Utrecht Research Group Eating Disorders

Utrecht, Netherlands

Utrecht Research Group Eating Disorders

Utrecht, Netherlands
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Berends T.,Altrecht Eating Disorders Rintveld | van Meijel B.,INHolland University of Applied Sciences | van Meijel B.,VU University Amsterdam | van Meijel B.,Parnassia Academy | And 13 more authors.
BMC Psychiatry | Year: 2016

Background: Relapse is common among recovered anorexia nervosa (AN) patients. Studies on relapse prevention with an average follow-up period of 18 months found relapse rates between 35 and 41 %. In leading guidelines there is general consensus that relapse prevention in patients treated for AN is a matter of essence. However, lack of methodological support hinders the practical implementation of relapse prevention strategies in clinical practice. For this reason we developed the Guideline Relapse Prevention Anorexia Nervosa. In this study we examine the rate, timing and predictors of relapse when using this guideline. Method: Cohort study with 83 AN patients who were enrolled in a relapse prevention program for anorexia nervosa with 18 months follow-up. Data were analyzed using Kaplan-Meijer survival analyses and Cox regression. Results: Eleven percent of the participants experienced a full relapse, 19 % a partial relapse, 70 % did not relapse. Survival analyses indicated that in the first four months of the program no full relapses occurred. The highest risk of full relapse was between months 4 and 16. None of the variables remained a significant predictor of relapse in the multivariate Cox regression analysis. Conclusion: The guideline offers structured procedures for relapse prevention. In this study the relapse rates were relatively low compared to relapse rates in previous studies. We recommend that all patients with AN set up a personalized relapse prevention plan at the end of their treatment and be monitored at least 18 months after discharge. It may significantly contribute to the reduction of relapse rates. © 2016 The Author(s).


Carrera O.,University Utrecht | Carrera O.,Altrecht Mental Health Institute | Carrera O.,University of Santiago de Compostela | Carrera O.,Complejo Hospitalario Universitario Of Santiago Of Compostela | And 16 more authors.
PLoS ONE | Year: 2012

Excessive physical activity is a common feature in Anorexia Nervosa (AN) that interferes with the recovery process. Animal models have demonstrated that ambient temperature modulates physical activity in semi-starved animals. The aim of the present study was to assess the effect of ambient temperature on physical activity in AN patients in the acute phase of the illness. Thirty-seven patients with AN wore an accelerometer to measure physical activity within the first week of contacting a specialized eating disorder center. Standardized measures of anxiety, depression and eating disorder psychopathology were assessed. Corresponding daily values for ambient temperature were obtained from local meteorological stations. Ambient temperature was negatively correlated with physical activity (p = -.405) and was the only variable that accounted for a significant portion of the variance in physical activity (p =. 034). Consistent with recent research with an analogous animal model of the disorder, our findings suggest that ambient temperature is a critical factor contributing to the expression of excessive physical activity levels in AN. Keeping patients warm may prove to be a beneficial treatment option for this symptom. © 2012 Carrera et al.


Danner U.N.,Altrecht Mental Health Institute | Danner U.N.,Utrecht Research Group Eating Disorders | Sanders N.,Altrecht Mental Health Institute | Sanders N.,University Utrecht | And 16 more authors.
International Journal of Eating Disorders | Year: 2012

Objective: The purpose of this study is to examine set-shifting, central coherence, and decision making in women currently ill with anorexia nervosa (AN), women recovered from AN, and healthy control women. We aim to test whether these neuropsychological weaknesses persist after recovery, and explore relations between the impairments Results: Compared to control women, ill and recovered women showed poor set-shifting and decision making. There were strong correlations between set-shifting and central coherence in the ill and recovered women. Decision making did not correlate with the other measures. Discussion: The present findings suggest that impaired set-shifting and decision making are stable traits in women with AN. Because individual differences within these groups were large, a rigid thinking style is only present in a (sub)- population of ill and recovered women. Decision-making performance is not related to a rigid thinking style, but further research in this area is warranted. © 2012 by Wiley Periodicals, Inc.


