Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-18T20:23:12.996Z Has data issue: false hasContentIssue false
  • English
  • Français

Early intervention in anorexia nervosa

Published online by Cambridge University Press:  02 January 2018

Gethin Morgan
Gethin Morgan*
Affiliation:
Emeritus Professor of Mental Health, University of Bristol, UK. Email: hilary.howard@blueyonder.co.uk
Rights & Permissions [Opens in a new window]

Abstract

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.
Type
Correspondence
Information
The British Journal of Psychiatry , Volume 199 , Issue 5 , November 2011 , pp. 432
Copyright
Copyright © Royal College of Psychiatrists, 2011 

It is indeed rewarding to see that Treasure & Russell, in their editorial on early intervention in anorexia nervosa, Reference Treasure and Russell1 offer much in support of it. Over many years our therapeutic approach in Bristol placed great emphasis on getting patients into treatment as soon as possible after the onset of anorexia. This was supported by evidence from a study which compared outcome in Bristol with two other treatment centres. Reference Morgan, Purgold and Welbourne2 In line with this we emphasised the importance of developing local, easily accessible treatment facilities.

Given their welcome support for close involvement of relatives in the treatment process, Treasure & Russell might well have also included family processes along with the several brain mechanisms that they evaluate as possible reasons why early intervention may be important. If the illness continues for any length of time, such factors as loss of heart by relatives and increased blame for failure to respond to help can lead to the progressive alienation of the relative with anorexia and impairment of the family’s ability to contribute constructively to treatment. Although negative attitudes have long been recognised, they remain a serious obstacle to the development of effective treatments of anorexia nervosa. Surely further research is still required into understanding them more fully as well as into their prevention and management, especially when the illness is at risk of becoming chronic.

Footnotes

Edited by Kiriakos Xenitidis and Colin Campbell

References

1 Treasure, J, Russell, G. The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. Br J Psychiatry 2011; 199: 5–7.CrossRefGoogle ScholarPubMed
2 Morgan, HG, Purgold, J, Welbourne, J. Management and outcome in anorexia nervosa: a standardised prognostic study. Br J Psychiatry 1983; 143: 282–7.CrossRefGoogle ScholarPubMed
1 Theander, S. Outcome and prognosis in anorexia nervosa and bulimia. Some results of previous investigations, compared with a Swedish long-term study. J Psychosom Res 1985; 19: 493–508.CrossRefGoogle ScholarPubMed
2 Russell, G. Anorexia nervosa. In New Oxford Textbook of Psychiatry. Second Edition (eds Gelder, MG, Andreasen, NC, Lopez-Ibor, JJ, et al): 788 & 790–2. Oxford University Press.Google Scholar
3 Treasure, J, Smith, G, Crane, A. Skills-based Learning for Caring for a Loved One with an Eating Disorder: The New Maudsley Method. Routledge, 2007.CrossRefGoogle Scholar
4 Goddard, E, Macdonald, P, Sepulveda, AR, Nauman, U, Landau, S, Schmidt, U, et al. Cognitive interpersonal maintenance model of eating disorders: intervention for carers. Br J Psychiatry 2011; 199: 225–31.CrossRefGoogle ScholarPubMed
1 Office for National Statistics. Deaths related to drug poisoning in England and Wales, 2009. Statistical Bulletin 2010; August.Google Scholar
2 Bunker, SJ, Colquhoun, DM, Esler, MD, Hickie, IB, Hunt, D, Jelinek, VM, et al. ‘Stress’ and coronary heart disease: psychosocial risk factors. National Heart Foundation of Australia position statement update. Med J Aust 2003; 178: 272–6.CrossRefGoogle Scholar
3 Hamer, M, Molloy, GJ, Stamatakis, E. Psychological distress as a risk factor for cardiovascular events: pathophysiological and behavioral mechanisms. J Am Coll Cardiol 2008; 52: 2156–62.CrossRefGoogle ScholarPubMed
4 Wildgust, HJ, Beary, M. Are there modifiable risk factors which will reduce the excess mortality in schizophrenia. J Psychopharmacol 2010; 24 (suppl 4): 37–50.CrossRefGoogle ScholarPubMed
5 Harris, EC, Barraclough, B. Excess mortality of mental disorder. Br J Psychiatry 1998; 173: 11–53.CrossRefGoogle ScholarPubMed
6 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. WHO, 1993.Google Scholar
7 Office for National Statistics. Mortality Statistics: Cause, England and Wales (Series DH2): Table 2.5 – Deaths: underlying cause, sex and age-group. ONS, 2005.Google Scholar
1 Coleman, PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. Br J Psychiatry 2011; 199: 180–6.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.