{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:47:47Z","timestamp":1791798467432,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100019916","name":"Schweizerische Anorexia Nervosa Stiftung","doi-asserted-by":"publisher","award":["Project #78\u201017"],"award-info":[{"award-number":["Project #78\u201017"]}],"id":[{"id":"10.13039\/501100019916","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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the efficacy of a 16\u2010week therapist\u2010guided, smartphone\u2010based aftercare intervention as an add\u2010on to treatment as usual (TAU) following inpatient treatment for anorexia nervosa (AN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      In this single\u2010center randomized clinical trial, 186 female inpatients with DSM\u20105 AN (\u2265\u200913\u2009years; body mass index (BMI) \u2265\u200915.0\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      at discharge; smartphone access) were randomized to TAU plus smartphone\u2010based aftercare (intervention group, IG;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200993) or TAU only (control group, CG;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200993). The intervention used the\n                      <jats:italic>Recovery Record<\/jats:italic>\n                      app with individualized goals and therapist feedback of decreasing frequency over 16\u2009weeks. Outcomes were assessed at discharge (T0), end of intervention (T1), and 6\u2010month follow\u2010up (T2) by blinded assessors, and were analyzed using linear mixed effect models (intention\u2010to\u2010treat). The primary outcome was the Eating Disorder Examination (EDE) global score; secondary outcomes included BMI, depressive symptoms, self\u2010reported eating disorder psychopathology, self\u2010efficacy, and stage of change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At T1, there was no significant between\u2010group difference in EDE global score (mean difference, 0.12; 95% CI, \u22120.21 to 0.46), and results were similar at T2 (0.27; 95% CI, \u22120.13 to 0.67). Secondary outcomes did not differ clearly between groups. Intervention adherence was high (69.9% completed 16\u2009weeks). Rehospitalizations occurred in 4.7% of participants by T1 and 26.4% by T2, without significant between\u2010group differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In a context of intensive TAU with rapid access to outpatient psychotherapy, adding therapist\u2010guided smartphone\u2010based aftercare did not yield additional short\u2010term symptom benefit after inpatient treatment for AN. Future work should refine digital aftercare and embed it more closely into blended treatment models.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT04228939\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70142","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:06:13Z","timestamp":1782219973000},"page":"2332-2343","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapist\u2010Guided Smartphone\u2010Based Aftercare for Inpatients With Severe Anorexia Nervosa (\n                    <scp>SMART<\/scp>\n                    \u2010\n                    <scp>AN<\/scp>\n                    ): A Randomized Clinical Trial"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1791-7379","authenticated-orcid":false,"given":"Sandra","family":"Schlegl","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy LMU University Hospital, LMU Munich  Munich Germany"},{"name":"Department of Clinical Psychology and Experimental Psychopathology Goethe\u2010University  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5498-861X","authenticated-orcid":false,"given":"Andreas","family":"Gerich","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy LMU University Hospital, LMU Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4091-5048","authenticated-orcid":false,"given":"Yannik","family":"Terhorst","sequence":"additional","affiliation":[{"name":"Department of Psychological Methods and Assessment LMU Munich  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4325-2595","authenticated-orcid":false,"given":"Christina","family":"Fricke Neumayr","sequence":"additional","affiliation":[{"name":"Schoen Clinic Roseneck  Prien am Chiemsee Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0261-3145","authenticated-orcid":false,"given":"Ulrich","family":"Voderholzer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy LMU University Hospital, LMU Munich  Munich Germany"},{"name":"Schoen Clinic Roseneck  Prien am Chiemsee Germany"},{"name":"Department of Psychiatry and Psychotherapy University Hospital of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.15626\/MP.2023.4021"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s44247-024-00105-9"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102645"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2012.04.037"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1214\/11-STS361"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24488"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-01252-z"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22398"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.12.003"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23891"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-021-00487-5"},{"key":"e_1_2_10_14_1","volume-title":"BDI\u2010II. 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