Van Elburg A.A.,Altrecht Mental Health Institute | Van Elburg A.A.,Utrecht Research Group Eating Disorders | Hillebrand J.J.G.,Altrecht Mental Health Institute | Hillebrand J.J.G.,Utrecht Research Group Eating Disorders | And 12 more authors.
International Journal of Eating Disorders | Year: 2012

Objective: A comparison of the efficacy of a novel treatment method for anorexia nervosa (AN), the Mandometer treatment (MT), with treatment as usual (TAU). Method: During treatment data were collected to determine weight recovery and outcome as assessed by the Morgan Russell Outcome Assessment Schedule (MROAS). Results: After treatment 63% of the MT group and 85% of the TAU group had reached a normal weight level and both MT and TAU showed a good outcome on the MROAS (75 and 71%, respectively). After two years more MT than TAU patients were still in treatment and more MT patients had relapsed. Discussion: The outcome for both treatments in our study were similar and comparable with, if not better than outcome data of other AN studies. MT is not superior to TAU in outcome results and in relapse rate during the first two years following admission for AN treatment. © 2011 by Wiley Periodicals, Inc.


Cardona Cano S.,Utrecht Research Group Eating Disorders | Cardona Cano S.,Parnassia Bavo Psychiatric Institute | Cardona Cano S.,Altrecht Mental Health Institute | Merkestein M.,University Utrecht | And 5 more authors.
CNS Drugs | Year: 2012

Ghrelin is the only known circulating orexigenic hormone. It increases food intake by interacting with hypothalamic and brainstem circuits involved in energy balance, as well as reward-related brain areas. A heightened gut-brain ghrelin axis is an emerging feature of certain eating disorders such as anorexia nervosa and Prader-Willi syndrome. In common obesity, ghrelin levels are lowered, whereas post-meal ghrelin levels remain higher than in lean individuals. Agents that interfere with ghrelin signalling have therapeutic potential for eating disorders, including obesity. However, most of these drugs are only in the preclinical phase of development. Data obtained so far suggest that ghrelin agonists may have potential in the treatment of anorexia nervosa, while ghrelin antagonists seem promising for other eating disorders such as obesity and Prader-Willi syndrome. However, large clinical trials are needed to evaluate the efficacy and safety of these drugs. © 2012 Adis Data Information BV. All rights reserved.


Danner U.N.,Altrecht Mental Health Institute | Danner U.N.,Utrecht Research Group Eating disorders | Sternheim L.,Altrecht Mental Health Institute | Sternheim L.,Utrecht Research Group Eating disorders | And 8 more authors.
Psychiatry Research | Year: 2016

The present study aims to examine the influence of negative affect on decision making in women with anorexia nervosa (AN) compared to healthy control women and, secondly, to assess differences between the restrictive (ANR) and binge-purge (ANBP) subtypes. One hundred four women (32 with ANR, 32 with ANBP, and 40 healthy controls) participated. All women were asked to watch either a negative or a control film fragment, both followed by the Bechara Gambling Task (BGT). Before and after the fragments negative affect was measured. Additionally, relevant characteristics (e.g., overall depressive symptoms) were assessed. Differences in negative affect did not influence decision making performance. Independent of affective state, decision making was found to be impaired in women with ANBP (no learning effect on the BGT), but not in women with ANR. These findings highlight the importance of considering different AN subtypes when examining decision making processes. However, the role of negative affect on decision making remains uncertain. Since other affect related factors such as affect dysregulation may also play a role, future studies on decision making in AN should take the role of affect into account. © 2016 Elsevier Ireland Ltd.


