Akershus University Hospital Retrospective Cohort Study of Family Based Treatment

Study Overview
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Brief Summary
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The goal of this observational study is to compare short and long-term effects of manualised Family Based Treatment for adolescent anorexia nervosa to those of non-manualised family therapy. The study will approach former patients who were treated before and after Family Based Therapy was adopted in an outpatient clinic, and extract data from electronic health records and public registries.

Detailed Description
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A two-group retrospective exploratory cohort study with longitudinal follow-up comparing adolescents with anorexia nervosa treated with generic family therapy to those treated with the manualised Family Based Treatment (FBT). The primary aim is to investigate whether adoption of FBT has led to faster normalisation of weight and lower rates of eating disorder in early adulthood. Secondary aims are to investigate whether implementation of FBT has changed the time to discharge, heterogeneity of patient weight change across treatment, rates of adverse events, rates of readmission, patient experiences of the treatment, long term functional outcomes and mortality. Data are extracted from patient health records, reported by participants and extracted from public registries.

Official Title
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Changes in Outcomes of Treatment for Adolescent Anorexia Nervosa After Implementation of Family Based Treatment in a Norwegian Child and Adolescent Mental Health Service: A Retrospective Cohort Study With Prospective Follow-up

Conditions
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Anorexia Nervosa, Atypical Anorexia Nervosa

Intervention / Treatment
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* Behavioral: Non-manualised family therapy.
* Behavioral: Family Based Treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Clinical diagnosis of F50.0 Anorexia nervosa or F50.1 Atypical anorexia nervosa according to the International Classification of Diseases-10. Exclusion Criteria: • Patient was treated during the years 2018-2020 and FBT was never initiated according to patient health records.
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 2015-2017<br>Patients treated for anorexia nervosa in the years 2015-2017 at Nedre Romerike outpatient clinic, Department of child and adolescent mental health services, Akershus university hospital. | Behavioral: Non-manualised family therapy.<br>* Family therapy provided by qualified therapists without reference to a specific therapy manual.<br>|
| 2018-2020<br>Patients treated for anorexia nervosa in the years 2018-2020 at Nedre Romerike outpatient clinic, Department of child and adolescent mental health services, Akershus university hospital. | Behavioral: Family Based Treatment<br>* Family therapy implemented according to the published Treatment manual for anorexia nervosa: A family-based approach by Lock & Le Grange (2nd edition, 2015).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to weight restoration | Number of days from start of treatment to a weight measurement placing the patient at or above 95% of expected body weight (50. percentile) for age and sex given Norwegian population norms. | Assessed retrospectively at enrolment. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to discharge from treatment | Number of days from start of treatment to the date of discharge from the outpatient clinic. | Assessed retrospectively at enrolment. | 
| Time to readmission to treatment | Number of days from start of treatment to any date of readmission to the outpatient clinic. | Assessed retrospectively at enrolment. | 
| Mortality | Death from any cause. | Assessed 5, 10, 15 and 20 years post treatment. | 
| Level of education | Highest level of education achieved, obtained from national registries. | Assessed 5, 10, 15 and 20 years post treatment. | 
| Employment status and welfare benefits | Employment status or receipt of welfare benefits, obtained from national registries. | Assessed 5, 10, 15 and 20 years post treatment. | 
| Treatment for eating disorder in adulthood | Treatment in specialist mental health services for any eating disorder. | Assessed 5, 10, 15 and 20 years post treatment. |