{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:01:01Z","timestamp":1791522061794,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The duration of untreated illness (DUI), that is, the interval between the onset of anorexia nervosa (AN) symptoms and start of specialized treatments, has a strong influence on the prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantify modifiable predictors of the DUI and to derive recommendations for secondary prevention strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Within a multicenter, multi\u2010informant study, DUI was assessed in interviews with patients undergoing first specialized AN treatment. Modifiable factors were assessed perspectives of AN\u2010patients, their relatives, and primary care practitioners [PCPs]) with the FABIANA\u2010checklist (Facilitators and barriers in anorexia nervosa treatment initiation). The effect of FABIANA\u2010items on the DUI for each perspective was calculated using Cox Regression (control variables: age, eating disorder pathology, health care status, migration background, body mass index [BMI]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included data from <jats:italic>N<\/jats:italic>\u2009=\u2009125 female patients with AN (72 adults, 53 adolescents, <jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub>\u2009=\u200919.2\u2009years, <jats:italic>SD<\/jats:italic>\u2009=\u20094.2, <jats:italic>M<\/jats:italic><jats:sub>BMI<\/jats:sub>\u2009=\u200915.7\u2009kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>SD<\/jats:italic>\u2009=\u20091.9), <jats:italic>N<\/jats:italic>\u2009=\u200989 relatives (81.8% female, 18.2% male, <jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub>\u2009=\u200946.0\u2009years, <jats:italic>SD<\/jats:italic>\u2009=\u200911.0) and <jats:italic>N<\/jats:italic>\u2009=\u200940 PCPs (<jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub>\u2009=\u200949.7\u2009years, <jats:italic>SD<\/jats:italic>\u2009=\u20099.0). Average DUI was 12.0\u2009months. Watching or reading articles about the successful treatment of other individuals with AN (patients' perspective) and regular appointments with a PCP (PCPs' perspective) were related to a shorter DUI (HR\u2009=\u20090.145, <jats:italic>p<\/jats:italic>\u2009=\u2009.046\/ HR\u2009=\u20090.395, <jats:italic>p<\/jats:italic>\u2009=\u2009.018). Patients whose relatives rated that PCPs trivialized patients' difficulties had a longer DUI (HR\u2009=\u2009\u22120.147, <jats:italic>p<\/jats:italic>\u2009=\u2009.037). PCPs and relatives rated PCPs' competence higher than patients did.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>It is recommended (a) to incorporate treatment success stories in prevention strategies, (b) to inform PCPs about potential benefits of regular appointments during the transition to specialized care, and (c) to train PCPs in dealing with patients' complaints.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>Many individuals with AN seek treatment very late. Our study shows that a promising approach to facilitate earlier AN treatment is to inform patients about successful treatments of affected peers, to foster regular appointments with a PCP and, to motivate these PCPs to take individuals' with AN difficulties seriously. Thus, our study provides important suggestions for interventions that aim to improve early treatment in AN.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.24069","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T02:42:02Z","timestamp":1697078522000},"page":"2315-2327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Factors influencing the duration of untreated illness among patients with anorexia nervosa<scp>: A<\/scp> multicenter and multi\u2010informant study"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2193-6540","authenticated-orcid":false,"given":"Antje","family":"Gumz","sequence":"first","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Department of Psychosomatics and Psychotherapy Psychologische Hochschule Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Reuter","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Department of Psychosomatics and Psychotherapy Psychologische Hochschule Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"L\u00f6we","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Voderholzer","sequence":"additional","affiliation":[{"name":"Sch\u00f6n Clinic Roseneck  Prien am Chiemsee Germany"},{"name":"Department of Psychiatry and Psychotherapy University Hospital, LMU Munich  Munich Germany"},{"name":"Department of Psychiatry and Psychotherapy University Hospital of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Schwennen","sequence":"additional","affiliation":[{"name":"MediClin Seepark Clinic  Bad Bodenteich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Fehrs","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy Asklepios Westklinikum Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wally","family":"W\u00fcnsch\u2010Leiteritz","sequence":"additional","affiliation":[{"name":"Clinic L\u00fcneburger Heide  Bad Bevensen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romuald","family":"Brunner","sequence":"additional","affiliation":[{"name":"Department for Paediatric and Adolescent Medicine Medical University Center Regensburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"K\u00e4stner","sequence":"additional","affiliation":[{"name":"Department of Psychosomatics and Psychotherapy Psychologische Hochschule Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Zapf","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry and Epidemiology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Weigel","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22911"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1359104519827629"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.74"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2745"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3205\/psm000089"},{"key":"e_1_2_11_7_1","volume-title":"SCID\u20105\u2010CV. 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