{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:52:14Z","timestamp":1791377534871,"version":"4.3.2"},"reference-count":59,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T00:00:00Z","timestamp":1591142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001778","name":"Deakin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001778","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Approximately 20% of people with Anorexia Nervosa (AN) and 10% with Bulimia Nervosa (BN) will eventually develop a long\u2010standing illness. Although there is no set definition for Severe and Enduring eating Disorder (SE\u2010ED), the common criteria relate to a long duration of the disorder and a number of unsuccessful treatment attempts. Research evidence for treatment of SE\u2010ED remains limited, thus the objective of this systematic review was to describe different treatment interventions and their effects on SE\u2010ED\u2010related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A systematic search for quantitative treatment studies of adult participants with SE\u2010ED was conducted in June 2019 (PROSPERO, CRD42018115802) with no restriction on eating disorder type. Altogether, 2,938 studies were included for title and abstract screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After systematic searches and article screening, 23 studies (3 randomized controlled trials, 3 open\u2010label studies, 8 naturalistic follow\u2010up studies, 8 case series and case studies, and 1 partially blinded pilot study) were included in the analysis and data extraction. Methodological quality of the included studies was generally low. Inpatient treatment programs (\n                      <jats:italic>n<\/jats:italic>\n                      = 5) were effective in short\u2010term symptom reduction, but long\u2010term results were inconsistent. Outpatient and day\u2010hospital treatment programs (\n                      <jats:italic>n<\/jats:italic>\n                      = 5) seemed promising for symptom reduction. Drug interventions (\n                      <jats:italic>n<\/jats:italic>\n                      = 5) showed some benefits, especially as adjuvant therapies. Brain stimulation (\n                      <jats:italic>n<\/jats:italic>\n                      = 6) led to improvements in depressive symptoms. Other treatments (\n                      <jats:italic>n<\/jats:italic>\n                      = 2) produced mixed results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This is the first systematic review to examine all of the different treatment interventions that have been studied in SE\u2010ED. The results will inform future interventions in research and clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.23322","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T04:40:57Z","timestamp":1591159257000},"page":"1280-1302","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Treatment interventions for Severe and Enduring Eating Disorders: Systematic review"],"prefix":"10.1002","volume":"53","author":[{"given":"Emilia","family":"Kotilahti","sequence":"first","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"West","sequence":"additional","affiliation":[{"name":"Deakin University, Food &amp; Mood Centre, IMPACT \u2013 the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health  Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus","family":"Isomaa","sequence":"additional","affiliation":[{"name":"Department of Social Services and Health Care  Finland"},{"name":"Faculty of Education and Welfare Studies \u00c5bo Akademi University  \u00c5bo Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Karhunen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetyana","family":"Rocks","sequence":"additional","affiliation":[{"name":"Deakin University, Food &amp; Mood Centre, IMPACT \u2013 the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health  Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1169-7478","authenticated-orcid":false,"given":"Anu","family":"Ruusunen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, University of Eastern Finland  Kuopio Finland"},{"name":"Deakin University, Food &amp; Mood Centre, IMPACT \u2013 the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health  Geelong Australia"},{"name":"Department of Psychiatry Kuopio University Hospital  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22135"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2369"},{"key":"e_1_2_8_4_1","first-page":"1","article-title":"A multicenter audit of outpatient care for adult anorexia nervosa: Symptom trajectory, service use, and evidence in support of \"early stage\" versus \"severe and enduring\" classification","author":"Ambwani S.","year":"2020","journal-title":"International Journal of Eating Disorders"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2609"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22173"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20546"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2174\/1568007033338779"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1614.2003.01221.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2165\/00023210-200115020-00004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534650118755949"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22715"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2589"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2008.12.006"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2018.1471921"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2016.11.006"},{"issue":"8","key":"e_1_2_8_17_1","first-page":"27","article-title":"The use of duloxetine in chronic bulimia nervosa: A case report","volume":"6","author":"Christensen R.","year":"2009","journal-title":"Psychiatry (Edgmont (PA: Township))"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI17725"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psc.2019.01.007"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-021531"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2007.09.024"},{"key":"e_1_2_8_22_1","first-page":"265","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. 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