{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T22:43:18Z","timestamp":1770417798445,"version":"3.49.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Eat Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The aim of this quality-assessment study was to determine the outcome of patients with severe and extreme anorexia nervosa (AN) in a real-world outpatient setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Twenty-one adults with AN and a body mass index (BMI) of\u2009&lt;\u200916 were recruited from consecutive referrals to an outpatient clinic at a public hospital in Western Norway. All enrolled patients were provided with enhanced cognitive behaviour therapy (CBT-E) to treat their AN, commencing between January 2013 and December 2016. Their BMI was recorded at baseline, at the end of CBT-E and 1\u00a0year after the end of treatment.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Ten patients completed the CBT-E treatment and achieved a large weight gain with the change remaining stable at follow-up. Eleven patients did not complete the treatment but had a significant increase in BMI at the premature end of treatment. One year after end of therapy 14\/21 (66.7%) of the patients had BMI above 18.5\u00a0kg\/m<jats:sup>2<\/jats:sup>. No severe complications were observed during therapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Although 52.4% of the patients did not complete outpatient CBT-E, the findings of this quality-assessment study support previous findings indicating that CBT-E may represent a valid alternative to inpatient treatment in patients with severe and extreme AN.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40337-021-00499-1","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T10:04:26Z","timestamp":1635847466000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Enhanced cognitive behaviour therapy (CBT-E) for severe and extreme anorexia nervosa in an outpatient eating disorder unit at a public hospital: a quality-assessment study"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5327-8418","authenticated-orcid":false,"given":"Stein","family":"Frostad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Calugi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline B. N.","family":"Engen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Dalle Grave","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"499_CR1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders (DSM-5)","author":"American Psychiatric Association","year":"2013","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5). Washington DC: American Psychiatric Association; 2013."},{"key":"499_CR2","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23428","author":"S Calugi","year":"2021","unstructured":"Calugi S, Sartirana M, Frostad S, Dalle Grave R. Enhanced cognitive behavior therapy for severe and extreme anorexia nervosa: an outpatient case series. Int J Eat Disord. 2021. https:\/\/doi.org\/10.1002\/eat.23428.","journal-title":"Int J Eat Disord"},{"key":"499_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-018-0198-y","author":"S Frostad","year":"2018","unstructured":"Frostad S, Danielsen YS, Rekkedal G\u00c5, Jevne C, Dalle Grave R, R\u00f8 \u00d8, et al. Implementation of enhanced cognitive behaviour therapy (CBT-E) for adults with anorexia nervosa in an outpatient eating-disorder unit at a public hospital. J Eat Disord. 2018. https:\/\/doi.org\/10.1186\/s40337-018-0198-y.","journal-title":"J Eat Disord"},{"issue":"Suppl 20","key":"499_CR4","first-page":"22","volume":"59","author":"DV Sheehan","year":"1998","unstructured":"Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22\u201333.","journal-title":"J Clin Psychiatry"},{"key":"499_CR5","volume-title":"Cognitive behavior therapy and eating disorders","author":"CG Fairburn","year":"2008","unstructured":"Fairburn CG. Cognitive behavior therapy and eating disorders. London: The Guilford Press; 2008."},{"issue":"10","key":"499_CR6","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1016\/j.brat.2008.06.012","volume":"46","author":"K Bohn","year":"2008","unstructured":"Bohn K, Doll HA, Cooper Z, O\u2019Connor M, Palmer RL, Fairburn CG. The measurement of impairment due to eating disorder psychopathology. Behav Res Ther. 2008;46(10):1105\u201310.","journal-title":"Behav Res Ther"},{"key":"499_CR7","unstructured":"R: A language and environment for statistical computing. R Foundation for Statistical Computing. http:\/\/www.R-project.org. Accessed 15 April 2021."},{"key":"499_CR8","first-page":"186","volume-title":"Encyclopedia of research design","author":"S Chen","year":"2012","unstructured":"Chen S, Chen H. Cohen\u2019s f Statistic. In: Salkind N, editor. Encyclopedia of research design. Thousand Oaks: SAGE Publications, Inc.; 2012. p. 186\u20137."},{"issue":"3","key":"499_CR9","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1002\/erv.2775","volume":"29","author":"TD Wade","year":"2021","unstructured":"Wade TD, Allen K, Crosby RD, Fursland A, Hay P, McIntosh V, et al. Outpatient therapy for adult anorexia nervosa: early weight gain trajectories and outcome. Eur Eat Disord Rev. 2021;29(3):472\u201381.","journal-title":"Eur Eat Disord Rev"},{"issue":"12","key":"499_CR10","doi-asserted-by":"publisher","first-page":"2501","DOI":"10.1017\/S0033291713000949","volume":"43","author":"S Touyz","year":"2013","unstructured":"Touyz S, Le Grange D, Lacey H, Hay P, Smith R, Maguire S, et al. Treating severe and enduring anorexia nervosa: a randomized controlled trial. Psychol Med. 2013;43(12):2501\u201311.","journal-title":"Psychol Med"}],"container-title":["Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-021-00499-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40337-021-00499-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-021-00499-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T10:04:30Z","timestamp":1635847470000},"score":1,"resource":{"primary":{"URL":"https:\/\/jeatdisord.biomedcentral.com\/articles\/10.1186\/s40337-021-00499-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,2]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["499"],"URL":"https:\/\/doi.org\/10.1186\/s40337-021-00499-1","relation":{},"ISSN":["2050-2974"],"issn-type":[{"value":"2050-2974","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,2]]},"assertion":[{"value":"10 October 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This project was a part of the DED quality-assessment work at Haukeland University Hospital and was approved by the data protection officer at that hospital (approval no. 1217). The project protocol was submitted for consideration to the Regional Ethical Committee and deemed exempt from review as it was classified as quality assessment (2018\/2265\/REK Nord). Consent to participate is not required for quality-assessment projects.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This is a quality-assessment publication of de-identified data and so consent for publication is not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors report no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"143"}}