Danner U.N.,Altrecht Eating Disorders Rintveld | Danner U.N.,Utrecht Research Group Eating Disorders | Dingemans A.E.,Center for Eating Disorders Ursula | Steinglass J.,Columbia University
Current Opinion in Psychiatry | Year: 2015

Purpose of review This review compares the literature on cognitive remediation therapy (CRT) for eating disorders with findings in the field of schizophrenia, and discusses future directions for CRT for eating disorders. Recent findings First studies using a randomized controlled trial design show the added value of CRT for eating disorders. Patients reported lessened symptoms and further improvements in quality of life and cognitive flexibility. Furthermore, the acceptability of the intervention was good and attrition rates for CRT itself were low. Research into the use of cognitive remediation for schizophrenia is extensive and the results on global cognition appeared to be robust at post-treatment and durable at follow-up, with small to medium effect sizes. Recent articles within the field of schizophrenia emphasize the necessity of intrinsic motivation to translate cognitive gains into actual changes in everyday life. Summary A next step is to examine the impact of CRT for eating disorders on motivation. It is also important to focus on the transdiagnostic use of CRT, considering the overlap in cognitive inefficiencies between eating disorders. Another important step may be to develop effective personalized methods of CRT by taking into account individual differences in cognitive processes most relevant to improvement in outcome. © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Danner U.N.,Altrecht Eating Disorders Rintveld | Danner U.N.,Utrecht Research Group Eating Disorders | Sternheim L.,Altrecht Eating Disorders Rintveld | Sternheim L.,Utrecht Research Group Eating Disorders | And 2 more authors.
Psychiatry Research | Year: 2014

People with eating disorders (ED) have difficulties regulating their emotions adaptively. Little is known about differences and similarities between different types of ED and how these regulation difficulties relate to other emotional problems. The present study examines maladaptive (suppression) and adaptive (cognitive reappraisal) emotion regulation strategies in women with different ED and relationships with anxiety and depression levels. In 32 women with AN restrictive subtype (ANR), 32 with AN binge-purge subtype (ANBP), 30 with bulimia nervosa (BN), 29 with binge eating disorder (BED), and 64 healthy women, the ERQ (emotion regulation) as well as STAI-T (anxiety), BDI-SF (depression), and EDDS (eating pathology) were administered. Women across different ED subtypes were inclined to suppress emotions and lacked the capacity to reappraise emotions (except women with ANBP). Correlational relations of suppression and reappraisal with anxiety and depression levels differed across ED groups. Emotion regulation problems were found across ED subtypes. However, the types of emotion regulation problems, and the effect of coexisting other emotional problems such as anxiety and depression may differ across ED subtypes. These findings illustrate the importance to of considering ED subtypes in emotion regulation research rather than consider ED as a whole. © 2014 Elsevier Ireland Ltd.


PubMed | University Utrecht and Utrecht Research Group Eating Disorders
Type: Journal Article | Journal: Psychiatry research | Year: 2014

People with eating disorders (ED) have difficulties regulating their emotions adaptively. Little is known about differences and similarities between different types of ED and how these regulation difficulties relate to other emotional problems. The present study examines maladaptive (suppression) and adaptive (cognitive reappraisal) emotion regulation strategies in women with different ED and relationships with anxiety and depression levels. In 32 women with AN restrictive subtype (ANR), 32 with AN binge-purge subtype (ANBP), 30 with bulimia nervosa (BN), 29 with binge eating disorder (BED), and 64 healthy women, the ERQ (emotion regulation) as well as STAI-T (anxiety), BDI-SF (depression), and EDDS (eating pathology) were administered. Women across different ED subtypes were inclined to suppress emotions and lacked the capacity to reappraise emotions (except women with ANBP). Correlational relations of suppression and reappraisal with anxiety and depression levels differed across ED groups. Emotion regulation problems were found across ED subtypes. However, the types of emotion regulation problems, and the effect of coexisting other emotional problems such as anxiety and depression may differ across ED subtypes. These findings illustrate the importance to of considering ED subtypes in emotion regulation research rather than consider ED as a whole.

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