• Ulrike Schmidt, Nicholas Magill, Bethany Renwick, Alexandra Keyes, Martha Kenyon, Hannah Dejong, Anna Lose, Hannah Broadbent, Rachel Loomes, Huma Yasin, Charlotte Watson, Shreena Ghelani, Eva-Maria Bonin, Lucy Serpell, Lorna Richards, Eric Johnson-Sabine, Nicky Boughton, Linette Whitehead, Jennifer Beecham, Janet Treasure, and Sabine Landau.
• Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Section of Eating Disorders, King's College London.
• J Consult Clin Psychol. 2015 Aug 1; 83 (4): 796-807.

ObjectiveAnorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).MethodOne hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m²) were randomly allocated to receive 20 to 30 weekly sessions (depending on clinical severity) plus add-ons (4 follow-up sessions, optional sessions with dietician and with carers) of MANTRA (n = 72) or SSCM (n = 70). Assessments were administered blind to treatment condition at baseline, 6 months, and 12 months after randomization. The primary outcome was BMI at 12 months. Secondary outcomes included eating disorders symptomatology, other psychopathology, neuro-cognitive and social cognition, and acceptability. Additional service utilization was also assessed. Outcomes were analyzed using linear mixed models.ResultsBoth treatments resulted in significant improvements in BMI and reductions in eating disorders symptomatology, distress levels, and clinical impairment over time, with no statistically significant difference between groups at either 6 or 12 months. Improvements in neuro-cognitive and social-cognitive measures over time were less consistent. One SSCM patient died. Compared with SSCM, MANTRA patients rated their treatment as significantly more acceptable and credible at 12 months. There was no significant difference between groups in additional service consumption.ConclusionsBoth treatments appear to have value as first-line outpatient interventions for patients with broadly defined AN. Longer term outcomes remain to be evaluated.(c) 2015 APA, all rights reserved).

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