of experts to guide item selection, and a face to face panel meeting. The resultant 12 item TIDieR checklist (brief name, why, what (materials), what (procedure), who provided, how, where, when and how much, tailoring, modifications, how well (planned), how well (actual)) is an extension of the CONSORT 2010 statement (item 5) and the SPIRIT 2013 statement (item 11). While the emphasis of the checklist is on trials, the guidance is intended to apply across all evaluative study designs. This paper presents the TIDieR checklist and guide, with an explanation and elaboration for each item, and examples of good reporting. The TIDieR checklist and guide should improve the reporting of interventions and make it easier for authors to structure accounts of their interventions, reviewers and editors to assess the descriptions, and readers to use the information.
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              Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.

              Morbidity and mortality rates in patients with eating disorders are thought to be high, but exact rates remain to be clarified. To systematically compile and analyze the mortality rates in individuals with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS). A systematic literature search, appraisal, and meta-analysis were conducted of the MEDLINE/PubMed, PsycINFO, and Embase databases and 4 full-text collections (ie, ScienceDirect, Ingenta Select, Ovid, and Wiley-Blackwell Interscience). English-language, peer-reviewed articles published between January 1, 1966, and September 30, 2010, that reported mortality rates in patients with eating disorders. Primary data were extracted as raw numbers or confidence intervals and corrected for years of observation and sample size (ie, person-years of observation). Weighted proportion meta-analysis was used to adjust for study size using the DerSimonian-Laird model to allow for heterogeneity inclusion in the analysis. From 143 potentially relevant articles, we found 36 quantitative studies with sufficient data for extraction. The studies reported outcomes of AN during 166 642 person-years, BN during 32 798 person-years, and EDNOS during 22 644 person-years. The weighted mortality rates (ie, deaths per 1000 person-years) were 5.1 for AN, 1.7 for BN, and 3.3 for EDNOS. The standardized mortality ratios were 5.86 for AN, 1.93 for BN, and 1.92 for EDNOS. One in 5 individuals with AN who died had committed suicide. Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN. The mortality rates for BN and EDNOS are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS.
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                Author and article information

                Contributors
                tanja.wittek@meduniwien.ac.at
                stefanie.truttmann@meduniwien.ac.at
                michael.zeiler@meduniwien.ac.at
                julia.philipp@meduniwien.ac.at
                ellen.auer-welsbach@kabeg.at
                praxis@kiju.co.at
                susanne.ohmann@meduniwien.ac.at
                sonja.werneck-rohrer@meduniwien.ac.at
                petra.sackl-pammer@meduniwien.ac.at
                gabriele.schoefbeck@meduniwien.ac.at
                dunja.mairhofer@meduniwien.ac.at
                leonie.kahlenberg@meduniwien.ac.at
                ulrike.schmidt@kcl.ac.uk
                andreas.karwautz@meduniwien.ac.at
                gudrun.wagner@meduniwien.ac.at
                Journal
                J Eat Disord
                J Eat Disord
                Journal of Eating Disorders
                BioMed Central (London )
                2050-2974
                8 March 2021
                8 March 2021
                2021
                : 9
                : 33
                Affiliations
                [1 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Department of Child and Adolescent Psychiatry, , Medical University of Vienna, ; 1090 Vienna, Austria
                [2 ]Department of Neurology and Psychiatry of Childhood and Adolescence, Clinical Center Klagenfurt, 9020 Klagenfurt am Wörthersee, Austria
                [3 ]Medical Practice for Child and Adolescent Psychiatry, 4020 Linz, Austria
                [4 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, ; London, WC2R 21S UK
                Author information
                http://orcid.org/0000-0002-4845-9684
                Article
                387
                10.1186/s40337-021-00387-8
                7941930
                33685522
                5139dd8b-fcad-4ebf-90fa-cf219f8e2257
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 October 2020
                : 22 February 2021
                Funding
                Funded by: Gemeinsame Gesundheitsziele aus dem Rahmen-Pharmavertrag/Pharma Master Agreement (AT)
                Award ID: 99901006800
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2021

                mantra,maudsley model,anorexia nervosa,treatment,psychotherapy,adolescents,young adults,study protocol

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