Enhanced Cognitive Behavioral Therapy for Young Adolescents with Anorexia Nervosa: Identifying Predictors of Treatment Response.

(1)

Background

This study aimed to identify baseline demographic, clinical, and psychosocial predictors of treatment response in adolescents with anorexia nervosa (AN) undergoing an intensive 20-week enhanced cognitive behavioral therapy (CBT-E) program, which included inpatient and day patient phases. Treatment outcomes were assessed at the end of intensive treatment (EOIT) and at a 20-week follow-up. (2)

Methods

A prospective cohort of 68 adolescents under the age of 16 consecutively admitted to intensive CBT-E was evaluated. Baseline measures included body mass index (BMI)-for-age percentiles, percentage of expected body weight (%EBW), eating disorder psychopathology (EDE-Q), general psychopathology, and functional impairment. (3)

Results

Of those who began treatment, 83.4% completed the program and 70.2% were available for follow-up assessment. Based on intent-to-treat analysis, 94.1% achieved a "good BMI outcome" and 73.5% met criteria for "full response" at EOIT. At follow-up, 64.7% maintained a good BMI and 55.9% sustained a full response. Completers' analysis indicated that baseline body weight, clinical impairment, general psychopathology, and weight regain influenced treatment outcomes. However, no baseline demographic or clinical variables predicted treatment completion or outcome at either time point at intention-to-treat analysis, except that younger age at admission was linked to higher eating disorder psychopathology at follow-up. (4)

Conclusions

In treatment completers, certain baseline clinical factors and weight regain influenced outcomes, while in the full sample, younger age predicted greater residual psychopathology at follow-up. These findings, if confirmed, emphasize the need for early intervention, focused support for weight regain, and potential adaptations of CBT-E for early adolescents.